A    B    C    D    E    F    G    H    I    J    K    L    M    N    O    P    Q    R    S    T    U    V    W    X    Y    Z     Absolute Poverty: a situation where the per capita income is equivalent to less than one international dollar per day. Absorbed Dose: the energy imparted to matter by ionizing radiation per unit mass of irradiated material. The unit is gray (Gy), defined to be an energy absorption of 1 joule / kg. The old unit was the rad, which was defined as an energy absorption of 100 ergs / g. Absorbent Products: pads and garments, either disposable, worn to contain urinary incontinence or uncontrolled urine leakage. Absorbent products include shields, guards, undergarment pads, combination pad-pant systems, diaper like garments, and bed pads. Acceptability: degree to which a service meets the cultural needs and standards of a community. This in turn will affect utilization of that service. Access to Social Support Networks: one of the aspects of the responsiveness of health systems whereby health care activities are integrated into community interaction in order to ensure patient welfare. Accessible Antigen: antigens of self that are in contact with antibody-forming and to a host that is normally tolerant. Accessibility of Health Care: a measure of the proportion of a population that reaches appropriate health services. Accessory Cell: cell required for, but actually mediating, a specific immune response. Often used to describe antigen-presenting cells. Accountability: the obligation to disclose periodically, in adequate detail and consistent form, to all directly and indirectly responsible or properly interested parties, the purposes, principles, procedures, relationships, results, incomes, and expenditures involved in any activity, enterprise, or assignment so that they can be evaluated by the interested parties. Accreditation, also see Licensing: the process by which an authorized agency or organization evaluates and recognizes an institution or an individual according to a set of “standards” describing the structures and processes that contribute to desirable patient outcomes. Acetylcholine: substance (neurotransmitter) that plays an important part in the transmission of nerve impulses in the parasympathetic nervous system. These transmitters control smooth muscles, including those of the bladder and urethra, and stimulate the bladder to contract. Acidemia: increased concentration of hydrogen ions in the blood. Acidemia-Pathologic: a pH level associated with adverse neurologic sequelae; the threshold for pathologic-acidemia varies among research protocols, but some investigators have suggested a pH of less than 7. Acontractile Detrusor: detrusor muscle that cannot be demonstrated to contract during testing (urodynamic studies). Acquired Genetic Mutation: see somatic cell genetic mutation. Action: any measure taken with some intention. Active Immunization: direct immunization of the intact individual or of immunocompetent cells derived from and returned to the individual. Active Immunotherapy: may be divided into two groups: specific immunogens and non-specific adjuvants. Active specific immunotherapy is attempted by the immunization of a tumor-bearing patient with autochthonous altered (radiation, chemical) tumor cells. Non-specific immunotherapy attempts to augment antitumor immunologic activity with non-specific stimulants such as BCG or C. Parvum. Activities of Daily Living: activities necessary to meet essential human needs, such as bathing, grooming, toileting, and social interactions. Actuarial (Life Table) Survival: this technique uses grouped information to estimate the survival curve. The data are grouped into fixed time periods (e.g., months, years) that include the maximum follow-up. The survival curve is estimated as a continuous curve and gives an estimate of the proportions of a group of patients who will be alive at different times after the initial observation. The group includes patients with incomplete follow-up. Acute Care (Short-Stay): hospitals with an average length of stay of 30 days or less. Acute Incontinence: incontinence that comes on suddenly, usually caused by a new illness or condition, and is often easily reversed with appropriate treatment of the condition that caused it. Adaptation: a process whereby protection accorded a foreign graft from the immune reaction of the recipient renders it less vulnerable to immunologic attack by the host. Additive Genetic Effects: when the combined effects of alleles at different loci are equal to the sum of their individual effects. See also — anticipation, complex trait. Adenine (A): a nitrogenous base, one member of the base pair AT (adenine-thymine). See also — base pair, nucleotide. Adequacy: application of measures, technologies, and resources which are qualitatively and quantitatively sufficient for achieving the desired goal. Adjusted Relative Risk: the ratio of risk of disease or death among the exposed to that of the risk among the unexposed adjusted for a specific covariate (eg, maternal age, weeks of gestation, size of gestational age). Adjuvant: a substance that when mixed with an antigen enhances its antigenicity. Adnexae: ovaries, fallopian tubes and supporting structures. Adoptive Immunization: the transfer of immunity from one individual to another by means of specifically immune lymphoid cells or materials derived from such cells that are capable of transferring specific immunologic information to the recipient’s lymphocytes. Adverse Selection: a situation where individuals are able to purchase insurance at rates which are below actuarially fair rates, because information known to them is not available to insurers (asymmetric information). Affected Relative Pair: individuals related by blood, each of whom is affected with the same trait. Examples are affected sibling, cousin, and avuncular pairs. See also — avuncular relationship. Affinity: a measure of the binding constant of a single antigen-combining site with a monovalent antigenic determinant. Affordability: extent to which the intended clients of a service can pay for it. AFP: see α-fetoprotein. Age-Rating: technique for adjusting insurance premiums according to the age of the insured. Age Specific Rates: these are calculated by dividing the number of cases of deaths or other health variable occurring in each specified age group by the corresponding population or survey sample in the same age group. Sometimes, this is expressed as a rate per 100,000 population; other times as a percent of sampled population. This rate may be calculated for a particular age and sex grouping to show how a risk factor, occurrence of death or incidence of a disease changes with age and sex. Age Standardization: rates are adjusted for age to facilitate comparisons between populations which have different age structures. (There are two different methods commonly used to adjust for age, direct or indirect. We use direct standardization in which age-specific rates are multiplied againsta constant population, the WHO standard population EIP 1999). Agency Principle: the process of having one party (the agent) make decisions on behalf of another (the principal). Agglutinin: any antibody that produces aggregation or agglutination of a particular or insoluble antigen. Aggregation Technique: a technique used in model organism studies in which embryos at the 8-cell stage of development are pushed together to yield a single embryo (used as an alternative to microinjection). See also — model organisms. AIDS: acquired immune deficiency syndrome. AIDS Incidence: the number of new cases registered from Acquired Immunodeficiency Syndrome (AIDS) for a given sex, in a specific year, expressed per 1,000,000 population, for a given country, territory, or geographic area. Algorithm: a sequence of logical steps that should be taken when dealing with a given task. Allele: one of two or more alternate forms of a gene. Alternative form of a genetic locus; a single allele for each locus is inherited from each parent (e.g., at a locus for eye color the allele might result in blue or brown eyes). See also — locus, gene expression. Allele Specific Oligonucleotides: synthetic oligonucleotide designed to hybridize to a specific sequence, and under the right conditions, to fail to hybridize to a related sequence. Allele specific oligonucleotides also are use as PCR primers in several methods similarly designed to distinguish between closely related alleles. Allelic Exclusion: the ability of heterozygous lymphoid cell to produce only an allelic form of an antigen-specific receptor (immunoglobulin or T cell receptor) when they have the genetic endowment to produce both. Allergen: a substance (antigen or hapten) that incites allergy. Allergy: a state of specific increased reactivity to an antigen or hapten such as occurs in hay fever. The term is used to designate states of delayed sensitivity caused by contact allergens. Alloantibody (Isoantibody): any antibody produced by one individual that reacts specifically with an antigen present in another individual of the same species. The isoantibody is commonly used in hematology; the alloantibody is used in tissue transplantation. Allogeneic: variation in alleles among members of the same species. Referring to genetically dissimilar individuals of the same species. Allogeneic Disease: any systemic illness resulting from a graft-vs-host response when the graft contains immunologically competent cells and the host is immunologically competent cells and the host is immunologically incompetent (e.g., runt disease). Allograft (Homograft): a graft derived from an allogeneic donor. Alloimmune: specifically immune to an allogeneic antigen. Alpha Error: the error of rejecting a true null hypothesis, i.e. declaring that a difference exists when it does not. The rejection of the null hypothesis when it is, in fact, correct. Also called a Type I error. Alternative Complement Pathway: the mechanism of complement activation that does not involve activation of the C1-C4-C2 pathway by antigen-antibody complexes and begins with the activation of C3. Alternative Splicing: different ways of combining a gene’s exons to make variants of the complete protein Ambulatory Care: all types of health services provided to patients who are not confined to an institutional bed as inpatients during the time services are rendered. Amino Acid: any of a class of 20 molecules that are combined to form proteins in living things. The sequence of amino acids in a protein and hence protein function are determined by the genetic code. Amplification: an increase in the number of copies of a specific DNA fragment; can be in vivo or in vitro. See also — cloning, polymerase chain reaction. Anal Sphincters: two rings of muscles surrounding the rectum and anus, which help control passage of bowel movements. Anamnestic Response (Recall Phenomenon, Memory Phenomenon): an accelerated response of antibody production to an antigen that occurs in an animal that has previously responded to the antigen. Anaphylaxis, Acute: systemic shock (often fatal) that develops in a minutes after subsequent exposure to a specific foreign antigen to which the host has already reacted. Anergy: absence of a hypersensitivity reaction that would be expected in other similarly sensitized individuals. Aneuploidy: in this condition there is an extra or missing chromosome. Animal Model: see — model organisms. Anonymous: presented without identity; anonymity is an ethical practice whereby research results cannot be linked to any particular individual. Annotation: adding pertinent information such as gene coded for, amino acid sequence, or other commentary to the database entry of raw sequence of DNA bases. See also — bioinformatics. Annual Birth Average: total number of live births expected in a specific year, for a given country, territory, or geographic area. Technical Note: The annual births average corresponds to an estimated value, consistent with the corresponding United Nations fertility medium-variant quinquennial population projections. Annual Death Average: total number of deaths expected in a specific year, for a given country, territory, or geographic area. Technical Note: The annual deaths average corresponds to an estimated value, consistent with the corresponding United Nations fertility medium-variant quinquennial population projections. Annual GDP Growth Rate: the annual average rate of change of the gross domestic product (GDP) at market prices based on constant local currency, for a given national economy, during a specified period of time. It expresses the difference between GDP values from one period to the next as a proportion of the GDP from the earlier period, usually multiplied by 100. Technical Note: GDP average annual growth rates are those estimated by the World Bank from the corresponding data in the United Nations’ Systems of National Accounts expressed in 1995 US dollars constant prices, using the least-squares method. The least-squares growth rate is estimated by fitting a linear regression trend line to the logarithmic annual values of the variable in the relevant period. The calculated growth rate is an average rate that is representative of the available observations over the entire period. It does not necessarily match the actual growth rate between any two periods. Annual Growth Rate: indicator used in population studies to assess average change in the size of a population from one year to the next. Annual National Health Expenditure as a Proportion of The Gross Domestic Product (GDP): estimates of public expenditure corresponds to expenditures of the institutions of General Government in the function of Health (Division 07) of the international classification of Government Expenditures by functions or purposes of the Systems of National Accounts of United Nations (SCN 1993); derived from the Government Financial Statistical Yearbook 2002 (GSF 2002) from the International Monetary Fund or country’s health account studies. Estimates of private expenditure in health corresponds to the expenditures by the Household Sector in the function of Health or Health or Health Personal Care of the international classification of Individual Consumption by Purposes of the SCN 1993; derived from data from the Consumer Price Index, household surveys, and/or national studies on health accounts. Annual Number of Registered Deaths Under-5 due to Diphtheria: the number of deaths in children under 5 years of age from diphtheria (ICD-9 code 032 ; ICD-10 code A36) as the underlying cause of death, as registered in their death certificates, for a given year, in a given country, territory, or geographic area. Annual Number of Registered Deaths Under-5 due to Pertussis: the number of deaths in children under 5 years of age from whooping cough (ICD-9 code 033; ICD-10 code A37) as the underlying cause of death, as registered in their death certificates, for a given year, in a given country, territory, or geographic area. Annual Number of Registered Deaths Under-5 due to Tetanus: the number of deaths in children under 5 years of age from tetanus (ICD-9 code 037; ICD-10 code A35) as the underlying cause of death, as registered in their death certificates, for a given year, in a given country, territory, or geographic area. Annual Parasite Index: the number of confirmed new cases from malaria registered in a specific year, expressed per 1,000 individuals under surveillance, for a given country, territory, or geographic area. Annual parasite index (API) refers to high and moderate malaria transmission risk areas. Annual Population Growth Rate: the annual average rate of change of population size, for a given country, territory, or geographic area, during a specified period. It expresses the ratio between the annual increase in the population size and the total population for that year, usually multiplied by 100. The annual increase in the population size is defined as a sum of differences: the difference between births less deaths and the difference between immigrants less emigrants, in a given country, territory or geographic area at a given year. Annual Proportion of Registered Deaths Under 5 Years of Age due to Intestinal Infectious Diseases (ADD): proportion of deaths in children under 5 years of age for which the underlying cause of death was an intestinal infectious disease (ICD-9 codes 001-009; ICD-10 codes A00-A09) for a given year, in a given country, territory, or geographic area. Annual Proportion of Registered Deaths Under 5 Years of Age due to Acute Respiratory Infections (ARI): proportion of deaths in children under 5 years of age for which the underlying cause of death was an acute respiratory infection (ICD-9 codes 460-466, 480-487; ICD-10 codes J00-J22) for a given year, in a given country, territory, or geographic area. Antibiotics:  substances that inhibit the growth of or kill microorganisms (bacteria and viruses); used to treat infections. Antibody (Ab): a substance (usually a gamma globulin) that can be incited in an animal by an antigen or by a hapten combined in an animal by an antigen or by a hapten combined with a carrier and that reacts specifically with the antigen or hapten. Some antibodies can occur naturally without known antigen stimulation. Antibody-dependent Cell-mediated Cytotoxicity:  a phenomenon in which target cells, coated with antibody, are destroyed by specialized killer cells (NK cells and macrophages), which bear receptors for the Fc portion on the coating antibody. Antibody Reaction Site (Antigen-binding Site, Antibody-combining Site): the inverted surface site on antibody that reacts with the antigen determinant site on the antigen. Antibody Response: the production of antibody in response to stimulation by specific antigen. Anticholinergic: drug that interferes with the effects of acetylcholine, thus impeding the action of the parasympathetic nervous system. An anticholinergic drug will facilitate storage of urine by increasing bladder capacity and decreasing bladder overactivity. Anticipation: each generation of offspring has increased severity of a genetic disorder; e.g., a grandchild may have earlier onset and more severe symptoms than the parent, who had earlier onset than the grandparent. See also — additive genetic effects, complex trait. Antigen: a substance that can react specifically with antibodies and under certain conditions can incite an animal to form specific antibodies. Extrinsic: an antigen that is not a constituent or product of the cell. Intrinsic: an antigen that is a constituent or product of the cell. Antigen Determinant: a small, three-dimensional everted surface configuration on the antigen molecule that specifically reacts with the antibody reaction site on the antibody molecule. Antigen-presenting Cell: a specialized type of cell, bearing cell antigen-presenting cell surface class II major histocompatibility complex molecules, and involved in the processing and presentation of antigen to inducer or helper T cells. Antigen Receptor: the specific antigen-binding receptor on T or B lymphocytes; these receptors are transcribed and translated from rearrangements of V genes. Antigenic Modulation: loss of antigenicity or change in antigenic markers by which tumor cells may avoid immunologic identification or destruction. Antigenic Paralysis: see immunologic tolerance. Antioncogene: see tumor suppressor gene. Antisense: nucleic acid that has a sequence exactly opposite to an mRNA molecule made by the body; binds to the mRNA molecule to prevent a protein from being made. See also — transcription. Anus: final two inches of the rectum, surrounded by the internal anal sphincter and the external sphincter. Apoptosis: programmed cell death, the body’s normal method of disposing of damaged, unwanted, or unneeded cells. A form of programmed cell death caused by activation of endogenous molecules leading to the fragmentation of DNA. See also — cell. Appraisal (Assessment): appraisal or assessment follows on from the scoping stage of a HIA, where the potential health impacts which have been identified are assessed and evaluated using the available evidence base. Appropriate (ness): if an expected health benefit exceeds the expected negative consequences by a large enough margin to justify performing the procedure rather than other alternatives. Arrayed Library: individual primary recombinant clones (hosted in phage, cosmid, YAC, or other vector) that are placed in two-dimensional arrays in microtiter dishes. Each primary clone can be identified by the identity of the plate and the clone location (row and column) on that plate. Arrayed libraries of clones can be used for many applications, including screening for a specific gene or genomic region of interest. See also — library, genomic library, gene chip technology. Arthus Reaction: an inflammatory reaction characterized by edema, hemorrhage, and necrosis that follows the administration of antigen to an animal that already possesses precipitating antibody to that antigen. Artificial Urinary Sphincter: mechanical device surgically implanted into the patient that consists of a cuff placed around the bulbar urethra or bladder neck, a pressure-regulating balloon, and a pump. The device is used to control opening and closing of the urethra manually and is the most commonly used surgical procedure for the treatment of male urethral insufficiency. Asphyxia: a clinical situation of damaging acidemia, hypoxia, and metabolic acidosis. This definition, although traditional, is not specific to cause. A more complete definition of birth asphyxia includes a requirement for a recognizable sentinel event capable of interrupting oxygen supply to the fetus or infant. This definition fails to include conditions that are not readily recognized clinically, such as occult abruption, but is probably correct in a majority of cases. Assembly: putting sequenced fragments of DNA into their correct chromosomal positions. Atonic Bladder:  often caused by peripheral neuropathies, such as diabetes mellitus. The bladder is flaccid and overdistended with urine. Overflow incontinence may occur. Also referred to as a lower motor neuron bladder. Atopy: a hereditary predisposition of various individuals to develop immediate-type hypersensitivity on contact with certain antigens. Attributable Risk: the difference in actual incidence between exposed and unexposed groups, providing a realistic estimate of the change in incidence in a given population. A modest increase in relative risk will produce only a small number of cases when clinical events are rare, such as venous thromboembolism and arterial thrombosis in young women. Audit Trail: documentation that allows reconstruction of the course of events (from ICH E6). In relation to trial registration applies to the ability to monitor changes made to the trial registration data set after the time of initial registration. Auto- : self or same. Autoantibodies: antibodies produced by an animal that react with the animal’s own antigens. The stimulus is not known but could be the animal’s own antigens or cross-reacting foreign antigens. Autoantigen: a self-antigen that incites the formation of autoantibodies. Autochthonous (Indigenous): found in the same individual in which it originates, as in the case of a neoplasm; autochthonous tumor is a tumor borne by the host of origin. Autograft: a graft derived from the same individual to whom it is transplanted. Autoimmune: condition in which the body produces antibodies to its own tissue. Autologous: derived from the recipient itself. Autonomy:  one of the aspects of the responsiveness of health systems whereby one enjoys the freedom to decide for oneself on alternative treatment, testing and care options, including the decision to refuse treatment, if of sound mind. It literally means self-rule. In medical practice, the principle of autonomy implies personal rule of the self that is free both from controlling interferences by others and from personal limitations that prevent meaningful choice, such as inadequate understanding. Autonomy provides a strong moral foundation for informed consent, in which a patient, fully informed about his/her medical condition and available therapies, freely chooses to be a willing participant in any treatment or non-treatment. Autoradiography: a technique that uses X-ray film to visualize radioactively labeled molecules or fragments of molecules; used in analyzing length and number of DNA fragments after they are separated by gel electrophoresis. Autosomal Dominant: an allele located on an autosome (non-sex chromosome) that express itself phenotypically in the presence of the same or a different allele (ie, in a homozygous or heterozygous condition). A gene on one of the non-sex chromosomes that is always expressed, even if only one copy is present. The chance of passing the gene to offspring is 50% for each pregnancy. See also — autosome, dominant, gene. Autosomal Recessive: an allele located on an autosome that does not express itself phenotypically in the presence of a dominant allele (ie, in a heterozygous condition). It is only phenotypically expressed in a homozygous condition. Autosome: a chromosome not involved in sex determination. The diploid human genome consists of a total of 46 chromosomes: 22 pairs of autosomes, and 1 pair of sex chromosomes (the X and Y chromosomes). See also — sex chromosome. Availability: identifies the presence or absence of needed health care services. Average Length of Stay: average length of stay is computed by dividing the (total) number of days in inpatient or acute care institutions by the number of discharges (or admissions). Avuncular Relationship: the genetic relationship between nieces and nephews and their aunts and uncles.Read More

    A    B    C    D    E    F    G    H    I    J    K    L    M    N    O    P    Q    R    S    T    U    V    W    X    Y    Z     Objective: the end result a program, a project or an institution seeks to achieve. A specific end point, condition or situation one is determined to achieve. A measurable condition or level of achievement at each stage of progression toward a goal. Observation: a data-collection technique that involves personally witnessed documentation of events. Occupancy Rate: the percentage of a hospital’s beds filled at a specific time (or in a specific period). Odds Ratio (OR): An odds of an event is the number of events divided by the number of non-events. In epidemiology an event might be a disease studied in the exposed group versus the control group, e.g. lung cancer. An odds ratio is obtained by dividing the odds in the exposed group by the control group. The ratio of odds that an event will occur in one group compared with the odds that the event will occur in the other group. An odds ratio of 1 means that both groups have a similar likelihood of having an event. Oligo: see — oligonucleotide. Oligogenic: a phenotypic trait produced by two or more genes working together. See also polygenic disorder. Oligonucleotide: a molecule usually composed of 25 or fewer nucleotides; used as a DNA synthesis primer. See also — nucleotide. Oligonucleotide Primer: a short sequence of nucleotides that is necessary to hybridize to a DNA or RNA strand using the enzymes DNA polymerase or reverse transcriptase. Oncogene: a gene, one or more forms of which is associated with cancer. Many oncogenes are involved, directly or indirectly, in controlling the rate of cell growth. Genes that regulate cell growth in a positive fashion (i.e., promote cell growth). Oncogenes include transforming genes of viruses and normal cellular genes (proto-oncogenes) that are activated by mutations to promote cell growth. Oncogenic: an agent capable of causing normal cells to acquire neoplastic characteristics. The term is often applied to viruses, such as adenoviruses. One-tail Test: a test to determine a difference in only one direction; for example, to determine if drug A is better than drug B. Oocyte: an immature female reproductive cell, one that has not completed the maturing process to form an ovum (gamete). Open-Ended Questions: free response questions that allow respondents to answer in their own words in either written form via questionnaires or expressed verbally to an interviewer. Open Enrolment: a period during which an insurer may be required to take any new member or subscriber irrespective of their risk. Open Reading Frame (ORF): the sequence of DNA or RNA located between the start-code sequence (initiation codon) and the stop-code sequence (termination codon). A sequence of DNA representing at least some of the coding portion of a gene that is transcribed and subsequently translated into a protein because it does not contain any internal translation termination codons. Operations Research: also called intervention research; research that includes design, implementation, and assessment of a service-delivery or community intervention. Operon: a set of genes transcribed under the control of an operator gene. Opting-In: the process whereby people choose to participate in a — usually public — health plan that they would not belong to without their active decision to do so. Opting-Out: the process whereby people choose not to participate in the — usually public — health plan they would be assigned to if they don’t make an active decision. Outcomes: a change to a situation resulting from an action. The effect the process has had on the people targeted by it. These might include, for example, changes in their self-perceived health status or changes in the distribution of health determinants, or factors which are known to affect their health, well-being and quality of life. Outputs: the products or results of the process. These might include, for example, how many people a project has affected, their ages and ethnic groups or the number of meetings held and the ways in which the findings of the project are disseminated. Out-of-Pocket Expenditure: in public health, especially in relations to national health accounts, the sum of all out-of pocket payment made by individuals. Out-of-Pocket Payment: fee paid by the consumer of health services directly to the provider at the time of delivery. Outcomes Research: evaluates the impact of health care on the health outcomes of patients and populations. Outpatient: a patient who receives treatment without being hospitalized. Outpatient Health Care Visits Ratio: the number of outpatient health care visits per every 1,000 inhabitants in a population, at a given year, for a given country, territory, or geographic area. Output: the result of a process. Overactive Bladder (OAB): condition characterized by involuntary detrusor contractions during the bladder filling phase, which may be spontaneous or provoked and which the patient cannot suppress. Overflow Incontinence: involuntary loss of urine associated with over-distension of the bladder. Overflow incontinence results from urinary retention that causes the capacity of the bladder to be overwhelmed. Continuous or intermittent leakage of a small amount of urine results. Overlapping Clones: see — genomic library. Oxygen Enhancement Ratio (OER): the ratio of the dose required for a given level of cell killing under hypoxic conditions compared with the dose needed in air.Read More

    A    B    C    D    E    F    G    H    I    J    K    L    M    N    O    P    Q    R    S    T    U    V    W    X    Y    Z     P1-derived artificial chromosome (PAC): one type of vector used to clone DNA fragments (100- to 300-kb insert size; average, 150 kb) in Escherichia coli cells. Based on bacteriophage (a virus) P1 genome. See also — cloning vector. Painful Bladder Syndrome (PBS): complaint of suprapubic pain related to bladder filling, accompanied by other symptoms such as increased daytime and nighttime frequency, in the absence of proven urinary tract infection or other obvious pathology. This term is used in place of interstitial cystitis (IC). Palindrome (Inverted Repeats): these are sequences that look the same if read forward or backward. This allows the sequence to fold back on itself, and it is particularly susceptible to mutation. Palpate / Palpation: to feel with the palmar surface of the hands and fingers to delineate organs, masses, and tenderness during a physical examination. Paramedical Staff: personnel including all types of professions related to medicine, e.g. personnel in the fields of nursing, midwifery, sanitation, dental hygiene, pharmacy, physiotherapy, laboratory medicine, therapeutic exercise, etc. Parasympathetic Nerves: maintenance component of the automatic nervous system. Stimulation of the parasympathetic nervous system that innervates the bladder promotes voiding by stimulating the bladder muscle to contract, causing the urge sensation, and indirectly relaxing the internal urethral sphincter, which allows urine to enter the urethra. Stimulation of the parasympathetic nervous system that innervates the intestinal tract will increase motility and secretion. Parenteral Therapy: therapy given by some other means than through the gastrointestinal tract; usually refers to drugs given intravenously, intramuscularly or subcutaneously. Partner Register: a register that provides data indirectly to the Central Repository, usually via a Primary Register. Partnership: a group of people or organizations brought together with a common purpose such as developing a regeneration program or undertaking. Passive Transfer of Immunity: the transfer of specific antibody from one individual to another. Patent: in genetics, conferring the right or title to genes, gene variations, or identifiable portions of sequenced genetic material to an individual or organization. See also — gene. Pathogen: a microorganism, such as a bacterium, that lives on and feeds from a host and causes disease. Patient: a person in contact with the health system seeking attention for a health condition. Patient-Centered Care: an approach to care that consciously adopts a patient’s perspective. Patients’ Rights: a set of rights, responsibilities and duties under which individuals seek and receive health care services. Pay-As-You-Go System: a system of insurance financing under which total expenditure in a given period is met by income from contributions and other sources from the same period. Payment: the allocation of resources (usually money) to health sector organizations and individuals in return for some activity (e.g. delivering services, managing organizations). Payroll Tax: a tax paid by the employer on the basis of its presence on the payroll. Pedigree: a family tree diagram that shows how a particular genetic trait or disease has been inherited. See also — inherit. Pelvic Diaphragm: levator ani group. Pelvic Muscle Exercises (PMEs): repetitive active exercise of the levator ani muscle to improve urethral resistance and urinary control by strengthening the periurethral and pelvic muscles. Also called Kegel exercises, pelvic-floor exercises, or pelvic-floor muscle training. Pelvic Muscles: general term referring to the muscles of the pelvic diaphragm and urogenital diaphragm as one unit. These muscles form a “hammock” slung from the front of the pelvis to the back. They support the organs of the pelvis — the bladder, uterus and rectum. Also referred to as pelvic floor. Pelvis: ring of bones at the lower end of the trunk in which the pelvic organs lie. Penetrance: the ability of a mutant gene to be expressed in an individual who carries the gene. The probability of a gene or genetic trait being expressed. “Complete” penetrance means the gene or genes for a trait are expressed in all the population who have the genes. “Incomplete” penetrance means the genetic trait is expressed in only part of the population. The percent penetrance also may change with the age range of the population. Penumbra: the radiation outside the full beam, which is often caused by scatter or incomplete collimation. Peptide: two or more amino acids joined by a bond called a “peptide bond.” See also — polypeptide. Per-diem Charge / Fee / Payment: payment for services per day usually for inpatient treatment. Performance: the level of attainment of a goal in comparison to a given effort. Perinatal Death: death of a fetus or a newborn in the perinatal period that commences at 22 completed weeks (154 days) of gestation (the time when birth weight is normally 500 g) and ends seven completed days after birth. Perinatal Period: from 20 weeks of gestation to 28 days of life. Perineum: area between the anus and vagina in women and anus and base of penis in men. Person Time: the sum of the observation period of risk for the persons in a group being studied. Pessary: devices for women that are placed intra-vaginally to treat pelvic relaxation or prolapse or pelvic organs by supporting or lifting these organs. Phage: a virus for which the natural host is a bacterial cell. Pharmacogenomics: the study of the interaction of an individual’s genetic makeup and response to a drug. Pharmacological Treatment: use of medications to treat urinary incontinence. Phenocopy: a trait not caused by inheritance of a gene but appears to be identical to a genetic trait. Phenotype: observable physical characteristics of an organism resulting from the expression of the genotype and its interaction with the environment. The physical characteristics of an organism or the presence of a disease that may or may not be genetic. See also — genotype. Phimosis: when the orifice of the foreskin is constricted, preventing retraction of the foreskin over the glans of the penis. Physical Map: a map of the locations of identifiable landmarks on DNA (e.g., restriction-enzyme cutting sites, genes), regardless of inheritance. Distance is measured in base pairs. For the human genome, the lowest-resolution physical map is the banding patterns on the 24 different chromosomes; the highest-resolution map is the complete nucleotide sequence of the chromosomes. Physician: a person who has completed studies in medicine at the university level. To be legally licensed for the independent practice of medicine, (s) he must, in most cases, undergo additional postgraduate training in a hospital. Physicians Ratio: the number of physicians available per every 10,000 inhabitants in a population, at a given year, for a given country, territory, or geographic area. Phytohemagglutinins: lectins extracted from the red kidney bean, Phaseolus vulgaris or P. Communis, the extract can be purified to yield a glycoprotein mitogen that stimulates lymphocyte transformation and causes agglutination of certain red cells; provides a method for calculating the pool of thymus-dependent lymphocytes (T cells). Pilot Study: an initial or trial test of an intervention. Planning: a process of organizing decisions and actions to achieve particular ends, set within a policy. Plasma Cell: end-stage differentiation of a B cell to an antibody-producing cell. Plasmid: autonomously replicating extra-chromosomal circular DNA molecules, distinct from the normal bacterial genome and nonessential for cell survival under nonselective conditions. Some plasmids are capable of integrating into the host genome. A number of artificially constructed plasmids are used as cloning vectors. Pleiotropy: one gene that causes many different physical traits such as multiple disease symptoms. Pluripotency: the potential of a cell to develop into more than one type of mature cell, depending on environment. Point Mutation: the replacement of one nucleotide in the DNA sequence of the wild type with anther nucleotide. Pokeweed Mitogen: a mitogen extracted from the pokeweed plant; it can be purified to yield a specific glycoprotein. Pokeweed mitogen stimulates blast formation of both B and T cells. Polyclinic: a type of health provider that provides ambulatory health care for more than one specialty of services. Policy: a written statement used to guide and determine present and future decisions about standards of care. A policy can be defined as an agreement or consensus on a range of issues, goals and objectives which need to be addressed (Ritsatakis et al., 2000). For example, “Saving Lives: Our Healthier Nation” can be seen as a national health policy aimed at improving the health of the population of England, reducing health inequalities and setting objectives and targets which can be used to monitor progress towards the policy’s overall goal or aims. Policy Formulation: the development, expression and adoption of a policy. Polygenic Disorder: genetic disorder resulting from the combined action of alleles of more than one gene (e.g., heart disease, diabetes, and some cancers). Although such disorders are inherited, they depend on the simultaneous presence of several alleles; thus the hereditary patterns usually are more complex than those of single-gene disorders. See also — single-gene disorder. Polygenic Inheritance: inheritance of traits that are determined by the combined effects of many genes. Polymerase Chain Reaction (PCR): a method for enzymatically amplifying a short sequence of DNA through repeated cycles of denaturation, binding with an oligonucleotide primer and extension of the primers by a DNA polymerase. A method for amplifying a DNA base sequence using a heat-stable polymerase and two 20-base primers, one complementary to the (+) strand at one end of the sequence to be amplified and one complementary to the (-) strand at the other end. Because the newly synthesized DNA strands can subsequently serve as additional templates for the same primer sequences, successive rounds of primer annealing, strand elongation, and dissociation produce rapid and highly specific amplification of the desired sequence. PCR also can be used to detect the existence of the defined sequence in a DNA sample. Polymerase, DNA or RNA: enzyme that catalyzes the synthesis of nucleic acids on preexisting nucleic acid templates, assembling RNA from ribonucleotides or DNA from deoxyribonucleotides. Polymorphism: minor differences that distinguish one individual from another. Difference in DNA sequence among individuals that may underlie differences in health. Genetic variations occurring in more than 1% of a population would be considered useful polymorphisms for genetic linkage analysis. See also — mutation. Polypeptide: a protein or part of a protein made of a chain of amino acids joined by a peptide bond. Polyuria: excretion of a large volume of urine (usually >2.5 liters in 24 hours). Can be a result of uncontrolled diabetes mellitus or the administration of a diuretic. Population: all the inhabitants of a country, territory, or geographic area, total or for a given sex and/or age group, at a specific point of time. In demographic terms it is the total number of inhabitants of a given sex and/or age group that actually live within the border limits of the country, territory, or geographic area at a specific point of time, usually mid-year. The mid-year population refers to the actual population at July 1st. Population at Malaria Risk: the proportion of the population residing in areas of moderate and high transmission of malaria, in a given country, territory, or geographic area. Areas of moderate and high transmission are those in which the Annual Parasite Index (API) (=number of confirmed malaria cases/1,000 pop) is between 1-10/1,000 and over 10 per thousand respectively. Areas of low transmission are those with an API below 1 per 1,000 population. Population Genetics: the study of variation in genes among a group of individuals. Population Medicine: analysis and assessment of health care on the basis of the community or group rather than the individual. Population Sample: a randomized sample that is statistically representative of a particular population. Positional Cloning: a technique used to identify genes, usually those that are associated with diseases, based on their location on a chromosome. Positive Predictive Value: in screening and diagnostic tests, the probability that an individual with a positive test result is a true positive (ie, does have the condition) is referred to as the predictive value of a positive test. Post-Abortion: period of time that immediately follows abortion, usually no longer than 2 weeks. Post-Abortion Care: care given to manage complications of abortion. Key elements include emergency treatment of abortion complications, family planning counseling and services, and links to comprehensive reproductive health services. The treatment of abortion complications, provision of post-abortion family-planning services (including counseling and contraceptive method delivery, and delivery), and linkages to other appropriate reproductive health services. Postmature-Dysmature Neonate: an undernourished newborn who exhibits wasting of subcutaneous tissue, meconium staining, and peeling of skin; approximately 10-20% of true postterm fetuses exhibit these findings at birth. Postpartum: the first 6 weeks after childbirth. Post-Term: 42 completed weeks or more (294 days or more) of gestation. Postterm Pregnancy: gestation of 42 weeks or more (294 days or more from the first day of the last menstrual period); the term “postdates” can be simply interpreted as a pregnancy 1 or more days beyond the expected date of confinement and is not synonymous with postterm pregnancy. Post Void Dribbling: involuntary loss of urine immediately after a person has finished voiding. Post Void Residual (PVR): volume of urine remaining in the bladder immediately following the completion of urination. Estimation of PVR volume can be made by abdominal palpation and percussion or bimanual examination. Specific measurement or PVR volume can be accomplished by catheterization, pelvic ultrasound, radiography, or radioisotope studies. Potential Years of Life Lost: measure of the years of life lost due to premature death. Power: the probability that a study will be able to correctly detect a true effect of a specific magnitude. The statistical power refers to the probability of finding a difference when one truly exists or how well the null hypothesis will be rejected. The power is usually specified beforehand in prospective studies. The values of 0.8 (80%) or 0.9 (90%) are typical. The higher the value, the less chance there is of a type II error. A 0.9 value means that a type II error would be avoided 90% of the time. Precipitin: an antibody that reacts specifically with soluble antigen to form a precipitate. Predictive Value Positive: the proportion of positive test results that is truly positive. Predictive Value Negative: the proportion of negative test results that is truly negative. The predictive value of a negative test result refers to the proportion of patients with a negative test result who are free of disease. These values, unlike sensitivity and specificity, indicate the reliability of the test in the determination of presence or absence of disease. Preembryo: the developing cells produced by the division of the zygote until the formation of the embryo proper at the appearance of the primitive streak about 14 days after fertilization. Pre-existing Condition: an insurance contract may specify that it will not apply for medical problems already diagnosed or under treatment before the policy is purchased, known as pre-existing conditions. Preferred Method: contraceptive method that patient thinks she would like to use. Pre-labor Rupture of Membranes: rupture of membranes before labor has begun. (1) Preterm – when fetus is immature <37 weeks (2) Term – when fetus is mature >37 weeks. Premature Chromosome Condensation (PCC): a method of studying chromosomes in the interphase stage of the cell cycle. Primitive Streak: the initial band of cells from which the embryo begins to develop, located at the caudal end of the embryonic disc. The primitive streak is present at about 15 days after fertilization. Premium: a flat-rate payment for voluntary insurance. Prepayment: fee paid by a potential consumer of health services in anticipation of services that may be required. Pressure Sore: lesion resulting from prolonged pressure and involving loss of integrity of skin or damage to underlying tissue. Presumptive Treatment: treatment with a full curative dose of drugs (e.g., antibiotics) based on assumption that person is infected, not on evidence of the disease. Pre-Term: less than 37 completed weeks (less than 259 days) of gestation. Preterm Rupture of Membrane: rupture of membranes before 37 weeks of gestation (before pregnancy is carried to term). Pretest: an initial or trial test of a data-collection instrument or process. Prevalence: the number of events, e.g., instances of a given disease or other condition, in a given population at a designated time; sometimes used to mean PREVALENCE RATE. When used without qualification, the term usually refers to the situation at a specified point in time (point prevalence). Note that this is a number, not a rate. The prevalence of a disease/risk factor in a statistical population is defined as the ratio of the number of cases of a disease present in a statistical population at a specified time and the number of individuals in the population at that specified time. In plain English, “prevalence” simply means “proportion” (typically expressed as a percentage). Prevalence Rate: the number of cases of a disease existing in a given population at a specific point or period of time. The amount of disease in a population. Prevalence measures the proportion of diseased individuals at a particular time and represents a snapshot of the disease. Other commonly used terminology is prevalence proportion and point prevalence. Prevalence of Exclusive Breastfeeding Through 120 Days of Age: the number of children who, from birth until the end of the forth month of life, are fed exclusively breast milk, expressed as a percentage of the corresponding mid-year population, for a given year, in a given country, territory, or geographic area. Prevalence of Moderate and Severe Nutritional Deficiency in Children Less Than 5 Years: the number of prevalent cases of moderate and severe nutritional deficiency in children under 5 year of age detected in a given year, expressed as a percentage of the corresponding mid-year population, for a given country, territory, or geographic area. Under-5 moderate and severe nutritional deficiency is defined as any weight-for-age (W/A) ratio less than minus two standard deviations (-2SD) from the reference median. Prevalence of Overweight Among Adult Population: the number of overweight adults, registered at a specific point in time, among the adult population 20 to 74 years of age, total or of a given sex, expressed as a percentage of that population, for a given year, in a given country, territory, or geographic area. Body Mass Index (BMI) is an anthropometric measure defined as the ratio between the weight measured in kilograms, and the square of the height measured in meters. Overweight is defined as a BMI equal to or greater than 25 Kg/m2. Prevalence of Tobacco Consumption Among Adolescents: the number of students between 13 and 15 years of age that consumed any quantity of a tobacco product during the past 30 days of the survey, expressed as a percentage of that population, at a specific point in time, total or for a given sex, for a given year, in a given country, territory, or geographic area. Prevalence of Use of Contraceptive Methods in Women: the number women aged 15 to 49 years who use any type of contraceptive method, at a specific point in time, expressed as a percentage of the corresponding mid-year population, for a given year, in a given country, territory, or geographic area. Contraceptive methods include female and male sterilization, injectable and oral contraceptives, intrauterine devices, diaphragms, spermicides, condoms, rhythm method and withdrawal. Price: amount of money for which a thing is bought or sold. Primary Health Care (PHC): the first level contact with people taking action to improve health in a community. Primary Infertility: infertility in a couple that has never conceived. Primary Register: a register that provides data directly to the Central Repository. Primer: short preexisting polynucleotide chain to which new deoxyribonucleotides can be added by DNA polymerase. Short DNA pieces that are complementary to portions of specific DNA sequences. Principal Investigator: the person who directs and has ultimate responsibility for a research project. Privacy: in genetics, the right of people to restrict access to their genetic information. Private Health Care Expenditure: that part of total expenditure on health which is not public; it is mainly comprised by out-of-pocket payments and premiums for voluntary health insurance (sometimes by employers on behalf of the individual). Private Health Care Sector: private health care sector refers to both private finance and provision of services. Private Patient: a patient who pays the full cost of all the medical and other services provided for him. Privatization: involves the transfer of ownership and government functions from public to private bodies, which may consist of voluntary organizations and for-profit and not-for-profit private organizations. The degree of government regulation is variable. Probability Sample: a sample based on the random selection of subjects. All individuals have a known chance of selection. They may all have an equal chance of being selected, or, if a stratified sampling method is used, the rate at which individuals from several subsets are sampled can be varied so as to produce greater representation of some classes than of others. A probability sample is created by assigning an identity (label, number) to all individuals in the “universe population, e.g., by arranging them in alphabetical order and numbering in sequence, or simply assigning a number to each, or by grouping according to area of residence and numbering of groups. The next step is to select individuals (or groups) for study by a procedure such as use of a table of random numbers (or comparable procedure) to ensure that the chance of selection is know. Probe: single-stranded DNA or RNA molecules of specific base sequence, labeled either radioactively or immunologically, that are used to detect the complementary base sequence by hybridization. Process: a continuous and regular action or succession of actions, taking place or being carried out in a definite manner, and leading to the accomplishment of some results. A course of action or series of activities. Production: a succession of actions designed to generate a product. Productivity: the volume of output per unit or input. Productivity Cost: charges (or payment) less the cost. Professional Accountability: a conduct in accordance with good practice as recognized and endorsed by a professional society. Professional Nurses Ratio: the number of certified nurses available per every 10,000 inhabitants in a population, at a given year, for a given country, territory, or geographic area. Certified nurses not include auxiliary and unlicensed personnel. Professional Self-Regulation: the enforcement of certain rules of conduct among its members by a professional community. Program: the term program usually refers to a group of activities which are designed to be implemented in order to reach policy objectives (Ritsatakis et al., 2000). For example, many Single Regeneration Budget programs and New Deal for Communities initiatives have a range of themes within their programs — often including health, community safety (crime), education, employment and housing — and within these themes are a number of specific projects which, together, make up the overall program. Progressive Tax: a tax in which the rich pay a larger fraction of their income than the poor. Project: a project is usually a discrete piece of work addressing a single population group or health determinant, usually with a pre-set time limit. For example, “Private Rented Dwellings” was a three year project in Southport, Merseyside which provided money to private landlords in order to bring their rented properties up to housing fitness standards (Hirschfield et al., 2001). Prokaryote: cell or organism lacking a membrane-bound, structurally discrete nucleus and other sub-cellular compartments. Bacteria are examples of prokaryotes. See also — chromosome, eukaryote. Prolapse: to slide forward or downward, usually referring to the pelvic organs, such as the falling down of the bladder, uterus, or rectum through the vagina. Prolapses are staged, using objective criteria, by the severity of the maximum protrusion of the prolapse during examination. Promoter: a DNA site to which RNA polymerase will bind and initiate transcription. The DNA sequence of a gene to which RNA polymerase binds and initiates transcription. Prompt Attention: one of the aspects of the responsiveness of health systems whereby those needing care are able to access it speedily through conveniently located health care units, short waiting times and short waiting lists for consultation and treatment. Prompted Voiding: behavioral technique for use primarily with dependent or cognitively impaired persons. Prompted voiding attempts to teach the incontinent person awareness of his or her incontinence status and to request toileting assistance, either independently or after being prompted by a caregiver. Pronuclei: the egg and sperm nuclei after penetration of the sperm into the egg during fertilization. Pronucleus: the nucleus of a sperm or egg prior to fertilization. See also — nucleus, transgenic. Prophylactic Immunization: represents pre-immunization of an individual against a causative agent (e.g., oncogenic virus) or tumor-specific antigen, in advance of any natural encounter with the agent or tumor. Prophylactic Treatment: often refers to a partial dose of drugs (in comparison to the full curative dose) that may prevent a process that can lead to disease. Prophylaxis: prevention of disease or of a process that can lead to disease. Proportion of Certified Deaths due to Ill-Defined and Unknown Conditions: the number of death certificates issued in a given year for which the underlying cause of death was symptoms, signs, and ill-defined and unknown conditions (ICD-9 codes 780-799; ICD-10 codes R00-R99), expressed as a percentage of the total registered deaths due to natural causes at the same year, in a given country, territory, or geographic area. Proportion of Deliveries Attended by Trained Personnel: the number of deliveries assisted by trained personnel in a specific year, regardless of their site of occurrence, expressed as a percentage of the total number of births in that same year, in a given country, territory, or geographic area. Trained staff includes medical obstetricians, physicians with training in delivery care, university midwives and nurses with training in delivery care and graduated midwives; it does not include traditional midwives trained or not. Proportion of Population Below the International Poverty Line: the percentage of the population living below the international poverty line in a given country, territory, or geographic area, for a given sex and/or age group, at a specific period in time, usually a year. International poverty line is defined at less than US$1.08 a day at 1993 international prices, equivalent to US$1 in 1985 international prices, adjusted to local currency using purchasing power parities. Technical Note: The international poverty line is prepared by the World Bank, based on its most recent consumption purchasing power parity (PPP) estimates in 1993 prices. Any revisions in the PPP of a country to incorporate better price indexes can produce dramatically different poverty lines in local currency. PPP exchange rates are designed for comparing aggregates from national accounts; thus, there is no certainty that an international poverty line measures the same degree of need or deprivation across countries. Proportion of Population Below the National Poverty Line: the percentage of the population living below the national poverty line in a given country, territory, or geographic area, at a specific period in time, usually a year. The operational definition for a national poverty line varies from country to country and represents the amount of income required by each household to meet the basic needs of all its members. Technical Note: The poverty line is based on an estimate of the cost of a basic food basket that covers the nutritional needs of the population, taking into account its consumption habits, as well as the actual availability of food in the country and its relative prices. The value of this basket is combined with an estimate of the resources required by households to meet basic non-dietary needs. Some countries also define a national extreme poverty line by taking into account the cost of the basic food basket only (i.e., excluding basic non-dietary needs). National estimates are based on population-weighted subgroup data from household surveys. Proportion of Population of 1 Year of Age Immunized Against Measles: the number of children of 1 year of age who have received one dose of vaccine against measles (in general in combination with rubella and mumps — MMR), expressed as a percentage of corresponding mid-year population, for a specific year, in a given country, territory, or geographic area. Proportion of Population Less Than 15 Years Old: the percentage of total population of a country, territory, or geographic area, under 15 years of age, total or a given sex and at a specific point of time, usually mid-year. Proportion of Population 60 Years and Older: the percentage of total population of a country, territory, or geographic area, 60 years of age and over, total or for a given sex and at a specific point of time, usually mid-year. Proportion of Population with Access to Improved Sanitation: population with access to improved sanitation in a given year, expressed as a percentage of the corresponding population of that year, in a given country, territory, or geographic area. Excreta disposal systems are considered adequate if they are private and if they separate human excreta from human contact. Improved sanitation facilities are: connection to a public sewer, connection to a septic system, pour-flush latrine, simple pit latrine, ventilated improved pit latrine. Unimproved sanitation facilities are: public or shared latrine, open pit latrine, bucket latrine. Urban and rural area according to countries’ own working definition. Proportion of Population with Sustainable Access to an Improved Water Source: population with improved drinking water sources, in a given year, expressed as a percentage of the corresponding population of that year, in a given country, territory, or geographic area. Access to safe drinking water sources is defined by the availability of at least 20 liters of water per person per day from a source within 1 kilometer of walking distance. Improved drinking water sources are: household connection, public standpipe, borehole, protected dug well, protected spring, rainwater collection. Unimproved drinking water sources are: unprotected well, unprotected spring, rivers or ponds, vendor-provided water, bottled water, tanker truck water. Bottled water is not considered improved due to limitations in the potential quantity, not quality, of the water. Urban and rural area according to countries’ own working definition. Proportion of Pregnant Women Attended by Trained Personnel During Pregnancy: the number of pregnant women who have received at least one health care visit during pregnancy provided by a trained health worker, expressed as a percentage of the live birth population, at a given year, for a given country, territory, or geographic area. Health care visit during pregnancy is defined as those health care services for the control and monitoring of the pregnancy and ambulatory care for associated morbidity; it does not include neither direct vaccination activities nor the health care services rendered immediately prior to delivery. Trained staff includes medical obstetricians, physicians with training in delivery care, university midwives and nurses with training in delivery care and graduated midwives; it does not include traditional midwives trained or not. Proportion of Under-1 Population Immunized Against Diphtheria, Pertussis, and Tetanus: the number of children who, on completing their first year of life, have received three doses of DPT (diphtheria, pertussis, and tetanus) toxoid, expressed as a percentage of the corresponding mid-year population, for a specific year, in a given country, territory, or geographic area. Proportion of Under-1 Population Immunized Against Poliomyelitis: the number of children who, on completing their first year of life, have received three doses of live oral poliomyelitis vaccine (OPV), expressed as a percentage of the corresponding mid-year population, for a specific year, in a given country, territory, or geographic area. Proportion of Under-1 Population Immunized Against Tuberculosis: the number of children under 1 year of age who have received one dose of vaccine against tuberculosis BCG (bacille Calmette-Guerin), expressed as a percentage of the corresponding mid-year population, for a specific year, in a given country, territory, or geographic area. Proportion of Urban Population: the percentage of total population of a country, territory, or geographic area living in places defined as urban, at a specific point of time, usually mid-year. The term urban refers essentially to cities, towns, and other densely populated areas. The demarcation of urban areas is usually defined by countries as part of census procedures, and is usually based on the size of localities, and/or the classification of areas as administrative centers or in accordance to special criteria such as population density or type of economic activity of residents. There is no international agreed definition of urban areas, and national operational definitions may vary from country to country. Prospective Data: data collected from the present until some specified future date. Data collection may be staged or continuous. Prospective HIA: prospective HIA is carried out before any action has been taken, either in terms of drafting a policy, putting together an action plan or implementing it so that steps can be taken, at the planning stage, to maximize the positive health impacts of a policy, program or project and to minimize the negative effects (Scott-Samuel et al., 1998). Prospective Payment: a payment whose level is fixed in advance of actually providing a service. Prostate: walnut-shaped gland found only in men that surrounds the urethra between the bladder and the pelvic floor. Prostatitis: irritation or inflammation of the prostate. Protein: a large molecule composed of one or more chains of amino acids in a specific order; the order is determined by the base sequence of nucleotides in the gene that codes for the protein. Proteins are required for the structure, function, and regulation of the body’s cells, tissues, and organs; and each protein has unique functions. Examples are hormones, enzymes, and antibodies. Proteome: proteins expressed by a cell or organ at a particular time and under specific conditions. Proteomics: the study of the full set of proteins encoded by a genome. Protocol: a document that describes the objective(s), design, methodology, statistical considerations, and organization of a trial. The protocol usually also gives the background and rationale for the trial (from ICH E6). Protocol Amendment: a written description of a change(s) to or formal clarification of a protocol. (from ICH E 6). Proto-Oncogenes: any of a number of genes that encode various proteins involved in normal cell growth and proliferation, including growth factors, growth factor receptors, regulators of DNA synthesis, and phosphorylating modifiers of protein function. These are cellular genes that are the normal counterparts of transforming viral oncogenes. Provider: professionals and institutions providing health care services to patients. Proximal Urethra: portion of the urethra closest to the bladder. Pseudogene: a sequence of DNA similar to a gene but nonfunctional; probably the remnant of a once-functional gene that accumulated mutations. Pubic Symphysis: the center front portion of the pelvic bone. Public Health: the science and art of promoting health, preventing disease, and prolonging life through the organized efforts of society. Public Health Care Expenditure: includes publicly funded health care by both publicly and privately owned providers. Public funds are state, regional and local Government bodies and social security schemes. Public capital formation on health includes publicly-financed investment in health facilities plus capital transfers to the private sector for hospital construction and equipment and subsidies from government to health care service providers. It includes funds for state employees. Public Health Care Sector: refers to public finance and provision of health care services. Pubococcygeus Muscle: another name for the levator ani muscle, one of the pelvic muscles that holds the pelvic organs in place. Pudendal Nerve: main nerve that innervates all of the muscles of the pelvic floor, including the external urinary sphincter. The pudendal nerve originates at S2-S4 (the sacral micturition center) and causes the external urinary sphincter to contract, retaining urine in the bladder. Purchaser: a health care body which assesses the needs of a defined population and buys services to meet those needs from providers. Purchasing Power Parity (PPP): PPPs are the rates of currency conversion that equalize the purchasing power of across the full range of goods and services contained in total expenditure and Gross Domestic Product of a country. Purine: a nitrogen-containing, double-ring, basic compound that occurs in nucleic acids. The purines in DNA and RNA are adenine and guanine. See also — base pair. Purposive Sample: a non-probability sample that is biased towards a particular “type” of subject (e.g., women with complications of unsafe abortion). Pyrimidine: a nitrogen-containing, single-ring, basic compound that occurs in nucleic acids. The pyrimidines in DNA are cytosine and thymine; in RNA, cytosine and uracil. See also — base pair. Pyuria: pus cells present in the urine, which is a hallmark of an inflammatory response.Read More

    A    B    C    D    E    F    G    H    I    J    K    L    M    N    O    P    Q    R    S    T    U    V    W    X    Y    Z     QALY (Quality-Adjusted Life-Years): a measure that combines mortality and quality of life gains (outcome of a treatment measured as the number of years of life saved, adjusted for quality). Qualitative and Quantitative: HIA tries to balance qualitative and quantitative evidence. It involves an evaluation of the quantitative, “scientific” evidence where it exists but also recognizes the importance of more qualitative information. This may include the opinions, experience and expectations of those people most directly affected by public policies and try to balance the various types of evidence (Barnes and Scott Samuel, 1999). Generally speaking, quantitative evidence is based on what can be counted or measured objectively whilst qualitative evidence cannot be measured in the usual ways and may more subjective, for example, encompassing people’s perceptions, opinions and views. Qualitative Variable: a variable or response that describes a quality rather than a quantity; qualitative variables are usually described in words rather than numbers. Quality: a character, characteristic, or property of anything that makes it good or bad, commendable or reprehensible; thus, the degree of excellence that a thing possesses. Quality of Basic Amenities: one of the aspects of the responsiveness of health systems whereby non-health enhancing physical attributes of health care units, such as cleanliness of the facility, adequacy of furniture and quality of food, are paid attention to. Quality of Medical Care: the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. Quality of Pharmaceutical Products: the suitability of drugs for their intended use is determined by: Their efficiency weighed against safety, according to label claim, or as promoted or publicized Their conformity to specifications regarding identity, purity and other characteristics. The quality assurance of pharmaceutical products is a wide-ranging concept covering all matters that individually or collectively influence the quality of a product. It is the totality of the arrangements made to ensure that pharmaceutical products are of the quality required for their intended use. The quality control of pharmaceutical products is a concept that covers all measures taken, including the setting of specifications, sampling, testing and analytical clearance, to ensure that the raw materials, intermediates, packaging materials and finished pharmaceutical products conform with established specifications for identity, strength, purity and other characteristics. Quantitative Variable: a variable or response that describes a quantity rather than a quality; quantitative variables are usually described in numbers as well as, or instead of, words. Quasi-Experimental Research Design: research designs that allow researchers to take an experimental approach without full experimental control; usually, these designs do not include random assignment of subjects but do include supplementary cross-checks for validity, and may also include the use of control groups. Quasi-Experimental Study: a study with non-random assignment of participants to groups, usually because it would be unethical or unfeasible to randomize.Read More

    A    B    C    D    E    F    G    H    I    J    K    L    M    N    O    P    Q    R    S    T    U    V    W    X    Y    Z     rad: a unit-absorbed dose of ionizing radiation equivalent to the absorption of 100 erg per gram of irradiated material. Radiation hybrid: a hybrid cell containing small fragments of irradiated human chromosomes. Maps of irradiation sites on chromosomes for the human, rat, mouse, and other genomes provide important markers, allowing the construction of very precise STS maps indispensable to studying multifactorial diseases. See also — sequence tagged site. Random Assignment: a process (such as a coin toss) for sample selection that gives each individual in a given population an equal chance of being included (also known as random selection). Random Error: it is the portion of variation in a measurement that has no apparent connection to any other measurement or variable, generally regarded as due to chance. Randomization: the process of assigning trial subjects to treatment or control groups using an element of chance to determine the assignments in order to reduce bias. (from ICH E6). Rapid (mini) HIA: a rapid or “mini” HIA, as the name suggests, is done quickly. It may be a “desk top” exercise, reliant on information which is already available already available “off the shelf” (Parry and Stevens, 2001), or through a half day or one day workshop with key stakeholders (Barnes et al., 2001). In either case, there is usually a minimum quantification of the potential health impacts which are identified. Rare-Cutter Enzyme: see — restriction-enzyme cutting site. ras Gene: a family of genes that encode similar cell membrane-bound proteins involved in signal transduction. Three types, K-ras, N-ras, and H-ras, are the widely studied ras genes in human tumors. Their proto-oncogene becomes activated by point mutations, most often in specific codons, of the gene sequence. Ratio of Male to Female AIDS Cases: the quotient between the number of new cases registered from Acquired Immunodeficiency Syndrome (AIDS) of male to female cases, in a specific year, for a given country, territory, or geographic area. Rationing: restricting supply of services according to implicit or explicit criteria, where demand exceeds supply. RB: the first tumor suppressor gene to be discovered. It is a 4.7-kilobase gene, located on chromosome 13q14, and encodes a 110,000-dalton nuclear phosphoprotein that suppresses the cell cycle. Absence of RB is the cause of retinoblastoma, and research is revealing that it is involved in the pathogenesis of many other neoplasms. RCT: randomized controlled trial. Real Gross Domestic Product (Real GDP): GDP which is expressed in purchasing power parity (PPP) and adjusted to the relative domestic purchasing power of the national currency as compared to the US dollar. Reassuring Fetal Heart Rate Monitor Strip/Tracing: the absence of fetal heart rate patterns defined as nonreassuring (see Nonreassuring Fetal Heart Rate Monitor Strip/Tracing). Receiver Operator Characteristics (ROC): these curves are the best way to demonstrate the relationships between sensitivity and specificity. These curves plot sensitivity (true positive rate) against the false positive rate (1-specificity). Along any particular ROC curve one can observe the impact of compromising the true positive and false positive rates. As the requirement that a test have a high true positive rate increases, the false positive rate will also increase. Recessive Gene: a gene which will be expressed only if there are 2 identical copies or, for a male, if one copy is present on the X chromosome. Reciprocal Translocation: when a pair of chromosomes exchange exactly the same length and area of DNA. Results in a shuffling of genes. Recombinant: a gene that has been isolated and recombined with other sequences responsible for gene expression. Recombinant Clone: clone containing recombinant DNA molecules. See also — recombinant DNA technology. Recombinant DNA: a new DNA sequence formed by the combination of two non-homologous DNA molecules. Recombinant DNA Molecules: a combination of DNA molecules of different origin that are joined using recombinant DNA technologies. Recombinant DNA Technology: procedure used to join together DNA segments in a cell-free system (an environment outside a cell or organism). Under appropriate conditions, a recombinant DNA molecule can enter a cell and replicate there, either autonomously or after it has become integrated into a cellular chromosome. Recombination: the process by which progeny derive a combination of genes different from that of either parent. In higher organisms, this can occur by crossing over. See also — crossing over, mutation. Rectocele: bulging of the rectum into the space normally occupied by the vagina, suggesting weakness of the pelvic floor. Rectum: last segment of colon, or large intestine, the lowest part of the bowel found right before the anus. Recurrent Expenditure: ‘Ongoing expenditure’ such as salaries, wages, travelling expenses, drugs, etc. Reference Price: the maximum price for a group of equal or similar products (mostly pharmaceuticals) the third party payer is ready to reimburse. Reform: a purposeful, dynamic process that involves systematic policy, structural and process changes and is aimed at achieving desired goals. Regeneration: regeneration is a broad concept used to describe a wide variety of measures that are designed to revive disadvantaged (mainly urban) areas. This might include -modifying the physical environment; -altering lifestyles; -improving leisure opportunities; -enhancing the training and employment prospects of local residents; -reducing stress, anxiety and fear; -strengthening control over people’s lives and fostering empowerment; -improving access to public services; and -enhancing relationships between local residents and public sector agencies. Since the second world war there have been many regeneration initiatives — the most recent being the neighborhood renewal and other related programs — and many inner city areas have been “regenerated” more than once. ((Hirschfield et al., 2001). Regressive Tax: a tax in which the poor pay a larger fraction of their income than the rich. Regulation: intervention by government, by means of rules, in health care markets or systems. Regulatory Capture: a deviance in transaction practice by which one of the parties with vested interests in the deal exerts pressure on the regulators in order to obtain better conditions in the deal. Regulatory Region or Sequence: a DNA base sequence that controls gene expression. Rehab Urinals: portable receptacles for collecting urine, usually made of plastic or metal, that is specifically designed to aid individuals who have decreased dexterity or functional ability. Relative Biologic Effectiveness (RBE): a ratio of the absorbed dose of a reference radiation to the absorbed dose of a test radiation to produce the same level of biologic effect, other conditions being equal. Relative Risk: the ratio of risk of disease or death among the exposed to that of the risk among the unexposed; this usage is synonymous with risk ratio. If the relative risk is higher than 1, there is a positive association between the exposure and the disease; if it is less than 1, there is negative association. Reliability: a study situation in which different researchers conduct the same study using the same data collection instruments and obtain the same results. The degree of stability exhibited when a measurement is repeated under identical conditions. Reliability refers to the degree to which the results obtained by a measurement procedure can be replicated. Lack of reliability may arise from divergences between observers or instruments of measurement or instability of the attribute being measured. rem: the old unit of dose equivalent. It is the product of the absorbed dose in rads and modifying factor and is being replaced by the sievert. Remuneration: refers to the activity of compensating health professionals for their time and effort in providing care. Replicability: a characteristic of study design that means a study can be repeated and produce a similar outcome. Representative Sample: a sample that provides a close approximation of the population studied, making it possible to generalize back to the population from which it was drawn. Repetitive DNA: sequences of varying lengths that occur in multiple copies in the genome; it represents much of the human genome. Reporter Gene: see — marker. Reproductive Health: reproductive health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. Reproductive health therefore implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. Implicit in this last condition are the right of men and women to be informed of and to have access to safe, effective, affordable and acceptable methods of family planning of their choice, as well as other methods of their choice for regulation of fertility which are not against the law, and the right of access to appropriate health-care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant. In line with the above definition of reproductive health, reproductive health care is defined as the constellation of methods, techniques and services that contribute to reproductive health and well-being by preventing and solving reproductive health problems. It also includes sexual health, the purpose of which is the enhancement of life and personal relations, and not merely counseling and care related to reproduction and sexually transmitted diseases. (ICPD Program of Action, A/CONF.171/13, paragraph 7.2.) Reproductive Health Care: the sum total of services (clinical treatment, counseling, information, and education) and referrals of services as required to address individuals’ needs for health care related to human sexuality and reproduction, including: fertility regulation, prenatal care, safe birth, post-natal care, infertility, abortion, and reproductive tract infections (including sexually transmitted infections and diseases). Reproductive Rights: reproductive right rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health. They also include the right of all to make decisions concerning reproduction free of discrimination, coercion and violence. Reproductive Tract Infection (RTI): any infection associated with the reproductive/sexual organs; RTIs may be the result of endogenous infections (such as bacterial vaginosis or candida), sexually transmitted infections/diseases (such as HIV/AIDS, trichomonas or gonorrhea), or infections caused by a procedural complication (such as that related to induced abortion or other gynecological surgery). Research: any systematic inquiry that involves collecting data and disseminating the results. Research (Study) Design: a formalized and usually systematic plan to collect data that will inform a hypothesis. Researcher: any person who undertakes to conduct research (collect data). Resident Assessment Protocol (RAP): part of the Minimum Data Set that assists the nurse to assess the cause of various disruptions or conditions. The RAP provides a systematic method of assessment and is used in the development of the care plan for the individual residing in a nursing home. Residual Urine: retention of urine in the bladder after voiding due to incomplete emptying. Resolution: degree of molecular detail on a physical map of DNA, ranging from low to high. Resource Allocation: the process of deciding what is needed to carry out an activity and providing for those needs. This can include making provision for financial resources (money), capital resources (such as buildings and computer hardware) and staff resources (including the number of staff needed and the skill mix required). Resources: the basic inputs to production — the time and abilities of individuals (human resources), raw materials such as land and natural resources (air, water, minerals, etc.), transformation and accumulations of these into capital (facilities, equipment) and knowledge production processes (technologies). Responsiveness: one of the three goals of the health system to meet people’s legitimate non-health expectations about how the system treats them. Responsible Registrant: an appropriate representative of the trial’s primary Sponsor. The Responsible Registrant is responsible for ensuring that the trial is properly registered. The primary Sponsor may or may not be the primary funder. The responsible registrant should make every reasonable effort to ensure that a trial is registered once and only once in any one register, and that the trial is registered in the fewest number of registers necessary to meet applicable regulations. Restraints: medications or devices (e.g., belts, straps, jackets, chair) used to immobilize a person. Restriction Endonuclease: an enzyme that recognizes and cleaves a specific DNA sequence (usually 4-10 nucleotide bases long). Enzymes that cleave DNA at specific DNA sequences. Restriction Enzyme, Endonuclease: a protein that recognizes specific, short nucleotide sequences and cuts DNA at those sites. Bacteria contain over 400 such enzymes that recognize and cut more than 100 different DNA sequences. See also — restriction enzyme cutting site. Restriction Enzyme Cutting Site: a specific nucleotide sequence of DNA at which a particular restriction enzyme cuts the DNA. Some sites occur frequently in DNA (e.g., every several hundred base pairs); others much less frequently (rare-cutter; e.g., every 10,000 base pairs). Restriction Fragment Length Polymorphism (RFLP): a polymorphic difference in DNA sequence between individuals that can be recognized by restriction endonucleases. Variation between individuals in DNA fragment sizes cut by specific restriction enzymes; polymorphic sequences that result in RFLPs are used as markers on both physical maps and genetic linkage maps. RFLPs usually are caused by mutation at a cutting site. See also marker, polymorphism. Retrospective Data: data that are collected by reviewing past records or asking subjects about their past experience(s). Retrospective HIA: retrospective HIA is carried out after a program or project has been completed. It is used to inform the ongoing development of existing work. Retrospective Payment: a payment scheme whose level is determined only after services have been provided. Retroviral Infection: the presence of retroviral vectors, such as some viruses, which use their recombinant DNA to insert their genetic material into the chromosomes of the host’s cells. The virus is then propagated by the host cell. Reverse Transcriptase: an enzyme used by retroviruses to form a complementary DNA sequence (cDNA) from their RNA. The resulting DNA is then inserted into the chromosome of the host cell. An enzyme discovered in retro-viruses that has the unique ability to transcribe DNA from and RNA template. This is the reverse of the normal physiologic process. Ribonucleotide: see — nucleotide. Ribose: the five-carbon sugar that serves as a component of RNA. See also — ribonucleic acid, deoxyribose. Ribosomal RNA (rRNA): a class of RNA found in the ribosomes of cells. Ribosomes: small cellular components composed of specialized ribosomal RNA and protein; site of protein synthesis. See also — RNA. Risk: the chance of probability that an event will occur. The proportion of unaffected individuals who, on average, will contract the disease of interest over a specified period of time. Results of a trial are often expressed as absolute or relative risk reductions. The absolute difference is the actual difference between the units of the difference. In relative risk, the differences are the percentage change. Relative risk reductions often sound much more dramatic than do the absolute values. One must consider the prevalence of a disease when evaluating risk reductions. Where there is a low prevalence of a disease process, small risk reductions become unimpressive and must be evaluated in terms of the benefits of a particular mode of therapy. Risk Aversion: the extent to which an individual is willing to pay to reduce variation in losses or income due to random events. Risk Communication: in genetics, a process in which a genetic counselor or other medical professional interprets genetic test results and advises patients of the consequences for them and their offspring. Risk Factor: quality that makes a person more susceptible to a specific disease. Risk Pooling: the practice of bringing several risks together for insurance purposes in order to balance the consequences of the realization of each individual risk. Risk Rating: technique for adjusting insurance premiums according to the relative risk insured. Risk Selection: the practice of singling out or disaggregating a particular risk from a pool of insured risks. RNA (Ribonucleic Acid): a chemical found in the nucleus and cytoplasm of cells; it plays an important role in protein synthesis and other chemical activities of the cell. The structure of RNA is similar to that of DNA. There are several classes of RNA molecules, including messenger RNA, transfer RNA, ribosomal RNA, and other small RNAs, each serving a different purpose. Roentgen (R): an internationally accepted unit of radiation quantity; it is the quantity of “X-ray or gamma irradiation such that the associated corpuscular emission per 0.001293 g or air produces, in air, ions carrying 1 esu of quantity of electricity of either sign”. X-rays originate outside the nucleus. Runt Disease: a condition of dwarfing that follows the injection of mature allogeneic immunologically competent cells into immunologically immature recipients. It is characterized by failure to thrive, lymph node atrophy, hepatomegaly and splenomegaly, anemia, and diarrhea.Read More

    A    B    C    D    E    F    G    H    I    J    K    L    M    N    O    P    Q    R    S    T    U    V    W    X    Y    Z     Salary: (prospective) remuneration which is fixed per period of time and does not vary either with the number of individuals served or with the number of services rendered. Sample Size: the specific size of the group or groups being studied. Generally, the larger the sample size, the more reliable the study results, and the more likely it is that the results can be applied to larger groups of people. Note that within the InfoBase a survey sample size (N) refers to the number of people included in a particular survey. Whereas Sample Size (n) for a particular data row refers to the number of people within that age/sex group that responded to the survey. Sampling: the process of selecting a number of subjects from all the subjects in a particular group or “universe”. Conclusions based on sample results may be attributed only to the population sampled. Any extrapolation to a larger or different population is a judgment or a guess and is not part of statistical inference. Sanger Sequencing: a widely used method of determining the order of bases in DNA. See also — sequencing, shotgun sequencing. Satellite: a chromosomal segment that branches off from the rest of the chromosome but is still connected by a thin filament or stalk. Scaffold: in genomic mapping, a series of contigs that are in the right order but not necessarily connected in one continuous stretch of sequence. Scheduled Toileting: assistance to toilet or use of bedpan or urinal offered on a fixed schedule, for example, every 2-4 hours. Scoping: scoping refers to the process of identifying the potential health impacts of a policy, program or project before they are quantified, as in a rapid HIA. It may include reviewing the relevant literature and evidence base and collecting the views of key stakeholders (those with expert knowledge of the project, those involved and those potentially affected) followed by the tabulation of the potential health impacts (Parry and Stevens, 2001). Screening: examination of usually symptom-free individuals to detect those with signs of a given disease. In relation to HIA, screening usually refers to an initial step being taken in order to determine whether a policy, program or project should be subject to a HIA. The criteria used for this process may include, for example, the size and cost of the activity in question, the extent of any obvious or immediate health effects or the perceived extent of longer term effects. A new road transport policy, for example, might meet these criteria in view of its potentially high financial cost, the possibility of immediate health effects in terms of road traffic accidents and likely longer term effects in terms of air quality. Screen-Positive Rate: percentage of the population with a positive screening test result. This includes true positives and false positives. Scrotal Abscess: bacterial infection of the scrotum, causing swelling and pain. Search Portal: the Search Portal is a web site that enables users to search the Central Repository which contains the trial registration data sets provided by Contributing Registers. The Search Portal is not a clinical trials register. Secondary Health Care: specialized ambulatory medical services and commonplace hospital care (outpatient and inpatient services). Access is often via referral from primary health care services. Secondary Infertility: infertility in a couple that has previously conceived at least once. Segregation: the normal biological process whereby the two pieces of a chromosome pair are separated during meiosis and randomly distributed to the germ cells. Semashko System: a uniform model of organizing health services introduced in CEE/CIS countries after the Second World War, and abolished in the early 1990s. Financing of health services is entirely through the state budget, with publicly owned health care facilities and publicly provided services. Different levels of state administration—central, regional, and local—were responsible for planning, allocation of resources and managing capital expenditures. Semi-Structured Interviews: interviews that combine closed-ended and open-ended questions that facilitate the description and explanation of various phenomena. Sensitivity: the proportion of truly diseased persons who are classified as diseased by the test. The sensitivity of a test is therefore the probability of a test being positive when the disease is present. The sensitivity of test may also be called the true positive rate. Sensitivity is the proportion of truly diseased individuals in the screened population who are identified as diseased by the screening test. Sensitize: the process of increasing the specific reactivity of a subject or cell to an agent. Commonly used to designate the process of increasing reactivity caused by specific antibodies or immune cells. Sepsis: presence of pathogenic organisms or their toxins in the blood. Sepsis of the genitourinary tract is referred to as urosepsis. Sequence: see — base sequence. Sequence Assembly: a process whereby the order of multiple sequenced DNA fragments is determined. Sequence Tagged Site (STS): short (200 to 500 base pairs) DNA sequence that has a single occurrence in the human genome and whose location and base sequence are known. Detectable by polymerase chain reaction, STSs are useful for localizing and orienting the mapping and sequence data reported from many different laboratories and serve as landmarks on the developing physical map of the human genome. Expressed sequence tags (ESTs) are STSs derived from cDNAs. Sequencing: determination of the order of nucleotides (base sequences) in a DNA or RNA molecule or the order of amino acids in a protein. Sequencing Technology: the instrumentation and procedures used to determine the order of nucleotides in DNA. Serial Monogamy: situation in which a person has a series of consecutive sexual relations of various durations, such that he or she has multiple partners over time, but never more than one partner at any single point in time. Service User Involvement: involving those who use services in their planning and organization by, for example, inviting them to give feedback on the quality of services and ease of access to them or by having service user representatives on the steering groups which monitor service provision and plan future developments. Sex: refers to the biological characteristics which define humans as female or male. [These sets of biological characteristics are not mutually exclusive as there are individuals who possess both, but these characteristics tend to differentiate humans as males and females. In general use in many languages, the term sex is often used to mean “sexual activity”, but for technical purposes in the context of sexuality and sexual health discussions, the above definition is preferred.] Sex Chromosome: the X or Y chromosome in human beings that determines the sex of an individual. Females have two X chromosomes in diploid cells; males have an X and a Y chromosome. The sex chromosomes comprise the 23rd chromosome pair in a karyotype. See also — autosome. Sex-Linked: traits or diseases associated with the X or Y chromosome; generally seen in males. See also — gene, mutation, sex chromosome. Sexual Health: it is a state of physical, emotional, mental and social well-being related to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled. Sexuality: it is a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction. Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviors, practices, roles and relationships. While sexuality can include all of these dimensions, not all of them are always experienced or expressed. Sexuality is influenced by the interaction of biological, psychological, social, economic, political, cultural, ethical, legal, historical and religious and spiritual factors. Sexually Transmitted Disease (STD): a disease that can be transmitted from one individual to another through sexual contact. Sexually Transmitted Infection (STI): a virus (such as HIV) or bacteria that can be transmitted from one individual to another through sexual contact. Sexual Rights: sexual rights embrace human rights that are already recognized in national laws, international human rights documents and other consensus documents. These include the right of all persons, free of coercion, discrimination and violence, to: the highest attainable standard of health in relation to sexuality, including access to sexual and reproductive health care services; seek, receive and impart information in relation to sexuality; sexuality education; respect for bodily integrity; choice of partner; decide to be sexually active or not; consensual sexual relations; consensual marriage; decide whether or not, and when to have children; and pursue a satisfying, safe and pleasurable sexual life. The responsible exercise of human rights requires that all persons respect the rights of others. Sexual Violence: any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances, or acts to traffic women’s sexuality, using coercion, threats of harm or physical force, by any person regardless of relationship to the victim, in any setting, including but not limited to home and work. Sharp Curettage: a procedure for emptying the uterus that involves scraping the uterine lining with a metal curette (also known as dilatation and curettage, or D&C). Shotgun Method: sequencing method that involves randomly sequenced cloned pieces of the genome, with no foreknowledge of where the piece originally came from. This can be contrasted with “directed” strategies, in which pieces of DNA from known chromosomal locations are sequenced. Because there are advantages to both strategies, researchers use both random (or shotgun) and directed strategies in combination to sequence the human genome. See also — library, genomic library. Shwartzman Reaction: a local non-immunologic inflammatory reaction with hemorrhage and necrosis produced by the injection of a bacterial endotoxin. Sickness Fund: third-party payer in social health insurance system, covering the community as a whole or sections of the population. Sievert (SU): the unit of dose equivalent in the SI system (1 Sv = 100 rem). Significance Level: a level of significance termed the alpha value is determined before the study has begun. The alpha value is the likelihood that a difference as large or larger that occurred between the study groups could be determined by chance alone. The alpha level is established by those designing the study and becomes the level of statistical significance. The most typical alpha level is 0.05. Signs: abnormalities indicative of disease identified by health care provider on examination of the patient. Simple Random Sample: a simple random sample (or single stage random) is an example of a probability sample. It is the ideal sampling frame for a survey because each eligible individual in the population has a known and non-zero chance of being included in the sample. However, this sampling frame is very expensive and often not logistically feasible. As a result, most surveys employ some form of cluster sampling. Sin Tax: tax for (luxury) goods with adverse effects on health such as alcohol, tobacco, etc. Single Gene Disorder: hereditary disorder caused by a mutant allele of a single gene (e.g., Duchenne muscular dystrophy, retinoblastoma, sickle cell disease). See also — polygenic disorders. Single Nucleotide Polymorphism (SNP): DNA sequence variations that occur when a single nucleotide (A, T, C, or G) in the genome sequence is altered. See also — mutation, polymorphism, single-gene disorder. Single Patient Clinical Trials: these are indicated only in specific situations. They are generally used to evaluate rare diseases when other types of trials are inappropriate or when only a small percentage of patients respond to a specific treatment. Single patient clinical trials are useful to determine the response of a particular patient is due to placebo or if an adverse reaction is related to a specific medication. The disease should be chronic and the disease severity must be stable during the clinical trial duration. Small for Gestational Age: infant with a birth weight at the lower extreme of the normal birth weight distribution, commonly defined as a birth weight below the 10th percentile for gestational age. Snowball Sample: a non-probability sampling technique that involves obtaining subjects through chain referrals from friends, family, or acquaintances. Sphincter: muscular structure that opens and closes to allow bladder to store or empty urine. Social Care: services related to long-term inpatient care plus community care services, such as day care centers and social services for the chronically ill, the elderly and other groups with special needs such as the mentally ill, mentally handicapped and the physically handicapped. Social Group: any set of persons within society that differs from other sets due to demographic, economic or social characteristics such as age, sex, education level, race religion, income level, lifestyle, beliefs, etc. Social Health Insurance: social health insurance is an insurance program which meets at least one of the following three conditions: participation in the program is compulsory either by law or by the conditions of employment; the program is operated on behalf of a group and restricted to group members; or an employer makes a contribution to the program on behalf of an employee. Social Impact Assessment: social impact assessment is “the process of assessing or estimating, in advance, the social consequences that are likely to follow from specific policy actions or project development, particularly in the context of appropriate national, state or provisional policy legislation” (Vanclay and Bronstein, 1995). It is based on the assumption that the way in which the environment is structured can have a profound effect on people’s ability to interact socially with other people and to develop networks of support. For example, a major road cutting across a residential area can have the effect of dividing a community with implications for social cohesion (Hendley et al., 1998). Social Safety Net: basic arrangement to ensure that any person in a society can obtain financial and material help from the state to avoid absolute poverty and ensure survival. Social Security: the provision of social protection against a number of risks, such as incapacity to work resulting from disease or disability, unemployment, old age, or family maintenance. Somatic Cell: any cell in the body except gametes and their precursors. See also — gamete. Somatic Cell Gene Therapy: incorporating new genetic material into cells for therapeutic purposes. The new genetic material cannot be passed to offspring. See also — gene therapy. Somatic Cell Genetic Mutation: a change in the genetic structure that is neither inherited nor passed to offspring. Also called acquired mutations. See also germ line genetic mutation. Southern Blot: a technique used to detect specific DNA sequences by separating restriction enzyme digested DNA fragments on an electrophoresis gel, transferring (blotting) these fragments from the gel onto a membrane or nitrocellulose filter, followed by hybridization with a labeled probe to a specific DNA sequence. Transfer by absorption of DNA fragments separated in electrophoretic gels to membrane filters for detection of specific base sequences by radio-labeled complementary probes. Southern Blot Analysis: a molecular biology technique in which DNA is transferred to and fixed on a nylon or nitrocellulose membrane and studied with DNA probes that can then detect, for example, the presence of an oncogene. Specialist: a medical doctor who completed special post-graduate training and thereafter was licensed for expert consulting in a specific area of medicine. Specialty: a branch of medicine such as obstetrics and gynecology, orthopedics, pediatrics, psychiatry (which requires specialist training). Specificity: specificity is the proportion of truly nondiseased individuals who are so identified by the screening test. The proportion of a population of disease-free individuals who are classified as undiseased by a test. In contrast to the sensitivity of a test, the specificity of a test is the probability that a test being negative when the disease is absent. The cutoff point of a test for normality influences the specificity. Specific Fertility Rate in Women 15-19 Years of Age: ratio between the number of live births born to mothers 15 to 19 years of age during a given year and the mid-year female population 15 to 19 years of age, for a given country, territory, or geographic area, during a specified period, usually multiplied by 1,000. Spectral Karyotype (SKY): a molecular cytogenetic method in which all of the chromosomes in a metaphase spread are visualized in different colors (multicolor FISH). A graphic of all an organism’s chromosomes, each labeled with a different color. Useful for identifying chromosomal abnormalities. See also — chromosome. Spermatozoa: mature male germ cells (gametes). Splice Site: location in the DNA sequence where RNA removes the non-coding areas to form a continuous gene transcript for translation into a protein. Splice Site Mutation: nucleotide substitutions that occur in the sequence adjacent to intro-exon boundaries of genes. Splicing: the process by which introns are removed from heteronuclear RNA and the exons are joined together to maintain the open reading frame of the mRNA. Sponsor: an individual, company, institution, or organization which takes responsibility for the initiation, management, and/or financing of a clinical trial. (from ICH E6). Sponsor-Investigator: an individual who both initiates and conducts, alone or with others, a clinical trial, and under whose immediate direction the investigational product is administered to, dispensed to, or used by a subject (from ICH E6). Spontaneous Abortion: abortion that was not artificially induced; miscarriage. Unprovoked termination of pregnancy. Sporadic Cancer: cancer that occurs randomly and is not inherited from parents. Caused by DNA changes in one cell that grows and divides, spreading throughout the body. See also — hereditary cancer. Stakeholder: any party to a transaction which has particular interests in its outcome. Groups that have an interest in the organization and delivery of health care, and who either conduct, sponsor, or are consumers of health care research, such as patients, payers, health care practitioners. Standard Deviation: a measure of dispersion or variation. The mean tells where the values for a group are centered and the standard deviation is a summary of how widely dispersed the values are around this centre. Standard Error: the standard deviation of an estimate. It is used to calculate confidence intervals for the estimates. Standard of Care: professionally developed detailed written statement used to guide procedures. Standard Deviation: a measure of the variability within each group. If there is a normal (bell-shaped curve) distribution, approximately 95% of the values are within two standard deviations on both sides of the average. Standard Sampling (Proportionate): a stratified sampling technique is the process by which the population is divided into sub-groups. Sampling will then be conducted in each sub-group. Sub-groups are chosen because evidence is available that they are related to an outcome of interest (i.e. population coverage, health status, ethnicity, etc.). The strata chosen will vary by survey or country to reflect local needs. Standard Vocabulary: a set of terms covering a domain of knowledge (e.g., medicine) that can be used as a shared way to describe that domain of knowledge. The terms may be related to each other in meaningful ways (e.g., atenolol is an anti-hypertensive drug). Standardized Mortality Ratio / Rate (SMR): The number of deaths in a given year as a percentage of those expected (expected = standard mortality of the reference period, adjusted for age and sex). Statistical Significance: the degree of likelihood that a research finding (result) is due to a cause other than chance, or the affect of sampling bias (i.e. the finding is based on a randomly selected sample). Stratification: the division of a population into mutually exclusive groups, or strata. Steering Group: a group of people brought together to oversee a piece of work such as a HIA. Typically, a steering group might be made up of up of representatives of relevant professional groups, key statutory agencies and the local community and its terms of reference might include: -overseeing development and progress of the work; -agreeing the methodological framework and timescales; -providing an input of local knowledge and information; -acting as a bridge between partners; -facilitating the implementation of the assessment’s recommendations; and -helping to assimilate and disseminate the emerging lessons. (Barnes, 2000). Stem Cell: undifferentiated, primitive cells in the bone marrow that have the ability both to multiply and to differentiate into specific blood cells. Sterilization: the complete destruction of all microorganisms, including spores. It can be achieved by dry heat or steam under pressure. Stewardship: a function of a government responsible for the welfare of the population, and concerned with the trust and legitimacy with which its activities are viewed by the citizenry. It requires vision, intelligence and influence, primarily by the health ministry, which must oversee and guide the working and the development of the nation’s health actions on the government’s behalf. As used in the World Health Report 2000 components of stewardship are: Health policy formulation: defining the vision and direction for the health system; Regulation: setting fair rules of the game with a level playing field; Intelligence: assessing performance and sharing information. Stewardship is the overarching function that determines the success or failure of all other functions of the health system. It places the responsibility back on government and calls for the strengthening of ministries of health. However, it does not call for necessarily a hierarchical and controlling role of government but more of that of overseeing and steering of the health system. It calls for vision, setting of regulations and implementing them, and the capacity to assess and monitor performance over time. A strong stewardship should in fact permit a more efficient use of the private sector to meet the needs of the health system. Stillbirth: the complete expulsion or extraction from its mother of a product of conception, of at least 22 weeks gestation or 500 grams, which after separation did not show any signs of life. Strategic Environmental Assessment (SEA): SEA has been defined as “the environmental assessment of a strategic action: a policy, plan or program (Therivel and Partidario, 1996). SEA developed out of the recognition that the environmental impact assessment of specific projects, whilst an extremely valuable device, does not allow sufficient scope for the examination of the effect of a combination of projects. A commitment to sustainable development requires that a strategic approach to the environment be adopted. (Wood, 1995). Strategy: the term strategy usually refers to a series of broad lines of action intended to achieve a set of goals and targets set out within a policy or program (Ritsatakis et al., 2000). For example, within the themes of Single Regeneration Budget or New Deal for Communities initiatives it is usual to set out the strategic direction needed to be taken in order to achieve the goals and objectives of each theme, such as reducing unemployment, improving health or raising educational attainment. Stress Urinary Incontinence (SUI): involuntary loss of urine from the urethra due to effort or physical exertion; for example, during coughing and laughing. Structural Genomics: the effort to determine the 3D structures of large numbers of proteins using both experimental techniques and computer simulation. Structured Interviews: interviews with closed-ended, codable responses. Study (Research) Designs: a formalized and usually systematic plan to collect data that will inform a hypothesis. Subjects: the participants of research studies. Subsidy: a payment made by the government with the objective of reducing the market price of a particular product, or of maintaining the income of the producer. Substitution: in genetics, a type of mutation due to replacement of one nucleotide in a DNA sequence by another nucleotide or replacement of one amino acid in a protein by another amino acid. See also — mutation. Substitution Effect: a proportion of the change in demand as a consequence of change in relative prices. Supply: the amount of a product made available for sale at a particular price. Supplier-Induced Demand: a phenomenon whereby a health care provider, usually a physician, influences the level of a person’s demand for health care services. Suppository: medication adapted for introduction into the rectum, vagina, or urethra. Suppository bases are solid at room temperature but melt or dissolve at body temperature. Suppression: a mechanism for producing a specific state of immunologic unresponsiveness by the induction of suppressor T cells. This type of unresponsiveness is passively transferable by suppressor T cells or their soluble products. Suppressor Gene: a gene that can suppress the action of another gene. Suppressor T Cells: represent an important set of feed-back controls, centered around sensitized T lymphocytes, through which inhibitory populations of these T cells suppress the production of sensitized lymphocytes and antibody-forming cells. Suprapubic: above the pubic bone. Suprapubic Catheterization: a surgical procedure involving insertion of a tube or similar instrument through the anterior abdominal wall above the Symphysis pubis into the bladder to permit urine drainage from the bladder. Surveillance: ongoing collection of information on developments within a sector. The routine collection and analysis of data that may be used to take appropriate action. In the context of unsafe abortion, surveillance could include collecting data on maternal deaths due to complications of abortion, and caseloads within services for treatment of abortion complications. Continuous analysis, interpretation and feedback of systematically collected data, generally using methods distinguished by their practicality, uniformity, and rapidity rather than by accuracy or completeness. By observing trends in time, place and persons, changes can be observed or anticipated and appropriate action including investigative or control measures, can be taken. Sources of data may relate directly to disease or to factors influencing disease. Survey: the process of collecting information by canvassing a chosen group. Surveys Used in Analysis: main survey in analysis — adjustment of country-reported survey data to produce comparable estimates requires a survey that: is recent; is nationally representative or has broad country coverage; uses one or more of the following definitions: current smoker, current daily smoker, current smoker of cigarettes, provides age-specific prevalence rates. Surveys meeting these criteria are preferred for analysis. Where multiple surveys of the same standard exist, surveys are weighted by sample size for inclusion in the analysis. Additional surveys — sometimes a country has several surveys that can be used in the analysis. Surveys Used in Analysis — BMI: surveys chosen are the ones with — the best coverage, age specific rates for the overweight/obesity prevalence value, and/or mean BMI. Sustainability: the capacity to meet the needs of the present without compromising the ability to meet future needs. Sustainability and Sustainable Development: the plethora of regeneration and neighborhood renewal initiatives under way are all intended to provide sustainable changes — that is to say, benefits for the future as well as the present. A commonly used definition of sustainable development is “development which meets the needs of present generation without compromising the ability of future generations to meet their own needs” (World Commission on Environment and Development, 1987). Swab: a rolled piece of cotton or gauze attached to the end of a stick or clamp, used for applying medications or collecting biological samples from a surface. Sympathetic Nerves: fight or flight component of the autonomic nervous system, which originates in the thoracic and lumbar region of the spinal cord. Stimulation of the sympathetic nervous system that innervates the bladder will promote bladder filling by relaxing the bladder (detrusor) muscle and contraction the internal proximal portion of the urethral sphincter to prevent urine from entering the urethra. Sympathetic fibers that innervate the intestine will cause reduced motility and reduced secretions. Symptom: abnormal phenomenon experienced by patient and indicative of disease. Syndrome: the group or recognizable pattern of symptoms or abnormalities that indicate a particular trait or disease. Syngamy: the final stage of the fertilization process in which the haploid chromosome sets from the male and female gametes come together following breakdown of the pronuclear membranes to form the zygote. Syngeneic (Isogeneic): genetically identical members of the same species. Pertaining to genetically identical or nearly identical animals, such as identical twins of highly inbred animals. Syngraft (Isograft): a graft derived from a syngeneic donor. Synteny: genes occurring in the same order on chromosomes of different species. See also linkage, conserved sequence. System: set of elements interconnected in a complex whole fulfilling a function. Range of values an index may take depending on the actual values of each of the parameters integrated in it. For the purpose of the World Health Report 2000, indices have been calculated based on best available figures. Where data were missing, estimates have been used, in accordance with classical estimation techniques. The resulting index is subject to revision once actual data become available. Consequently, present values may have to be adjusted within the range indicated by the uncertainty interval. Systematic Detection: all eligible subjects are screened for the presence of the condition being investigated. Systematic Interventions: interventions involving the use of a standardized protocol based on best practice guidelines. Systematic Sampling: systematic sampling incorporates a systematic method to a random sample (for example, the randomly selected number is five; therefore every fifth household would be sampled on selected streets).Read More

    A    B    C    D    E    F    G    H    I    J    K    L    M    N    O    P    Q    R    S    T    U    V    W    X    Y    Z     Tandem Repeat Sequences: multiple copies of the same base sequence on a chromosome; used as markers in physical mapping. See also — physical map. Target Income: a specified income which a provider is assumed to aim for. Targeted Mutagenesis: deliberate change in the genetic structure directed at a specific site on the chromosome. Used in research to determine the targeted region’s function. See also — mutation, polymorphism. Technology Transfer: the process of transferring scientific findings from research laboratories to the commercial sector. Telomerase: the enzyme that directs the replication of telomeres. Telomere: the end of a chromosome. This specialized structure is involved in the replication and stability of linear DNA molecules. See also — DNA replication. Temporal Sample: a non-probability sampling technique that involves recruiting subjects over a specified period of time. Teratogenic: substances such as chemicals or radiation that cause abnormal development of an embryo. See also — mutatgen. Teratogenicity: the ability to cause defects in a developing fetus—a potential side-effect of many drugs. Term: from 37 completed weeks to less than 42 completed weeks (259 to 293 days) of gestation. Term Pregnancy: from 37 to 42 completed weeks of gestation since the first day of the last menstrual period. Tertiary Health Care: refers to medical and related services of high complexity and usually high cost. Third-Party Payer: Any organization, public or private, that pays or insures health care expenses for beneficiaries at the time at which they are patients. Threshold Traits: traits that are not manifested until a certain threshold of liability are exceeded. Thrombophilia: a tendency to the occurrence of thrombosis, the presence or development of an aggregation of blood factors frequently causing vascular obstruction. Thymine (T): a nitrogenous base, one member of the base pair AT (adenine-thymine). See also — base pair, nucleotide. Time-Motion Studies: studies that involve highly-structured observation of activity patterns; researchers closely follow subjects while documenting each discreet activity. T Lymphocyte (T Cells): lymphocytes that have matured and differentiated under thymic influence, termed thymus-dependent lymphocytes. These cells are involved primarily in the mediation of cellular immunity as well as in tissue and organ graft rejection. Tolerance: antigen-specific turnoff or unresponsiveness of B or T cells; usually produced as a result of contact with that antigen under non-immunizing conditions. Toolkit: the term toolkit is generally held to mean an information resource including, for example, routinely available data which may be required for quantifying potential health impacts, a compilation of literature on health determinants or a template for organizing a HIA or parts of the HIA process such as a workshop for key stakeholders. Topical: when a medication (e.g., cream, ointment) is applied to a specific site or location, usually on the skin or external mucosa. Topoisomerase: an enzyme that controls conformational changes in DNA and aids in orderly progression of DNA replication, gene transcription, and separation of daughter chromosomes by cell division. Total Expenditure on Health: total (or national) expenditure on health is based on the following identity and functional boundaries of medical care: Personal health care services + Medical goods dispensed to outpatients = Total personal expenditure on health + Services of prevention and public health + Health administration and health insurance = Total current expenditure on health + Investment into medical facilities = Total expenditure on health. Total Fertility Rate: the expected average number of children that would be born to a woman in her lifetime, if she were to pass through her childbearing years experiencing the age-specific fertility rates prevailing in a given year/period, for a given country, territory, or geographic area. Totipotent: able to differentiate alone any line; the capacity of a cell or group of cells to produce all of the products of conception — the extra-embryonic membrane and tissue, the embryo, and subsequently the fetus. Toxicogenomics: the study of how genomes respond to environmental stressors or toxicants. Combines genome-wide mRNA expression profiling with protein expression patterns using bioinformatics to understand the role of gene-environment interactions in disease and dysfunction. Tp53 Gene: a tumor suppressor gene that encodes a nuclear phosphoprotein that arrests cells from entering the S-phase of the cell cycle. Located on chromosome 17(pl13), Tp53 is postulated to contribute to diverse tumorigenesis. Transaction Costs: the costs which are incurred by the process of negotiating between buyer (= third-party payer/ purchaser) and seller (= provider). Transcervical procedure: any procedure that requires passage of an instrument or device through the cervix into the uterus (e.g. IUD insertion, MVA, endometrial biopsy). Transcription: the process of RNA synthesis from a DNA template that is directed by RNA polymerase. The synthesis of an RNA copy from a sequence of DNA (a gene); the first step in gene expression. The process of converting the DNA code into a complementary mRNA segment. Transfer of genetic code information from one kind of nucleic acid to another. See also — translation. Transcription Factor: a protein that binds to regulatory regions and helps control gene expression. Transcriptome: the full complement of activated genes, mRNAs, or transcripts in a particular tissue at a particular time. Transfection: the introduction of foreign DNA into a host cell. See also — cloning vector, gene therapy. Transfer Factor: a heat-liable, dialyzable extract of human lymphocytes (a lymphokine) that is capable of conferring specific antigen reactivity to the donor. Transfer RNA (tRNA): a class of RNA having structures with triplet nucleotide sequences that are complementary to the triplet nucleotide coding sequences of mRNA. The role of tRNAs in protein synthesis is to bond with amino acids and transfer them to the ribosomes, where proteins are assembled according to the genetic code carried by mRNA. Transformation: a process by which the genetic material carried by an individual cell is altered by incorporation of exogenous DNA into its genome. Transgenic: an experimentally produced organism in which DNA has been artificially introduced and incorporated into the organism’s germ line. See also — cell, DNA, gene, nucleus, germ line. Transient (acute) Urinary Incontinence: temporary episodes of urinary incontinence that is reversible once the cause or causes of the episode(s) are identified and treated. Transinstitutionalization: the transfer of patients from one type of institutional setting to another, usually from long-stay psychiatric wards to some form of nursing home. Transitional Economy: term used to describe economies which used to be run on command lines, but which are now giving an increased role to market forces. Translation: the process in which the genetic code carried by mRNA directs the synthesis of proteins from amino acids. The process by which specific amino acids are incorporated into a protein as dictated by the sequence of the mRNA template. See also — transcription. Translocation: a mutation in which a large segment of one chromosome breaks off and attaches to another chromosome. Non-homologous recombination. See also — mutation. Transmission: passage of disease-causing microorganisms from one person to another. Transposable Element: a class of DNA sequences that can move from one chromosomal site to another. Trial Phase: biomedical clinical trials of experimental drug, treatment, device or behavioral intervention may proceed through four phases (from NIH): Clinical trials test a new biomedical intervention in a small group of people (e.g., 20-80) for the first time to evaluate safety (e.g., to determine a safe dosage range and to identify side effects). Clinical trials study the biomedical or behavioral intervention in a larger group of people (several hundred) to determine efficacy and to further evaluate its safety. Studies investigate the efficacy of the biomedical or behavioral intervention in large groups of human subjects (from several hundred to several thousand) by comparing the intervention to other standard or experimental interventions as well as to monitor adverse effects, and to collect information that will allow the intervention to be used safely. Studies are conducted after the intervention has been marketed. These studies are designed to monitor effectiveness of the approved intervention in the general population and to collect information about any adverse effects associated with widespread use. Trial Registration Data Set: the minimum amount of trial information that must appear in a register in order for a given trial to be considered fully registered. Trial Results Database: a trial results database provides the results of completed studies, and should be accompanied by methodological details to place the results in context. The results may or may not have been peer reviewed. A results database may be separate from a trial register. Thus, a trial may be registered in one register and have its results reported in a different results database. Trial Site: the location(s) where trial-related activities are actually conducted. (from ICH E6). Trigone: triangle-shaped muscle that extends up from the urethra to the posterior bladder wall and to the urethral openings. The trigone is the most sensitive area of the bladder muscle because of its high concentration of nerves. Triplet Repeat Expansion: (see Hereditary Unstable DNA). Trinucleotide Repeat Analysis (Repeats): unstable DNA sequences found in several human genes. Normally the triplets are repeated in tandem 5-50 times. When the number rises above the normal range, mutant disease syndromes appear. Trisomy: possessing three copies of a particular chromosome instead of the normal two copies. See also — cell, gene, gene expression, chromosome. Trophectoderm: peripheral cells of the balstocyst that form the membrane sac surrounding the embryo. Tuberculosis Incidence: the number of new cases registered from tuberculosis in a specific year, expressed per 100,000 population, for a given country, territory, or geographic area. Tumor Angiogenesis Factor: represents the induction of the growth of blood vessels caused by this stimulant released by tumor cells. The growth of a tumor appears to parallel the development of new blood vessels. Tumor Necrosis Factor (TNF): a family of cytokines produced by activated monocytes and lymphocytes that can induce hemorrhagic necrosis and regression of tumors. Tumor Suppressor Gene: a gene that suppresses cellular growth and proliferation. Therefore, when its protein products are absent, it contributes to tumor development or progression. Also known as antioncogenes, these normal cellular genes encode proteins that are thought to normally regulate growth in a negative fashion. Two-tail Test: a test to determine any difference between the variable; for example, if either drug A or drug B is superior to the other. It is usually considered that in a two-tail test more trust can be placed in the statistically significant results than with a one-tail test. When in doubt, the two-tail test is preferred.Read More

    A    B    C    D    E    F    G    H    I    J    K    L    M    N    O    P    Q    R    S    T    U    V    W    X    Y    Z     UEMS: European Union of Medical Specialists. Under-5 Mortality, Estimated: the quotient between the number of deaths in children under 5 year of age in a given year and the number of live births in that year, for a given country, territory, or geographic area, expressed per 1,000 live births. Technical Note: Data correspond to mid-year estimated values, obtained by linear interpolation of the corresponding United Nations fertility medium-variant quinquennial population projections. Under-Registered Deaths: the difference between the number of estimated deaths, according to the corresponding period life tables, and the number of currently registered deaths, expressed as a percentage of the total estimated deaths at a given year, in a given country, territory, or geographic area. Under-The-Table Payments: informal, unofficial payments which are usually prohibited in order to obtain one’s wishes/ demands/ needs fulfilled in a timely manner/to a larger extent than by following the official rules and regulations. Unemployed Proportion of the Labor Force: the number of members of the total population or of a given sex of the economically active population, who are unemployed but are available to work and seeking employment. This includes members who have lost their jobs and those who have voluntarily left work, at a specific point in time, expressed as a percentage of the economically active population in total or by sex. An economically active individual is considered employed if he or she falls into one of the following categories: has in-currency or in-kind paid employment, is self-employed, works in a family business, or is not working temporarily for a particular reason. Technical Note: Unemployment rates represent mid-year estimated values, according to the International Labor Organization (ILO) estimates and definitions. The ILO definition of unemployment notwithstanding, reference periods, criteria for seeking work, and the treatment of people temporarily laid off and those seeking work for the first time vary across countries. Informal sector employment is difficult to quantify in the absence of regulation for registering and tracking informal activities. Uninformative: the term used to describe the situation when the two homologous chromosomes from an individual cannot be distinguished from one another at a given locus; homozygous is an alternative term. Uniparental Disomy: inheritance of two copies of part or all of a chromosome from one parent and no copy from the other parent. Uniparental Heterodisomy: inheritance of two homologous chromosomes from one parent. Uniparental Isodisomy: inheritance of two identical chromosomes from one parent. Unique Identifier (ID): a unique identifier is assigned by a register to each registered trial. This identifier is unique to a specific register. If a trial is registered on more than one register they may have more than one unique identifier. Unique Trial: a trial is considered a single, unique trial if it is conducted according to a single document (the protocol) that describes the objective(s), design, methodology, statistical considerations, and organization of a trial. Univariate Analysis: analyses may be Univariate or multivariate as they examine one or more variables at a time, respectively. Universal Health Insurance: a national plan providing health insurance or services to all citizens, or to all residents. Unplanned Pregnancy: a pregnancy that is not expected. Unsafe Abortion: a procedure for terminating unwanted pregnancy either by persons lacking the necessary skills or in an environment lacking the minimal medical standards or both. Unwanted Pregnancy: a pregnancy that for a variety of often overlapping reasons is unexpected and undesired. Reasons a pregnancy may be unwanted include, but are not limited to, social/cultural, environmental, economic, and/or health factors. Upper Genital Tract Infection: includes infection of endometrium, fallopian tubes, ovaries and surrounding tissues. Uracil: a nitrogenous base normally found in RNA but not DNA; uracil is capable of forming a base pair with adenine. See also — base pair, nucleotide. Ureters: two very thin muscular tubes about 8 or 9 inches long that transport urine from the kidneys to the bladder. Urethra: narrow tube through which urine flows from the bladder to the outside of the body; the opening of the urethra is at the end of the penis in men and just above the vaginal opening in women. Urethral Dilatation: procedure in which a metal rod, called a dilator, is passed through the urethra for purpose of opening a urethral stricture. Urethral Obstruction: blockage of the urethra causing difficulty with urination, usually caused by a stricture or, in men, by an enlarged prostate. Urethral Pressure Profilometry (UPP): test used to measure pressures in the urethra. Urethral Sphincter Mechanism: segment of the urethra that influences storage and emptying of urine in the bladder. It controls bladder voiding by relaxing, which opens the outlet from the bladder, allowing urine to flow from the bladder to the outside of the body. A deficiency of the urethral sphincter mechanism may allow leakage of urine in the absence of a detrusor contraction. Urethral Stricture: narrowing of the urethra. Urethrocele: prolapse or falling down of the urethra into the vaginal wall. Urge: sensation from the bladder producing the desire to void. Urge Incontinence: involuntary and accidental loss of urine when the person is aware of the need to get to the bathroom but is not able to hold the urine long enough to get there. Usually, it is accompanied by or immediately preceded by urgency. Urgency: strong, intense, and often sudden desire to void. Urgency, with or without urge incontinence, usually with frequency and nocturia, can be described as overactive bladder syndrome, urge syndrome, or urgency-frequency syndrome. Urinary Frequency: voiding more than eight times in a 24-hour period. Urinary Frequency Volume Chart: records the volumes voided as well as the time of each micturition, day and night, for at least 24 hours. Urinary Incontinence (UI): involuntary or accidental loss (leakage) of urine. Urinary Retention: inability to empty urine from the bladder, which can be caused by atonic bladder or obstruction of the urethra. Urinary System: Part of the body (kidneys, ureters, bladder, and urethra) that produces, stores, and eliminates urine. Urinary Tract: Passageway from the pelvis of the kidney to the urinary orifice through the ureters, bladder, and urethra. Urinary Tract Infection (UTI): infection in the urinary tract caused by the invasion of disease-causing micro-organisms that proceed to establish themselves, multiply, and produce various symptoms in their host. UTI in women is known as cystitis. In men, infection is usually associated with obstruction to the flow of urine, such as prostate gland enlargement. Urinate: to void or to pass urine. Urination: act of passing urine. Urine: waste products filtered from the blood and combined with excess water by the kidneys. Urine Culture: test to determine whether bacteria is present in the urine. The type of bacteria can be determined by the color and appearance of the colonies. The number of bacteria is determined by estimating the number of colonies per milliliter. Urodynamic Assessment: tests designed to duplicate as nearly as possible the symptoms of incontinence in the way that people actually experience them. These tests determine the anatomic and functional status of the urinary bladder and urethra. Uroflowmetry: urodynamic test that measures urine flow either visually, electronically, or with the use of a disposable flowmeter unit. Urosepsis: infection of the urinary tract that causes bacteria to enter the blood-stream, causing tissue destruction. User Charge: user charges are charges for goods or services that the user, or patient, is required to pay. Uterine Prolapse: uterus has dropped from its normal position, and the cervix is closer to or may protrude outside the vagina. Utilization: the number of health services used, often expressed per 1000 persons per month or year. UTRN (Universal Trial Reference Number): the UTRN is a number, obtained by the trial’s Sponsor, early in the history of the trial. The intention is that this number will then become part of the trial’s identity. Trial investigators will be encouraged to use the UTRN whenever they communicate information in relation to the trial, and specifically to document it in the trial protocol. The aim of the UTRN is to facilitate the unique identification of clinical trials submitted to the Central Repository and hence the Search Portal.Read More

    A    B    C    D    E    F    G    H    I    J    K    L    M    N    O    P    Q    R    S    T    U    V    W    X    Y    Z     Vaccination: injection or ingestion of an immunogenic antigen for the purpose of producing active immunity. Vaccine: a suspension of dead or living micro-organisms that is injected or ingested for the purpose of producing active immunity. Vagina: collapsible tube of smooth muscle with its opening located between the urethral orifice and the anal sphincter of women. Also known as the birth canal. Validity: the accuracy of research results based on the method(s) used to obtain them. Valsalva Maneuver: action of closing the airways and straining down on the abdominal muscles (such as when straining to have a bowel movement). Variable: any measurable entity that might constitute an aspect of a research study. Vector: a DNA vehicle that can be propagated in living cells (e.g., bacteria and yeast) into which foreign DNA can be inserted and propagated with the vector DNA. Examples of vectors include bacterial plasmids, cosmids, bacteriophages, and most recently, yeast artificial chromosomes. See — cloning vector. Vertical Transmission of Viruses: transmission from one generation to another. Can include transmission from one generation to the next through milk or through the placenta. Very Low Birth Weight: a birth weight of less than 1500 g. Virus: a non-cellular biological entity that can reproduce only within a host cell. Viruses consist of nucleic acid covered by protein; some animal viruses are also surrounded by membrane. Inside the infected cell, the virus uses the synthetic capability of the host to produce progeny virus. See also — cloning vector. Void: synonym for urination. Voiding or Bladder Diary (Record): record maintained by the patient or caregiver that is used to record the frequency, timing, amount of voiding, and/or other factors associated with the patient’s urinary incontinence. Also called an incontinence chart. Voiding Reflex: reflex in which the bladder indicates to the spinal cord that it is full of urine, and the spinal cord signals the bladder to contract and empty. Voluntary Health Insurance (VHI): Health insurance which is taken up and paid for at the discretion of individuals (whether directly or via their employers). Vulnerable Groups: while there is agreement that globalization has both positive and negative effects, it is less clear exactly how these negative effects exert their impact on people’s lives. Whether globalization is the cause of increased vulnerability or whether vulnerability is maintained by an inability to maximize the benefits of globalization is not clear. It is probable that both forces are at work. Thus vulnerable groups such as the elderly, the young, and the poor are already so marginalized that they cannot benefit from globalization, and are increasing in numbers as globalization increases the gap between rich and poor.Read More

    A    B    C    D    E    F    G    H    I    J    K    L    M    N    O    P    Q    R    S    T    U    V    W    X    Y    Z     Waiting List: the number of people awaiting admission to hospital as inpatients. Waiting Period: the period an insured or covered person has to wait before he or she qualifies for benefits. Waiting Time: the time which elapses between 1) the request by a general practitioner for an appointment and the attendance of the patient at the outpatients’ department, or 2) the date a patient’s name is put on an inpatients’ list and the date he is admitted. Washington Consensus: This is the set of 10 policies that the US government and the international financial institutions based in the US capital believed were necessary elements of “first stage policy reform” that all countries should adopt to increase economic growth. At its heart is an emphasis on the importance of macroeconomic stability and integration into the international economy – in other words a neo-liberal view of globalization. The framework included: Fiscal discipline – strict criteria for limiting budget deficits Public expenditure priorities – moving them away from subsidies and administration towards previously neglected fields with high economic returns Tax reform – broadening the tax base and cutting marginal tax rates Financial liberalization – interest rates should ideally be market-determined Exchange rates – should be managed to induce rapid growth in non-traditional exports Trade liberalization Increasing foreign direct investment (FDI) – by reducing barriers Privatization – state enterprises should be privatized Deregulation – abolition of regulations that impede the entry of new firms or restrict competition (except in the areas of safety, environment and finance) Secure intellectual property rights (IPR) – without excessive costs and available to the informal sector Reduced role for the state. These ideas proved very controversial, both inside and outside the Bretton Woods Institutions. However, they were implemented through conditionality under International Monetary Fund (IMF) and World Bank guidance. They are now being replaced by a post-Washington consensus. Weighted Sample: a sample that is not strictly proportional to the distribution of classes in the total population. A weighted sample has been adjusted to include larger proportions of some other parts of the total population, because those parts accorded greater “weight” would otherwise not have the sufficient numbers in the sample to lead to generalizable conclusions. Well-Being Impact Assessment: well-being impact assessment is difficult to distinguish from HIA although it could be argued that, instead of looking at all aspects of health, including medical factors, it concentrates primarily on aspects of quality of life and physical and mental well being. Western Blot: a technique, conceptually related to the Southern and Northern blot that is used to detect specific proteins. A technique used to identify and locate proteins based on their ability to bind to specific antibodies. See also — DNA, Northern blot, protein, RNA, Southern blotting. WHO Network of Collaborating Clinical Trial Registers (The Register Network): the Register Network is a forum for registers to exchange information and work together to establish best practice for clinical trial registration. Wild Type: the form of an organism that occurs most frequently in nature. The term used to describe the normal gene or gene product. In contrast, a gene that has had its DNA sequence altered is referred to as a mutant gene, and its resultant product is a mutant protein. A gene that encodes a proto-oncogene, for example, is a wild-type gene because it is unaltered. Willingness To Pay: how far a person or group is prepared to pay for particular goods or services. Workers Compensation: a mandatory insurance program covering the costs of medical treatment and disability due to work-related accidents and illness. Working Draft DNA Sequence: see — Draft DNA Sequence. Working Group: in contrast to a steering group, a working group convened for the purpose of carrying out usually consists of those charged with carrying out the work on a day to day basis. Typically it might include people with a range of complementary public health skills such as project management, epidemiology, statistical analysis and presentation, questionnaire design and community development (Barnes and MacArthur, 2000). Workshops: workshops involve bringing together a group of people for a specific purpose. In HIA this might include, for example, identifying key stakeholders’ health concerns in relation to the policy, program or project being addressed, identifying sources of current knowledge in relation to the evidence base or training staff in HIA techniques. Workshops are usually structured in some way with a mixture of presentations and “hands on” participative work. WPA: World Psychiatric Association.Read More