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Data: information collected to answer research questions.

Data Analysis: the process of answering research questions through the qualitative and quantitative manipulation of data.

Data Collectors: persons trained to collect data (or information).

Data Interchange Standard: a set of rules for sending information between machines. Includes agreement and standardization on the concepts exchanged (e.g., "primary sponsor"), and agreement and standardization on the structure of the actual message that is exchanged.

Data Warehouse: a collection of databases, data tables, and mechanisms to access the data on a single subject.

D Cell (Double Cell): lymphocytes that appear to have characteristics of both T and B cells.

Decentralization: changing relations within and between a variety of organizational structures/ bodies, resulting in the transfer of the authority to plan, make decisions or manage public functions from the national level to any organization or agency at the sub-national level.

Decision Making: the process of reviewing the findings and recommendations of a HIA and making choices about how they should be taken forward.

Decreased Bladder Compliance: failure to store urine in the bladder caused by the loss of bladder wall elasticity and of bladder accommodation. This condition may result from radiation cystitis or from inflammatory bladder conditions such as chemical cystitis, interstitial cystitis, and certain neurologic bladder disorders.

Decubitus Ulcer: area of local tissue necrosis (death or damage) that usually develops where soft tissues are compressed between bony prominences and any external surface for prolonged periods.

Deductible: cost-sharing in the form of a fixed amount which must be paid for a service or of total cost incurred over a defined period by a covered person before the third-party payer then covers all of or a percentage of the rest of the cost.

Defecation: act of emptying the bowels or having a bowel movement.

Defining Goal: the single most characteristic and specific reason for setting up a system, its raison d'être.

Dehydration: state that occurs when not enough fluid is present to fulfill the body's fluid needs.

Deinstitutionalization: the transfer of patients from institutional settings to community settings.

Delayed Hypersensitivity: a specific sensitive state characterized by a delay of many hours in initiation time and course of reaction. It is transferable with cell but not with serum.

Delegation: giving an authority the right to plan and implement decisions relating to particular activities without direct supervision by a higher authority.

Deletion: a mutation that is generated by removal of a sequence of DNA, with the regions on either side being joined together. A loss of part of the DNA from a chromosome; can lead to a disease or abnormality. See also -- chromosome, mutation.

Deletion Map: a description of a specific chromosome that uses defined mutations --specific deleted areas in the genome-- as 'biochemical signposts,' or markers for specific areas.

Dementia: general loss of short- and long-term memory and mental deterioration. It may affect emotions, abstract thinking, judgment, impulse control, and learning and can cause functional incontinence.

Demography: the quantitative and qualitative study of population dynamics.

Dendritic Cells: white blood cells found in the spleen and other lymphoid organs. Dendritic cells typically use thread-like tentacles to enmesh antigens, which they present to T cells.

Dentists Ratio: the number of dentists available per every 10,000 inhabitants in a population, at a given year, for a given country, territory, or geographic area.

Deoxyribonucleotide: see -- nucleotide.

Deoxyribose: a type of sugar that is one component of DNA (deoxyribonucleic acid).

Dependency Ratio: indicator used in population studies to measure the portion of the population which is economically dependent on active age group. It is calculated as the sum of 0-14 year olds and over 60 or 65 year olds, depending on the working age limit considered, divided by the number of people aged betwe15 and 59 or 64, respectively. For the purpose of the World Health Report, it is calculated as the sum of 0-14 year olds and over 65 year olds divided by the number of people aged betwe15 and 64.

Dependant: the spouse, children or other close relatives of a person covered by a health plan who are covered free of additional taxes, contributions or premiums.

Dependent Variable: the variable which the researcher wants to predict or explain.

Descriptive Data: data or information that describe "who", "what", "where", or "how many".

Desensitization: the procedure of rendering a sensitive individual insensitive to an antigen or hapten by treatment with that specific agent.

Design Effect: a specific form of bias attributable to intra-class correlation in CLUSTER SAMPLING. The design effect for a cluster design is the ratio of the prevalence for that design to the variance calculated from a simple random sample random sample of the same size.

Determinant Group: the part of the structure of an antigen molecule that is responsible for specific interaction with antibody molecules evoked by the same or a similar antigen.

Determinants of Health: determinants of health are factors which influence health status and determine health differentials or health inequalities. They are many and varied and include, for example, · natural, biological factors, such as age, gender and ethnicity; x behavior and lifestyles, such as smoking, alcohol consumption, diet and physical exercise; x the physical and social environment, including housing quality, the workplace and the wider urban and rural environment; and x access to health care. (Lalonde, 1974; Labonté 1993) All of these are closely interlinked and differentials in their distribution lead to health inequalities.

Detrusor: smooth muscle bladder wall that stretches to accommodate and store urine and contracts uniformly to expel of urine.

Detrusor Hyperactivity with Impaired Bladder Contractility (DHIC): condition characterized by involuntary detrusor contractions in which patients either are unable to empty their bladders completely or can empty their bladders completely only when straining, due to poor contractility of the detrusor.

Detrusor Overactivity: urodynamic observation characterized by involuntary detrusor contractions during bladder filling, which may be spontaneous or provoked.

Detrusor Overactivity Incontinence: incontinence due to an involuntary detrusor contraction.

Detrusor Sphincter Dyssynergia (DSD): inappropriate contraction of the urethral and/or periurethral striated sphincter concurrent with an involuntary contraction of the detrusor. Occasionally voiding may be prevented altogether.

Detrusor Underactivity: contraction of reduced strength and/or duration, resulting in prolonged bladder emptying and/or failure to achieve complete bladder emptying within a normal time span.

Devolution: Involves passing responsibility and a degree of independence to regional or local government, with or without financial responsibility (i.e. the ability to raise and spend revenues).

Diabetic Neuropathy: condition in which portions of the spinal cord and its nerves have degenerated as a result of diabetes.

Diagnosis-Related Group (DRG): a way of categorizing patients according to diagnosis and intensity of resources required, usually for the period of one hospital stay.

Diagnosis-Based Payment: refers to a mechanism whereby the provider or health care organization receives a fixed, pre-specified payment for each instance in which they treat an individual with a specified diagnosis.

Diagnostic Studies: exploratory studies; studies that help develop the context of a specific issue or problem.

Differentiation: the process of acquiring individual characteristics, as occurs in progressive diversification of cells and tissues of the developing pre-embryo and embryo.

Dignity: the right of individuals to be treated with respect as persons in their own right.

Dilatation and Curettage: a technique that may be used for induced abortion. It involves stretching the cervical channel and scraping the interior of the uterine cavity to remove products of conception.

Diploid: a full set of genetic material consisting of paired chromosomes, one from each parental set. A cell having two chromosome sets, one maternal and one paternal, twice the haploid number (in humans, 46). Most animal cells except the gametes have a diploid set of chromosomes. The diploid human genome has 46 chromosomes. See also -- haploid.

Direct Methods: methods or questions that explicitly expose the data collector's true intentions.

Directed Evolution: a laboratory process used on isolated molecules or microbes to cause mutations and identify subsequent adaptations to novel environments.

Directed Mutagenesis: alteration of DNA at a specific site and its reinsertion into an organism to study any effects of the change.

Directed Sequencing: successively sequencing DNA from adjacent stretches of chromosome.

Disadvantaged / Vulnerable / Marginalized Groups: these terms are applied to groups of people who, due to factors usually considered outside their control, do not have the same opportunities as other, more fortunate groups in society. Examples might include unemployed people, refugees and others who are socially excluded.

Disability-Adjusted Life Expectancy: the number of healthy years of life that can be expected on average in a given population. It is generally calculated at birth, but estimates can also be prepared at other ages. Healthy life expectancy has the advantage of capturing all causes of disability across a population and relating them to life expectancy defined by mortality.

Disability-Adjusted Life Years (DALYs): the number of healthy years of life lost due to premature death and disability. A unit for measuring both the global burden of disease and the effectiveness of health interventions, as indicated by reductions in the disease burden. It is calculated as the present value of the future years of disability-free life that are lost as the result of the premature deaths or cases of disability occurring in a particular year.

Discharge: the official termination of a patient's stay in a hospital or other medical facility to which one has been admitted.

Disease-Associated Genes: alleles carrying particular DNA sequences associated with the presence of disease.

Disimpaction: act of removing stool from the rectum, which could not be eliminated normally.

Disinfection: treatment of objects or surfaces to remove or inactivate organisms such as vegetative bacteria, viruses and fungi, but not spores. Disinfection can be achieved by heat, by immersion in boiling water or by applying certain antiseptics.

Dispensary: a specialized ambulatory facility which can be assigned to a hospital or serve as an independent institution.

Distribution: the complete summary of the frequencies of the values or categories of a measurement made on a group of persons. The distribution tells either how many or what proportion of the group was found to have each value (or range of values) out of all the possible values that the quantitative measure can have.

Diuresis: production of excessive amounts of urine that may precipitate urinary incontinence or overactive bladder. Can be caused by medical problems such as diabetes mellitus and edema.

Diuretic: agent (e.g., drug, alcohol, caffeine) that increases urination by causing the kidneys to secrete more fluid from the blood.

Diverticula: pouches in the walls of organs that, if found in the bladder or urethra, can hold excess urine and become infected or inflamed.

DMFT Index at Age 12: the mean number of permanent teeth decayed, filled and missing (DMFT) in children at age 12, in a specific year, for a given country, territory, or geographic area.

DNA (deoxyribonucleic acid): a double-helical structure composed of two coils of nucleotide chains connected by nitrogen bases. The molecule that encodes genetic information. DNA is a double-stranded molecule held together by weak bonds between base pairs of nucleotides. The four nucleotides in DNA contain the bases adenine (A), guanine (G), cytosine (C), and thymine (T). In nature, base pairs form only between A and T and between G and C; thus the base sequence of each single strand can be deduced from that of its partner.

DNA Bank: a service that stores DNA extracted from blood samples or other human tissue.

DNA Hybridization: a process whereby labeled nucleic acid molecules (oligonucleotide probe) bind to a DNA sequence on a target (Southern blot, metaphase chromosomes, or interphase nuclei) that is complementary to its own.

DNA Methylation: a process for control of tissue specific gene expression. Methylation "turns off" the regulatory region of a gene, thereby preventing DNA transcription.

DNA Probe: a short segment of DNA in which the base sequence is specifically complementary to a particular gene segment. The probe is used, for example, on the Southern blot assay to determine whether a certain gene is present in a tumor sample undergoing DNA analysis. See -- probe.

DNA Repair Genes: genes encoding proteins that correct errors in DNA sequencing.

DNA Replication: the use of existing DNA as a template for the synthesis of new DNA strands. In humans and other eukaryotes, replication occurs in the cell nucleus.

DNA Sequence: the relative order of base pairs, whether in a DNA fragment, gene, chromosome, or an entire genome. See also -- base sequence analysis.

Domain: a discrete portion of a protein with its own function. The combination of domains in a single protein determines its overall function.

Dominant: an allele that is almost always expressed, even if only one copy is present. See also -- gene, genome.

Domus Unit: small community-based residential facilities that seek to maintain residents' independence and residual capacities through active participation.

Donors: people providing either sperm or ova.

Dosimetry: the term applied to the measurement and calculation of dose that the patient receives.

Double Helix: the twisted-ladder shape that two linear strands of DNA assume when complementary nucleotides on opposing strands bond together.

Draft Sequence: the sequence generated by the HGP as of June 2000 that, while incomplete, offers a virtual road map to an estimated 95% of all human genes. Draft sequence data are mostly in the form of 10,000 base pair-sized fragments whose approximate chromosomal locations are known. See also -- sequencing, finished DNA sequence, working draft DNA sequence.

Dry Sex: a sexual practice that involves penetrative vaginal sex where the woman has a dry vagina. Sometimes herbs are used to increase the dryness. Dry sex increases the risks of sexually transmitted infections, including HIV.

Dual Method Use: using a barrier method for protection against sexually transmitted infection and another method for contraception.

Dual Protection: prevention of both STI/HIV infection and unwanted pregnancy. This can be achieved by the correct and consistent use of condoms alone or by the simultaneous use of two methods, one of which must be a condom.

Dual Risk: risk of both pregnancy and STI/HIV.

Dysmaturity Syndrome: a dysmature fetus is characterized by wasting of subcutaneous tissue, meconium staining, peeling or desquamating skin, long fingernails, and often an alert facial expression; some are said to have "parchment-like" skin.

Dyspareunia: painful intercourse.

Dysuria: difficult or painful urination.

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