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Earmarked Taxes: taxes which are collected with the specific purpose of using them for health care.

Economic Impact Assessment: economic impact assessment involves exploring and identifying the ways in which the economy in general, or local economic circumstances in particular, will be affected by a policy, program or project.

Economics: the study of how individuals and societies choose to allocate scarce productive resources among competing alternative uses and to distribute the products from these uses among the members of the society.

Economic Analysis/ Evaluation: analyses which involve the allocation of scarce resources among competing alternative uses and the distribution of the products from these uses among the members of the society.

Economies of Scale, in contrast to Economies of Scope: the average cost per unit decreases as output increases.

Economies of Scope, in contrast to Economies of Scale: benefits of producing multiple goods or services (i.e., if it is cheaper to produce both good X and good Y together rather than separately).

Economic Outcome, see Health Outcome: a consequence of the use of health care products, services, or programs that affect costs from any of several perspectives.

Ectopic Pregnancy: a pregnancy in which the fertilized egg implants outside of the uterus, and the placenta and fetus begin to develop there. The most common site is within a fallopian tube.

Eczema: pruritic dermatitis that occurs as a reaction to a drug or some other skin contact. Characterized in the acute state by an erythema; edema associated with serious exudates between the cells of the epidermis; and an inflammatory infiltrate in the dermis, causing oozing, vesiculation, crusting, and scaling of the epidermis.

Effectiveness: a measure of the extent to which a specific intervention, procedure, regimen, or service, when deployed in the field in routine circumstances, does what it is intended to do for a specified population. Whether services deliver the outcome(s) in the way that is claimed in actual practice; does it do more good than harm.

Efficacy: the benefit of using a technology for a particular problem under ideal conditions, for example, in a laboratory setting, with in the protocol of a carefully managed randomized controlled trial, or at a "center of excellence." Whether services deliver the outcome(s) in the way that is claimed in ideal conditions; can it work.

Efficiency: the capacity to produce the maximum output for a given input.

e-Health: it is the transfer of health resources and health care by electronic means. It encompasses three main areas:

  • The delivery of health information, for health professionals and health consumers, through the Internet and telecommunications.
  • Using the power of IT and e-commerce to improve public health services, e.g. through the education and training of health workers.
  • The use of e-commerce and e-business practices in health systems management.

Elasticity: the ratio of substitution between two factors such as quantity of goods demanded and its price to the consumer.

Electrical Stimulation: application of electric current to stimulate or inhibit the pelvic floor muscles or their nerve supply in order to induce a direct therapeutic response.

Electromyography (EMG): diagnostic test used to measure the electrical activity of muscles.

Electron Volt (eV): the energy of motion acquired by an electron accelerated through a potential difference of 1 volt.

Electrophoresis: a method of separating large molecules (such as DNA fragments or proteins) from a mixture of similar molecules. An electric current is passed through a medium containing the mixture, and each kind of molecule travels through the medium at a different rate, depending on its electrical charge and size. Agarose and acrylamide gels are the media commonly used for electrophoresis of proteins and nucleic acids.

Electroporation: a process using high-voltage current to make cell membranes permeable to allow the introduction of new DNA; commonly used in recombinant DNA technology. See also -- transfection.

Embryonic Disc: the group of cells from which the embryo will develop, usually visible at the end of the first week of development after fertilization in humans.

Embryonic Stem (ES) Cells: an embryonic cell that can replicate indefinitely, transform into other types of cells, and serve as a continuous source of new cells.

Emergency Admission: a patient admitted on the same day that admission is requested.

Employment Zone: 15 Employment Zones (EZs) were launched in March 2000 in areas experiencing high levels of long term unemployment in order to help long term unemployed people get and keep work. Employment Zones pool funds for training, Employment Service support and the equivalent of benefit to maximize flexibility and choice. The areas selected were amongst the worst 150 unitary authorities or local authority districts in Great Britain when ranked by a composite measure of the share of unemployed claimants aged 25+ who were long term unemployed, the employment rate and the number of people unemployed for over two years as a percentage of the working age population based on 1997 data. Participants in the EZ schemes work with a personal adviser to establish their needs and identify any barriers preventing them from moving into sustainable work. A costed action plan is then drawn up between adviser and participant. Once the participant has started work, they continue to be supported to ensure that their move into employment is sustained where possible. A range of different organizations were contracted through a tendering process to administer the zones and their performance is monitored and linked to the funding process (Department for Work and Pensions, 2002).

Endonuclease: see -- restriction enzyme.

Enhancement Factor: see blocking factor.

Enhancing Antibodies: antibodies that enhance the survival of a graft or of a tumor.

Enterocele: prolapse or falling down of the intestines into the vagina.

Entitlements: benefits in-kind or cash benefits to which beneficiaries are entitled by law with little regard to actual contributions or premiums, or income qualifications.

Enuresis: involuntary loss of urine (urinary incontinence).

Environmental Impact Assessment: environmental impact assessment (EIA) is a well developed discipline, both in terms of theory and practice, having been in operation for nearly 30 years in the United States (Glasson et al. 1994). Its origins lie in the US National Environmental Policy Acts of 1969. In the same way that HIA explores the effect of policies, programs and projects on health, EIA does the same in terms of environmental effects. In many countries, including those of the European Union, there is now a statutory requirement for EIA to be undertaken under certain circumstances. The rules vary from country to country but generally EIA should lead to proposals which are likely to have any significant adverse effects on the environment being abandoned or modified (Hendley et al., 1998). There are numerous definitions of EIA, including the following an assessment of the impact of a planned activity on the environment (UN Economic Commission for Europe, 1991 in Glasson et al, 1994) the process of evaluating the likely environmental consequences of a proposed major action significantly affecting the natural and man-made environment (Walthern 1988, cited in Wood 1995) a technique and a process by which information about the environmental effects of a project is collected, both by the developed and from other sources, and taken into account by the planning authority in forming their judgments about whether the development should go ahead (Department of the Environment, Welsh Office 1989)

Enzyme: a protein that acts as a catalyst, speeding the rate at which a biochemical reaction proceeds but not altering the direction or nature of the reaction.

Enzyme-Linked Immunosorbent (ELISA): the assay in which an enzyme is linked to an antibody and a colored substrate is used to measure the activity of bound enzyme and the amount of bound antibody.

Epidemiology: the study of the incidence and distribution of disease. The study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to control health problems.

Epididymitis: inflammation of the epididymis; occasional complication of untreated urethral infection.

Epigenetic: non-DNA/RNA related process that affects genotype and phenotype (ie, methalization).

Episiotomy: surgical incision into the perineum between the vagina and anus to ease childbirth through the vagina.

Epistasis: one gene interferes with or prevents the expression of another gene located at a different locus.

Epithelialize: to become covered with epithelial tissue (to heal).

Epitope: an alternative term for antigenic determinant.

Equality: principle by which all persons or things under consideration are treated in the same way.

Equality of Child Survival: a composite index based on the distribution of child survival across countries and intended to provide a summary measure of countries' achievements in the distribution of health.

Equity: principle of being fair to all, with reference to a defined and recognized set of values.

Equity in Health: inequity -- as opposed to inequality -- has a moral and ethical dimension, resulting from avoidable and unjust differentials in health status. Equity in health implies that ideally everyone should have a fair opportunity to attain their full health potential and, more pragmatically, that no one should be disadvantaged from achieving this potential if it can be avoided. (WHO EURO, 1985) More succinctly, Equity is concerned with creating equal opportunities for health and with bringing health differentials down to the lowest possible level. (Whitehead, 1990). HIA is usually underpinned by an explicit value system and a focus on social justice in which equity plays a major role so that not only both health inequalities and inequities in health are explored and addressed wherever possible (Barnes and Scott-Samuel, 1999).

Escherichia coli: common bacterium that has been studied intensively by geneticists because of its small genome size, normal lack of pathogenicity, and ease of growth in the laboratory.

Essential Drugs: a policy initiative to ensure that a minimal number of effective drugs are available to treat priority health problems at a cost which can be afforded by the community.

Estimated General Mortality Rate: the estimated total number of deaths in a population of a given sex and/or age, divided by the total number of this population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area.

Estimated Incidence of Malignant Neoplasms of the Cervix Uteri, Adjusted: the ratio of the number of new cases from malignant neoplasms of the cervix uteri (ICD-9 code 179; ICD-10 code C53) estimated in a specific year among the female population, to the number of residents in that population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area.

Estimated Incidence of Malignant Neoplasms of the Female Breast, Adjusted: the ratio of the number of new cases from malignant neoplasms of the female breast (ICD-9 code 174; ICD-10 code C50) estimated in a specific year among the female population, to the number of residents in that population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area.

Estimated Incidence of Malignant Neoplasms of the Lung, Adjusted: the ratio of the number of new cases from malignant neoplasms of the lung (ICD-9 code 162; ICD-10 codes C33-C34; both including trachea and bronchus) estimated in a specific year among the population of a given sex, to the number of residents in that population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area.

Estimated Incidence of Malignant Neoplasms of the Stomach, Adjusted: the ratio of the number of new cases from malignant neoplasms of the stomach (ICD-9 code 151; ICD-10 code C16) estimated in a specific year among a population of a given sex, to the number of residents in that population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area.

Estimated Mortality Rate from Accidents, Excluding Transport Accidents: the estimated total number deaths from accidents, excluding transport accidents, in the total population of a given sex and/or age, divided by the total number of this population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area. Underlying causes of death grouped under this heading are those under ICD-9 codes E850-E949 or to ICD-10 codes W00-X59.

Estimated Mortality Rate from Cerebrovascular Diseases: the estimated total number deaths from cerebrovascular diseases in the total population or of a given sex and/or age, divided by the total number of this population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area. Underlying causes of death grouped under this heading are those under ICD-9 codes 430-438 or ICD-10 codes I60-I69.

Estimated Mortality Rate from Communicable Diseases, Adjusted by Age: the estimated total number of deaths from communicable diseases in a population of a given sex divided by the corresponding total number of this population, after removing the effect of differences in the age distribution, expressed per 100,000 population for a given year, in a given country, territory, or geographic area. Underlying causes of death grouped under this heading are: ICD-9 Chapter I (codes 001-139) or ICD-10 Chapter I (A00-B99), plus acute respiratory infections (ICD-9 codes 460-466, 480-487; ICD-10 codes J00-J22) and meningitis (CIE-9 codes 320-322; ICD-10 codes G00-G03).

Estimated Mortality Rate from Communicable Diseases: the estimated total number of deaths from communicable diseases in a population of a given sex and/or age, divided by the total number of this population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area. The cause categories grouped under this heading are Chapter I, ICD9 (codes 001-139) and ICD10 Chapter I (A00-B99), plus acute respiratory infections (ICD9 codes 460-466, 480-487; ICD10 codes J00-J22) and meningitis (CIE9 codes 320-322; ICD10 codes G00-G03).

Estimated Mortality Rate from Diseases of the Circulatory System, Age Adjusted: the estimated total number of deaths from diseases of the circulatory system in the total population or by a given sex, divided by the corresponding total number of this population, after removing the effect of differences in the age distribution, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area. Underlying causes of death grouped under this heading are those under ICD-9 Chapter VIII (codes 390-459) and ICD-10 Chapter IX (codes I00-I99).

Estimated Mortality Rate from Diseases of the Circulatory System: the estimated total number deaths from diseases of the circulatory system in the total population or of a given sex and/or age, divided by the total number of this population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area. Underlying causes of death grouped under this heading are those under ICD-9 Chapter VIII (codes 390-459) or ICD-10 Chapter IX (codes I00-I99).

Estimated Mortality Rate from Cirrhosis and Other Chronic Liver Diseases: the estimated total number deaths from cirrhosis and other chronic liver diseases, in the total population or of a given sex and/or age, divided by the total number of this population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area. Underlying causes of death grouped under this heading are those under the ICD-9 code 571 or to ICD-10 codes K70, K73-K74, K76.

Estimated Mortality Rate from Diabetes Mellitus: the estimated total number deaths from diabetes mellitus, in the total population or of a given sex and/or age, divided by the total number of this population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area. Underlying causes of death grouped under this heading are those under the ICD-9 code 250 or to ICD-10 codes E10-E14.

Estimated Mortality Rate from External Causes: the estimated total number deaths from external causes in the total population or of a given sex and/or age, divided by the total number of this population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area. Underlying causes of death grouped under this heading are those under the ICD-9 supplementary classification of external causes of injuries and poisonings (codes E800-E999) or ICD-10 Chapter XX (codes V01-Y89).

Estimated Mortality Rate from External Causes, Adjusted by Age: the estimated total number of deaths from external causes in the total population or of a given sex, divided by the total number of this population, after removing the effect of differences in the age distribution, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area. Underlying causes of death grouped under this heading are those under the ICD-9 supplementary classification of external causes of injuries and poisonings (codes E800-E999) or ICD-10 Chapter XX (codes V01-Y89).

Estimated Mortality Rate from Homicide: the estimated total number deaths from homicide and injury purposely inflicted, and injury due to legal intervention or war operations, in the total population or of a given sex and/or age, divided by the total number of this population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area. Underlying causes of death grouped under this heading are those under ICD-9 codes E960-E969, or to ICD-10 codes X85-Y09, Y87.1.

Estimated Mortality Rate from Ischemic Heart Disease: the estimated total number of deaths from ischemic heart disease in the total population or of a given sex and/or age, divided by the total number of this population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area. The cause categories grouped under this heading are: ICD-9 codes 410-414 or ICD-10 codes I20-I25.

Estimated Mortality Rate from Malignant Neoplasms: the estimated total number deaths from malignant neoplasms in the total population or of a given sex and/or age, divided by the total number of this population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area. Underlying causes of death grouped under this heading are those under ICD-9 codes 140-208 or ICD-10 codes C00-C97.

Estimated Mortality Rate from Malignant Neoplasms, Adjusted by Age: the estimated total number of deaths from malignant neoplasms in the total population or of a given sex, divided by the total number of this population, after removing the effect of differences in the age distribution, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area. Underlying causes of death grouped under this heading are those under ICD-9 codes 140-208 or ICD-10 codes C00-C97.

Estimated mortality Rate from Malignant Neoplasms of the Breast, Female: the estimated total number deaths from malignant neoplasms of the female breast in a female population of a given age, divided by the total number of this population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area. Underlying causes of death grouped under this heading are those under the ICD-9 code 174 or the ICD-10 code C50.

Estimated Mortality Rate from Malignant Neoplasms of the Digestive Organs and Peritoneum: the estimated total number deaths from malignant neoplasms of the digestive organs and peritoneum in the total population or of a given sex and/or age, divided by the total number of this population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area. Underlying causes of death grouped under this heading are those under ICD-9 codes 150-159 or ICD-10 codes C15-C26.

Estimated Mortality Rate from Malignant Neoplasms of the Lung, Trachea and Bronchi: the estimated total number deaths from malignant neoplasms of the lung, trachea, and bronchus in the total population or of a given sex and/or age, divided by the total number of this population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area. Underlying causes of death grouped under this heading are those under the ICD-9 code 162 or ICD-10 codes C33-C34.

Estimated Mortality Rate from Malignant Neoplasms of the Uterus, Female: the estimated total number deaths from malignant neoplasms of the uterus in a female population of a given age, divided by the total number of this population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area. Underlying causes of death grouped under this heading are those under ICD-9 codes 179-180, 182, or ICD-10 codes C53-C55.

Estimated Mortality Rate from Neoplasms, Adjusted by Age: the estimated total number of deaths from neoplasms in the total population or of a given sex, divided by the total number of this population, after removing the effect of differences in the age distribution, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area. Underlying causes of death grouped under this heading are those under ICD-9 Chapter II (codes 140-239) or ICD-10 Chapter II (codes C00-D48).

Estimated Mortality Rate from Neoplasms, Total: the estimated total number deaths from neoplasms in the total population or of a given sex and/or age, divided by the total number of this population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area. Underlying causes of death grouped under this heading are those under ICD-9 Chapter II (codes 140-239) or ICD-10 Chapter II (codes C00-D48).

Estimated Mortality Rate from Suicide and Purposely Self-Inflicted Injuries: the estimated total number deaths from suicide and purposely self-inflicted injuries, in the total population or of a given sex and/or age, divided by the total number of this population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area. Underlying causes of death grouped under this heading are those under ICD-9 codes E950-E959 or to ICD-10 codes X60-X84.

Estimated Mortality Rate from Transport Accidents: the estimated total number deaths from transport accidents, in the total population or of a given sex and/or age, divided by the total number of this population, expressed per 100,000 population, for a given year, in a given country, territory, or geographic area. Underlying causes of death grouped under this heading are those under ICD-9 codes E800-E848 or to ICD-10 codes V01-V99.

Estimated Mortality Rate due to Tuberculosis: the estimated number of deaths in total or by sex from tuberculosis, divided by the total number of this population, expressed per 100.000 population, for a given year, in a given country, territory, or geographic area (ICD-9 codes 010-018; ICD-10 codes A15-A19).

Estrogen: hormone produced primarily by the ovaries. Estrogen is believed to play a major role in maintaining the strength and tone of the pelvic floor.

Eugenics: the study of improving a species by artificial selection; usually refers to the selective breeding of humans.

Eukaryote: cell or organism with membrane-bound, structurally discrete nucleus and other well-developed sub-cellular compartments. Eukaryotes include all organisms except viruses, bacteria, and blue-green algae. See also -- prokaryote, chromosome.

Evaluation: the process of collecting and analyzing information at regular intervals about the effectiveness and impact of the program.

Evidence Base: the evidence base refers to a body of information, drawn from routine statistical analyses, published studies and "grey" literature, which tells us something about what is already known about factors affecting health. For example, in the field of housing and health there are a number of studies which demonstrate the links between damp and cold housing and respiratory disease and, increasingly, the links between high quality housing and quality of life (Thomson et al., 2001).

Evidence-Based Health Care: evidence-based health care is the conscientious use of current best evidence in making decisions about the care of individual patients or the delivery of health services. Current best evidence is up-to-date information from relevant, valid research about the effects of different forms of health care, the potential for harm from exposure to particular agents, the accuracy of diagnostic tests, and the predictive power of prognostic factors.

Evidence-Based Medicine: the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. As much as possible, medical decisions should be based on quality evidence. The best evidence is a properly designed randomized controlled trial.

Evolutionarily Conserved: see -- conserved sequence.

Excitation: the moving of an electron to a more distant orbit within the same action.

Exon: a region of a gene made up to DNA sequences that will be transcribed into mRNA. The protein-coding DNA sequence of a gene. The region of DNA coding for a protein or a segment of a protein. See also -- intron.

Exogenous DNA: DNA originating outside an organism that has been introduced into the organism.

Exonuclease: an enzyme that cleaves nucleotides sequentially from free ends of a linear nucleic acid substrate.

Expansion: (see Hereditary Unstable DNA).

Experience Rating: setting a group premium based on the actual losses experienced by that group during the prior year or years.

Experimental Research Design: "true" experimental research designs allow researchers to test a hypothesis by introducing a manipulated change (independent variable) into a system (a group of subjects, hospital or community setting) and subsequently assess the impact of that change on a dependent variable ideally, all other phenomena that might affect change in the dependent variable under study are eliminated through internal control mechanisms. One of the primary features of experimental design is the random assignment of subjects.

Explanatory Data: data or information that explain "why" and/or "how".

Expressed Gene: see -- gene expression.

Expressed Sequence Tag (EST): a short strand of DNA that is a part of a cDNA molecule and can act as identifier of a gene. Used in locating and mapping genes. See also -- cDNA, sequence tagged site.

Expressivity: the degree to which a genotype is expressed in the phenotype (range of phenotypic features).

Externality: the result of an activity that causes incidental benefits (desirable effects) or damages (costs, pollution) to others with no corresponding compensation provided or paid by those who generate the externality.

External (Condom) Catheters: devices made from latex, rubber, polyvinyl, or silicone that is used for externally draining the bladder. They are secured on the shaft of the penis by some form of adhesive and connected to urine collecting bags by a tube. Also called penile sheaths.

External Sphincter: band of muscle downstream from the internal sphincter that is responsible for maintaining urinary and fecal continence.

External Validity: a study is externally valid or generalizable if it can produce unbiased inferences regarding a target population (beyond the subjects in the study). This aspect of validity is only meaningful with regard to a specified external target population. For example, the results of a study conducted using only white male subjects might or might not be generalizable to all human males (the target population consisting of all human males). It is not generalizable to females (the target population consisting of all people).

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