Women's Health and Education Center (WHEC)


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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.

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