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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 administrationócentral, regional, and localówere 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).

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