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Objective. We examined the use of complementary and alternative medical (CAM) therapies among Chinese and Vietnamese Americans who had limited proficiency with the English language and explore the association between patient-clinician discussions about CAM therapy use and patient assessments of quality of care. Methods. We surveyed Chinese and Vietnamese Americans who visited 11 community health centers in 8 major cities throughout the United States. Results. Of the 4410 patients surveyed, 3258 (74%) returned completed questionnaires. Two thirds of respondents reported they had 'ever used' some form of CAM therapy; however, only 7.6% of these patients had discussed their use of CAM therapies with clinicians. Among patients who had used CAM therapies during the week before their most recent visits, clinician-patient discussions about CAM therapy use were associated with better overall patient ratings of quality of care. Conclusion. Use of CAM therapies was common among Chinese and Vietnamese Americans who had limited proficiency with the English language. Although discussions about CAM therapy use with clinicians were uncommon, these discussions were associated with better ratings of quality of care. doi:10.2105/AJPH.2004.048496)

Objectives. We estimated health care expenditures associated with overweight and obesity and examined the influence of age, race, and gender. Methods. Using 1998 Medical Expenditure Panel Survey data, we employed 2-stage modeling to estimate annual health care expenditures associated with high body mass index (BMI) and examine interactions between demographic factors and BMI. Results. Overall, the mean per capita annual health care expenditure (converted to December 2003 dollars) was $3338 before adjustment. While the adjusted expenditure was $2127 (90% confidence interval [CI] =$1927, $2362) for a typical normal-weight White woman aged 35 to 44 years, expenditures were $2358 (90% CI=$2128, $2604) for women with BMIs of 25 to 29.9 kg/[m.sup.2], $2873 (90% CI =$2530, $3236) for women with BMIs of 30 to 34.9 kg/[m.sup.2], $3058 (90% CI=$2529, $3630) for women with BMIs of 35 to 39.9 kg/[m.sup.2], and $3506 (90% CI=$2912, $4228) for women with BMIs of 40 kg/[m.sup.2] or higher. Expenditures related to higher BMI rose dramatically among White and older adults but not among Blacks or those younger than 35 years. We found no interaction between BMI and gender. Conclusions. Health care costs associated with overweight and obesity are substantial and vary according to race and age.

Determines whether the basal follicle-stimulating hormone (FSH) or clomiphene citrate challenge test is the better predictor of in vitro fertilization (IVF) in women over 40. Analysis of basal FSH and clomiphene-stimulated FSH levels from women who underwent IVF; Results of the analysis; Prediction of IVF success in clear prognostic cutoff values.