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RESUMEN. El objetivo de este estudio fue desarrollar una formulación optimizada de mermelada dietética, aplicando la metodología Taguchi. La razón que se tuvo para seleccionar dentro del diseño experimental esta metodología de trabajo fue demostrar las ventajas que tiene la aplicación de diseños factoriales ortogonales a problemas que ocurren con bastante frecuentes en la industria alimentaria especialmente en el área de desarrollo de productos, cuando la respuesta que se busca depende de la influencia de múltiples variables. En esta ocasión se desarrolló una formulación de mermelada de damasco de bajocontenido energético tratando de obtener la mejor combinación de múltiples variables para lograr una calidad sensorial óptima. Se trabajó simultáneamente con cinco factores de control: acidez, espesante, edulcorante, aromatizante y tiempo, así como posibles interacciones entre algunas de ellas, aplicando el diseño ortogonal L8 (2(7)). Se elaboraron ocho formulaciones experimentales que se analizaron sensorialmente aplicando el test de puntaje compuesto y una escala descriptiva cuantitativa desde "1= Malo hasta 5= Muy bueno". El análisis estadístico permitió comprobar que los factores espesante, edulcorante y aromatizante afectaban significativamente "(pSUMMARY. Development of an optimized dietetic formulation of damask marmalade using the taguchi methodology. The goal of this present study was the development of an optimized formula of damask marmalade low in calories applying taguchi methodology to improve the quality of this product. The selection of this methodoly lies on the fact that in real life conditions the result of an experiment frequently depends on the influence of several variables, therefore, one expedite way to solve this problem is utilizing factorial designs. The influence of acid, thickener, sweetener and aroma additives, as well as time of cooking, and possible interactions among some of them, were studied trying to get the best combination of these factors to optimize the sensorial quality of an experimental formulation of dietetic damask marmalade. An orthogonal arrayL8(2(7)) was applied in this experience, as well as level average analysis was carried out according taguchi methodology to determine the suitable working levels of the design factors previously choiced, to achieve a desirable product quality. A sensory trained panel was utilized to analyze the marmalade samples using a composite scoring test with a descriptive cuantitative scale ranging from 1= Bad, 5= Good. It was demonstrated that the design factors sugar/aspartame, pectin and damask aroma had a significant effect(p

Abstract Background Text-based patient medical records are a vital resource in medical research. In order to preserve patient confidentiality, however, the U.S. Health Insurance Portability and Accountability Act (HIPAA) requires that protected health information (PHI) be removed from medical records before they can be disseminated. Manual de-identification of large medical record databases is prohibitively expensive, time-consuming and prone to error, necessitating automatic methods for large-scale, automated de-identification. Methods We describe an automated Perl-based de-identification software package that is generally usable on most free-text medical records, e.g., nursing notes, discharge summaries, X-ray reports, etc. The software uses lexical look-up tables, regular expressions, and simple heuristics to locate both HIPAA PHI, and an extended PHI set that includes doctors' names and years of dates. To develop the de-identification approach, we assembled a gold standard corpus of re-identified nursing notes with real PHI replaced by realistic surrogate information. This corpus consists of 2,434 nursing notes containing 334,000 words and a total of 1,779 instances of PHI taken from 163 randomly selected patient records. This gold standard corpus was used to refine the algorithm and measure its sensitivity. To test the algorithm on data not used in its development, we constructed a second test corpus of 1,836 nursing notes containing 296,400 words. The algorithm's false negative rate was evaluated using this test corpus. Results Performance evaluation of the de-identification software on the development corpus yielded an overall recall of 0.967, precision value of 0.749, and fallout value of approximately 0.002. On the test corpus, a total of 90 instances of false negatives were found, or 27 per 100,000 word count, with an estimated recall of 0.943. Only one full date and one age over 89 were missed. No patient names were missed in either corpus. Conclusion We have developed a pattern-matching de-identification system based on dictionary look-ups, regular expressions, and heuristics. Evaluation based on two different sets of nursing notes collected from a U.S. hospital suggests that, in terms of recall, the software out-performs a single human de-identifier (0.81) and performs at least as well as a consensus of two human de-identifiers (0.94). The system is currently tuned to de-identify PHI in nursing notes and discharge summaries but is sufficiently generalized and can be customized to handle text files of any format. Although the accuracy of the algorithm is high, it is probably insufficient to be used to publicly disseminate medical data. The open-source de-identification software and the gold standard re-identified corpus of medical records have therefore been made available to researchers via the PhysioNet website to encourage improvements in the algorithm.

Human papillomavirus (HPV) is the most common sexually transmitted infection in men and women in the United States (1). Vaccination prevents and controls HPV infection and associated outcomes, including genital warts, precancerous lesions, and certain cancers, such as cervical, vaginal, vulvar, anal, penile, and oropharyngeal (2,3). HPV vaccination in the United States has been recommended for girls since 2006 and for boys since 2011 and requires multiple doses (2,3). This vaccine, targeted for children ages 11-12 years, may be started at age 9. This report uses parent-reported data from the 2022 National Health Interview Survey to describe the percentage of children ages 9-17 years who received at least one dose of the HPV vaccine by selected sociodemographic and health characteristics., (All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.)

Introduction: We examined national estimates of breast, cervical, and colorectal cancer (CRC) screening test use and compared them with Healthy People 2030 national targets. Test use in 2021 was compared with prepandemic estimates., Methods: In 2022, we used 2021 National Health Interview Survey (NHIS) data to estimate proportions of adults up to date with US Preventive Services Task Force recommendations for breast (women aged 50-74 y), cervical (women aged 21-65 y), and CRC screening (adults aged 50-75 y) across sociodemographic and health care access variables. We compared age-standardized estimates from the 2021 and 2019 NHIS., Results: Percentages of adults up to date in 2021 were 75.7% (95% CI, 74.4%-76.9%), 75.2% (95% CI, 73.9%-76.4%), and 72.2% (95% CI, 71.2%-73.2%) for breast, cervical, and CRC screening, respectively. Estimates were below 50% among those without a wellness check in 3 years (all screening types), among those without a usual source of care or insurance (aged <65 y) (breast and CRC screening), and among those residing in the US for less than 10 years (CRC screening). Percentages of adults who were up to date with breast and cervical cancer screening and colonoscopy were similar in 2019 and 2021. Fecal occult blood/fecal immunochemical test (FOBT/FIT) use was modestly higher in 2021 (P < .001)., Conclusions: In 2021, approximately 1 in 4 adults of screening age were not up to date with breast, cervical, and CRC screening recommendations, and Healthy People 2030 national targets were not met. Disparities existed across several characteristics, particularly those related to health care access. Breast, cervical, and colonoscopy test use within recommended screening intervals approximated prepandemic levels. FOBT/FIT estimates were modestly higher in 2021.

Telemedicine is a way for health care providers to deliver clinical health care to patients remotely through a computer or telephone, without an in-person office visit (1). The demonstrated benefits of telemedicine include improved access to care, convenience, and slowing spread of infection (1,2). During the COVID-19 pandemic, legislation expanded coverage for telemedicine health care services (3). This report uses 2021 National Health Interview Survey (NHIS) data to describe the percentage of adults who used telemedicine in the past 12 months by sociodemographic and geographic characteristics., (All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.)

Objective-This report presents national estimates of telemedicine use for U.S. children in the 12 months before the interview, and because of the coronavirus pandemic., (All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.)

Generalized anxiety disorder (GAD) is characterized by excessive worry that is difficult to control accompanied by physical symptoms including restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension, or sleep disturbance (1). The GAD-7 scale is a validated brief selfreport measure to screen for GAD and assess the severity of symptoms (2). Adults with GAD-7 scores of 0-4 are considered to have no or minimal symptoms of GAD, while those with scores of 5-9, 10-14, or 15-21 are considered to have mild, moderate, or severe symptoms, respectively (2). This report examines the percentage of adults aged 18 and over who experienced symptoms of anxiety in the past 2 weeks, by severity of symptoms and select demographic characteristics, using the GAD-7 scale., (All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.)

Depression is characterized by the presence of feelings of sadness, emptiness, or irritability, accompanied by bodily and cognitive changes lasting at least 2 weeks that significantly affect the individual's capacity to function (1). The eight-item Patient Health Questionnaire (PHQ-8) is a validated diagnostic and severity measure of symptoms of depressive disorders (2,3). Adults with scores of 0-4 are considered to have no or minimal symptoms of depression, while those with scores of 5-9, 10-14, or 15-24 are considered to have mild, moderate, or severe symptoms, respectively (2,3). This report examines the percentage of adults aged 18 and over with symptoms of depression in the past 2 weeks in 2019, by symptom severity and select demographic characteristics, using the PHQ-8 scale., (All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.)

Heavy drinking is defined as the average consumption of more than 7 drinks per week for women and more than 14 drinks per week for men in the past year (1). Heavy drinking is associated with an increased risk of alcohol use disorders, suicide, interpersonal violence, traffic injuries, liver disease, certain cancers and infectious diseases, and adverse birth outcomes in pregnant women (1,2). This report describes adult alcohol use in the United States and presents the prevalence of heavy drinking by demographic characteristics, select mental health indicators, and select measures of health care access and utilization., (All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.)

Historically, the American Indian and Alaska Native (AIAN) population in the United States has faced health disparities including greater prevalence of physical and mental health problems and high uninsured rates when compared with the non-AIAN population (1). Almost 80% of the AIAN population resides outside of reservations or land trusts and about 40% reside in rural areas (2). Rural Americans are more likely to die from preventable or selfmanageable conditions (3), and risk factors and health conditions may vary by urbanization level (4). This report examines differences in the percentage of selected health status and conditions by urbanization level between AIAN adults and all U.S. adults., (All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.)

Objective-This report describes how problems paying medical bills and forgone medical care vary by family composition among families with at least one older adult (aged 65 and over). Methods-Data from families in the 2017-2018 National Health Interview Survey that included at least one older adult were analyzed (n = 19,471). Bivariate and multivariate analyses, adjusted for selected family characteristics that may put families at financial risk, were conducted for both outcome measures and shown by family composition. The family compositions examined were one older adult living alone, two older adults, one younger (aged 18-64) and one older adult, three or more adults (where at least one was an older adult), and two or more adults (where at least one was an older adult) and at least one child (under age 18 years). Results-About 8.6% of families with older adults experienced problems paying medical bills, and 8.9% had forgone medical care. The most common composition for older-adult families was one older adult living alone (39.7%). Older-adult families consisting of only two older adults were the least likely to have experienced problems paying medical bills (4.0%) and to have forgone medical care (3.8%) compared with other family compositions. Older-adult families with at least one child were the most likely to experience problems paying medical bills (21.3%) and to have forgone medical care (18.4%). After adjusting for selected family characteristics in multivariate analyses, the odds of experiencing problems paying medical bills and forgone medical care weakened for all family compositions but remained significantly lower for families with two older adults. Conclusion-Among families with older adults, financial burdens of medical care vary based on family composition., (All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.)

In 2018, an estimated 8.1 million U.S. adults were current electronic cigarette (e-cigarette) users (1). E-cigarette use is a public health concern (2), and it has been linked to a recent outbreak of lung injury and deaths among adults (3). Although the potential long-term health risks of e-cigarettes are not yet as well-known as they are with cigarettes, e-cigarettes usually contain nicotine, and nicotine is highly addictive (2). Moreover, the most common tobacco product combination among adults is e-cigarettes and cigarettes (4). This report examines e-cigarette use among U.S. adults aged 18 and over by selected sociodemographic characteristics and in relation to cigarette smoking status., (All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.)

Diabetes increases with age. In 2017, the prevalence of diagnosed diabetes increased from 13.2% among adults aged 45-64 to 20.1% among those aged 65-74 and 19.8% among those aged 75 and over (1). Compared with adults without diabetes, adults with diabetes are more likely to develop eye disorders and vision loss from eye disorders (2,3). Moreover, duration of diabetes is a risk factor for the progression of visual problems (3,4). This report compares the age-adjusted percentages of adults aged 45 and over with diagnosed diabetes who were told by a doctor or other health professional that they had cataracts, diabetic retinopathy, glaucoma, or macular degeneration and vision loss due to these disorders, by years since their diabetes diagnosis., (All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.)

Routine dental care can promote oral health (1,2), and those with private dental insurance are more likely to visit a dentist than those with other types of dental coverage or no coverage (3,4). Geographical variation in dental coverage and care among adults under age 65 exists (5,6), as does the availability of dental health professionals (7). This report examines regional variation in dental coverage among dentate adults (i.e., adults who have not lost all permanent teeth) aged 18-64 who had private health insurance in the past year, their utilization of dental care, and unmet dental needs due to cost in the past year., (All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.)

The clavicular portion of the deltoid muscle (CPDM) in the human clavicle does not have a nomenclature in the Terminologia Anatomica (TA). This area is relevant in anatomy since the muscle participates in motions of glenohumeral articulation. The aim of this study was to describe the origin of the CPDM and to propose a name for the structure. Dry clavicles of 176 adults were studied, without distinction by sex. An osteometric board was used to measure the maximum length of the clavicles and a digital caliper to measure length of the CPDM's origin, distance from the origin to the sternal end, distance from the origin to the acromial end, distance of the lateral third and middle vertical diameter. The mean of maximum of the distances and CPDM's origin of left/right clavicle do not present significant differences. The CPDM s origin showed a high prevalence of structures as groove and roughened area (over 96% of cases). In conclusion, our definition of the CPDM shows the importance of clearly describing the observed groove and roughened area. Due to the high prevalence of the structures, the authors suggest that the terms "sulcus musculi deltoidei" and "tuberositas musculi deltoidei" be included in the TA to denominate the CPDM's origin on the human clavicle., (Copyright © 2018 Elsevier GmbH. All rights reserved.)

To describe methodological issues that arise in the construction and design-based estimation of multidimensional indices that aggregate state-specific inequalities in core health measures, using data from the National Health Interview Survey (NHIS)., (All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.)

Key Findings: Data from the National Health Interview Survey •Among adults aged 18 and over with diagnosed diabetes, 61.6% had an influenza vaccine in the past year. •A total of 52.6% of adults with diagnosed diabetes had a pneumococcal vaccine and 17.1% had the 3-dose vaccination schedule for hepatitis B at some point in the past. •Among adults aged 60 and over with diagnosed diabetes, 27.2% had ever had a shingles vaccine. •Among those with diagnosed diabetes, the vaccination coverage for influenza, pneumococcal, and shingles was lowest among poor adults, increased with age, and varied by race and ethnicity. •Hepatitis B vaccination coverage was lowest among poor adults, and it decreased with age. Persons with diabetes are at an increased risk for complications from vaccine-preventable infections (1-3). Several vaccines are recommended for adults with diabetes, including annual vaccination for influenza and at least a one-time dose of pneumococcal vaccine, regardless of age; a shingles vaccine starting at age 60; and a hepatitis B vaccine soon after diabetes diagnosis among those aged 19-59, and based on clinical discretion thereafter (4). This report describes the receipt of select vaccinations among adults with diagnosed diabetes by sex, age, race and ethnicity, and poverty status., (All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.)

Key Findings: Data from the National Health Interview Survey •During 2014, 78.1% of adults aged 18-64 were insured at the time of interview and had been insured for more than a year. •About 6.4% of adults were insured at the time of interview but had a period of no insurance in the past year. •About 12.3% of adults were uninsured at the time of interview and had been uninsured for more than a year, and 3.2% were uninsured at the time of interview but had a period of insurance coverage in the past year. •Those insured at the time of interview and insured for more than a year were more likely than those with any period of no insurance to have a usual place of care, visited a health care provider, received a flu vaccine, and were less likely to have had an unmet medical need due to cost., (All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.)

Key Findings: Data from the National Health Interview Survey, 2013. Nine percent of adults aged 18 and over have diagnosed diabetes, and more than 8 in 10 of these adults had contact with a doctor or health care professional in the past 6 months. The percentage of adults with diagnosed diabetes who were taking any medication to control their glucose levels increased with age. The percentage of adults with diagnosed diabetes who had contact with an eye or foot care specialist in the past 12 months increased with age. Among adults with diagnosed diabetes, those aged 18-39 were the least likely to have had their blood pressure or blood cholesterol checked by a doctor, nurse, or other health professional during the past 12 months. Diabetes is a chronic medical condition that affects 1 in 10 adults in the United States (1). Diabetes can affect multiple organs and lead to serious health complications (2). Ongoing medical care is recommended for persons of any age who have diabetes in order to manage levels of glucose, obtain preventive care services, and treat diabetes-related complications (2,3). This report describes differences by age in the utilization of selected medical care services among adults aged 18 and over with diagnosed diabetes, based on data from the 2013 National Health Interview Survey (NHIS)., (All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.)

Among U.S. adults aged 18-64, strategies for reducing prescription drug costs were more commonly practiced by those who were uninsured than those who had public or private coverage. Lack of health insurance coverage and poverty are recognized risk factors for not taking medication as prescribed due to cost. This cost-saving strategy may result in poorer health status and increased emergency room use and hospitalizations, compared with adults who follow their recommended pharmacotherapy. It is unknown whether adverse health outcomes and higher health care costs are also associated with the cost-reduction strategies of alternative therapy use or obtaining prescription drugs from abroad. Among adults aged 65 and over, those covered by both Medicare and Medicaid were more likely to have not taken their medication as prescribed to save money, but were less likely to have asked their doctor for a lower-cost prescription, than those who had private insurance coverage. Differences in cost-saving strategies by insurance coverage may be interrelated with socioeconomic and other patient characteristics. Belief that the recommended pharmacotherapy is needed, and an understanding of the recommended treatment, have been found to be lower among older adults who are economically vulnerable, compared with those with higher income. Income was also associated with the use of cost-reduction strategies. Among adults aged 65 and over, those living with incomes at 139%-400% FPL were more likely than adults living in lower or higher income thresholds to have asked their provider for a lower-cost prescription to save money. These patterns in the estimates by insurance status and poverty level are similar to those previously reported using the 2011 NHIS data., (All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.)

T. vaginalis infection (trichomoniasis) is the most common curable sexually transmitted infection (STI) in the U.S. It is associated with increased HIV risk and adverse pregnancy outcomes. Trichomoniasis surveillance data do not exist for either national or local populations. The Monitoring STIs Survey Program (MSSP) collected survey data and specimens which were tested using nucleic acid amplification tests to monitor trichomoniasis and other STIs in 2006-09 among a probability sample of young adults (N = 2,936) in Baltimore, Maryland--an urban area with high rates of reported STIs. The estimated prevalence of trichomoniasis was 7.5% (95% CI 6.3, 9.1) in the overall population and 16.1% (95% CI 13.0, 19.8) among Black women. The overwhelming majority of infected men (98.5%) and women (73.3%) were asymptomatic. Infections were more common in both women (OR = 3.6, 95% CI 1.6, 8.2) and men (OR = 9.0, 95% CI 1.8, 44.3) with concurrent chlamydial infection. Trichomoniasis did not vary significantly by age for either men or women. Women with two or more partners in the past year and women with a history of personal or partner incarceration were more likely to have an infection. Overall, these results suggest that routine T vaginalis screening in populations at elevated risk of infection should be considered.

Incarceration has been extensively linked with HIV and sexually transmitted infections (STIs). While a great deal of attention has been given to the risk behaviors of people who have been incarcerated, examination of the behaviors of partners of incarcerated individuals is also needed to understand the direct and indirect links between incarceration and HIV and to identify prevention avenues. In the present study, we hypothesize that incarceration is associated with risk behavior through attitudes and norms. The purpose of this paper is: (1) to describe the attitudes and norms about sexual behaviors that women have when a sexual partner is incarcerated; and (2) to examine the association between attitudes and norms with the behavior of having other sex partners while a main partner is incarcerated. In our sample (n = 175), 50 % of women reported having other sex partners while their partner was incarcerated. Our findings show that attitudes, descriptive norms (i.e., norms about what other people do), and injunctive norms (i.e., norms about what others think is appropriate) were associated with having other partners. Interventions designed for couples at pre- and post-release from prison are needed to develop risk reduction plans and encourage HIV/STI testing prior to their reunion.

INTRODUCTION. Glycogen storage disease type II, or Pompe disease, is a lysosomal disease with an autosomal recessive pattern of inheritance. Late-onset Pompe disease is a progressive metabolic myopathy caused by decreased activity of the enzyme acid alpha-glucosidase (GAA), which gives rise to reduced degradation and later accumulation of glycogen in the lysosomes and cell cytoplasm. CASE REPORT. A 16-year-old Venezuelan male, diagnosed with late-onset glycogen storage disease type II, or Pompe disease, based on the patient's clinical picture and the biochemical findings. The patient presented unmistakable signs of muscular atrophy in the upper and lower limbs, as well as positive Gowers' sign. Levels of creatinkinase in serum were high. His functional respiratory capacity was diminished. The quantification of the enzymatic activity of acid alpha-glucosidase on filter paper did not show any significant decrease in activity. A molecular genetic analysis revealed the existence of two homozygotic mutations in the gene GAA, c.547-67C>G and c.547-39T>G, both on exon 2 of chromosome 17. According to the human genome database and the review that was undertaken, the changes detected in this patient represent new mutations in the acid alpha-glucosidase gene, GAA. This claim is in agreement with the clinical features and biochemical changes found in the patient. CONCLUSION. A molecular genetic study is mandatory in patients suspected of having this disease.

Background: Chlamydia trachomatis (Ct) is the most frequently reported infectious disease in the United States. This article reports population and subpopulation prevalence estimates of Ct and correlates of infection among 15- to 35-year-olds in Baltimore, MD., Methods: The Monitoring STIs Survey Program (MSSP) monitored sexually transmitted infection (STI) prevalence among probability samples of residents of Baltimore, a city with high STI rates. MSSP respondents completed telephone audio computer-assisted self-interviews and provided biospecimens for STI testing., Results: Among 2120 Baltimore residents aged 15 to 35 years, the estimated prevalence of chlamydia was 3.9% (95% confidence interval [CI]: 2.8, 5.0). Prevalence was 5.8% (95% CI: 4.1, 7.6) among black MSSP respondents versus 0.7% (95% CI: 0.0, 1.4) among nonblack respondents; all but 4 infections detected were among black respondents. Sexual behaviors and other factors associated with infection were far more prevalent among black than nonblack Baltimore residents. Racial disparities persisted after adjustment for sociodemographic, behavioral, and health factors., Conclusion: The MSSP highlights a higher Ct prevalence among young people in Baltimore than in the United States overall, with notable racial disparities in infection and associated risk behaviors. Public health efforts are needed to improve the diagnosis and treatment of asymptomatic infections in this population.

Background: This study assesses the impact of Telephone Audio Computer-Assisted Self-Interviewing (T-ACASI) on the reporting of sensitive (mainly heterosexual) behaviours., Methods: A randomized experiment was embedded in a telephone survey that drew probability samples of the populations of the USA (N = 1543) and Baltimore city (N = 744). Respondents were randomly assigned to have questions asked either by a T-ACASI computer or by a human telephone interviewer., Results: Compared with interviewer-administered telephone surveys, T-ACASI obtained more frequent reporting of a range of mainly heterosexual behaviours that were presumed to be sensitive, including recency of anal sex [adjusted odds ratio (A-OR) = 2.00, P < 0.001), sex during menstrual period (A-OR = 1.49, P < 0.001), giving oral sex (A-OR = 1.40, P = 0.001) and receiving oral sex (A-OR = 1.36, P = 0.002), and sexual difficulties for the respondent (A-OR = 1.45, P = 0.034) and their main sex partner (A-OR = 1.48, P = 0.0). T-ACASI also obtained less frequent reporting that respondent had a 'main sex partner' (A-OR = 0.56, P = 0.011) and discussed contraception prior to first sex with that sex partner (A-OR = 0.82, P = 0.094). For both males and females, T-ACASI obtained more frequent reports of first vaginal sex occurring at early ages (before ages 12 through 15). 'For males only', T-ACASI also elicited more frequent reports that first vaginal sex had 'not' occurred at later ages (i.e. by ages 20 through 24)., Conclusion: T-ACASI increases the likelihood that survey respondents will report sensitive heterosexual behaviours.

Numerous studies have shown that audio-computer-assisted self-interviewing (audio-CASI) and telephone audio-CASI (T-ACASI) technologies yield increased reporting of sensitive and stigmatized objective phenomena such as sexual and drug use behaviors. Little attention has been given, however, to the impact of these technologies on the measurement of subjective phenomena (attitudes, opinions, feelings, etc.). This article reports results for the seven subjective measurements included in the National STD and Behavior Measurement Experiment (NSBME). NSBME drew probability samples of USA and Baltimore adults (Ns = 1,543 and 744, respectively) and randomized these respondents to be interviewed by T-ACASI or telephone interviewer-administered questioning (T-IAQ). Response distributions for all subjective measurements obtained by T-ACASI diverge from those obtained by human telephone interviewers. For six of our seven ordinal-scaled measurements, this divergence involved shifting responses directionally along the ordinal scale, as opposed to a nondirectional redistribution among response categories. When interviewed by T-ACASI, respondents were more supportive of traditional gender roles and corporal punishment, less supportive of integrated neighborhoods and same-gender sex, and more likely to agree that occasional marijuana use is harmless and to describe themselves as attractive. The majority of these results suggest that telephone survey respondents may provide more "tolerant" and "socially liberal" responses to human interviewers than to a T-ACASI computer. Similarly, although the evidence is not entirely consistent, the impact of T-ACASI appears to increase with the social vulnerability of the population surveyed.

Objectives: The enhanced sensitivity of nucleic acid amplification tests (NAAT) provides an opportunity for estimating the prevalence of untreated Chlamydia trachomatis infections. The transmissibility and public health significance of some NAAT-identified infections are, however, not known., Methods: Adults attending an urban emergency department provided specimens for C trachomatis screening using NAAT. Participants testing positive were offered follow-up including re-testing for C trachomatis using NAAT and traditional methods, eg culture and direct fluorescent antibody, and were treated. Partners were offered identical evaluation and treatment. Overall, 90 C trachomatis-positive participants had one or more sexual partners enrolled., Results: Evidence of transmission, as defined by infection concordance between partnerships, was observed among 75% of partners of index cases testing positive by both NAAT and traditional assay but only 45% of partners of index cases testing positive by NAAT only (prevalence ratio 1.7, 95% CI 1.1 to 2.5). Among index participants returning for follow-up, 17% had no evidence of C trachomatis infection by NAAT or traditional assay (median follow-up three weeks)., Conclusions: A substantial proportion of positive NAAT results for chlamydial infection may be of lower transmissibility and may not persist after a short follow-up. The long-term health effects of some positive NAAT are uncertain.

Well-conducted telephone surveys provide an economical means of estimating the prevalence of sexual and reproductive behaviors in a population. There is, however, a nontrivial potential for bias since respondents must report sensitive information to a human interviewer. The National STD and Behavior Measurement Experiment (NSBME) evaluates a new survey technology-telephone audio computer-assisted self-interviewing (T-ACASI)-that eliminates this requirement. The NSBME embedded a randomized experiment in a survey of probability samples of 1,543 U.S. and 744 Baltimore adults ages 18 to 45. Compared with NSBME respondents interviewed by human interviewers, respondents interviewed by T-ACASI were 1.5 to 1.6 times more likely to report same-gender sexual attraction, experience, and genital contact. The impact of T-ACASI was more pronounced (odds ratio = 2.5) for residents of locales that have historically been less tolerant of same-gender sexual behaviors and for respondents in households with children (odds ratio = 3.0).

Objectives: To examine whether audio computer assisted survey interviewing (ACASI) influenced responses to sensitive HIV risk behaviour questions, relative to interviewer administration of those questions (IAQ), among patients attending a sexually transmitted infection (STI) clinic and whether the impact of interview mode on reporting of risk behaviours was homogeneous across subgroups of patients (defined by age, sex, and previous STI clinic experience)., Methods: 1350 clinic patients were assigned to complete a detailed behavioural survey on sexual risk practices, previous STIs and symptoms, condom use, and drug and alcohol use using either ACASI or IAQ., Results: Respondents assigned to ACASI were more likely to report recent risk behaviours such as sex without a condom in the past 24 hours (adjusted OR = 1.9), anal sex (adjusted OR = 2.0), and one or more new partners in the past 6 months (adjusted OR = 1.5) compared to those interviewed by IAQ. The impact of ACASI varied by sex but, contrary to expectations, not by whether the patient had previously visited an STI clinic. Mode of survey administration made little difference within this population in reports of STI knowledge, previous STIs, STI symptoms, or illicit drug use., Conclusion: ACASI provides a useful tool for improving the quality of behavioural data in clinical environments.

Aim: To assess the impact of telephone audio computer-assisted self-interviewing (T-ACASI) on reporting of alcohol use, alcohol problems and illicit drug use in telephone surveys of the general population. Prior research suggests that illicit drug use is underreported in traditional, interviewer-administered, telephone surveys., Design: Randomized experiment embedded in telephone survey of probability samples of populations of USA and Baltimore, MD. Survey respondents were randomly assigned to be interviewed either by human telephone interviewers or by T-ACASI after household screening, recruitment, and informed consent procedures were completed., Setting: Respondents were interviewed by telephone in their homes., Participants: Probability samples of 1543 English-speaking adults ages 18-45 residing in telephone-accessible households in USA and 744 similarly defined adults residing in Baltimore, MD, USA., Measurements: Nine questions on alcohol, marijuana, cocaine, and injection drug use adapted from 1994 NHSDA and four CAGE questions on alcohol problems. Crude odds ratios and odds ratios controlling for demographic factors calculated to test for differences between responses obtained by T-ACASI and human interviewers., Findings: T-ACASI had mixed effects on reporting of alcohol use, but it did increase reporting of one of four CAGE alcohol problems: feeling guilty about drinking (23.0% in T-ACASI vs. 17.6% in T-IAQ, OR = 1.4, P < 0.01). T-ACASI also obtained significantly more frequent reporting of marijuana, cocaine, and injection drug use. The impact of T-ACASI was most pronounced for reporting of recent use of 'harder' drugs. Thus T-ACASI respondents were more likely to report marijuana use in the past month (10.0% vs. 5.7%, crude OR = 1.9, P < 0.001), cocaine use in the past month (2.1% vs. 0.7%, crude 3.2, P < 0.001) and injection drug use in the past five years (1.6% vs. 0.3%, crude OR = 4.8, P < 0.01)., Conclusions: Telephone survey respondents were more likely to report illicit drug use and one alcohol problem when interviewed by T-ACASI rather than by human telephone interviews.

Objectives: This pilot test assessed the feasibility of a cost effective population based approach to STI monitoring using automated telephone interviews, urine specimen collection kits sent out and returned by US Postal Service mail, and monetary incentives to motivate participation., Methods: 100 residents of Baltimore, MD, USA, completed an automated telephone survey and agreed to mail in a urine specimen to be tested for chlamydia and gonorrhoea. Participants were paid dollar 10 for completing the survey and dollar 40 for mailing the specimen., Results: 86% of survey participants mailed in a urine specimen for testing., Conclusions: Automated telephone surveys linked with testing of mailed-in urine specimens may be a feasible lower cost (relative to household surveys) method of estimating infection prevalences in a population.

The leucocyte and mineral profile changes were studied in bovines with different waiting time at the slaughterhouse. The stress induced by the waiting time at the slaughterhouse brought changes in relative leukocyte frequency, with inverted neutrophil:lymphocyte relation in animals with 24 hours of waiting time (1.45). However the sodium:potassium relation in the animals with 48 hours of waiting time was significantly lower (23.6, p < 0.001) than that almost normal in animals with 24 hours of waiting time (33.1). Also the high correlations between the parameters studied show an unique physiological or pathological situation. The found values point out hormonal changes similar to those in stress situations.

Growth of 230 very low birth weight infants (VLBWI) admitted to the neonatal wards of a metropolitan pediatric hospital at Santiago, Chile was studied prospectively up to 36 months of age, in the period 1980-1988. For further analysis patients were separated in groups A, 60 newborn infants with birth-weight below 1,001 g and B, 170 newborn infants with birth-weight between 1,001 and 1,500 g. We used Patri's growth charts, to compare the results with full term healthy newborns of 3,318 g average birth-weight from the same socio-economical status. The average weight of group A infants was below 2 SD at age one year and between one and two SD at 2 and 3 years of age. In group B infants weight was between one and 2 SD at one year of age and below 1 SD at 2 years. At age 3 years average weight was very close to normal. Group A infants were not successful to achieve the average height of the standard at age 3 year, but this same goal was obtained at 2 years of age in group B infants. Head circumference was within the normal average at ages 3 and 2 year in group A and B infants, respectively.