Data Dictionary for latcev
Number of Blaise fields: 882
| Seq # | Var | Question | Data Type/Coding |
|---|---|---|---|
| 1 | versiondate | Version Date | |
| 1 | versiondate | Version Date | |
| 2 | formdescr | Form Description | |
| 2 | formdescr | Form Description | |
| 3 | formno | Form Number | String[8] |
| 3 | formno | Form Number | String[8] |
| 4 | version | Version Number | String[10] |
| 4 | version | Version Number | String[10] |
| 5 | projid | ^formdescr Form: ^formno Version: ^version (^versiondate) Enter project ID number. | String[8] |
| 5 | projid | ^formdescr Form: ^formno Version: ^version (^versiondate) Enter project ID number. | String[8] |
| 6 | visit | String[2] | |
| 6 | visit | String[2] | |
| 7 | baseyear | 1993 .. 2025 | |
| 7 | baseyear | 1993 .. 2025 | |
| 8 | autodate | Automatic Date. | Date type |
| 8 | autodate | Automatic Date. | Date type |
| 9 | autotime | Automatic Time. | TimeType |
| 9 | autotime | Automatic Time. | TimeType |
| 10 | autolog | Automatic Logged Date. | Date type |
| 10 | autolog | Automatic Logged Date. | Date type |
| 11 | intid | INTERVIEWER ID | 100 .. 997 |
| 11 | intid | INTERVIEWER ID | 100 .. 997 |
| 12 | compid | Laptop ID | String[20] |
| 12 | compid | Laptop ID | String[20] |
| 13 | dateint | Date of interview | Date type |
| 13 | dateint | Date of interview | Date type |
| 14 | gender | Enter participant's gender. | 1= Male 2= Female |
| 14 | gender | Enter participant's gender. | 1= Male 2= Female |
| 15 | q1drg | Ahora me gustar�a preguntarle sobre medicaciones. 1. Durante las �ltimas dos semanas, �Ha tomado alguna medicaci�n recetada por un m�dico? | 1= Yes 2= No |
| 15 | q1drg | Now I would like to ask you about medicines. 1. During the past two weeks, HAVE YOU TAKEN ANY MEDICINE PRESCRIBED by a doctor? | 1= Yes 2= No |
| 16 | q2drg | 2. Now, about supplements not usually prescribed by a doctor such as vitamin preparations including multivitamins, vitamin C, vitamin A, vitamin D, or vitamin E . . . During the past two weeks have you taken any of these or any other vitamin preparations? | 1= Yes 2= No |
| 16 | q2drg | 2. Ahora, acerca de los suplementos nutricionales que no son comunmente prescritos por un doctor tales como complejos vitam�nicos incluyendo: multivitam�nicos, vitamina C, vitamina A, vitamina D, o vitamina E, pudiera decirme si durante las �ltimas dos semanas ha tomado alguna de �stas? | 1= Yes 2= No |
| 17 | q3drg | 3. Tambi�n estamos interesados en otras medicinas o suplementos no recetados por un doctor como aspirina, Tylenol, Bufferin, Anacin, pastillas para el dolor de cabeza o calmantes para el dolor, laxantes o medicinas para el intestino, medicinas para el resfriado, medicinas para la tos, medicinas para el sue�o, anti�cidos o medicinas para el est�mago, pomadas o ung�entos.. . . durante las �ltimas dos semanas, ha tomado una de estas o cualquier otras medicaciones de la farmacia? | 1= Yes 2= No |
| 17 | q3drg | 3. We are also interested in other medicines or supplements not prescribed by a doctor such as aspirin, Tylenol, Bufferin, Anacin, headache pills or pain killers, laxatives or bowel medicines, cold medicines, cough medicines, sleep medicines, antacids or stomach medicines, ointments or salves . . . During the past two weeks have you taken any of these or any other medicines from the drug store? | 1= Yes 2= No |
| 18 | q4drg | 4. May I please see all these medicines for the past two weeks? [INTERVIEWER RECORD ALL MEDICINES TAKEN WITHIN THE PAST 2 WEEKS WHETHER AVAILABLE FOR INSPECTION OR NOT] [ENTER TOTAL NUMBER OF MEDICINES TO BE RECORDED] | 0 .. 50 |
| 18 | q4drg | 4. �Podr�a ver todas estas medicaciones que ha tomado durante las �ltimas dos semanas? [INTERVIEWER RECORD ALL MEDICINES TAKEN WITHIN THE PAST 2 WEEKS WHETHER AVAILABLE FOR INSPECTION OR NOT] [ENTER TOTAL NUMBER OF MEDICINES TO BE RECORDED] | 0 .. 50 |
| 19 | name00 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 19 | name00 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 20 | stren00 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 20 | stren00 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 21 | drgnm00 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 21 | drgnm00 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 22 | seen00 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 22 | seen00 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 23 | dosage00 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 23 | dosage00 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 24 | recd00 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 24 | recd00 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 25 | name01 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 25 | name01 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 26 | stren01 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 26 | stren01 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 27 | drgnm01 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 27 | drgnm01 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 28 | seen01 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 28 | seen01 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 29 | dosage01 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 29 | dosage01 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 30 | recd01 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 30 | recd01 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 31 | name02 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 31 | name02 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 32 | stren02 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 32 | stren02 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 33 | drgnm02 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 33 | drgnm02 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 34 | seen02 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 34 | seen02 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 35 | dosage02 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 35 | dosage02 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 36 | recd02 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 36 | recd02 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 37 | name03 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 37 | name03 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 38 | stren03 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 38 | stren03 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 39 | drgnm03 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 39 | drgnm03 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 40 | seen03 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 40 | seen03 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 41 | dosage03 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 41 | dosage03 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 42 | recd03 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 42 | recd03 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 43 | name04 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 43 | name04 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 44 | stren04 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 44 | stren04 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 45 | drgnm04 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 45 | drgnm04 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 46 | seen04 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 46 | seen04 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 47 | dosage04 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 47 | dosage04 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 48 | recd04 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 48 | recd04 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 49 | name05 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 49 | name05 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 50 | stren05 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 50 | stren05 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 51 | drgnm05 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 51 | drgnm05 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 52 | seen05 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 52 | seen05 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 53 | dosage05 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 53 | dosage05 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 54 | recd05 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 54 | recd05 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 55 | name06 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 55 | name06 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 56 | stren06 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 56 | stren06 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 57 | drgnm06 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 57 | drgnm06 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 58 | seen06 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 58 | seen06 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 59 | dosage06 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 59 | dosage06 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 60 | recd06 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 60 | recd06 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 61 | name07 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 61 | name07 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 62 | stren07 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 62 | stren07 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 63 | drgnm07 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 63 | drgnm07 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 64 | seen07 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 64 | seen07 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 65 | dosage07 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 65 | dosage07 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 66 | recd07 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 66 | recd07 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 67 | name08 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 67 | name08 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 68 | stren08 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 68 | stren08 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 69 | drgnm08 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 69 | drgnm08 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 70 | seen08 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 70 | seen08 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 71 | dosage08 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 71 | dosage08 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 72 | recd08 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 72 | recd08 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 73 | name09 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 73 | name09 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 74 | stren09 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 74 | stren09 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 75 | drgnm09 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 75 | drgnm09 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 76 | seen09 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 76 | seen09 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 77 | dosage09 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 77 | dosage09 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 78 | recd09 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 78 | recd09 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 79 | name10 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 79 | name10 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 80 | stren10 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 80 | stren10 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 81 | drgnm10 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 81 | drgnm10 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 82 | seen10 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 82 | seen10 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 83 | dosage10 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 83 | dosage10 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 84 | recd10 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 84 | recd10 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 85 | name11 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 85 | name11 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 86 | stren11 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 86 | stren11 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 87 | drgnm11 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 87 | drgnm11 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 88 | seen11 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 88 | seen11 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 89 | dosage11 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 89 | dosage11 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 90 | recd11 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 90 | recd11 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 91 | name12 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 91 | name12 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 92 | stren12 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 92 | stren12 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 93 | drgnm12 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 93 | drgnm12 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 94 | seen12 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 94 | seen12 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 95 | dosage12 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 95 | dosage12 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 96 | recd12 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 96 | recd12 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 97 | name13 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 97 | name13 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 98 | stren13 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 98 | stren13 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 99 | drgnm13 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 99 | drgnm13 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 100 | seen13 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 100 | seen13 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 101 | dosage13 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 101 | dosage13 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 102 | recd13 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 102 | recd13 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 103 | name14 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 103 | name14 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 104 | stren14 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 104 | stren14 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 105 | drgnm14 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 105 | drgnm14 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 106 | seen14 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 106 | seen14 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 107 | dosage14 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 107 | dosage14 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 108 | recd14 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 108 | recd14 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 109 | name15 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 109 | name15 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 110 | stren15 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 110 | stren15 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 111 | drgnm15 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 111 | drgnm15 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 112 | seen15 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 112 | seen15 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 113 | dosage15 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 113 | dosage15 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 114 | recd15 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 114 | recd15 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 115 | name16 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 115 | name16 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 116 | stren16 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 116 | stren16 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 117 | drgnm16 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 117 | drgnm16 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 118 | seen16 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 118 | seen16 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 119 | dosage16 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 119 | dosage16 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 120 | recd16 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 120 | recd16 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 121 | name17 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 121 | name17 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 122 | stren17 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 122 | stren17 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 123 | drgnm17 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 123 | drgnm17 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 124 | seen17 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 124 | seen17 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 125 | dosage17 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 125 | dosage17 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 126 | recd17 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 126 | recd17 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 127 | name18 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 127 | name18 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 128 | stren18 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 128 | stren18 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 129 | drgnm18 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 129 | drgnm18 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 130 | seen18 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 130 | seen18 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 131 | dosage18 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 131 | dosage18 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 132 | recd18 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 132 | recd18 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 133 | name19 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 133 | name19 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 134 | stren19 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 134 | stren19 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 135 | drgnm19 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 135 | drgnm19 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 136 | seen19 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 136 | seen19 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 137 | dosage19 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 137 | dosage19 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 138 | recd19 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 138 | recd19 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 139 | name20 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 139 | name20 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 140 | stren20 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 140 | stren20 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 141 | drgnm20 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 141 | drgnm20 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 142 | seen20 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 142 | seen20 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 143 | dosage20 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 143 | dosage20 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 144 | recd20 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 144 | recd20 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 145 | name21 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 145 | name21 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 146 | stren21 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 146 | stren21 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 147 | drgnm21 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 147 | drgnm21 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 148 | seen21 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 148 | seen21 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 149 | dosage21 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 149 | dosage21 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 150 | recd21 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 150 | recd21 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 151 | name22 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 151 | name22 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 152 | stren22 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 152 | stren22 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 153 | drgnm22 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 153 | drgnm22 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 154 | seen22 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 154 | seen22 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 155 | dosage22 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 155 | dosage22 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 156 | recd22 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 156 | recd22 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 157 | name23 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 157 | name23 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 158 | stren23 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 158 | stren23 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 159 | drgnm23 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 159 | drgnm23 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 160 | seen23 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 160 | seen23 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 161 | dosage23 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 161 | dosage23 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 162 | recd23 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 162 | recd23 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 163 | name24 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 163 | name24 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 164 | stren24 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 164 | stren24 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 165 | drgnm24 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 165 | drgnm24 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 166 | seen24 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 166 | seen24 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 167 | dosage24 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 167 | dosage24 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 168 | recd24 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 168 | recd24 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 169 | name25 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 169 | name25 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 170 | stren25 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 170 | stren25 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 171 | drgnm25 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 171 | drgnm25 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 172 | seen25 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 172 | seen25 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 173 | dosage25 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 173 | dosage25 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 174 | recd25 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 174 | recd25 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 175 | name26 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 175 | name26 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 176 | stren26 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 176 | stren26 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 177 | drgnm26 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 177 | drgnm26 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 178 | seen26 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 178 | seen26 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 179 | dosage26 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 179 | dosage26 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 180 | recd26 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 180 | recd26 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 181 | name27 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 181 | name27 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 182 | stren27 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 182 | stren27 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 183 | drgnm27 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 183 | drgnm27 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 184 | seen27 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 184 | seen27 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 185 | dosage27 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 185 | dosage27 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 186 | recd27 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 186 | recd27 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 187 | name28 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 187 | name28 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 188 | stren28 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 188 | stren28 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 189 | drgnm28 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 189 | drgnm28 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 190 | seen28 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 190 | seen28 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 191 | dosage28 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 191 | dosage28 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 192 | recd28 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 192 | recd28 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 193 | name29 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 193 | name29 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 194 | stren29 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 194 | stren29 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 195 | drgnm29 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 195 | drgnm29 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 196 | seen29 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 196 | seen29 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 197 | dosage29 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 197 | dosage29 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 198 | recd29 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 198 | recd29 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 199 | name30 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 199 | name30 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 200 | stren30 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 200 | stren30 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 201 | drgnm30 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 201 | drgnm30 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 202 | seen30 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 202 | seen30 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 203 | dosage30 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 203 | dosage30 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 204 | recd30 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 204 | recd30 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 205 | name31 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 205 | name31 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 206 | stren31 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 206 | stren31 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 207 | drgnm31 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 207 | drgnm31 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 208 | seen31 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 208 | seen31 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 209 | dosage31 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 209 | dosage31 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 210 | recd31 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 210 | recd31 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 211 | name32 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 211 | name32 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 212 | stren32 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 212 | stren32 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 213 | drgnm32 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 213 | drgnm32 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 214 | seen32 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 214 | seen32 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 215 | dosage32 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 215 | dosage32 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 216 | recd32 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 216 | recd32 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 217 | name33 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 217 | name33 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 218 | stren33 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 218 | stren33 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 219 | drgnm33 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 219 | drgnm33 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 220 | seen33 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 220 | seen33 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 221 | dosage33 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 221 | dosage33 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 222 | recd33 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 222 | recd33 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 223 | name34 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 223 | name34 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 224 | stren34 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 224 | stren34 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 225 | drgnm34 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 225 | drgnm34 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 226 | seen34 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 226 | seen34 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 227 | dosage34 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 227 | dosage34 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 228 | recd34 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 228 | recd34 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 229 | name35 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 229 | name35 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 230 | stren35 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 230 | stren35 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 231 | drgnm35 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 231 | drgnm35 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 232 | seen35 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 232 | seen35 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 233 | dosage35 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 233 | dosage35 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 234 | recd35 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 234 | recd35 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 235 | name36 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 235 | name36 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 236 | stren36 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 236 | stren36 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 237 | drgnm36 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 237 | drgnm36 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 238 | seen36 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 238 | seen36 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 239 | dosage36 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 239 | dosage36 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 240 | recd36 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 240 | recd36 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 241 | name37 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 241 | name37 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 242 | stren37 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 242 | stren37 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 243 | drgnm37 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 243 | drgnm37 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 244 | seen37 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 244 | seen37 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 245 | dosage37 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 245 | dosage37 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 246 | recd37 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 246 | recd37 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 247 | name38 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 247 | name38 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 248 | stren38 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 248 | stren38 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 249 | drgnm38 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 249 | drgnm38 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 250 | seen38 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 250 | seen38 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 251 | dosage38 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 251 | dosage38 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 252 | recd38 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 252 | recd38 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 253 | name39 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 253 | name39 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 254 | stren39 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 254 | stren39 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 255 | drgnm39 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 255 | drgnm39 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 256 | seen39 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 256 | seen39 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 257 | dosage39 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 257 | dosage39 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 258 | recd39 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 258 | recd39 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 259 | name40 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 259 | name40 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 260 | stren40 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 260 | stren40 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 261 | drgnm40 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 261 | drgnm40 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 262 | seen40 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 262 | seen40 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 263 | dosage40 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 263 | dosage40 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 264 | recd40 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 264 | recd40 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 265 | name41 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 265 | name41 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 266 | stren41 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 266 | stren41 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 267 | drgnm41 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 267 | drgnm41 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 268 | seen41 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 268 | seen41 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 269 | dosage41 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 269 | dosage41 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 270 | recd41 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 270 | recd41 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 271 | name42 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 271 | name42 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 272 | stren42 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 272 | stren42 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 273 | drgnm42 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 273 | drgnm42 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 274 | seen42 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 274 | seen42 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 275 | dosage42 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 275 | dosage42 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 276 | recd42 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 276 | recd42 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 277 | name43 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 277 | name43 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 278 | stren43 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 278 | stren43 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 279 | drgnm43 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 279 | drgnm43 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 280 | seen43 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 280 | seen43 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 281 | dosage43 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 281 | dosage43 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 282 | recd43 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 282 | recd43 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 283 | name44 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 283 | name44 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 284 | stren44 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 284 | stren44 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 285 | drgnm44 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 285 | drgnm44 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 286 | seen44 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 286 | seen44 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 287 | dosage44 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 287 | dosage44 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 288 | recd44 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 288 | recd44 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 289 | name45 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 289 | name45 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 290 | stren45 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 290 | stren45 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 291 | drgnm45 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 291 | drgnm45 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 292 | seen45 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 292 | seen45 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 293 | dosage45 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 293 | dosage45 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 294 | recd45 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 294 | recd45 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 295 | name46 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 295 | name46 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 296 | stren46 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 296 | stren46 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 297 | drgnm46 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 297 | drgnm46 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 298 | seen46 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 298 | seen46 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 299 | dosage46 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 299 | dosage46 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 300 | recd46 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 300 | recd46 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 301 | name47 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 301 | name47 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 302 | stren47 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 302 | stren47 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 303 | drgnm47 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 303 | drgnm47 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 304 | seen47 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 304 | seen47 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 305 | dosage47 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 305 | dosage47 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 306 | recd47 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 306 | recd47 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 307 | name48 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 307 | name48 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 308 | stren48 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 308 | stren48 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 309 | drgnm48 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 309 | drgnm48 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 310 | seen48 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 310 | seen48 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 311 | dosage48 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 311 | dosage48 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 312 | recd48 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 312 | recd48 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 313 | name49 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 313 | name49 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 314 | stren49 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 314 | stren49 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 315 | drgnm49 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 315 | drgnm49 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 316 | seen49 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 316 | seen49 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 317 | dosage49 | d. On average, how many pills (capsules or other dosage units) did you take per day during the past two weeks? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 317 | dosage49 | d. En promedio, �cu�ntas pastillas (c�psulas u otra unidad de dosis) tom� cada d�a durante las �ltimas dos semanas? [CODE 66 IF TAKEN LESS THAN 01 PER DAY] | 1 .. 66 |
| 318 | recd49 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 318 | recd49 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 319 | stroke | MEDICAL HISTORY First I would like to ask you a few questions about specific medical conditions such as stroke and Parkinson's disease. STROKE 1. Have you EVER been told by a doctor, nurse or therapist that you had a STROKE, TRANSIENT ISCHEMIC ATTACK (TIA) or BRAIN HEMORRHAGE? | 1= Yes 2= Suspect or possible 3= No |
| 319 | stroke | HISTORIAL M�DICO Primero, me gustar�a hacerle algunas preguntas sobre condiciones m�dicas espec�ficas tales como embolia/derrame y la enfermedad de Parkinson? EMBOLIA/DERRAME 1. �Alg�n m�dico, enfermera, terapeuta o asistente m�dico le ha dicho alguna vez que ten�a una embolia, accidente isqu�mico transitorio (AIT), o hemorragia cerebral? | 1= S� 2= Sospecha or posible 3= No |
| 320 | strokeyr | 1a. �Cu�ndo fue la �ltima vez? [ENTER YEAR] [INTERVIEWER: `Last' refers to the most recent event.] | 1940 .. 2030 |
| 320 | strokeyr | 1a. When was the last time? [ENTER YEAR] [INTERVIEWER: `Last' refers to the most recent event.] | 1940 .. 2030 |
| 321 | faint0 | �Experiment� Ud. al momento de este (�ltimo) evento alguno de los siguientes s�ntomas? a. Desmayo o p�rdida de conocimiento? | 1= S� 2= Sospecha 3= No |
| 321 | faint0 | At the time of this (last) event, did you you have . . . a. Fainting, blackout or loss of consciousness? | 1= Yes 2= Suspect 3= No |
| 322 | dizzy0 | b. Dizzyness or lightheadedness? | 1= Yes 2= Suspect 3= No |
| 322 | dizzy0 | b. Mareos o sensaci�n de aturdimiento? | 1= S� 2= Sospecha 3= No |
| 323 | memory0 | c. P�rdida de memoria o estar olvidadizo/a? | 1= S� 2= Sospecha 3= No |
| 323 | memory0 | c. Memory loss or forgetfulness? | 1= Yes 2= Suspect 3= No |
| 324 | speech0 | At the time of this (last) event, did you you have . . . d. Language or speech change? | 1= Yes 2= Suspect 3= No |
| 324 | speech0 | �Experiment� Ud. al momento de este (�ltimo) evento alguno de los siguientes s�ntomas? d. Cambios en el lenguaje o en el habla? | 1= S� 2= Sospecha 3= No |
| 325 | vision0 | e. P�rdida de visi�n? | 1= No 2= Solo derecho 3= Solo izquierdo 4= Ambos |
| 325 | vision0 | e. Loss of vision? | 1= No 2= right only 3= left only 4= both |
| 326 | face0 | f. Debilidad o par�lisis en la cara? | 1= No 2= Solo derecho 3= Solo izquierdo 4= Ambos |
| 326 | face0 | f. Weakness or paralysis of your face? | 1= No 2= right only 3= left only 4= both |
| 327 | weaklim0 | g. Weakness or paralysis of your arms or legs? | 1= No 2= right only 3= left only 4= both |
| 327 | weaklim0 | g. Debilidad o par�lisis en los brazos o en las piernas? | 1= No 2= Solo derecho 3= Solo izquierdo 4= Ambos |
| 328 | limsens0 | h. P�rdida o cambio de sensaci�n en los brazos o en las piernas? | 1= No 2= Solo derecho 3= Solo izquierdo 4= Ambos |
| 328 | limsens0 | h. Loss or change of sensation in your arms or legs? | 1= No 2= right only 3= left only 4= both |
| 329 | sympspe0 | i. Specify any other signs or symptoms associated with this (last) event? | String[40] |
| 329 | sympspe0 | i. Especifique otras se�ales o s�ntomas asociadas con este �ltimo evento: | String[40] |
| 330 | sametim0 | j. �La embolia coincidi� con el momento de una OPERACION QUIRURGICA, ATAQUE DE CORAZON, DIFICULTADES RESPIRATORIAS, u OTRO PROBLEMA M�DICO SERIO? | 1= S� 2= Sospecha 3= No |
| 330 | sametim0 | j. Did the stroke occur around the same time as a SURGICAL OPERATION, HEART ATTACK, BREATHING DIFFICULTY, or ANOTHER SERIOUS MEDICAL PROBLEM? | 1= Yes 2= Suspect 3= No |
| 331 | samespe0 | Specify: | String[60] |
| 331 | samespe0 | Especifique: | String[60] |
| 332 | inhosp | 2. Have you EVER been HOSPITALIZED OVERNIGHT or longer because of a STROKE, a TIA or a BRAIN HEMORRHAGE? | 1= Yes 2= Suspect 3= No |
| 332 | inhosp | 2. �Alguna vez fue HOSPITALIZADO/A POR UNA NOCHE o m�s tiempo debido a una embolia/derrame, un accidente isqu�mico transitorio (AIT), o hemorragia cerebral? | 1= S� 2= Sospecha 3= No |
| 333 | prompt1 | 2a. �Fue �ste el mismo evento del que acabamos de hablar? | 1= Yes 2= No |
| 333 | prompt1 | 2a. Was this the same event we just spoke about? | 1= Yes 2= No |
| 334 | hospyear | When was the last time? [ENTER YEAR] [INTERVIEWER: `Last' refers to the most recent hospitalization event.] | 1940 .. 2030 |
| 334 | hospyear | �Cu�ndo fue la �ltima vez? [ENTER YEAR] [INTERVIEWER: `Last/�ltimo' refers to the most recent hospitalization event.] | 1940 .. 2030 |
| 335 | hospname | 2b. �Cu�l era el nombre del hospital? | String[30] |
| 335 | hospname | 2b. What was the name of the hospital? | String[30] |
| 336 | faint1 | At the time of this (last) event, did you you have . . . a. Fainting, blackout or loss of consciousness? | 1= Yes 2= Suspect 3= No |
| 336 | faint1 | �Experiment� Ud. al momento de este (�ltimo) evento alguno de los siguientes s�ntomas? a. Desmayo, o p�rdida de conocimiento? | 1= S� 2= Sospecha 3= No |
| 337 | dizzy1 | b. �Mareos o sensaci�n de aturdimiento? | 1= S� 2= Sospecha 3= No |
| 337 | dizzy1 | b. Dizzyness or lightheadedness? | 1= Yes 2= Suspect 3= No |
| 338 | memory1 | c. Memory loss or forgetfulness? | 1= Yes 2= Suspect 3= No |
| 338 | memory1 | c. P�rdida de memoria o estar olvidadizo/a? | 1= S� 2= Sospecha 3= No |
| 339 | speech1 | At the time of this (last) event, did you have . . . [INTERVIEWER: `Last' refers to the most recent hospitalization event.] d. Language or speech change? | 1= Yes 2= Suspect 3= No |
| 339 | speech1 | �Experiment� Ud. al momento de este (�ltimo) evento alguno de los siguientes s�ntomas? [INTERVIEWER: `Last/�ltimo' refers to the most recent hospitalization event.] d. Cambios en el lenguaje o en el habla? | 1= S� 2= Sospecha 3= No |
| 340 | vision1 | e. P�rdida de visi�n? | 1= No 2= Solo derecho 3= Solo izquierdo 4= Ambos |
| 340 | vision1 | e. Loss of vision? | 1= No 2= right only 3= left only 4= both |
| 341 | face1 | f. Debilidad o par�lisis en la cara? | 1= No 2= Solo derecho 3= Solo izquierdo 4= Ambos |
| 341 | face1 | f. Weakness or paralysis of your face? | 1= No 2= right only 3= left only 4= both |
| 342 | weaklim1 | g. Weakness or paralysis of your arms or legs? | 1= No 2= right only 3= left only 4= both |
| 342 | weaklim1 | g. Debilidad o par�lisis en los brazos o en las piernas? | 1= No 2= Solo derecho 3= Solo izquierdo 4= Ambos |
| 343 | limsens1 | h. P�rdida o cambio de sensaci�n en los brazos o en las piernas? | 1= No 2= Solo derecho 3= Solo izquierdo 4= Ambos |
| 343 | limsens1 | h. Loss or change of sensation in your arms or legs? | 1= No 2= right only 3= left only 4= both |
| 344 | sympspe1 | i. Specify any other signs or symptoms associated with this (last) event? | String[40] |
| 344 | sympspe1 | i. Especifique otras se�ales o s�ntomas asociadas con este �ltimo evento: | String[40] |
| 345 | sametim1 | j. �La embolia coincidi� con el momento de una OPERACION QUIRURGICA, ATAQUE DE CORAZON, DIFICULTADES RESPIRATORIAS, u OTRO PROBLEMA M�DICO SERIO? | 1= S� 2= Sospecha 3= No |
| 345 | sametim1 | j. Did the stroke occur around the same time as a SURGICAL OPERATION, HEART ATTACK, BREATHING DIFFICULTY, or ANOTHER SERIOUS MEDICAL PROBLEM? | 1= Yes 2= Suspect 3= No |
| 346 | samespe1 | Specify: | String[60] |
| 346 | samespe1 | Especifique: | String[60] |
| 347 | strokscn | 3. �Se ha sometido ALGUNA VEZ a una Tomograf�a Axial Computarizada (TC), Resonancia Magn�tica (RMN/MRI) u otro tipo de scanner/estudio cerebral debido a una EMBOLIA, un accidente isqu�mico transitorio (AIT) o una HEMORRAGIA CEREBRAL? | 1= S� 2= Sospecha 3= No |
| 347 | strokscn | 3. Have you EVER had a CT, MRI or other type of brain scan because of a STROKE, a TIA or a BRAIN HEMORRHAGE? | 1= Yes 2= Suspect 3= No |
| 348 | prompt2 | 3a. �Fue �ste el mismo evento del que acabamos de hablar? | 1= Yes 2= No |
| 348 | prompt2 | 3a. Was this for ^event we just spoke about? | 1= Yes 2= No |
| 349 | scanyear | When was the last time? [ENTER YEAR] [INTERVIEWER: `Last' refers to the most recent scan.] | 1940 .. 2030 |
| 349 | scanyear | �Cu�ndo fue la �ltima vez? [ENTER YEAR] [INTERVIEWER: `Last/�ltimo' refers to the most recent scan.] | 1940 .. 2030 |
| 350 | scanloc | 3b. �Cu�l era el nombre del lugar (consulta, hospital u otro lugar) en el que se realiz� el scanner/estudio? | String[30] |
| 350 | scanloc | 3b. What was the name of the place (doctor's office, hospital or other place) at which the scan was performed? | String[30] |
| 351 | faint2 | At the time of this (last) event, did you you have . . . a. Fainting, blackout or loss of consciousness? | 1= Yes 2= Suspect 3= No |
| 351 | faint2 | En el momento de este (�ltimo) evento, �experiment�...? a. Desmayo, o p�rdida del conocimiento? | 1= S� 2= Sospecha 3= No |
| 352 | dizzy2 | b. Mareos o sensaci�n de aturdimiento? | 1= S� 2= Sospecha 3= No |
| 352 | dizzy2 | b. Dizzyness or lightheadedness? | 1= Yes 2= Suspect 3= No |
| 353 | memory2 | c. Memory loss or forgetfulness? | 1= Yes 2= Suspect 3= No |
| 353 | memory2 | c. P�rdida de memoria o estar olvidadizo/a? | 1= S� 2= Sospecha 3= No |
| 354 | speech2 | d. Language or speech change? | 1= Yes 2= Suspect 3= No |
| 354 | speech2 | d. Cambios en el lenguaje o en el habla? | 1= S� 2= Sospecha 3= No |
| 355 | vision2 | e. P�rdida de visi�n? | 1= No 2= Solo derecho 3= Solo izquierdo 4= Ambos |
| 355 | vision2 | e. Loss of vision? | 1= No 2= right only 3= left only 4= both |
| 356 | face2 | f. Debilidad o par�lisis en la cara? | 1= No 2= Solo derecho 3= Solo izquierdo 4= Ambos |
| 356 | face2 | f. Weakness or paralysis of your face? | 1= No 2= right only 3= left only 4= both |
| 357 | weaklim2 | g. Weakness or paralysis of your arms or legs? | 1= No 2= right only 3= left only 4= both |
| 357 | weaklim2 | g. Debilidad o par�lisis en los brazos o en las piernas? | 1= No 2= Solo derecho 3= Solo izquierdo 4= Ambos |
| 358 | limsens2 | h. P�rdida o cambio de sensaci�n en los brazos o en las piernas? | 1= No 2= Solo derecho 3= Solo izquierdo 4= Ambos |
| 358 | limsens2 | h. Loss or change of sensation in your arms or legs? | 1= No 2= right only 3= left only 4= both |
| 359 | sympspe2 | i. Specify any other signs or symptoms associated with this (last) event? | String[40] |
| 359 | sympspe2 | i. Especifique otras se�ales o s�ntomas asociadas con este �ltimo evento: | String[40] |
| 360 | sametim2 | j. �La embolia coincidi� con el momento de una OPERACION QUIRURGICA, ATAQUE DE CORAZON, DIFICULTADES RESPIRATORIAS, u OTRO PROBLEMA M�DICO SERIO? | 1= S� 2= Sospecha 3= No |
| 360 | sametim2 | j. Did the stroke occur around the same time as a SURGICAL OPERATION, HEART ATTACK, BREATHING DIFFICULTY, or ANOTHER SERIOUS MEDICAL PROBLEM? | 1= Yes 2= Suspect 3= No |
| 361 | samespe2 | Specify: | String[60] |
| 361 | samespe2 | Especifique: | String[60] |
| 362 | multiple | 4. Did you have only ONE STROKE, TIA or BRAIN HEMORRHAGE, or more than one? | 1= Only one 2= More than one |
| 362 | multiple | 4. �Tuvo una EMBOLIA, un accidente isqu�mico transitorio (AIT) o una HEMORRAGIA CEREBRAL o m�s de uno? | 1= S�lo uno one 2= M�s de uno |
| 363 | leftspec | 5. Especifique cu�les son las secuelas actuales de su embolia/derrame(s)? | String[60] |
| 363 | leftspec | 5. Specify leftover troubles from your stroke(s)? | String[60] |
| 364 | everscan | 6. Have you EVER had a CT, MRI or other type of brain scan? | 1= Yes 2= Suspect 3= No |
| 364 | everscan | 6. �Se someti� ALGUNA VEZ a una Tomograf�a Axial Computarizada (TC), Resonancia Magn�tica (RMN/MRI), u otro tipo de scanner/estudio cerebral? | 1= S� 2= Sospecha 3= No |
| 365 | reason | 6c. Reason | String[60] |
| 365 | reason | 6c. Reason | String[60] |
| 366 | escanloc | 6d. What was the name of the place (doctor's office, hospital or other place) at which the scan was performed? | String[30] |
| 366 | escanloc | 6d. �Cu�l era el nombre del lugar (consulta, hospital u otro lugar) en el que se realiz� el scanner/estudio? | String[30] |
| 367 | parks | 1. �Alg�n m�dico, enfermera, terapeuta o asistente m�dico le ha dicho alguna vez que ten�a PARKINSONISMO o LA ENFERMEDAD DE PARKINSON? | 1= S� 2= Sospecha or posible 3= No |
| 367 | parks | 1. Have you EVER been told by a doctor, nurse or therapist that you had PARKINSONISM or PARKINSON'S DISEASE? | 1= Yes 2= Suspect or possible 3= No |
| 368 | year | 1a. When were you first told this? | 1940 .. 2030 |
| 368 | year | 1a. �Cu�ndo le informaron de ello por primera vez? | 1940 .. 2030 |
| 369 | gait | 2. Con el parkinsonismo, ha padecido usted alguna vez de . . . andar arrastrando los pies o andar tambale�ndose? | 1= S� 2= Sospecha 3= No |
| 369 | gait | With the parkinsonism, did you have . . . 2. Shuffling or unsteady gait, or loss of balance? | 1= Yes 2= Suspect 3= No |
| 370 | writing | 3. A change in your handwriting? | 1= Yes 2= Suspect 3= No |
| 370 | writing | 3. �Un cambio en su letra manuscrita? | 1= S� 2= Sospecha 3= No |
| 371 | stiff | 4. �Agarrotamiento o rigidez en sus brazos o piernas? | 1= No 2= Solo derecho 3= Solo izquierdo 4= Ambos |
| 371 | stiff | 4. Stiffness or rigidity of your arms or legs? | 1= No 2= right only 3= left only 4= both |
| 372 | slowmove | 5. Slowness of movement of your arms, hands or legs? | 1= No 2= right only 3= left only 4= both |
| 372 | slowmove | 5. �Lentitud en el movimiento de sus brazos, manos o piernas? | 1= No 2= Solo derecho 3= Solo izquierdo 4= Ambos |
| 373 | tremor | 6. �Temblor en sus manos o pies? | 1= No 2= Solo derecho 3= Solo izquierdo 4= Ambos |
| 373 | tremor | 6. Tremor of your hands or feet? | 1= No 2= right only 3= left only 4= both |
| 374 | medicate | 7. �Est� usted tomando actualmente alguna medicaci�n para su parkinsonismo o enfermedad de Parkinson (algunos ejemplos son Sinemet, Symmetrel, Parlodel, Bromocriptine, etc.)? | 1= S� 2= Sospecha or posible 3= No |
| 374 | medicate | 7. Are you currently taking any medication for your parkinsonism or Parkinson's disease (some examples are Sinemet, Symmetrel, Parlodel, Bromocriptine, etc.)? | 1= Yes 2= Suspect or possible 3= No |
| 375 | medspec | 7a. Specify | String[30] |
| 375 | medspec | 7a. Especifique: | String[30] |
| 376 | histad | �Alg�n m�dico, enfermera o terapeuta le ha dicho alguna vez que usted padec�a de demencia senil, o de la enfermedad de Alzheimer? | 1= S� 2= Sospecha 3= No |
| 376 | histad | Have you ever been told by a doctor, nurse, or therapist that you had dementia, senility, or Alzheimer's disease? | 1= Yes 2= Suspect 3= No |
| 377 | spiroqs | Will spirometry data be entered directly into Blaise form? | 1= Yes 2= No |
| 377 | spiroqs | Will spirometry data be entered directly into Blaise form? | 1= Yes 2= No |
| 378 | fev11 | RESET Spirometry device FEV1 Trial 1 [Enter 95.5 for tried but unable.] _____ liters | 0.00 .. 95.50 |
| 378 | fev11 | Este pr�ximo test medir� c�mo de r�pido y cu�nto aire puede usted soplar. No hay resistencia. Ser� como soplar cien velas en un pastel de cumplea�os. Esto es lo que quiero que haga usted. Tome aire tan profundamente como pueda (llene sus pulmones con todo el aire que pueda), sujete, abra la boca, ponga sus labios firmemente en el tubo, luego sople tan fuerte y r�pido como usted pueda, como si usted estuviera soplando cien velas en un pastel de cumplea�os.(demostrar) �Preparado?...tome aire profundamente, sujete, abra bien, labios firmes, Sople!!! ... y pare (repetir para el Segundo intento) RESET Spirometry device FEV1 Trial 1 [Enter 95.5 for tried but unable.] _____ liters | 0.00 .. 95.50 |
| 379 | pvc1 | PVC Trial 1 _____ liters | 0.00 .. 10.00 |
| 379 | pvc1 | PVC Trial 1 _____ liters | 0.00 .. 10.00 |
| 380 | fer1 | FER Trial 1 _____ percent | 0 .. 100 |
| 380 | fer1 | FER Trial 1 _____ percent | 0 .. 100 |
| 381 | pef1 | PEF Trial 1 _____ liters/minute [If greater than 999, enter 999.] | 0 .. 999 |
| 381 | pef1 | PEF Trial 1 _____ liters/minute [If greater than 999, enter 999.] | 0 .. 999 |
| 382 | fev12 | RESET Spirometry device FEV1 Trial 2 [Enter 95.5 for tried but unable.] _____ liters | 0.00 .. 95.50 |
| 382 | fev12 | RESET Spirometry device FEV1 Trial 2 [Enter 95.5 for tried but unable.] _____ liters | 0.00 .. 95.50 |
| 383 | pvc2 | PVC Trial 2 _____ liters | 0.00 .. 10.00 |
| 383 | pvc2 | PVC Trial 2 _____ liters | 0.00 .. 10.00 |
| 384 | fer2 | FER Trial 2 _____ percent | 0 .. 100 |
| 384 | fer2 | FER Trial 2 _____ percent | 0 .. 100 |
| 385 | pef2 | PEF Trial 2 _____ liters/minute [If greater than 999, enter 999.] | 0 .. 999 |
| 385 | pef2 | PEF Trial 2 _____ liters/minute [If greater than 999, enter 999.] | 0 .. 999 |
| 386 | spcom | Spirometry Enter any comment. [Press enter to continue if none.] | String[250] |
| 386 | spcom | Spirometry Enter any comment. [Press enter to continue if none.] | String[250] |
| 387 | q8atap | FINGER TAPPING [DEPRESS BUTTON UNTIL '--' APPEARS.] 1. Right index finger. 'I want to see how quickly you can tap this key. When I tell you to begin, tap this key as quickly as you can until I tell you to stop.' Record first trial. ______Taps completed in 10 seconds. 97 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 1 .. 97 |
| 387 | q8atap | FINGER TAPPING [TURN DIAL TO TAPPING TEST] 1. Right hand. 'Quiero ver que tan r�pido usted puede presionar esta tecla. Ahora pruebe con su mano derecha. Cuando yo le diga que empiece, presione esta tecla de forma continua o repetida, lo m�s r�pido que pueda hasta que le diga que pare.' Record first trial. ______Taps completed in 10 seconds. 97 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 1 .. 97 |
| 388 | q8ana | Specify reason. | String[40] |
| 388 | q8ana | Specify reason. | String[40] |
| 389 | q8btap | FINGER TAPPING [RESET TAPPER] Left index finger. Record first trial. ______Taps completed in 10 seconds. 97 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 1 .. 97 |
| 389 | q8btap | FINGER TAPPING [RESET TAPPER] Left index finger. Record first trial. ______Taps completed in 10 seconds. 97 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 1 .. 97 |
| 390 | q8bna | Specify reason. | String[40] |
| 390 | q8bna | Specify reason. | String[40] |
| 391 | q8ctap | FINGER TAPPING [RESET TAPPER] Right index finger. Record second trial. ______Taps completed in 10 seconds. 97 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 1 .. 97 |
| 391 | q8ctap | FINGER TAPPING [RESET TAPPER] Right index finger. Record second trial. ______Taps completed in 10 seconds. 97 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 1 .. 97 |
| 392 | q8cna | Specify reason. | String[40] |
| 392 | q8cna | Specify reason. | String[40] |
| 393 | q8dtap | FINGER TAPPING [RESET TAPPER] Left index finger. Record second trial. ______Taps completed in 10 seconds. 97 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 1 .. 97 |
| 393 | q8dtap | FINGER TAPPING [RESET TAPPER] Left index finger. Record second trial. ______Taps completed in 10 seconds. 97 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 1 .. 97 |
| 394 | q8dna | Specify reason. | String[40] |
| 394 | q8dna | Specify reason. | String[40] |
| 395 | rhand1 | HAND DYNAMOMETRY [SET RED NEEDLE TO 0.] 'Quiero ver con cu�nta fuerza puede usted apretar este aparato manual. Cuando yo le diga que empiece, apriete con tanta fuerza como pueda hasta que yo le diga que pare.' Right Hand Trial 1 [RECORD IN POUNDS.] 777 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 0 .. 777 |
| 395 | rhand1 | HAND DYNAMOMETRY [SET RED NEEDLE TO 0.] 'I want to see how strongly you can squeeze this handle. When I say go, squeeze the handle as hard as you can until I tell you to stop.' Right Hand Trial 1 [RECORD IN POUNDS.] 777 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 0 .. 777 |
| 396 | rhand1na | Specify reason. | String[40] |
| 396 | rhand1na | Specify reason. | String[40] |
| 397 | lhand1 | HAND DYNAMOMETRY [RESET NEEDLE TO 0.] Left Hand Trial 1 [RECORD IN POUNDS]. 777 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 0 .. 777 |
| 397 | lhand1 | HAND DYNAMOMETRY [RESET NEEDLE TO 0.] Left Hand Trial 1 [RECORD IN POUNDS]. 777 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 0 .. 777 |
| 398 | lhand1na | Specify reason. | String[40] |
| 398 | lhand1na | Specify reason. | String[40] |
| 399 | rhand2 | HAND DYNAMOMETRY [RESET NEEDLE TO 0.] Right Hand Trial 2 [RECORD IN POUNDS]. 777 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 0 .. 777 |
| 399 | rhand2 | HAND DYNAMOMETRY [RESET NEEDLE TO 0.] Right Hand Trial 2 [RECORD IN POUNDS]. 777 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 0 .. 777 |
| 400 | rhand2na | Specify reason. | String[40] |
| 400 | rhand2na | Specify reason. | String[40] |
| 401 | lhand2 | HAND DYNAMOMETRY [RESET NEEDLE TO 0.] Left Hand Trial 2 [RECORD IN POUNDS]. 777 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 0 .. 777 |
| 401 | lhand2 | HAND DYNAMOMETRY [RESET NEEDLE TO 0.] Left Hand Trial 2 [RECORD IN POUNDS]. 777 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 0 .. 777 |
| 402 | lhand2na | Specify reason. | String[40] |
| 402 | lhand2na | Specify reason. | String[40] |
| 403 | rthand1 | PINCH DYNAMOMETRY [SET RED NEEDLE TO 0.] 'Quiero ver con cu�nta fuerza puede usted apretar este disco. Cuando yo le diga que empiece, apriete este disco con tanta fuerza como pueda hasta que yo le diga que pare.' Right Hand Trial 1 [RECORD IN POUNDS]. 77 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 0 .. 77 |
| 403 | rthand1 | PINCH DYNAMOMETRY [SET RED NEEDLE TO 0.] 'I want to see how strongly you can pinch this plate. When I say go, squeeze the plate as hard as you can until I tell you to stop.' Right Hand Trial 1 [RECORD IN POUNDS]. 77 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 0 .. 77 |
| 404 | rthand1n | Specify reason. | String[40] |
| 404 | rthand1n | Specify reason. | String[40] |
| 405 | lthand1 | PINCH DYNAMOMETRY [RESET NEEDLE TO 0.] Left Hand Trial 1 [RECORD IN POUNDS]. 77 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 0 .. 77 |
| 405 | lthand1 | PINCH DYNAMOMETRY [RESET NEEDLE TO 0.] Left Hand Trial 1 [RECORD IN POUNDS]. 77 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 0 .. 77 |
| 406 | lthand1n | Specify reason. | String[40] |
| 406 | lthand1n | Specify reason. | String[40] |
| 407 | rthand2 | PINCH DYNAMOMETRY [RESET NEEDLE TO 0.] Right Hand Trial 2 [RECORD IN POUNDS]. 77 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 0 .. 77 |
| 407 | rthand2 | PINCH DYNAMOMETRY [RESET NEEDLE TO 0.] Right Hand Trial 2 [RECORD IN POUNDS]. 77 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 0 .. 77 |
| 408 | rthand2n | Specify reason. | String[40] |
| 408 | rthand2n | Specify reason. | String[40] |
| 409 | lthand2 | PINCH DYNAMOMETRY [RESET NEEDLE TO 0.] Left Hand Trial 2 [RECORD IN POUNDS]. 77 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 0 .. 77 |
| 409 | lthand2 | PINCH DYNAMOMETRY [RESET NEEDLE TO 0.] Left Hand Trial 2 [RECORD IN POUNDS]. 77 : Tried but unable, Specify reason________________________ ] Don't Know, Specify reason________________________ ] Refusal - Not Attempted, Specify reason________________________ ] | 0 .. 77 |
| 410 | lthand2n | Specify reason. | String[40] |
| 410 | lthand2n | Specify reason. | String[40] |
| 411 | rtoevib | SENSORY FUNCTION Vamos a probar su sensaci�n a la vibraci�n en sus pies. Voy a ense�arle lo que usted va a sentir. Ahora voy a probarlo en los dos dedos gordos de uno y otro pie. D�game si usted siente lo mismo. Vibratory sensation 1. Right big toe [EXAMINER: First, make sure that subject understands the sensation. Tap tuning fork in palm of hand and test for ability to perceive vibration on the top of the large toe of each foot.] | 1= Normal 2= possred 3= defred 4= Absent 7= notest |
| 411 | rtoevib | SENSORY FUNCTION Vibratory sensation 1. Right big toe [EXAMINER: First, make sure that subject understands the sensation. Tap tuning fork in palm of hand and test for ability to perceive vibration on the top of the large toe of each foot.] | 1= Normal 2= Possibly reduced 3= Definitely reduced 4= Absent 7= Unable to test |
| 412 | ltoevib | Vibratory sensation 2. Left big toe | 1= Normal 2= Possibly reduced 3= Definitely reduced 4= Absent 7= Unable to test |
| 412 | ltoevib | Vibratory sensation 2. Left big toe | 1= Normal 2= possred 3= defred 4= Absent 7= notest |
| 413 | rlegvib | Stocking pattern of vibratory loss 3. Right Leg. [EXAMINER: Determine whether there is a greater sensory loss in the toe vs. the ankle] | 1= Yes 2= Possible 3= No |
| 413 | rlegvib | Stocking pattern of vibratory loss 3. Right Leg. [EXAMINER: Determine whether there is a greater sensory loss in the toe vs. the ankle] | 1= Yes 2= Possible 3= No |
| 414 | ltlegvib | Stocking pattern of vibratory loss 4. Left leg. [EXAMINER: Determine whether there is a greater sensory loss in the toe vs. the ankle] | 1= Yes 2= Possible 3= No |
| 414 | ltlegvib | Stocking pattern of vibratory loss 4. Left leg. [EXAMINER: Determine whether there is a greater sensory loss in the toe vs. the ankle] | 1= Yes 2= Possible 3= No |
| 415 | cov1 | Revised COVID FORM 2022 This form serves as an update to the original COVID-19 Survey released in summer 2020, and reflects on several important updates since that time, including vaccinations and evolving understanding of the long-term impacts of COVID-19 particularly on cognitive function. We are asking these questions because COVID-19 has presented multiple challenges for us all, and we would like to learn about your experience. 1. Have you been diagnosed with COVID-19 (you tested positive or were presumed to have COVID-19 by a healthcare provider)? | 0= No 1= Yes, based on a positive test for acute infection 2= Yes, presumed COVID-19 diagnosis by healthcare provider but not tested 8= Decline to answer 9= Unsure/unknown |
| 415 | cov1 | Revised COVID FORM 2022 Este formulario es una actualizaci�n del cuestionario original del COVID-19, administrado en el verano del 2020, y refleja acontecimientos importantes desde esa �poca, incluyendo vacunas y el conocimiento de los efectos del COVID-19 a largo plazo, en particular relacionados con el funcionamiento cognitivo. Les hacemos estas preguntas porque el COVID-19 ha presentado numerosos retos para todos, y nos gustar�a aprender mas sobre su experiencia. 1. �Ha sido diagnosticado con COVID-19 (usted recibi� un resultado positivo o es presunto positivo)? | 0= No 1= Si, basado en un resultado positive de una infecci�n aguda 2= Si, diagnostico presunto positivo por un proveedor m�dico, pero sin administrar prueba 8= Se reh�sa a contestar 9= Inseguro/desconocido |
| 416 | cov1a | Revised COVID FORM 2022 1a. �Cu�ntas veces ha sido diagnosticado con COVID-19 (episodios de enfermedad distintos)? | 1= Una 2= Dos 3= Tres o m�s veces 9= Inseguro/desconocido |
| 416 | cov1a | Revised COVID FORM 2022 1a. How many times have you been diagnosed with COVID-19 (distinct episodes of illness)? | 1= Once 2= Twice 3= Three or more times 9= Unsure/unknown |
| 417 | cov1b | Revised COVID FORM 2022 1b. When did your first COVID-19 infection begin (month/year)? [ 88/8888 = Decline to answer ] | String[7] |
| 417 | cov1b | Revised COVID FORM 2022 1b. �Cuando comenz� su primera infecci�n del COVID-19 (mes/a�o)? [ 88/8888 = Decline to answer ] | String[7] |
| 418 | cov1c | Revised COVID FORM 2022 1c. �Cu�nto tiempo duro su primera infecci�n del COVID-19? | 1= < 1 semana 2= 1-2 semanas 3= 2-4 semanas 4= >4 semanas 5= Aun no se ha recuperado (los s�ntomas contin�an en la actualidad) |
| 418 | cov1c | Revised COVID FORM 2022 1c. What was the duration of your first COVID-infection? | 1= <1 week 2= 1-2 weeks 3= 2-4 weeks 4= >4 weeks 5= Not yet recovered (symptoms persist to the present) |
| 419 | cov1d | Revised COVID FORM 2022 1d. During any of your COVID-19 infections, did you lose the ability to smell or taste, experience lower ability to determine smells or tastes, or experience episodes of unprovoked, unfamiliar, or strange smells or tastes? | 0= No 1= Yes 8= Decline to answer 9= Unsure/unknown |
| 419 | cov1d | Revised COVID FORM 2022 1d. �En alg�n momento durante cualquiera de sus infecciones del COVID-19, perdi� el sentido del gusto o el sentido del olfato, sinti� disminuci�n en su capacidad de percibir olores o sabores, o experimento olores o sabores raros o desconocidos? | 0= No 1= Si 8= Se reh�sa a contestar 9= Inseguro/Desconocido |
| 420 | cov1e | Revised COVID FORM 2022 1e. Durante cualquiera de sus infecciones del COVID-19, experimento problemas nuevos con el pensamiento, perdida de memoria, o concentraci�n (e.g., niebla mental/niebla cerebral)? | 0= No 1= Si 8= Se reh�sa a contestar 9= Inseguro/Desconocido |
| 420 | cov1e | Revised COVID FORM 2022 1e. During any of your COVID-19 infections, did you experience new problems with thinking, remembering, or concentration (e.g., brain fog)? | 0= No 1= Yes 8= Decline to answer 9= Unsure/unknown |
| 421 | cov1f | Revised COVID FORM 2022 1f. Did you ever seek medical care for COVID-19? | 0= No 1= Yes 8= Decline to answer 9= Unsure/unknown |
| 421 | cov1f | Revised COVID FORM 2022 1f. �En alg�n momento solicito atenci�n m�dica para el COVID-19? | 0= No 1= Si 8= Se reh�sa a contestar 9= Inseguro/Desconocido |
| 422 | cov1g | Revised COVID FORM 2022 1g. �Cu�l es el nivel m�s alto de cuidado que recibi�? | 1= Consulta con un m�dico o cl�nica de urgencia, incluyendo consultas virtuales 2= Sala de emergencia 3= Hospitalizado, pero sin ingresar a la unidad de cuidados intensivos 4= Hospitalizado, incluyendo una estancia en la unidad de cuidados intensivos y/o apoyo respiratorio mec�nico (tubo para respirar insertado por la garganta) 8= Se reh�sa a contestar 9= Inseguro/Desconocido |
| 422 | cov1g | Revised COVID FORM 2022 1g. What was the highest level of care received? | 1= Physician or urgent care visit, including virtual care visit 2= Emergency department 3= Hospitalized but not the intensive care unit 4= Hospitalized, including a stay in the ICU and/or ventilator support (breathing tube in your throat) 8= Decline to answer 9= Unsure/unknown |
| 423 | cov1h | Revised COVID FORM 2022 1h. To what degree have you recovered from your COVID-19 symptoms (scale 1 to 5)? | 1= No improvement 2= Slightly improved 3= Somewhat improved 4= Mostly improved 5= Totally recovered or never had symptoms 8= Decline to answer 9= Unsure/unknown |
| 423 | cov1h | Revised COVID FORM 2022 1h. �Cu�nta mejor�a relacionada a los s�ntomas del COVID-19 ha sentido? | 1= ninguna mejor�a 2= mejor�a leve 3= alguna mejor�a 4= mayormente mejorado 5= completamente recuperado o nunca tuvo s�ntomas 8= Se reh�sa a contestar 9= Inseguro/Desconocido |
| 424 | cov2 | Revised COVID FORM 2022 2. �Ha recibido al menos una vacuna contra el COVID 19? | 0= No 1= Si 8= Se reh�sa a contestar 9= Inseguro/Desconocido |
| 424 | cov2 | Revised COVID FORM 2022 2. Have you received at least one vaccination against COVID-19? | 0= No 1= Yes 8= Decline to answer 9= Unsure/unknown |
| 425 | ivisit | visit | |
| 425 | ivisit | visit | |
| 426 | cuff | BLOODPRESSURE Now I would like to take some blood pressure readings. 3. IS CUFF SIZE AVAILABLE? [IF CUFF NOT AVAILABLE, AT END OF INTERVIEW SET UP TIME TO RETURN FOR BLOOD PRESSURE MEASUREMENT] | 1= Yes 2= No |
| 426 | cuff | BLOODPRESSURE Now I would like to take some blood pressure readings. 3. IS CUFF SIZE AVAILABLE? [IF CUFF NOT AVAILABLE, AT END OF INTERVIEW SET UP TIME TO RETURN FOR BLOOD PRESSURE MEASUREMENT] | 1= Yes 2= No |
| 427 | bp11 | 6. FIRST SITTING BLOOD PRESSURE READING [INTERVIEWER: The subject should be seated for five minutes prior to obtaining the seated blood pressure readings. ENTER SYSTOLIC/DIASTOLIC] | String[7] |
| 427 | bp11 | 6. FIRST SITTING BLOOD PRESSURE READING [INTERVIEWER: The subject should be seated for five minutes prior to obtaining the seated blood pressure readings. ENTER SYSTOLIC/DIASTOLIC] | String[7] |
| 428 | bp2 | 7. SECOND SITTING BLOOD PRESSURE READING [INTERVIEWER: ENTER SYSTOLIC/DIASTOLIC] | String[7] |
| 428 | bp2 | 7. SECOND SITTING BLOOD PRESSURE READING [INTERVIEWER: ENTER SYSTOLIC/DIASTOLIC] | String[7] |
| 429 | bp31 | 8. STANDING BLOOD PRESSURE READING [INTERVIEWER: ASK THE SUBJECT TO STAND. WAIT 60 SECONDS THEN REPEAT BLOOD PRESSURE READING. ENTER SYSTOLIC/DIASTOLIC] | String[7] |
| 429 | bp31 | 8. STANDING BLOOD PRESSURE READING [INTERVIEWER: ASK THE SUBJECT TO STAND. WAIT 60 SECONDS THEN REPEAT BLOOD PRESSURE READING. ENTER SYSTOLIC/DIASTOLIC] | String[7] |
| 430 | howwell | 1. INTERVIEWER OBSERVATIONS How well do you think the participant understood the questions? | 1= qw 2= fw 3= sw 4= vl 5= naa |
| 430 | howwell | 1. INTERVIEWER OBSERVATIONS How well do you think the participant understood the questions? | 1= Quite well 2= Fairly well 3= Somewhat 4= Very Little 5= Not at all |
| 431 | hearimp | 2. Does the participant have a SUBSTANTIAL hearing impairment? | 1= Yes 2= No |
| 431 | hearimp | 2. Does the participant have a SUBSTANTIAL hearing impairment? | 1= Yes 2= No |
| 432 | visimp | 3. Does the participant have a SUBSTANTIAL visual impariment? | 1= Yes, completely blind 2= Yes, very poor 3= Yes, poor 4= No, not substantial |
| 432 | visimp | 3. Does the participant have a SUBSTANTIAL visual impariment? | 1= ycb 2= yvp 3= yp 4= nns |
| 433 | phyeffrt | 4. How great an effort do you think the participant put into the physical function items? | 1= agd 2= aca 3= ama 4= alb 5= ha |
| 433 | phyeffrt | 4. How great an effort do you think the participant put into the physical function items? | 1= A great deal 2= A considerable amount 3= A moderate amount 4= A little bit 5= Hardly any |
| 434 | formcode | Please enter status code. 11 = COMPLETE 13 = COMPLETE, portion with proxy 12 = INCOMPLETE, refused 14 = INCOMPLETE, too impaired 21 = INCOMPLETE interim, complete later 73 = NOT TESTED, out of town 31 = NOT TESTED, moved 33 = NOT TESTED, refused 75 = NOT TESTED, hospitalized 76 = NOT TESTED, other 42 = DECEASED 43 = WITHDRAWN 44 = WITHDRAWN, Autopsy OK | 11 .. 76 |
| 434 | formcode | Please enter status code. 11 = COMPLETE 13 = COMPLETE, portion with proxy 12 = INCOMPLETE, refused 14 = INCOMPLETE, too impaired 21 = INCOMPLETE interim, complete later 73 = NOT TESTED, out of town 31 = NOT TESTED, moved 33 = NOT TESTED, refused 75 = NOT TESTED, hospitalized 76 = NOT TESTED, other 42 = DECEASED 43 = WITHDRAWN 44 = WITHDRAWN, Autopsy OK | 11 .. 76 |
| 435 | formpart | Was participant reluctant, and/or does participant have special needs? | 1= Yes 2= No |
| 435 | formpart | Was participant reluctant, and/or does participant have special needs? | 1= Yes 2= No |
| 436 | formcomm | Please explain reluctance or any other factors which may have affected this data. [Press enter if no comment needed.] | String[120] |
| 436 | formcomm | Please explain reluctance or any other factors which may have affected this data. [Press enter if no comment needed.] | String[120] |
| 437 | statid | Please enter you staff id. | 100 .. 997 |
| 437 | statid | Please enter you staff id. | 100 .. 997 |
| 438 | formch | Has the form been modified? | 1= Yes 2= No |
| 438 | formch | Has the form been modified? | 1= Yes 2= No |
| 439 | revidate | Enter the date that the form was modified. | Date type |
| 439 | revidate | Enter the date that the form was modified. | Date type |
| 440 | revintd | Enter your staff id number. | 100 .. 997 |
| 440 | revintd | Enter your staff id number. | 100 .. 997 |
| 441 | comm | Comments. | String[120] |
| 441 | comm | Comments. | String[120] |