Number of Blaise fields: 808
| 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 | Enter curent visit code from face sheet: CODE F/U Year CODE F/U Year CODE F/U Year CODE F/U Year 00 = Baseline 08 = 8th F/U 16 = 16th F/U 24 = 24th F/U 01 = 1st F/U 09 = 9th F/U 17 = 17th F/U 25 = 25th F/U 02 = 2nd F/U 10 = 10th F/U 18 = 18th F/U 26 = 26th F/U 03 = 3rd F/U 11 = 11th F/U 19 = 19th F/U 27 = 27th F/U 04 = 4th F/U 12 = 12th F/U 20 = 20th F/U 28 = 28th F/U 05 = 5th F/U 13 = 13th F/U 21 = 21th F/U 29 = 29th F/U 06 = 6th F/U 14 = 14th F/U 22 = 22th F/U 30 = 30th F/U 07 = 7th F/U 15 = 15th F/U 23 = 23th F/U 31 = 30th F/U ... 50 = 50th F/U | String[2] |
| 6 | visit | Enter curent visit code from face sheet: CODE F/U Year CODE F/U Year CODE F/U Year CODE F/U Year 00 = Baseline 08 = 8th F/U 16 = 16th F/U 24 = 24th F/U 01 = 1st F/U 09 = 9th F/U 17 = 17th F/U 25 = 25th F/U 02 = 2nd F/U 10 = 10th F/U 18 = 18th F/U 26 = 26th F/U 03 = 3rd F/U 11 = 11th F/U 19 = 19th F/U 27 = 27th F/U 04 = 4th F/U 12 = 12th F/U 20 = 20th F/U 28 = 28th F/U 05 = 5th F/U 13 = 13th F/U 21 = 21th F/U 29 = 29th F/U 06 = 6th F/U 14 = 14th F/U 22 = 22th F/U 30 = 30th F/U 07 = 7th F/U 15 = 15th F/U 23 = 23th F/U 31 = 30th F/U ... 50 = 50th F/U | String[2] |
| 7 | baseyear | Enter year of baseline from face sheet: | 1993 .. 2025 |
| 7 | baseyear | Enter year of baseline from face sheet: | 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 | datlas | Date of previous interview | Date type |
| 14 | datlas | Date of previous interview | Date type |
| 15 | gender | Enter participant's gender. | 1= Male 2= Female |
| 15 | gender | Enter participant's gender. | 1= Male 2= Female |
| 16 | phone | Was this interview completed in person or over the telephone? | 1= In-person Nurse 2= Telephone 3= In-person RA |
| 16 | phone | Was this interview completed in person or over the telephone? | 1= inper 2= Telephone 3= inper_ra |
| 17 | autotm | [COMPUTER CLOCK TIME] | String[8] |
| 17 | autotm | [COMPUTER CLOCK TIME] | String[8] |
| 18 | formlang | What language will be used to administer this form? [INTERVIEWER: To change the form language, click on Options in the main menu, then select Form Language.] | 1= ENG 2= ESP |
| 18 | formlang | What language will be used to administer this form? [INTERVIEWER: To change the form language, click on Options in the main menu, then select Form Language.] | 1= English 2= Espa�ol |
| 19 | 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 |
| 19 | 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= S� 2= No |
| 20 | 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= S� 2= No |
| 20 | 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 |
| 21 | 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 |
| 21 | 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= S� 2= No |
| 22 | 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 |
| 22 | 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 |
| 23 | name00 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 23 | name00 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 24 | stren00 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 24 | stren00 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 25 | drgnm00 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 25 | drgnm00 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 26 | seen00 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 26 | seen00 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 27 | 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 |
| 27 | 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 |
| 28 | recd00 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 28 | recd00 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 29 | name01 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 29 | name01 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 30 | stren01 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 30 | stren01 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 31 | drgnm01 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 31 | drgnm01 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 32 | seen01 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 32 | seen01 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 33 | 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 |
| 33 | 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 |
| 34 | recd01 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 34 | recd01 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 35 | name02 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 35 | name02 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 36 | stren02 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 36 | stren02 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 37 | drgnm02 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 37 | drgnm02 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 38 | seen02 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 38 | seen02 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 39 | 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 |
| 39 | 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 |
| 40 | recd02 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 40 | recd02 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 41 | name03 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 41 | name03 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 42 | stren03 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 42 | stren03 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 43 | drgnm03 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 43 | drgnm03 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 44 | seen03 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 44 | seen03 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 45 | 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 |
| 45 | 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 |
| 46 | recd03 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 46 | recd03 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 47 | name04 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 47 | name04 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 48 | stren04 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 48 | stren04 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 49 | drgnm04 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 49 | drgnm04 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 50 | seen04 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 50 | seen04 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 51 | 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 |
| 51 | 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 |
| 52 | recd04 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 52 | recd04 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 53 | name05 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 53 | name05 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 54 | stren05 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 54 | stren05 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 55 | drgnm05 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 55 | drgnm05 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 56 | seen05 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 56 | seen05 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 57 | 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 |
| 57 | 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 |
| 58 | recd05 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 58 | recd05 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 59 | name06 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 59 | name06 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 60 | stren06 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 60 | stren06 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 61 | drgnm06 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 61 | drgnm06 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 62 | seen06 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 62 | seen06 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 63 | 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 |
| 63 | 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 |
| 64 | recd06 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 64 | recd06 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 65 | name07 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 65 | name07 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 66 | stren07 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 66 | stren07 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 67 | drgnm07 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 67 | drgnm07 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 68 | seen07 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 68 | seen07 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 69 | 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 |
| 69 | 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 |
| 70 | recd07 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 70 | recd07 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 71 | name08 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 71 | name08 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 72 | stren08 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 72 | stren08 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 73 | drgnm08 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 73 | drgnm08 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 74 | seen08 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 74 | seen08 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 75 | 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 |
| 75 | 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 |
| 76 | recd08 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 76 | recd08 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 77 | name09 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 77 | name09 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 78 | stren09 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 78 | stren09 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 79 | drgnm09 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 79 | drgnm09 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 80 | seen09 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 80 | seen09 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 81 | 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 |
| 81 | 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 |
| 82 | recd09 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 82 | recd09 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 83 | name10 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 83 | name10 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 84 | stren10 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 84 | stren10 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 85 | drgnm10 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 85 | drgnm10 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 86 | seen10 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 86 | seen10 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 87 | 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 |
| 87 | 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 |
| 88 | recd10 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 88 | recd10 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 89 | name11 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 89 | name11 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 90 | stren11 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 90 | stren11 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 91 | drgnm11 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 91 | drgnm11 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 92 | seen11 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 92 | seen11 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 93 | 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 |
| 93 | 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 |
| 94 | recd11 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 94 | recd11 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 95 | name12 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 95 | name12 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 96 | stren12 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 96 | stren12 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 97 | drgnm12 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 97 | drgnm12 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 98 | seen12 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 98 | seen12 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 99 | 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 |
| 99 | 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 |
| 100 | recd12 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 100 | recd12 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 101 | name13 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 101 | name13 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 102 | stren13 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 102 | stren13 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 103 | drgnm13 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 103 | drgnm13 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 104 | seen13 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 104 | seen13 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 105 | 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 |
| 105 | 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 |
| 106 | recd13 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 106 | recd13 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 107 | name14 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 107 | name14 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 108 | stren14 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 108 | stren14 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 109 | drgnm14 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 109 | drgnm14 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 110 | seen14 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 110 | seen14 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 111 | 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 |
| 111 | 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 |
| 112 | recd14 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 112 | recd14 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 113 | name15 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 113 | name15 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 114 | stren15 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 114 | stren15 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 115 | drgnm15 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 115 | drgnm15 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 116 | seen15 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 116 | seen15 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 117 | 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 |
| 117 | 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 |
| 118 | recd15 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 118 | recd15 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 119 | name16 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 119 | name16 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 120 | stren16 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 120 | stren16 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 121 | drgnm16 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 121 | drgnm16 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 122 | seen16 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 122 | seen16 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 123 | 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 |
| 123 | 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 |
| 124 | recd16 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 124 | recd16 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 125 | name17 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 125 | name17 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 126 | stren17 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 126 | stren17 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 127 | drgnm17 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 127 | drgnm17 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 128 | seen17 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 128 | seen17 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 129 | 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 |
| 129 | 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 |
| 130 | recd17 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 130 | recd17 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 131 | name18 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 131 | name18 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 132 | stren18 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 132 | stren18 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 133 | drgnm18 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 133 | drgnm18 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 134 | seen18 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 134 | seen18 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 135 | 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 |
| 135 | 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 |
| 136 | recd18 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 136 | recd18 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 137 | name19 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 137 | name19 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 138 | stren19 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 138 | stren19 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 139 | drgnm19 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 139 | drgnm19 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 140 | seen19 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 140 | seen19 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 141 | 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 |
| 141 | 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 |
| 142 | recd19 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 142 | recd19 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 143 | name20 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 143 | name20 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 144 | stren20 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 144 | stren20 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 145 | drgnm20 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 145 | drgnm20 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 146 | seen20 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 146 | seen20 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 147 | 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 |
| 147 | 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 |
| 148 | recd20 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 148 | recd20 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 149 | name21 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 149 | name21 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 150 | stren21 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 150 | stren21 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 151 | drgnm21 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 151 | drgnm21 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 152 | seen21 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 152 | seen21 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 153 | 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 |
| 153 | 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 |
| 154 | recd21 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 154 | recd21 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 155 | name22 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 155 | name22 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 156 | stren22 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 156 | stren22 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 157 | drgnm22 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 157 | drgnm22 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 158 | seen22 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 158 | seen22 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 159 | 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 |
| 159 | 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 |
| 160 | recd22 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 160 | recd22 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 161 | name23 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 161 | name23 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 162 | stren23 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 162 | stren23 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 163 | drgnm23 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 163 | drgnm23 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 164 | seen23 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 164 | seen23 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 165 | 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 |
| 165 | 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 |
| 166 | recd23 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 166 | recd23 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 167 | name24 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 167 | name24 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 168 | stren24 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 168 | stren24 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 169 | drgnm24 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 169 | drgnm24 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 170 | seen24 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 170 | seen24 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 171 | 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 |
| 171 | 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 |
| 172 | recd24 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 172 | recd24 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 173 | name25 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 173 | name25 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 174 | stren25 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 174 | stren25 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 175 | drgnm25 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 175 | drgnm25 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 176 | seen25 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 176 | seen25 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 177 | 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 |
| 177 | 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 |
| 178 | recd25 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 178 | recd25 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 179 | name26 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 179 | name26 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 180 | stren26 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 180 | stren26 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 181 | drgnm26 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 181 | drgnm26 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 182 | seen26 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 182 | seen26 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 183 | 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 |
| 183 | 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 |
| 184 | recd26 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 184 | recd26 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 185 | name27 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 185 | name27 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 186 | stren27 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 186 | stren27 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 187 | drgnm27 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 187 | drgnm27 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 188 | seen27 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 188 | seen27 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 189 | 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 |
| 189 | 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 |
| 190 | recd27 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 190 | recd27 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 191 | name28 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 191 | name28 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 192 | stren28 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 192 | stren28 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 193 | drgnm28 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 193 | drgnm28 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 194 | seen28 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 194 | seen28 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 195 | 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 |
| 195 | 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 |
| 196 | recd28 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 196 | recd28 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 197 | name29 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 197 | name29 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 198 | stren29 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 198 | stren29 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 199 | drgnm29 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 199 | drgnm29 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 200 | seen29 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 200 | seen29 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 201 | 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 |
| 201 | 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 |
| 202 | recd29 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 202 | recd29 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 203 | name30 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 203 | name30 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 204 | stren30 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 204 | stren30 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 205 | drgnm30 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 205 | drgnm30 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 206 | seen30 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 206 | seen30 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 207 | 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 |
| 207 | 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 |
| 208 | recd30 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 208 | recd30 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 209 | name31 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 209 | name31 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 210 | stren31 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 210 | stren31 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 211 | drgnm31 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 211 | drgnm31 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 212 | seen31 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 212 | seen31 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 213 | 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 |
| 213 | 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 |
| 214 | recd31 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 214 | recd31 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 215 | name32 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 215 | name32 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 216 | stren32 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 216 | stren32 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 217 | drgnm32 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 217 | drgnm32 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 218 | seen32 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 218 | seen32 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 219 | 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 |
| 219 | 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 |
| 220 | recd32 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 220 | recd32 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 221 | name33 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 221 | name33 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 222 | stren33 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 222 | stren33 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 223 | drgnm33 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 223 | drgnm33 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 224 | seen33 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 224 | seen33 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 225 | 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 |
| 225 | 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 |
| 226 | recd33 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 226 | recd33 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 227 | name34 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 227 | name34 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 228 | stren34 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 228 | stren34 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 229 | drgnm34 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 229 | drgnm34 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 230 | seen34 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 230 | seen34 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 231 | 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 |
| 231 | 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 |
| 232 | recd34 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 232 | recd34 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 233 | name35 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 233 | name35 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 234 | stren35 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 234 | stren35 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 235 | drgnm35 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 235 | drgnm35 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 236 | seen35 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 236 | seen35 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 237 | 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 |
| 237 | 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 |
| 238 | recd35 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 238 | recd35 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 239 | name36 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 239 | name36 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 240 | stren36 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 240 | stren36 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 241 | drgnm36 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 241 | drgnm36 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 242 | seen36 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 242 | seen36 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 243 | 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 |
| 243 | 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 |
| 244 | recd36 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 244 | recd36 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 245 | name37 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 245 | name37 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 246 | stren37 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 246 | stren37 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 247 | drgnm37 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 247 | drgnm37 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 248 | seen37 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 248 | seen37 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 249 | 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 |
| 249 | 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 |
| 250 | recd37 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 250 | recd37 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 251 | name38 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 251 | name38 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 252 | stren38 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 252 | stren38 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 253 | drgnm38 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 253 | drgnm38 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 254 | seen38 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 254 | seen38 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 255 | 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 |
| 255 | 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 |
| 256 | recd38 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 256 | recd38 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 257 | name39 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 257 | name39 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 258 | stren39 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 258 | stren39 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 259 | drgnm39 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 259 | drgnm39 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 260 | seen39 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 260 | seen39 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 261 | 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 |
| 261 | 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 |
| 262 | recd39 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 262 | recd39 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 263 | name40 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 263 | name40 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 264 | stren40 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 264 | stren40 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 265 | drgnm40 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 265 | drgnm40 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 266 | seen40 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 266 | seen40 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 267 | 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 |
| 267 | 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 |
| 268 | recd40 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 268 | recd40 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 269 | name41 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 269 | name41 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 270 | stren41 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 270 | stren41 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 271 | drgnm41 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 271 | drgnm41 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 272 | seen41 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 272 | seen41 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 273 | 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 |
| 273 | 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 |
| 274 | recd41 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 274 | recd41 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 275 | name42 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 275 | name42 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 276 | stren42 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 276 | stren42 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 277 | drgnm42 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 277 | drgnm42 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 278 | seen42 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 278 | seen42 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 279 | 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 |
| 279 | 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 |
| 280 | recd42 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 280 | recd42 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 281 | name43 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 281 | name43 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 282 | stren43 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 282 | stren43 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 283 | drgnm43 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 283 | drgnm43 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 284 | seen43 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 284 | seen43 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 285 | 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 |
| 285 | 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 |
| 286 | recd43 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 286 | recd43 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 287 | name44 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 287 | name44 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 288 | stren44 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 288 | stren44 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 289 | drgnm44 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 289 | drgnm44 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 290 | seen44 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 290 | seen44 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 291 | 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 |
| 291 | 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 |
| 292 | recd44 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 292 | recd44 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 293 | name45 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 293 | name45 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 294 | stren45 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 294 | stren45 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 295 | drgnm45 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 295 | drgnm45 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 296 | seen45 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 296 | seen45 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 297 | 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 |
| 297 | 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 |
| 298 | recd45 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 298 | recd45 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 299 | name46 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 299 | name46 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 300 | stren46 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 300 | stren46 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 301 | drgnm46 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 301 | drgnm46 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 302 | seen46 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 302 | seen46 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 303 | 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 |
| 303 | 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 |
| 304 | recd46 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 304 | recd46 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 305 | name47 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 305 | name47 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 306 | stren47 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 306 | stren47 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 307 | drgnm47 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 307 | drgnm47 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 308 | seen47 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 308 | seen47 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 309 | 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 |
| 309 | 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 |
| 310 | recd47 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 310 | recd47 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 311 | name48 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 311 | name48 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 312 | stren48 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 312 | stren48 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 313 | drgnm48 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 313 | drgnm48 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 314 | seen48 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 314 | seen48 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 315 | 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 |
| 315 | 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 |
| 316 | recd48 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 316 | recd48 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 317 | name49 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 317 | name49 | a1. [INTERVIEWER: NAME OF MEDICINE] | String[50] |
| 318 | stren49 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 318 | stren49 | a2. [INTERVIEWER: ENTER STRENGTH] | String[10] |
| 319 | drgnm49 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 319 | drgnm49 | b. [INTERVIEWER: IS DRUG NAME FROM CONTAINER?] | 1= Yes 2= No |
| 320 | seen49 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 320 | seen49 | c. [INTERVIEWER: IS DRUG SEEN?] | 1= Yes 2= No |
| 321 | 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 |
| 321 | 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 |
| 322 | recd49 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 322 | recd49 | e. [INTERVIEWER: ENTER NAME OF PHARMACY AND PRESCRIPTION NO. TYPE `OTC' IF MEDICINE IS NOT PRESCRIBED] | String[40] |
| 323 | strokefu | 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. Since your evaluation on ^IntroBlock.datlas, have you 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 |
| 323 | strokefu | 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. Desde su �ltima evaluaci�n en ^IntroBlock.datlas, �se le ha dicho que usted tuvo una embolia, accidente isqu�mico transitorio (AIT), accidentes cerebrovasculares o hemorragia cerebral? | 1= S� 2= Sospecha o posible 3= No |
| 324 | faint0fu | �Cuando sufri� este �ltimo evento experiment� Ud. alguno de los siguientes s�ntomas? a. Desmayo o p�rdida de conocimiento? | 1= S� 2= Sospecha 3= No |
| 324 | faint0fu | At the time of this (last) event, did you you have . . . a. Fainting, blackout or loss of consciousness? | 1= Yes 2= Suspect 3= No |
| 325 | dizzy0fu | b. Dizzyness or lightheadedness? | 1= Yes 2= Suspect 3= No |
| 325 | dizzy0fu | b. Mareos o sensaci�n de aturdimiento? | 1= S� 2= Sospecha 3= No |
| 326 | memor0fu | c. Memory loss or forgetfulness? | 1= Yes 2= Suspect 3= No |
| 326 | memor0fu | c. P�rdida de memoria o estar olvidadizo/a? | 1= S� 2= Sospecha 3= No |
| 327 | speec0fu | �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 |
| 327 | speec0fu | At the time of this (last) event, did you you have . . . d. Language or speech change? | 1= Yes 2= Suspect 3= No |
| 328 | visio0fu | e. Loss of vision? | 1= No 2= right only 3= left only 4= both |
| 328 | visio0fu | e. P�rdida de visi�n? | 1= No 2= s�lo derecho 3= s�lo izquierdo 4= ambos |
| 329 | face0fu | f. Debilidad o par�lisis en la cara? | 1= No 2= s�lo derecho 3= s�lo izquierdo 4= ambos |
| 329 | face0fu | f. Weakness or paralysis of your face? | 1= No 2= right only 3= left only 4= both |
| 330 | weakl0fu | g. Weakness or paralysis of your arms or legs? | 1= No 2= right only 3= left only 4= both |
| 330 | weakl0fu | g. Debilidad o par�lisis en los brazos o en las piernas? | 1= No 2= s�lo derecho 3= s�lo izquierdo 4= ambos |
| 331 | limse0fu | h. P�rdida o cambio de sensaci�n en los brazos o en las piernas? | 1= No 2= s�lo derecho 3= s�lo izquierdo 4= ambos |
| 331 | limse0fu | h. Loss or change of sensation in your arms or legs? | 1= No 2= right only 3= left only 4= both |
| 332 | symps0fu | i. Specify any other signs or symptoms associated with this (last) event? | String[40] |
| 332 | symps0fu | i. Especifique otras se�ales o s�ntomas asociados con este �ltimo evento: | String[40] |
| 333 | samet0fu | 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 |
| 333 | samet0fu | 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 |
| 334 | sames0fu | Specify: | String[60] |
| 334 | sames0fu | Especif�que: | String[60] |
| 335 | inhospfu | 2. Since your evaluation on ^IntroBlock.datlas, have you been HOSPITALIZED OVERNIGHT or longer because of a STROKE, a TIA or a BRAIN HEMORRHAGE? | 1= Yes 2= Suspect 3= No |
| 335 | inhospfu | 2. Desde su �ltima evaluaci�n en ^IntroBlock.datlas, �ha sido HOSPITALIZADO POR UNA NOCHE o m�s tiempo debido a una embolia/derrame, un AIT, o hemorragia cerebral? | 1= S� 2= Sospecha 3= No |
| 336 | promp1fu | 2a. Was this the same event we just spoke about? | 1= Yes 2= No |
| 336 | promp1fu | 2a. �Fue �ste el mismo evento del que acabamos de hablar? | 1= S� 2= No |
| 337 | hospnafu | 2b. What was the name of the hospital? | String[30] |
| 337 | hospnafu | 2b. �Cu�l era el nombre del hospital? | String[30] |
| 338 | faint1fu | �Cuando sufri� este �ltimo evento experiment� Ud. alguno de los siguientes s�ntomas? a. Desmayo, o p�rdida de conocimiento? | 1= S� 2= Sospecha 3= No |
| 338 | faint1fu | At the time of this (last) event, did you you have . . . a. Fainting, blackout or loss of consciousness? | 1= Yes 2= Suspect 3= No |
| 339 | dizzy1fu | b. Dizzyness or lightheadedness? | 1= Yes 2= Suspect 3= No |
| 339 | dizzy1fu | b. �Mareos o sensaci�n de aturdimiento? | 1= S� 2= Sospecha 3= No |
| 340 | memor1fu | c. Memory loss or forgetfulness? | 1= Yes 2= Suspect 3= No |
| 340 | memor1fu | c. P�rdida de memoria o estar olvidadizo/a? | 1= S� 2= Sospecha 3= No |
| 341 | speec1fu | �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 |
| 341 | speec1fu | 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 |
| 342 | visio1fu | e. P�rdida de visi�n? | 1= No 2= right only 3= left only 4= both |
| 342 | visio1fu | e. Loss of vision? | 1= No 2= s�lo derecho 3= s�lo izquierdo 4= ambos |
| 343 | face1fu | f. Debilidad o par�lisis en la cara? | 1= No 2= s�lo derecho 3= s�lo izquierdo 4= ambos |
| 343 | face1fu | f. Weakness or paralysis of your face? | 1= No 2= right only 3= left only 4= both |
| 344 | weakl1fu | g. Weakness or paralysis of your arms or legs? | 1= No 2= right only 3= left only 4= both |
| 344 | weakl1fu | g. Debilidad o par�lisis en los brazos o en las piernas? | 1= No 2= s�lo derecho 3= s�lo izquierdo 4= ambos |
| 345 | limse1fu | h. P�rdida o cambio de sensaci�n en los brazos o en las piernas? | 1= No 2= s�lo derecho 3= s�lo izquierdo 4= ambos |
| 345 | limse1fu | h. Loss or change of sensation in your arms or legs? | 1= No 2= right only 3= left only 4= both |
| 346 | symps1fu | i. Specify any other signs or symptoms associated with this (last) event? | String[40] |
| 346 | symps1fu | i. Especifique otras se�ales o s�ntomas asociados con este �ltimo evento: | String[40] |
| 347 | samet1fu | 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 |
| 347 | samet1fu | 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 |
| 348 | sames1fu | Specify: | String[60] |
| 348 | sames1fu | Especif�que: | String[60] |
| 349 | stroksfu | 3. Since ^IntroBlock.datlas, have you 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 |
| 349 | stroksfu | 3. Desde ^IntroBlock.datlas, �se ha sometido a un Tomograf�a Axial Computarizada (TC), Resonancia Magn�tica (RMN/MRI) u otro tipo de scanner/estudio cerebral debido a una EMBOLIA, un AIT o una HEMORRAGIA CEREBRAL? | 1= S� 2= Sospecha 3= No |
| 350 | promp2fu | 3a. Was this for ^event we just spoke about? | 1= Yes 2= No |
| 350 | promp2fu | 3a. �Fue �ste el mismo evento del que acabamos de hablar? | 1= S� 2= No |
| 351 | scanlofu | 3b. �Cu�l era el nombre del lugar (consulta, hospital u otro lugar) en el que se realiz� el scanner/estudio?: | String[30] |
| 351 | scanlofu | 3b. What was the name of the place (doctor's office, hospital or other place) at which the scan was performed? | String[30] |
| 352 | faint2fu | At the time of this (last) event, did you you have . . . a. Fainting, blackout or loss of consciousness? | 1= Yes 2= Suspect 3= No |
| 352 | faint2fu | �Cuando sufri� este �ltimo evento experiment� Ud. alguno de los siguientes s�ntomas? a. Desmayo, o p�rdida del conocimiento? | 1= S� 2= Sospecha 3= No |
| 353 | dizzy2fu | b. Mareos o sensaci�n de aturdimiento? | 1= S� 2= Sospecha 3= No |
| 353 | dizzy2fu | b. Dizzyness or lightheadedness? | 1= Yes 2= Suspect 3= No |
| 354 | memor2fu | c. Memory loss or forgetfulness? | 1= Yes 2= Suspect 3= No |
| 354 | memor2fu | c. P�rdida de memoria o estar olvidadizo/a? | 1= S� 2= Sospecha 3= No |
| 355 | speec2fu | d. Cambios en el lenguaje o en el habla? | 1= S� 2= Sospecha 3= No |
| 355 | speec2fu | d. Language or speech change? | 1= Yes 2= Suspect 3= No |
| 356 | visio2fu | e. Loss of vision? | 1= No 2= right only 3= left only 4= both |
| 356 | visio2fu | e. P�rdida de visi�n? | 1= No 2= s�lo derecho 3= s�lo izquierdo 4= ambos |
| 357 | face2fu | f. Debilidad o par�lisis en la cara? | 1= No 2= s�lo derecho 3= s�lo izquierdo 4= ambos |
| 357 | face2fu | f. Weakness or paralysis of your face? | 1= No 2= right only 3= left only 4= both |
| 358 | weakl2fu | g. Weakness or paralysis of your arms or legs? | 1= No 2= right only 3= left only 4= both |
| 358 | weakl2fu | g. Debilidad o par�lisis en los brazos o en las piernas? | 1= No 2= s�lo derecho 3= s�lo izquierdo 4= ambos |
| 359 | limse2fu | h. P�rdida o cambio de sensaci�n en los brazos o en las piernas? | 1= No 2= s�lo derecho 3= s�lo izquierdo 4= ambos |
| 359 | limse2fu | h. Loss or change of sensation in your arms or legs? | 1= No 2= right only 3= left only 4= both |
| 360 | symps2fu | i. Specify any other signs or symptoms associated with this (last) event? | String[40] |
| 360 | symps2fu | i. Especifique otras se�ales o s�ntomas asociados con este �ltimo evento: | String[40] |
| 361 | samet2fu | 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 |
| 361 | samet2fu | 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 |
| 362 | sames2fu | Specify: | String[60] |
| 362 | sames2fu | Especifique: | String[60] |
| 363 | multipfu | 4. Desde su �ltima evaluaci�n en ^IntroBlock.datlas, �ha tenido una EMBOLIA, un AIT o una HEMORRAGIA CEREBRAL o m�s de uno? | 1= S�lo uno 2= M�s de uno |
| 363 | multipfu | 4. Since your last evaluation on ^IntroBlock.datlas, did you have only ONE STROKE, TIA or BRAIN HEMORRHAGE, or more than one? | 1= Only one 2= More than one |
| 364 | leftspfu | 5. Specify leftover troubles from your stroke(s)? | String[60] |
| 364 | leftspfu | 5. Especifique cu�les son las secuelas actuales de su embolia/derrame(s)? | String[60] |
| 365 | everscfu | 6. Since ^IntroBlock.datlas, have you had a CT, MRI or other type of brain scan? | 1= Yes 2= Suspect 3= No |
| 365 | everscfu | 6. Desde ^IntroBlock.datlas, �Se ha sometido a un TC, MRI u otro tipo de scanner/estudio cerebral? | 1= S� 2= Sospecha 3= No |
| 366 | reasonfu | 6c. Reason | String[60] |
| 366 | reasonfu | 6c. Reason | String[60] |
| 367 | escanlfu | 6d. What was the name of the place (doctor's office, hospital or other place) at which the scan was performed? | String[30] |
| 367 | escanlfu | 6d. �Cu�l era el nombre del lugar (consulta, hosptial u otro lugar) en el que se realiz� el scanner/estudio?: | String[30] |
| 368 | parksfu | 1. Desde ^IntroBlock.datlas, �alg�n m�dico, enfermera, terapeuta o asistente m�dico le ha dicho que ten�a PARKINSONISMO o LA ENFERMEDAD DE PARKINSON? | 1= S� 2= Sospecha o posible 3= No |
| 368 | parksfu | 1. Since ^IntroBlock.datlas, have you been told by a doctor, nurse or therapist that you had PARKINSONISM or PARKINSON'S DISEASE? | 1= Yes 2= Suspect or possible 3= No |
| 369 | gaitfu | With the parkinsonism, did you have . . . 2. Shuffling or unsteady gait, or loss of balance? | 1= Yes 2= Suspect 3= No |
| 369 | gaitfu | Con el parkinsonismo, ha padecido usted alguna vez de . . . 2. andar arrastrando los pies o andar tambale�ndose? | 1= S� 2= Sospecha 3= No |
| 370 | writinfu | 3. A change in your handwriting? | 1= Yes 2= Suspect 3= No |
| 370 | writinfu | 3. �Un cambio en su letra manuscrita (escritura)? | 1= S� 2= Sospecha 3= No |
| 371 | stifffu | 4. �Agarrotamiento o rigidez en sus brazos o piernas? | 1= No 2= s�lo derecho 3= s�lo izquierdo 4= ambos |
| 371 | stifffu | 4. Stiffness or rigidity of your arms or legs? | 1= No 2= right only 3= left only 4= both |
| 372 | slowmofu | 5. �Lentitud en el movimiento de sus brazos, manos o piernas? | 1= No 2= s�lo derecho 3= s�lo izquierdo 4= ambos |
| 372 | slowmofu | 5. Slowness of movement of your arms, hands or legs? | 1= No 2= right only 3= left only 4= both |
| 373 | tremorfu | 6. Tremor of your hands or feet? | 1= No 2= right only 3= left only 4= both |
| 373 | tremorfu | 6. �Temblor en sus manos o pies? | 1= No 2= s�lo derecho 3= s�lo izquierdo 4= ambos |
| 374 | medicafu | 7. �Est� usted tomando actualmente algun medicamento para su parkinsonismo o enfermedad de Parkinson (algunos ejemplos son Sinemet, Symmetrel, Parlodel, Bromocriptine, etc.)? | 1= S� 2= Sospecha o posible 3= No |
| 374 | medicafu | 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 | medspefu | 7a. Specify | String[30] |
| 375 | medspefu | 7a. Especifique: | String[30] |
| 376 | histadfu | �Desde ^IntroBlock.datlas, �alg�n m�dico, enfermera, terapeuta o asistente m�dico le ha dicho que ten�a demencia, senilidad, o LA ENFERMEDAD de Alzheimer? | 1= S� 2= Sospecha 3= No |
| 376 | histadfu | Since your last evaluation on ^IntroBlock.datlas, have you been told by a doctor, nurse, or therapist that you had dementia, senility, or Alzheimer's disease? | 1= Yes 2= Suspect 3= No |
| 377 | 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 |
| 377 | 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 |
| 378 | 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 |
| 378 | 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 |
| 379 | cov1b | Revised COVID FORM 2022 1b. When did your first COVID-19 infection begin (month/year)? [ 88/8888 = Decline to answer ] | String[7] |
| 379 | 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] |
| 380 | 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) |
| 380 | 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) |
| 381 | 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 |
| 381 | 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 |
| 382 | 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 |
| 382 | 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 |
| 383 | 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 |
| 383 | 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 |
| 384 | 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 |
| 384 | 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 |
| 385 | 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 |
| 385 | 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 |
| 386 | 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 |
| 386 | 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 |
| 387 | ivisit | visit | |
| 387 | ivisit | visit | |
| 388 | 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 |
| 388 | 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 |
| 389 | 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] |
| 389 | 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] |
| 390 | bp2 | 7. SECOND SITTING BLOOD PRESSURE READING [INTERVIEWER: ENTER SYSTOLIC/DIASTOLIC] | String[7] |
| 390 | bp2 | 7. SECOND SITTING BLOOD PRESSURE READING [INTERVIEWER: ENTER SYSTOLIC/DIASTOLIC] | String[7] |
| 391 | 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] |
| 391 | 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] |
| 392 | howwell | 1. INTERVIEWER OBSERVATIONS How well do you think the participant understood the questions? | 1= qw 2= fw 3= sw 4= vl 5= naa |
| 392 | 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 |
| 393 | hearimp | 2. Does the participant have a SUBSTANTIAL hearing impairment? | 1= Yes 2= No |
| 393 | hearimp | 2. Does the participant have a SUBSTANTIAL hearing impairment? | 1= Yes 2= No |
| 394 | 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 |
| 394 | visimp | 3. Does the participant have a SUBSTANTIAL visual impariment? | 1= ycb 2= yvp 3= yp 4= nns |
| 395 | 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 |
| 395 | 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 |
| 396 | comm | Comments. | String[120] |
| 396 | comm | Comments. | String[120] |
| 397 | autotm1 | [COMPUTER CLOCK TIME] | String[8] |
| 397 | autotm1 | [COMPUTER CLOCK TIME] | String[8] |
| 398 | 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 |
| 398 | 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 |
| 399 | formpart | Was participant reluctant, and/or does participant have special needs? | 1= Yes 2= No |
| 399 | formpart | Was participant reluctant, and/or does participant have special needs? | 1= Yes 2= No |
| 400 | formcomm | Please explain reluctance or any other factors which may have affected this data. [Press enter if no comment needed.] | String[120] |
| 400 | formcomm | Please explain reluctance or any other factors which may have affected this data. [Press enter if no comment needed.] | String[120] |
| 401 | statid | Please enter you staff id. | 100 .. 997 |
| 401 | statid | Please enter you staff id. | 100 .. 997 |
| 402 | formch | Has the form been modified? | 1= Yes 2= No |
| 402 | formch | Has the form been modified? | 1= Yes 2= No |
| 403 | revidate | Enter the date that the form was modified. | Date type |
| 403 | revidate | Enter the date that the form was modified. | Date type |
| 404 | revintd | Enter your staff id number. | 100 .. 997 |
| 404 | revintd | Enter your staff id number. | 100 .. 997 |