Behavioral Responses to Losses Disguised as Wins: A Field Study of Slot Machine Players.

We present the results of a field study examining the effect of losses disguised as wins (LDWs) on subsequent slot machine gambler betting behavior. An LDW occurs when the amount won is less than the amount bet. Using non-experimental, individual transaction gambling data, we examine post LDW betting behavior in a panel of 42,669 gamblers and 17 million slot machine plays. The primary empirical findings include: (1) streaks of three LDWs greater than 75% of the original amount bet lead slot gamblers to increase the amount bet on the next spin; (2) streaks of three LDWs less than 25% of the original amount bet results in gamblers decreasing their bet size on the next spin; (3) slot machine gamblers play faster following streaks of three LDWs compared to losses. We interpret these behavioral findings of differing outcomes associated with small versus large LDWs as consistent with a cognitive dissonance effect (Festinger, 1957). Specifically, the disconnect between the amount "won" (actually lost) and the audio and video stimulus produced by the slot machine highlighting the LDW, produces a dissonance-related arousal that players seek to avoid or reduce leading to changes in betting behavior. Our results complement the experimental findings on LDWs and suggest that the size of the LDW matters in examining the impact on gambling behavior.

Modeling the Effect of Relative Humidity on Adsorption Dynamics of Volatile Organic Compound onto Activated Carbon.

A two-dimensional heterogeneous mathematical model was developed and validated to study the effect of relative humidity on volatile organic compound (VOC) adsorption onto activated carbon. The dynamic adsorption model consists of the macroscopic mass, momentum, and energy conservation equations and includes a multicomponent adsorption isotherm to predict the competitive adsorption equilibria between VOC and water vapor, which is described by an extended Manes method. Experimental verifications show that the model predicted the breakthrough profiles during competitive adsorption of the studied VOCs (2-propanol, acetone, n-butanol, toluene, 1,2,4-trimethylbenzene) at relative humidity range 0-95% with an overall mean relative absolute error (MRAE) of 11.8% for dry (0% RH) conditions and 17.2% for humid (55 and 95% RH) conditions, and normalized root-mean-square error (NRMSE) of 5.5 and 8.4% for dry and humid conditions, respectively. Sensitivity analysis was also conducted to test the robustness of the model in accounting for the impact of relative humidity on VOC adsorption by varying the adsorption temperature. Good agreement was observed between the experimental and simulated results with an overall MRAE of 12.4 and 7.1% for the breakthrough profiles and adsorption capacity, respectively. The model can be used to quantify the impact of carrier gas relative humidity during adsorption of contaminants from gas streams, which is useful when optimizing adsorber design and operating conditions.

Using microwave heating to improve the desorption efficiency of high molecular weight VOC from beaded activated carbon.

Incomplete regeneration of activated carbon loaded with organic compounds results in heel build-up that reduces the useful life of the adsorbent. In this study, microwave heating was tested as a regeneration method for beaded activated carbon (BAC) loaded with n-dodecane, a high molecular weight volatile organic compound. Energy consumption and desorption efficiency for microwave-heating regeneration were compared with conductive-heating regeneration. The minimum energy needed to completely regenerate the adsorbent (100% desorption efficiency) using microwave regeneration was 6% of that needed with conductive heating regeneration, owing to more rapid heating rates and lower heat loss. Analyses of adsorbent pore size distribution and surface chemistry confirmed that neither heating method altered the physical/chemical properties of the BAC. Additionally, gas chromatography (with flame ionization detector) confirmed that neither regeneration method detectably altered the adsorbate composition during desorption. By demonstrating improvements in energy consumption and desorption efficiency and showing stable adsorbate and adsorbent properties, this paper suggests that microwave heating is an attractive method for activated carbon regeneration particularly when high-affinity VOC adsorbates are present.

Prohibiting consent: what are the costs of denying permanent contraception concurrent with abortion care?

OBJECTIVE: Oregon and federal laws prohibit giving informed consent for permanent contraception when presenting for an abortion. The primary objective of this study was to estimate the number of unintended pregnancies associated with this barrier to obtaining concurrent tubal occlusion and abortion, compared with the current policy, which limits women to obtaining interval tubal occlusion after abortion. The secondary objectives were to compare the financial costs, quality-adjusted life years, and the cost-effectiveness of these policies. STUDY DESIGN: We designed a decision-analytic model examining a theoretical population of women who requested tubal occlusion at time of abortion. Model inputs came from the literature. We examined the primary and secondary outcomes stratified by maternal age (>30 and <30 years). A Markov model incorporated the possibility of multiple pregnancies. Sensitivity analyses were performed on all variables and a Monte Carlo simulation was conducted. RESULTS: For every 1000 women age <30 years in Oregon who did not receive requested tubal occlusion at the time of abortion, over 5 years there would be 1274 additional unintended pregnancies and an additional $4,152,373 in direct medical costs. Allowing women to receive tubal occlusion at time of abortion was the dominant strategy. It resulted in both lower costs and greater quality-adjusted life years compared to allowing only interval tubal occlusion after abortion. CONCLUSION: Prohibiting tubal occlusion at time of abortion resulted in an increased incidence of unintended pregnancy and increased public costs.

Modeling competitive adsorption of mixtures of volatile organic compounds in a fixed-bed of beaded activated carbon.

A two-dimensional mathematical model was developed to study competitive adsorption of n-component mixtures in a fixed-bed adsorber. The model consists of an isotherm equation to predict adsorption equilibria of n-component volatile organic compounds (VOCs) mixture from single component isotherm data, and a dynamic adsorption model, the macroscopic mass, energy and momentum conservation equations, to simulate the competitive adsorption of the n-components onto a fixed-bed of adsorbent. The model was validated with experimentally measured data of competitive adsorption of binary and eight-component VOCs mixtures onto beaded activated carbon (BAC). The mean relative absolute error (MRAE) was used to compare the modeled and measured breakthrough profiles as well as the amounts of adsorbates adsorbed. For the binary and eight-component mixtures, the MRAE of the breakthrough profiles was 13 and 12%, respectively, whereas, the MRAE of the adsorbed amounts was 1 and 2%, respectively. These data show that the model provides accurate prediction of competitive adsorption of multicomponent VOCs mixtures and the competitive adsorption isotherm equation is able to accurately predict equilibrium adsorption of VOCs mixtures.

Elucidation of bacteria found in car interiors and strategies to reduce the presence of potential pathogens.

The human microbiome is influenced by a number of factors, including environmental exposure to microbes. Because many humans spend a large amount of time in built environments, it can be expected that the microbial ecology of these environments will influence the human microbiome. In an attempt to further understand the microbial ecology of built environments, the microbiota of car interiors was analyzed using culture dependent and culture independent methods. While it was found that the number and type of bacteria varied widely among the cars and sites tested, Staphylococcus and Propionibacterium were nearly always the dominant genera found at the locations sampled. Because Staphylococcus is of particular concern to human health, the characteristics of this genus found in car interiors were investigated. Staphylococcus epidermidis, S. aureus, and S. warnerii were the most prevalent staphylococcal species found, and 22.6% of S. aureus strains isolated from shared community vehicles were resistant to methicillin. The reduction in the prevalence of pathogenic bacteria in cars by using silver-based antimicrobial surface coatings was also evaluated. Coatings containing 5% silver ion additives were applied to steering wheels, placed in cars for five months and were found to eliminate the presence of culturable pathogenic bacteria recovered from these sites relative to controls. Together, these results provide new insight into the microbiota found in an important built environment, the automobile, and potential strategies for controlling the presence of human pathogens.

Two-dimensional modeling of volatile organic compounds adsorption onto beaded activated carbon.

A two-dimensional heterogeneous computational fluid dynamics model was developed and validated to study the mass, heat, and momentum transport in a fixed-bed cylindrical adsorber during the adsorption of volatile organic compounds (VOCs) from a gas stream onto a fixed bed of beaded activated carbon (BAC). Experimental validation tests revealed that the model predicted the breakthrough curves for the studied VOCs (acetone, benzene, toluene, and 1,2,4-trimethylbenzene) as well as the pressure drop and temperature during benzene adsorption with a mean relative absolute error of 2.6, 11.8, and 0.8%, respectively. Effects of varying adsorption process variables such as carrier gas temperature, superficial velocity, VOC loading, particle size, and channelling were investigated. The results obtained from this study are encouraging because they show that the model was able to accurately simulate the transport processes in an adsorber and can potentially be used for enhancing absorber design and operation.

Screening for HPV-Related Oropharyngeal Cancer in Gay and Bisexual Men: Acceptability and Predicting Possible Use of "Oral Selfies" by Smartphone as a Secondary Prevention Approach.

Oropharyngeal cancers (OPCa) caused by HPV have emerged as one of the leading causes of malignancies caused by HPV infection. They are also significantly more likely to occur in males and in people with a history of oral sex with multiple partners. Gay and bisexual men are disproportionately affected by HPV-positive oropharyngeal cancers. We studied 1699 gay and bisexual men on 2 major dating sites in the US to assess their knowledge about HPV-related OPCa, attitudes toward screening for it, beliefs about oropharyngeal cancer screening based on the Health Belief Model, and attitudes toward possible screening approaches for OPCa. Knowledge on a 12-item scale was low, with a median of 5 items correct: 72% knew of the benefits of HPV vaccination. Significant predictors of needing OPCa screening included perception of risk for OPCa, seeing it as severe, having lower barriers, fewer reasons to avoid screening, higher knowledge, and being HPV vaccinated were significant predictors, explaining half the total variance. Most participants would accept routine, virtual/online doctor or dental appointments, and over half would accept an in-person screening. Nearly two-thirds stated that they would accept getting checked for OPCa if they could do self-screening at home, and half were prepared to use an online screening tool or app, where they could take an "oral selfie" and send it to a healthcare provider for examination. One-third stated that they would trust the results of a home screening completed by themselves and posted to a website equally as cancer screening completed online by a healthcare provider. Data indicate that despite low OPCA knowledge levels, the risk of HPV-associated OPCa was known. Being at personal risk and having knowledge of disease severity had 70% of the sample thinking about, or preparing to get, screening. Self-screening by a smartphone "oral selfie" transmitted to a screening website was acceptable to many gay and bisexual men, and online screening by a doctor or dentist was acceptable to most. OPCa screening in this population using electronic technology, together with the increasing incidence of HPV-associated OPCa in gay and bisexual men, brings together an opportunity to detect OPCa early.

Adsorption and desorption of mixtures of organic vapors on beaded activated carbon.

In this study, adsorption and desorption of mixtures of organic compounds commonly emitted from automotive painting operations were experimentally studied. A mixture of two alkanes and a mixture of eight organic compounds were adsorbed onto beaded activated carbon (BAC) and then thermally desorbed under nitrogen. Following both adsorption and regeneration, samples of the BAC were chemically extracted. Gas chromatography-mass spectrometry (GC-MS) was used to quantify the compounds in the adsorption and desorption gas streams and in the BAC extracts. In general, for both adsorbate mixtures, competitive adsorption resulted in displacing low boiling point compounds by high boiling point compounds during adsorption. In addition to boiling point, adsorbate structure and functionality affected adsorption dynamics. High boiling point compounds such as n-decane and 2,2-dimethylpropylbenzene were not completely desorbed after three hours regeneration at 288 °C indicating that these two compounds contributed to heel accumulation on the BAC. Additional compounds not present in the mixtures were detected in the extract of regenerated BAC possibly due to decomposition or other reactions during regeneration. Closure analysis based on breakthrough curves, solvent extraction of BAC and mass balance on the reactor provided consistent results of the amount of adsorbates on the BAC after adsorption and/or regeneration.

Effect of adsorption and regeneration temperature on irreversible adsorption of organic vapors on beaded activated carbon.

This paper investigates the effect of adsorption and regeneration temperature on the irreversible adsorption of a mixture of organic compounds typically emitted from automobile painting operations. Adsorption of the organic vapors mixture onto microporous beaded activated carbon (BAC) and regeneration of the saturated BAC were completed under different conditions. Results indicated that increasing the adsorption temperature from 25 to 35 or 45 °C increased heel buildup on BAC by about 30% irrespective of the regeneration temperature due to chemisorption. The adsorption capacity (for the first cycle) of the mixture onto the BAC at these three temperatures remained almost unchanged indicating chemisorption of some of these compounds onto the BAC. Increasing the regeneration temperature from 288 to 400 °C resulted in 61% reduction in the heel at all adsorption temperatures, possibly due to desorption of chemicals from narrow micropores. BET area and pore volumes of the BAC decreased proportionally to the cumulative heel. Pore size distribution and pore volume reduction confirmed that the heel was mainly built up in narrow micropores which can be occupied or blocked by some of the adsorbates.

A sensitive non-radioactive northern blot method to detect small RNAs.

The continuing discoveries of potentially active small RNAs at an unprecedented rate using high-throughput sequencing have raised the need for methods that can reliably detect and quantitate the expression levels of small RNAs. Currently, northern blot is the most widely used method for validating small RNAs that are identified by methods such as high-throughput sequencing. We describe a new northern blot-based protocol (LED) for small RNA (approximately 15-40 bases) detection using digoxigenin (DIG)-labeled oligonucleotide probes containing locked nucleic acids (LNA) and 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide for cross-linking the RNA to the membrane. LED generates clearly visible signals for RNA amounts as low as 0.05 fmol. This method requires as little as a few seconds of membrane exposure to outperform the signal intensity using overnight exposure of isotope-based methods, corresponding to approximately 1000-fold improvement in exposure-time. In contrast to commonly used radioisotope-based methods, which require freshly prepared and hazardous probes, LED probes can be stored for at least 6 months, facilitate faster and more cost-effective experiments, and are more environmentally friendly. A detailed protocol of LED is provided in the Supplementary Data.

Breast cancer-derived M543V mutation in helix 12 of estrogen receptor alpha inverts response to estrogen and SERMs.

We have isolated from human breast cancers several mutations in the Helix 12 component of activation function 2 (AF-2) in the estrogen receptor alpha (ERalpha). We used a novel approach to detect changes in the hormone-binding domain of ERalpha, based on the evidence that antiestrogens, such as 4-hydroxytamoxifen (ZOHT) and ICI 182,780, block the function of ERalpha by binding and folding the AF-2 transcriptional domain in a way that inhibits its association with coactivator proteins. We have identified a Helix 12 mutation, M543V, which leads to greater ERalpha transcription with ZOHT and other antiestrogens (including 1,1-dichloro-2,2,3-triarylcyclopropanes, DTACs) than with 17-beta estradiol (E2). We also found an independent mutation at the same position, M543I, which did not show this inverted ligand phenotype. In comparison to further Helix 12 mutations made in vitro, it appears that relative hydrophobicity of the amino acid side chains on the inner face of Helix 12 is key to maintaining the transcriptionally active, agonist conformation with bound E2. This active conformation can be induced, resulting in increased transcription, by adding excess p160 coactivator AIB1 in transcriptional assays with E2-bound receptors, while the ZOHT-bound receptors were not further activated by AIB1. Other experiments show that the cross talk between ERalpha and AP-1 protein from AP-1-binding sites is not dependent on Helix 12 integrity. We show that two alleles containing a proline substitution in Helix 12 that inactivate AF-2 function of ERalpha at EREs have little negative effect on function through AP-1 elements, supporting a prominent role for the N-terminal AF-1 of ERalpha in AP-1/ERalpha transcriptional cross talk.

Modeling VOC adsorption in lab- and industrial-scale fluidized bed adsorbers: Effect of operating parameters and heel build-up.

Scale-up and optimization of fluidized beds are challenging due to the difficulty in accounting for the interrelated effect of various phenomena, which are typically described by empirical and/or semi-empirical equations. In this study, a two-phase model was introduced to simulate the adsorption of VOCs on beaded activated carbon (BAC) in a lab-scale fluidized bed adsorber. The model assumes the presence of a bubble phase free from adsorbent particles, and an emulsion phase composed of the adsorbent particles and interstitial gas. The versatility of the proposed model was then evaluated using data from an industrial scale adsorber with different operating conditions, adsorbent properties, and bed geometry. The response of the model to the operating conditions (adsorbent feed rate, air flow rate and initial concentration) showed better agreement with the experimental lab-scale data when the emulsion gas in two-phase model was considered in plug flow than in perfectly-mixed flow (R2 = 0.96 compared to 0.91). To simulate the performance of BACs with different service lifetimes (degree of exhaustion as a result of heel developed inside their pores), the main characteristics of the BACs (pore diameter, porosity, and adsorption capacity) were first correlated to their apparent densities. The model could accurately predict the experimental lab-scale VOC concentrations in each stage (R2 = 0.92) as well as overall removal efficiencies (R2 = 0.99) for BACs ranging from virgin to fully-spent. Finally, the model was used to predict the performance of an industrial-scale fluidized bed adsorber for VOC removal at different operating conditions and apparent densities. Predicted and measured VOC removal efficiencies were in good agreement (R2 = 0.94). Although the model was verified for adsorption of VOCs on BAC, the modeling approach presented in this study could be used for describing adsorption in different adsorbate-adsorbent systems in multistage counter-current fluidized bed adsorbers.

Pain control in first trimester surgical abortion.

BACKGROUND: First trimester abortions especially cervical dilation and suction aspiration are associated with pain, despite various methods of pain control. OBJECTIVES: Compare different methods of pain control during first trimester surgical abortion. SEARCH STRATEGY: We searched multiple electronic databases with the appropriate key words, as well as reference lists of articles, and contacted professionals to seek other trials. SELECTION CRITERIA: Randomized controlled trials comparing methods of pain control in first trimester surgical abortion at less than 14 weeks gestational age using electric or manual suction aspiration. Outcomes included intra- and postoperative pain, side effects, recovery measures and satisfaction. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data. Meta-analysis results are expressed as weighted mean difference (WMD) or Peto Odds ratio with 95% confidence interval (CI). MAIN RESULTS: We included forty studies with 5131 participants. Due to heterogeneity we divided studies into 7 groups:Local anesthesia: Data was insufficient to show a clear benefit of a paracervical block (PCB) compared to no PCB or a PCB with bacteriostatic saline. Pain scores during dilation and aspiration were improved with deep injection (WMD -1.64 95% CI -3.21 to -0.08; WMD 1.00 95% CI 1.09 to 0.91), and with adding a 4% intrauterine lidocaine infusion (WMD -2.0 95% CI -3.29 to -0.71, WMD -2.8 95% CI -3.95 to -1.65 with dilation and aspiration respectively).PCB with premedication: Ibuprofen and naproxen resulted in small reduction of intra- and post-operative pain.Analgesia: Diclofenac-sodium did not reduce pain.Conscious sedation: The addition of conscious intravenous sedation using diazepam and fentanyl to PCB decreased procedural pain.General anesthesia (GA): Conscious sedation increased intraoperative but decreased postoperative pain compared to GA (Peto OR 14.77 95% CI 4.91 to 44.38, and Peto OR 7.47 95% CI 2.2 to 25.36 for dilation and aspiration respectively, and WMD 1.00 95% CI 1.77 to 0.23 postoperatively). Inhalation anesthetics are associated with increased blood loss (p<0.001).GA with premedication: The COX 2 inhibitor etoricoxib, the non-selective COX inhibitors lornoxicam, diclofenac and ketorolac IM, and the opioid nalbuphine were improved postoperative pain.Non-pharmacological intervention: Listening to music decreased procedural pain.No major complication was observed. AUTHORS' CONCLUSIONS: Conscious sedation, GA and some non-pharmacological interventions decreased procedural and postoperative pain, while being safe and satisfactory to patients. Data on the widely used PCB is inadequate to support its use, and it needs to be further studied to determine any benefit.

Body mass index and sexual behavior.

OBJECTIVE: To characterize the relationship between body mass index and sexual behavior, including sexual orientation, age at first intercourse, ever having had sex with a male partner, number of partners, and frequency of intercourse. METHODS: This study employed the 2002 National Survey of Family Growth, a cross-sectional, nationally representative database in which women between the ages of 15 years and 44 years were surveyed regarding reproductive health outcomes. Sexual behavior was compared between body mass index groups-normal (less than 25 m/kg2), overweight (25-30 m/kg2), and obese (greater than 30 m/kg2)-using self-reported height and weight. Multiple logistic regression with adjustment for the sampling design was used to measure associations of interest. RESULTS: Body mass index was not significantly associated with sexual orientation, age at first intercourse, frequency of heterosexual intercourse, and the number of lifetime or current male partners. Overweight women and obese women were more likely to report ever having male sexual intercourse (P<.001). This difference persisted when we adjusted for age as well as type of residence. CONCLUSION: With the exception of ever engaging in sexual intercourse with a man, sexual behavior differs little between women of different body mass indices.

The relationship between body mass index and unintended pregnancy: results from the 2002 National Survey of Family Growth.

BACKGROUND: The study was conducted to characterize the relationship between body mass index (BMI) and unintended pregnancy, contraceptive use patterns, and perceived fertility. METHODS: This study employed a cross-sectional, nationally representative database (2002 National Survey of Family Growth). Unintended pregnancy was compared among BMI groups [normal (<25 m/kg(2)), overweight (25-30 m/kg(2)) and obese (>30 m/kg(2))]. Analyses also evaluated the association between demographic, socioeconomic, behavioral and health-related variables and BMI. Multiple logistic regression with adjustment for sampling design was used to measure associations of interest. RESULTS: BMI data were available from 6690 nonpregnant women. Of these, 3600 (53.6%) were normal weight, 1643 (25%) were overweight and 1447 (21.4%) were obese. Compared to women with normal BMIs, the risk of unintended pregnancy in the last 5 years did not differ among overweight [adjusted OR 0.95 (95% CI 0.77-1.17)] or obese [adjusted OR 0.87 (95% CI 0.70-1.09)] women. There were no differences in contraceptive use patterns or perceived fertility among BMI groups. CONCLUSION: Data from the 2002 NSFG do not support an association between obesity and unintended pregnancy.

Effect of "observed start" vs. traditional "Sunday start" on hormonal contraceptive continuation rates after medical abortion.

OBJECTIVE: This study was conducted to determine whether early initiation of combined hormonal contraception under direct clinical observation following successful medical abortion increases continuation rates with the method compared to traditional "Sunday start." STUDY DESIGN: Women enrolled in a multicenter medical abortion trial with mifepristone and misoprostol who requested combined hormonal contraception (pill, ring or patch) following medical abortion were recruited. Women were randomized to initiate the method under supervision either at the 1-week medical abortion follow-up visit ("observed start") or at the first Sunday following this visit ("Sunday start"). Primary outcome was continuation of the chosen method at 6 weeks. RESULTS: Of the 1128 women in the primary trial, 261 subjects enrolled in this substudy and 36/261 (13.8%) were lost to follow-up. There was no significant difference in method continuation at 6 weeks [observed start 108/114 (94.7%), Sunday start 101/111 (91.0%, p=.27]. CONCLUSION: Short-term continuation rates among those choosing hormonal contraception following medical abortion are high and are not significantly improved by initiating the method at the time of the first follow-up visit.

Predictors and perception of pain in women undergoing first trimester surgical abortion.

BACKGROUND: The aim of the study was to evaluate pain and predictors of pain in women undergoing electric (EVA) or manual vacuum aspiration (MVA) for first trimester surgical abortions and to examine how perceptions of pain differ among participants, advocates (participant support person) and physicians. STUDY DESIGN: In this randomized controlled study, women presenting for first trimester abortion underwent standardized EVA or MVA. Participants completed questionnaires, visual analog scales (VAS) and Likert scales for pain. Logistic and linear regression models were used to analyze the data. RESULTS: Nonwhite women and women who preoperatively expected more pain reported higher procedure-related pain scores. Vacuum source, previous history of abortion, comfort with decision to have an abortion and partner involvement did not affect participant pain scores. In the multivariable analyses, no single factor predicted procedure-associated pain. The advocates perceived that more educated women had less pain. Physicians felt longer procedures and a woman's fear of pelvic examinations caused more pain. Physicians believed women had less pain than the participants reported themselves (p<.001). Only physicians thought that EVA was less painful than MVA (p<.01). CONCLUSION: Distinct factors other than vacuum source affect the perception of abortion-related pain. Understanding these factors may help inform counseling strategies aimed at ameliorating pain perception during first trimester abortions.

Online availability of hormonal contraceptives without a health care examination: effect of knowledge and health care screening.

BACKGROUND: The study was conducted to investigate whether the knowledge of women using an online resource to obtain hormonal contraceptives (HCs) without a health care examination is similar to women who obtain HC in the clinic. STUDY DESIGN: Women who accessed HC prescriptions online or through a clinic visit were offered an anonymous self-administered survey regarding the contraindications to and possible complications of HC. Tests of equivalence were used to compare the mean scores between the two populations. RESULTS: Online users (n=243) were older, more affluent, more educated, and more likely to be insured than clinic patients (n=161). The two populations demonstrated equivalent HC knowledge [contraindications (mean score, 95% confidence interval): clinic 81.1% (77.2-85.0%), online 85.0% (82.0-88.0%); complications: clinic 77.6% (72.7-82.6%), online 82.1% (78.8-85.5%)]. The online population remained equivalent or superior to the clinic population in an age-restricted analysis. CONCLUSION: Women who self-select to obtain HC prescriptions online demonstrate at least equivalent knowledge of potential HC risks as women seen in a clinic encounter without a pelvic examination.

Acceptability of contraceptive-induced amenorrhea in a racially diverse group of US women.

OBJECTIVE: The study was conducted to determine women's preferences about menstrual bleeding patterns and their willingness to manipulate bleeding with contraception. STUDY DESIGN: Women presenting for routine obstetric and gynecologic care at two US locations (Portland, OR, and Atlanta, GA) were offered a self-administered, anonymous survey. A validated survey tool was used. RESULTS: Valid surveys from 292 women were obtained. Mean age was 27 years (SD 8.0). We were unable to separate geographic vs. racial differences in responses because race significantly differed between sites (p<.001). The populations surveyed were predominantly black in Georgia (88%, 58/66) and white in Oregon (83%, 142/172). Overall, the majority of women did not like their menstrual period (69%, 190/275) and preferred a menstrual frequency of every 3 months or never (58%, 164/281) with no differences between racial groups. When asked if they would consider using a birth control method that stopped their menstrual periods, 40% (111/278) reported yes, 28% (78/278) reported no and 32% (89/278) were undecided. However, significantly fewer black than white women would consider a birth control method to stop their menstrual periods (29% vs. 49%, p=.006). CONCLUSIONS: Although the majority of US women surveyed dislike menstruation and prefer less frequent or no menstrual periods, black women were less accepting than white women of contraception that induces amenorrhea.