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alspac_95_pnq
PARTNER'S NEW QUESTIONNAIRE
This questionnaire aims to find out what problems parents have. Your answers will help us to identify those problems that may be solved by changes in the health care system. It should be filled in by the mother's partner.
To answer simply tick the box which is most accurate in your opinion.
Some questions are the same as those you have answered before. This is so that we can tell what changes have happened to you.
Please answer all questions if you can, even if they are similar . If you cannot answer a question or if it does not apply to you, put a line through it. There are no good or bad answers. Just tell us what you really think.
All answers are confidential.
THANK YOU VERY MUCH
SECTION A: YOUR HEALTH

Which of the following would you say describes your health now?

1
fit and well
2
mostly well and healthy
3
often feel unwell
4
hardly ever feel well
Have you had any of the following in the past year?
-
anxiety or 'nerves'
depression
headache or migraine
backache
indigestion
cough or cold
haemorrhoids/piles
influenza
wheezing
bronchitis
stomach ulcer
eczema
psoriasis
arthritis
rheumatism
urinary infection

Have you had any of the following in the past year? other problems (please tick and describe)

1
Yes and consulted doctor
2
Yes but did not consult doctor
3
No
Other
In the past year how often have you taken or used the following?
-
sleeping pills
vitamins
cannabis/marihuana
tranquillisers
pills for depression
antibiotics
painkillers (aspirin paracetamol, etc.)
amphetamines or other stimulants
iron
heroin, methadone, crack, cocaine
anticonvulsants
steroids

Other pill, medicine, treatment, drug, ointment or cream (please describe each and tick how frequently you have taken in the past year.)

Other
1
Every day
2
Often
3
Sometimes

Other pill, medicine, treatment, drug, ointment or cream (please describe each and tick how frequently you have taken in the past year.)

Other
1
Every day
2
Often
3
Sometimes

Other pill, medicine, treatment, drug, ointment or cream (please describe each and tick how frequently you have taken in the past year.)

Other
1
Every day
2
Often
3
Sometimes
Please list all the names of the actual medicines, pills or ointments that you have taken in the past month:
What did you take: About how many days did you take or use it? How often per day?
Generic textHow manyHow many Generic textHow manyHow many Generic textHow manyHow many
1
2
3
4
5
6
7
8
9
10

Since your study child was 3 years old have you had to go and stay in hospital?

1
Yes
2
No
If no, go to A6 below
If yes,
qc_A5_a == 1

how many times?

How many
Please describe for each admission.
How old was your study child? ... months What were the reasons for your admission? (please describe) How long did you stay? ... days
Age in monthsGeneric textHow many Age in monthsGeneric textHow many Age in monthsGeneric textHow many
1st admission
2nd admission
3rd admission
In the past month, how often have you had the following:
-
backache
headaches or migraines
urinary infection
nausea
vomiting
diarrhoea
haemorrhoids or piles
feeling weepy/tearful
feeling irritable
feeling exhausted
varicose veins
passing urine very often
problem holding urine when you jump, sneeze etc.
indigestion
feeling dizzy/fainting
flashing lights/spots before eyes
shoulder ache
tingling in hands/fingers
tingling in feet/toes
neck ache
feeling depressed

In the past month, how often have you had the following: other problem (please tick and describe)

1
Almost all the time
2
Sometimes
3
Not at all
Other

How often are you having sexual intercourse now?

1
not at all
2
less than once a month
3
1-3 times a month
4
about once a week
5
2-4 times a week
6
5 or more times a week

In general do you enjoy it?

1
yes, very much
2
yes, somewhat
3
no, not a lot
4
no, not at all
5
no sex at the moment
SECTION B: YOUR DIET
How often nowadays do you eat the following foods? Please answer every question even if you never eat the food (in this case tick "Never or rarely").
-
Oat cereals (e.g. porridge, Ready Brek, muesli)
Wholegrain or bran cereals (e.g. All Bran, Bran Flakes, Weetabix, Wheatflakes, Fruit & Fibre, Shredded Wheat)
Other cereals (e.g. Cornflakes, Rice Krispies, Special K, Frosties)
Sausages, Burgers
Meat Pies, Pasties (pork pie, steak/meat pie, Cornish pastie etc.)
Vegetarian Pies, Pasties (cheese and onion pasty, vegetable samosa, onion bhaji, vegetable grills etc.)
Ham, bacon, pat and cold meats (e.g. salami, luncheon meat, garlic sausage etc.)
Meat: roast, chops and stews etc. (e.g. beef, lamb, pork, mince)
Liver, kidney, heart and other offal
Chicken/Turkey in crispy coating (e.g. chicken nuggets, turkey burgers, chicken fingers etc.)
Poultry: roast, baked or stewed (chicken, turkey etc.)
Shellfish (prawns, scampi, crab, cockles, mussels etc.)
White fish in breadcumbs or batter (e.g. fishfingers, chip shop fish, breaded cod, plaice or haddock,)
White fish without coating (e.g. grilled fish, cod in parsley sauce etc.)
Tuna
Other fish (pilchards, sardines, mackerel, herrings, kippers, trout, salmon etc.)
Eggs, quiche/flans, omelettes etc.
Cheese
Pizza
Oven chips
Fried chips, potato waffles and croquettes, Alphabites etc.
Roast potatoes (cooked in fat or oil)
Boiled, mashed, jacket potatoes
Rice (boiled, or fried, not rice pudding)
Canned pasta (e.g. spaghetti rings, ravioli, macaroni cheese etc.) Pot Noodles, Super Noodles etc.
Boiled pasta (e.g. spaghetti, fusilli, lasagne) bulgar wheat and cous-cous

Do you eat the fat on meat?

1
yes, all of it
2
yes, some of it
3
no
4
never eat meat
How many times nowadays do you eat:
-
Baked beans
Peas, broad beans
Sweetcorn
Cabbage, brussel sprouts, spinach, broccoli and other dark green leafy vegetables
Other green vegetables (cauliflower, runner beans, leeks, courgettes etc.)
Carrots
Other root vegetables (turnip, swede, parsnip etc.)
Tomatoes (cooked or raw)
Salads
Pulses - dried peas, beans, lentils, chick peas etc.
Soya 'Meat', TVP, Soya-type Vegeburgers, Bean Curd (Tofu, Miso etc.)
Nuts (eg peanuts, cashews), nut roast etc.
Fresh citrus fruit e.g. oranges, grapefruit, satsumas, tangerines etc.
Other fresh fruit e.g. apple, banana, pear, bunch of grapes, peach etc.
Canned fruit
Yoghurt, Fromage Frais, Milk puddings (e.g. rice pudding, semolina) mousse
Ice cream, choc ice, chocolate ice cream bar etc.
Pudding e.g. fruit pie, crumble, cheesecake, gateaux
Custard, cream, Elmlea, Tip-Top, evaporated milk etc. on puddings
Cakes or buns (fruit cake, sponge, teacake, doughnut, flapjack, scone, custard tart, cream cake etc.)
Crispbreads (Ryvita, crackerbread etc.)
Full-coated chocolate biscuits eg. Club, Kit Kat, Penguin, Breakaway etc.
Other biscuits eg. rich tea, shortcake, digestive and chocolate digestive, Hob Nobs
Chocolate (dairy milk or plain, nut, fruit, filled etc.)
Sweets (peppermints, boiled sweets, toffees etc.)
Crisps, corn snacks (e.g. Wotsits, Quavers), tortilla chips etc.
How many times a week nowadays do you drink
-
Fruit juice from a carton, tin or freshly squeezed including tomato juice
Squash, fruit drinks or Ribena
Cola drinks eg. Coca Cola, Pepsi etc.
Other fizzy drinks e.g. lemonade
Bottled water
Water from tap
Milk on its own
Flavoured milk drinks (e.g. Horlicks, Ovaltine, milkshakes) or yoghurt drinks

When you have a soft drink (e.g. lemonade, cola or squash) how often do you choose low calorie or diet soft drinks?

1
always
2
sometimes
3
not at all
4
don't drink soft drinks

When you have a cola drink how often do you choose decaffeinated cola?

1
always
2
sometimes
3
not at all
4
don't drink cola

How many pieces of bread, rolls or chappatis do you eat on a usual day?

1
less than 1
2
1-2
3
3-4
4
5 or more

What type of bread do you eat? white bread

1
Yes usually
2
Yes sometimes
3
No not at all

What type of bread do you eat? soft grain white bread (e.g. Mighty White)

1
Yes usually
2
Yes sometimes
3
No not at all

What type of bread do you eat? brown/granary bread

1
Yes usually
2
Yes sometimes
3
No not at all

What type of bread do you eat? wholemeal bread

1
Yes usually
2
Yes sometimes
3
No not at all

What type of bread do you eat? chappatis or pitta bread

1
Yes usually
2
Yes sometimes
3
No not at all

What type of bread do you eat? naan bread

1
Yes usually
2
Yes sometimes
3
No not at all
What sort of fat do you mainly use:
on bread or vegetables for frying

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

Butter, Ghee, Dripping, Lard , solid cooking fat
Polyunsaturated margarine eg Flora, sunflower margarine, Vitalite
Hard or soft margarine e.g. Blue Band, Stork, supermarket own brand
Low fat spread e.g. Delight, St Ivel Gold, Flora Xtra Light
Sunflower oil, corn oil, soya oil
Olive oil, hazelnut oil, rapeseed oil
Other vegetable oil
Other (please describe )

What sort of fat do you mainly use: Other (please describe )

Other

How many slices of bread (or rolls) spread with fat do you eat each day? (include shop bought sandwiches)

How many

What types of milk do you use? Full fat (e.g. silver or gold top )

1
Yes usually
2
Yes sometimes
3
No not at all

What types of milk do you use? Semi Skimmed (e.g. red stripe )

1
Yes usually
2
Yes sometimes
3
No not at all

What types of milk do you use? Skimmed (e.g. blue stripe )

1
Yes usually
2
Yes sometimes
3
No not at all

What types of milk do you use? Dried milk (e.g. Marvel )

1
Yes usually
2
Yes sometimes
3
No not at all

What types of milk do you use? Goat/sheep milk

1
Yes usually
2
Yes sometimes
3
No not at all

What types of milk do you use? Soya milk

1
Yes usually
2
Yes sometimes
3
No not at all

What types of milk do you use? Other (please describe )

1
Yes usually
2
Yes sometimes
3
No not at all
Other

Is this milk usually:

1
Pasteurised
2
UHT
3
Sterilised
4
Other (please describe )
Other

How many cups of tea do you drink in a day? (do not include herbal teas )

How many

How many spoons of sugar in each cup?

How many

How many cups per day are with milk?

How many

How many cups per day are decaffeinated?

How many

How many cups of coffee do you drink in a day?

How many

How many spoons of sugar in each cup?

How many

How many cups per day are with milk ?

How many

How many cups per day are decaffeinated?

How many

How many are made with real (not instant) coffee?

How many

Do you drink herbal teas at all?

1
yes, often
2
yes, occasionally
3
no, not at all
If no, go to B16 below
If yes,
qc_B15_a == 1 || qc_B15_a == 2

how many cups/mugs of herbal teas have you drunk in the past week ?

How many

Please list the types of herbal teas you have drunk in the past 3 months:

Generic text

Apart from herbal teas, are there any other health foods (whether or not bought from a health food shop) that you often eat or drink?

1
Yes
2
No
If yes,
qc_B16 == 1

please describe below:

Generic text

Are you at present on a diet to lose weight?

1
Yes
2
No

Are you at present a vegetarian (do not eat any meat or poultry)?

1
Yes
2
No

Are you at present a vegan (i.e. do not eat meat, poultry, fish, eggs, butter, milk or cheese)?

1
Yes
2
No

Are you at present on any kind of special diet?

1
Yes
2
No
If yes,
qc_B20 == 1

please describe below.

Generic text
During the last week how many of each type of alcoholic drink did you have on each day? (Please put a number.)
Mon. Tues. Wed. Thurs. Frid. Sat. Sun.
How manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow many
Beer, lager or cider (no. of 1/2 pints)
Wine (no. of glasses)
Spirits (no. of single pub measures)
Other alcoholic drinks (please describe) (no. of glasses or measures)
Low alcohol drink (no. of glasses or 1/2 pints)

During the last week how many of each type of alcoholic drink did you have on each day? (Please put a number.) Other alcoholic drinks (please describe) (no. of glasses or measures)

Other

Is this week fairly typical of your alcohol drinking?

1
No
2
Yes
If yes, go to B22 below
If no,
qc_B21_b == 1

would you normally drink

1
More
2
Less

For your main meal of the day how often do you eat takeaway foods or have meals out?

1
Never or rarely
2
1 - 3 times a month
3
1 - 2 times a week
4
3-4 times a week
5
5-7 times a week

For your main meal of the day how often do you eat an oven/microwave ready or convenience meal (e.g. Menu Master lasagne, individual shepherds pie, ready prepared chilli con carne etc.)?

1
Never or rarely
2
1 - 3 times a month
3
1 - 2 times a week
4
3-4 times a week
5
5-7 times a week
SECTION C: RECENT EVENTS
Listed below are a number of events which may have brought changes in your life. Have any of these occurred since the study child was 2 1/2 years old? If so please assess how much effect it had on you.

Since the study child was 2 1/2 years old: Your partner died

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: One of your children died

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: A friend or relative died

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: One of your children was ill

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: Your partner was ill

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: A friend or relative was ill

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: You were admitted to hospital

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: You were in trouble with the law

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: You were divorced

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: You found that your partner didn't want your child

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: You were very ill

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: Your partner lost her job

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: Your partner had problems at work

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: You had problems at work

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: You lost your job

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: Your partner went away

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: Your partner was in trouble with the law

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: You and your partner separated

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: Your income was reduced

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: You argued with your partner

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: You argued with your family and friends

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: You moved house

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: Your partner was physically cruel to you

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: You became homeless

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: You had a major financial problem

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: You got married

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: Your partner was physically cruel to your children

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: You were physically cruel to your children

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: You attempted suicide

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: You were convicted of an offence

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: Your partner became pregnant

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: You started a new job

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: Your partner had a miscarriage

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: Your partner had an abortion

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: You took an examination

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: Your partner was emotionally cruel to you

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: Your partner was emotionally cruel to your children

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: You were emotionally cruel to your children

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: Your house or car was burgled

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: Your partner started a new job

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: A pet died

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen

Since the study child was 2 1/2 years old: You had an accident (please tick and describe)

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Generic text

Is there anything else which is not on the list which has concerned you or required additional effort from you to cope in the last year?

1
Yes
2
No
If no, go to C44a below
If yes,
qc_C43_a == 1

please describe:

Generic text

How did this affect you?

1
a lot
2
moderately
3
mildly
4
not at all

Are you currently employed?

1
Yes
2
No
If no, go to section D on page 23
If yes,
qc_C44_a == 1

What is your occupation?

Generic text

Have you had the same type of job since this child was 2 1/2 years old?

1
Yes
2
No

Do you work nights?

1
yes, always
2
yes, sometimes
3
no, never

Do you ever leave home for several days as part of your work?

1
yes, often
2
yes, occasionally
3
no, never
SECTION D: YOUR HOUSEHOLD

How many people live in your household now? (including yourself) ... adults (over 18 years)

How many

How many people live in your household now? (including yourself) ... young adults (16-18 years)

How many

How many people live in your household now? (including yourself) ... children (less than 16 years)

How many

Please indicate who the adults over 18 are: yourself

1
Yes

Please indicate who the adults over 18 are: your partner

1
Yes

Please indicate who the adults over 18 are: your parent(s)

1
Yes

Please indicate who the adults over 18 are: your partner's parent(s)

1
Yes

Please indicate who the adults over 18 are: other relation(s) of yourself

1
Yes

Please indicate who the adults over 18 are: other relation(s) of your partner

1
Yes

Please indicate who the adults over 18 are: friend(s)

1
Yes

Please indicate who the adults over 18 are: lodger

1
Yes

Please indicate who the adults over 18 are: other (please tick and describe)

1
Yes
Other

Do you have a rule that smoking never happens in particular rooms?

1
no smoking in house at all
2
smoking only allowed in some rooms
3
smoking allowed anywhere

How many people living in your household (including yourself) are smokers?

How many

What is your present marital status?

1
never married
2
widowed
3
divorced
4
separated
5
married (once only)
6
married for second or third time
If married,
qc_D3_a == 5 || qc_D3_a == 6

what was the date of the most recent marriage?

Generic date
Please indicate how many of the children living with you have:
Number of children
you and your partner as their natural parents
you as their natural father (but their natural mother is not present)
your partner as the natural mother (but you are not their natural father)

Please indicate how many of the children living with you have: neither you nor your partner as natural parents (please describe whether you have adopted fostered etc.) Number of children

How many
Generic text
Are there other children of yourself or your partner who visit (whether to play or to stay)?
- Number of children

1 - No

2 - Yes

How many

1 - No

2 - Yes

How many
children of my partner but not me
children of myself but not my partner
children of me and my partner

Do you or your partner have any chronic illness or disabling condition?

1
Yes
2
No
If no, go to D7 below
If yes,
qc_D6 == 1
please describe:
Nature of condition(s) Person(s) involved (self/partner)
Generic textGeneric text Generic textGeneric text
1
2
3
4
5
6

Do you have any pets?

1
Yes
2
No
If no, go to D8 on page 26
If yes,
qc_D7_a == 1

How many of the following pets do you have? cats

How many

How many of the following pets do you have? dogs

How many

How many of the following pets do you have? rabbits

How many

How many of the following pets do you have? rodents (mice, hamster, gerbil etc)

How many

How many of the following pets do you have? birds (budgerigar, parrot, etc.)

How many

How many of the following pets do you have? fish

How many

How many of the following pets do you have? turtles/tortoises/terrapin

How many

How many of the following pets do you have? other pets (please say how many and describe)

How many
Other

Would you say that owning a pet has helped your health?

1
Yes improved it
2
No, made it worse
3
No effect

How often do you take pets along when you visit friends or relatives?

1
Never
2
Occasionally
3
Sometimes
4
Often
5
Always

How often are your feelings towards people affected by the way they react to your pets?

1
Never
2
Occasionally
3
Sometimes
4
Often
5
Always

Do you keep a picture of your pet(s) with you or on display at home or at work?

1
Yes
2
No
Below are questions about financial matters. We realise this may be a sensitive subject. As with all our questions you may leave this section out if you want to.[If you can complete it though it will be of great help to the study].

On average, about how much is the take home family income each week (include social benefits etc.)?

1
less than £100
2
£100-£199
3
£200-£299
4
£300-£399
5
£400 or more
9
don't know

Out of this, how much do you pay for rent, loans or mortgage each week?

1
nothing
2
less than £20
3
£20-£39
4
£40-£59
5
£60-£79
6
£80 or more
9
don't know

About how much do you spend on food for the whole family each week?

1
less than £20
2
£20-£29
3
£30-£39
4
£40-£49
5
£50-£59
6
£60 or more
9
don't know

How much do you spend on child care each week (playgroup, childminder, baby sitter etc.)

1
nothing
2
less than £10
3
£10-£19
4
£20-£29
5
£30-£39
6
£40-£49
7
£50 or more
8
varies
9
don't know

Do you manage to save at all?

1
Yes
2
No

Do you receive any financial help from your parents or other relatives?

1
Yes
2
No

Do you give financial help to your parents or other relatives?

1
Yes
2
No
Now we would like you to think about your 4 year old study child's behaviour over the last six months.
-
Is considerate of other people's feelings
Is restless, overactive, cannot stay still for long
Often complains of headaches, stomach-aches or sickness
Shares readily with other children (treats, toys, pencils etc.)
Often has temper tantrums or hot tempers
Is rather solitary, tends to play alone
Is generally obedient, usually does what adults request
Has many worries, often seems worried
Is helpful if someone is hurt, upset or feeling ill
Is constantly fidgeting or squirming
Has at least one good friend
Often fights with other children or bullies them
Is often unhappy, down hearted or tearful
Is generally liked by other children
Is easily distracted, concentration wanders
Is nervous or clingy in new situations, easily loses confidence
Is kind to younger children
Often lies or cheats
Is picked on or bullied by other children
Often volunteers to help others (parents, teachers, other children)
Thinks things out before acting
Steals from home, school or elsewhere
Gets on better with adults than with other children
Has many fears, is easily scared
Sees tasks through to the end, has good attention span
You and your study child:
Below are some statements about relationships with children. Please indicate how you think these apply in your situation
-
I really love this child
I often get very irritated with this child
I don't mind the mess and noise that surrounds this child
This child makes me pretty happy
I have frequent battles of will with this child
This child is very affectionate to me
This child gets on my nerves
I feel very close to this child
Your partner and your study child:

Below are some statements about your partner's relationships with children. Please indicate how you think these apply in your situation.

7
Have no partner
If Have no partner to question D11 Go to E1 on page 30
qc_D11 == 7
SECTION E YOUR PARTNER
This section below is concerned with your relationship with your partner. (The partner will be referred to as 'she', although the questions refer to all partners).

How would you assess your partner's physical health?

1
always fit and well
2
mostly well and healthy
3
often feels unwell
4
hardly ever feels well

How many cigarettes per day does your partner currently smoke?

How many

Is your partner currently employed?

1
Yes
2
No
If no, go to E4a on page 31
If yes,
qc_E3_a == 1

What is her occupation?

Generic text

Has she had the same type of job since this child was 2 1/2 years old?

1
Yes
2
No

Does she work nights?

1
yes, always
2
yes, sometimes
3
no, never

Does she ever leave home for several days as part of her work?

1
yes, often
2
yes, occasionally
3
no, never

How many evenings a month do you go out and do things on your own or with your own friends?

1
none
2
once
3
2-3 times
4
4-7 times
5
8 or more times

How many times a month does your partner go out and do things on her own or with her own friends?

1
none
2
once
3
2-3 times
4
4-7 times
5
8 or more times
How often in a week, on average, would you and your partner:
-
discuss work or how the day has gone
laugh together
calmly talk over something (e.g. the news, a hobby or interest)
kiss or hug
make plans
talk over feelings or worries

Which of the following statements about alcohol best applies to you and you partner: You

1
Never drinks alcohol
2
Very occasionally (less than once a week)
3
Occasionally (at least once a week)
4
Drinks 1-2 glasses* nearly every day
5
Drinks 3-9 glasses* every day
6
Drinks at least 10 glasses* a day
9
Don't know

Which of the following statements about alcohol best applies to you and you partner: Your partner

1
Never drinks alcohol
2
Very occasionally (less than once a week)
3
Occasionally (at least once a week)
4
Drinks 1-2 glasses* nearly every day
5
Drinks 3-9 glasses* every day
6
Drinks at least 10 glasses* a day
9
Don't know
[*by glass we mean a pub measure (1oz) of spirits or 1/2 pint of beer or cider, a wine glass of wine etc.]

How many days in the past month did you have the equivalent of 2 pints of beer, 4 glasses of wine or 4 pub measures of spirit?

1
every day
2
more than 10 days
3
5-10 days
4
3-4 days
5
1-2 days
6
none
9
don't know
SECTION F: CHEMICALS IN YOUR ENVIRONMENT
In the last few months, how often have you used the following (whether at home or at work):
-
disinfectant
bleach
window cleaner
carpet shampoo
oven/drain cleaner
dry cleaning fluid
turpentine/white spirit
paint stripper
household paint or varnish
weed killers
pesticides/insect killers
aerosols or sprays, including hair spray)
hair dye/bleach
deodorants
air fresheners (spray, stick or aerosol)
ceramics/enamels
solder
dental amalgam
electroplating
glues
leather work
fabric/textiles
dyes
radiation (x-ray or other)
plastics
metal cleaners/degreasers, polishers
petrol
machining
photographic chemicals
electrical wiring
diesel

In the last few months, how often have you used the following (whether at home or at work): other chemical (please tick and describe)

1
Every day
2
Most days
3
About once a week
4
Less than once a week
5
Not at all
Other

Do you drive a car, van or lorry?

1
Yes
2
No
If yes,
qc_F2 == 1

what type of fuel is used? diesel

1
Yes

what type of fuel is used? lead free petrol

1
Yes

what type of fuel is used? other petrol

1
Yes

How often during the day are you in a room or enclosed place where other people are smoking? weekdays

1
all the time
2
more than 5 hours
3
3-5 hours
4
1-2 hours
5
less than 1 hour
6
not at all

How often during the day are you in a room or enclosed place where other people are smoking? weekends

1
all the time
2
more than 5 hours
3
3-5 hours
4
1-2 hours
5
less than 1 hour
6
not at all
THANK YOU VERY MUCH FOR YOUR HELP

This questionnaire was completed by: child's father

1
Yes

This questionnaire was completed by: child's mother

1
Yes

This questionnaire was completed by: someone else (please describe)

1
Yes
Other

Please give the date on which you completed this questionnaire:

Generic date

Please give your date of birth:

Date of birth

Space for any additional comments you would like to make.

Long text
NB Please remember that we cannot respond personally to your comments unless they are signed.
When completed, please return the questionnaire to: Dr. Jean Golding, Children of the Nineties - ALSPAC Institute of Child Health
End

alspac_95_pnq

PARTNER'S NEW QUESTIONNAIRE
This questionnaire aims to find out what problems parents have. Your answers will help us to identify those problems that may be solved by changes in the health care system. It should be filled in by the mother's partner.
To answer simply tick the box which is most accurate in your opinion.
Some questions are the same as those you have answered before. This is so that we can tell what changes have happened to you.
Please answer all questions if you can, even if they are similar . If you cannot answer a question or if it does not apply to you, put a line through it. There are no good or bad answers. Just tell us what you really think.
All answers are confidential.
THANK YOU VERY MUCH

SECTION A: YOUR HEALTH

Which of the following would you say describes your health now?
1
fit and well
2
mostly well and healthy
3
often feel unwell
4
hardly ever feel well

Have you had any of the following in the past year?

-
anxiety or 'nerves'
depression
headache or migraine
backache
indigestion
cough or cold
haemorrhoids/piles
influenza
wheezing
bronchitis
stomach ulcer
eczema
psoriasis
arthritis
rheumatism
urinary infection
Have you had any of the following in the past year? other problems (please tick and describe)
1
Yes and consulted doctor
2
Yes but did not consult doctor
3
No
Other

In the past year how often have you taken or used the following?

-
sleeping pills
vitamins
cannabis/marihuana
tranquillisers
pills for depression
antibiotics
painkillers (aspirin paracetamol, etc.)
amphetamines or other stimulants
iron
heroin, methadone, crack, cocaine
anticonvulsants
steroids
Other pill, medicine, treatment, drug, ointment or cream (please describe each and tick how frequently you have taken in the past year.)
Other
1
Every day
2
Often
3
Sometimes
Other pill, medicine, treatment, drug, ointment or cream (please describe each and tick how frequently you have taken in the past year.)
Other
1
Every day
2
Often
3
Sometimes
Other pill, medicine, treatment, drug, ointment or cream (please describe each and tick how frequently you have taken in the past year.)
Other
1
Every day
2
Often
3
Sometimes

Please list all the names of the actual medicines, pills or ointments that you have taken in the past month:

What did you take: About how many days did you take or use it? How often per day?
Generic textHow manyHow many Generic textHow manyHow many Generic textHow manyHow many
1
2
3
4
5
6
7
8
9
10
Since your study child was 3 years old have you had to go and stay in hospital?
1
Yes
2
No
If no, go to A6 below
qc_A5_a == 1
how many times?
How many
qc_A5_a == 1

Please describe for each admission.

How old was your study child? ... months What were the reasons for your admission? (please describe) How long did you stay? ... days
Age in monthsGeneric textHow many Age in monthsGeneric textHow many Age in monthsGeneric textHow many
1st admission
2nd admission
3rd admission

In the past month, how often have you had the following:

-
backache
headaches or migraines
urinary infection
nausea
vomiting
diarrhoea
haemorrhoids or piles
feeling weepy/tearful
feeling irritable
feeling exhausted
varicose veins
passing urine very often
problem holding urine when you jump, sneeze etc.
indigestion
feeling dizzy/fainting
flashing lights/spots before eyes
shoulder ache
tingling in hands/fingers
tingling in feet/toes
neck ache
feeling depressed
In the past month, how often have you had the following: other problem (please tick and describe)
1
Almost all the time
2
Sometimes
3
Not at all
Other
How often are you having sexual intercourse now?
1
not at all
2
less than once a month
3
1-3 times a month
4
about once a week
5
2-4 times a week
6
5 or more times a week
In general do you enjoy it?
1
yes, very much
2
yes, somewhat
3
no, not a lot
4
no, not at all
5
no sex at the moment

SECTION B: YOUR DIET

How often nowadays do you eat the following foods? Please answer every question even if you never eat the food (in this case tick "Never or rarely").

-
Oat cereals (e.g. porridge, Ready Brek, muesli)
Wholegrain or bran cereals (e.g. All Bran, Bran Flakes, Weetabix, Wheatflakes, Fruit & Fibre, Shredded Wheat)
Other cereals (e.g. Cornflakes, Rice Krispies, Special K, Frosties)
Sausages, Burgers
Meat Pies, Pasties (pork pie, steak/meat pie, Cornish pastie etc.)
Vegetarian Pies, Pasties (cheese and onion pasty, vegetable samosa, onion bhaji, vegetable grills etc.)
Ham, bacon, pat and cold meats (e.g. salami, luncheon meat, garlic sausage etc.)
Meat: roast, chops and stews etc. (e.g. beef, lamb, pork, mince)
Liver, kidney, heart and other offal
Chicken/Turkey in crispy coating (e.g. chicken nuggets, turkey burgers, chicken fingers etc.)
Poultry: roast, baked or stewed (chicken, turkey etc.)
Shellfish (prawns, scampi, crab, cockles, mussels etc.)
White fish in breadcumbs or batter (e.g. fishfingers, chip shop fish, breaded cod, plaice or haddock,)
White fish without coating (e.g. grilled fish, cod in parsley sauce etc.)
Tuna
Other fish (pilchards, sardines, mackerel, herrings, kippers, trout, salmon etc.)
Eggs, quiche/flans, omelettes etc.
Cheese
Pizza
Oven chips
Fried chips, potato waffles and croquettes, Alphabites etc.
Roast potatoes (cooked in fat or oil)
Boiled, mashed, jacket potatoes
Rice (boiled, or fried, not rice pudding)
Canned pasta (e.g. spaghetti rings, ravioli, macaroni cheese etc.) Pot Noodles, Super Noodles etc.
Boiled pasta (e.g. spaghetti, fusilli, lasagne) bulgar wheat and cous-cous
Do you eat the fat on meat?
1
yes, all of it
2
yes, some of it
3
no
4
never eat meat

How many times nowadays do you eat:

-
Baked beans
Peas, broad beans
Sweetcorn
Cabbage, brussel sprouts, spinach, broccoli and other dark green leafy vegetables
Other green vegetables (cauliflower, runner beans, leeks, courgettes etc.)
Carrots
Other root vegetables (turnip, swede, parsnip etc.)
Tomatoes (cooked or raw)
Salads
Pulses - dried peas, beans, lentils, chick peas etc.
Soya 'Meat', TVP, Soya-type Vegeburgers, Bean Curd (Tofu, Miso etc.)
Nuts (eg peanuts, cashews), nut roast etc.
Fresh citrus fruit e.g. oranges, grapefruit, satsumas, tangerines etc.
Other fresh fruit e.g. apple, banana, pear, bunch of grapes, peach etc.
Canned fruit
Yoghurt, Fromage Frais, Milk puddings (e.g. rice pudding, semolina) mousse
Ice cream, choc ice, chocolate ice cream bar etc.
Pudding e.g. fruit pie, crumble, cheesecake, gateaux
Custard, cream, Elmlea, Tip-Top, evaporated milk etc. on puddings
Cakes or buns (fruit cake, sponge, teacake, doughnut, flapjack, scone, custard tart, cream cake etc.)
Crispbreads (Ryvita, crackerbread etc.)
Full-coated chocolate biscuits eg. Club, Kit Kat, Penguin, Breakaway etc.
Other biscuits eg. rich tea, shortcake, digestive and chocolate digestive, Hob Nobs
Chocolate (dairy milk or plain, nut, fruit, filled etc.)
Sweets (peppermints, boiled sweets, toffees etc.)
Crisps, corn snacks (e.g. Wotsits, Quavers), tortilla chips etc.

How many times a week nowadays do you drink

-
Fruit juice from a carton, tin or freshly squeezed including tomato juice
Squash, fruit drinks or Ribena
Cola drinks eg. Coca Cola, Pepsi etc.
Other fizzy drinks e.g. lemonade
Bottled water
Water from tap
Milk on its own
Flavoured milk drinks (e.g. Horlicks, Ovaltine, milkshakes) or yoghurt drinks
When you have a soft drink (e.g. lemonade, cola or squash) how often do you choose low calorie or diet soft drinks?
1
always
2
sometimes
3
not at all
4
don't drink soft drinks
When you have a cola drink how often do you choose decaffeinated cola?
1
always
2
sometimes
3
not at all
4
don't drink cola
How many pieces of bread, rolls or chappatis do you eat on a usual day?
1
less than 1
2
1-2
3
3-4
4
5 or more
What type of bread do you eat? white bread
1
Yes usually
2
Yes sometimes
3
No not at all
What type of bread do you eat? soft grain white bread (e.g. Mighty White)
1
Yes usually
2
Yes sometimes
3
No not at all
What type of bread do you eat? brown/granary bread
1
Yes usually
2
Yes sometimes
3
No not at all
What type of bread do you eat? wholemeal bread
1
Yes usually
2
Yes sometimes
3
No not at all
What type of bread do you eat? chappatis or pitta bread
1
Yes usually
2
Yes sometimes
3
No not at all
What type of bread do you eat? naan bread
1
Yes usually
2
Yes sometimes
3
No not at all

What sort of fat do you mainly use:

on bread or vegetables for frying

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

Butter, Ghee, Dripping, Lard , solid cooking fat
Polyunsaturated margarine eg Flora, sunflower margarine, Vitalite
Hard or soft margarine e.g. Blue Band, Stork, supermarket own brand
Low fat spread e.g. Delight, St Ivel Gold, Flora Xtra Light
Sunflower oil, corn oil, soya oil
Olive oil, hazelnut oil, rapeseed oil
Other vegetable oil
Other (please describe )
What sort of fat do you mainly use: Other (please describe )
Other
How many slices of bread (or rolls) spread with fat do you eat each day? (include shop bought sandwiches)
How many
What types of milk do you use? Full fat (e.g. silver or gold top )
1
Yes usually
2
Yes sometimes
3
No not at all
What types of milk do you use? Semi Skimmed (e.g. red stripe )
1
Yes usually
2
Yes sometimes
3
No not at all
What types of milk do you use? Skimmed (e.g. blue stripe )
1
Yes usually
2
Yes sometimes
3
No not at all
What types of milk do you use? Dried milk (e.g. Marvel )
1
Yes usually
2
Yes sometimes
3
No not at all
What types of milk do you use? Goat/sheep milk
1
Yes usually
2
Yes sometimes
3
No not at all
What types of milk do you use? Soya milk
1
Yes usually
2
Yes sometimes
3
No not at all
What types of milk do you use? Other (please describe )
1
Yes usually
2
Yes sometimes
3
No not at all
Other
Is this milk usually:
1
Pasteurised
2
UHT
3
Sterilised
4
Other (please describe )
Other
How many cups of tea do you drink in a day? (do not include herbal teas )
How many
How many spoons of sugar in each cup?
How many
How many cups per day are with milk?
How many
How many cups per day are decaffeinated?
How many
How many cups of coffee do you drink in a day?
How many
How many spoons of sugar in each cup?
How many
How many cups per day are with milk ?
How many
How many cups per day are decaffeinated?
How many
How many are made with real (not instant) coffee?
How many
Do you drink herbal teas at all?
1
yes, often
2
yes, occasionally
3
no, not at all
If no, go to B16 below
qc_B15_a == 1 || qc_B15_a == 2
how many cups/mugs of herbal teas have you drunk in the past week ?
How many
qc_B15_a == 1 || qc_B15_a == 2
Please list the types of herbal teas you have drunk in the past 3 months:
Generic text
Apart from herbal teas, are there any other health foods (whether or not bought from a health food shop) that you often eat or drink?
1
Yes
2
No
qc_B16 == 1
please describe below:
Generic text
Are you at present on a diet to lose weight?
1
Yes
2
No
Are you at present a vegetarian (do not eat any meat or poultry)?
1
Yes
2
No
Are you at present a vegan (i.e. do not eat meat, poultry, fish, eggs, butter, milk or cheese)?
1
Yes
2
No
Are you at present on any kind of special diet?
1
Yes
2
No
qc_B20 == 1
please describe below.
Generic text

During the last week how many of each type of alcoholic drink did you have on each day? (Please put a number.)

Mon. Tues. Wed. Thurs. Frid. Sat. Sun.
How manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow many
Beer, lager or cider (no. of 1/2 pints)
Wine (no. of glasses)
Spirits (no. of single pub measures)
Other alcoholic drinks (please describe) (no. of glasses or measures)
Low alcohol drink (no. of glasses or 1/2 pints)
During the last week how many of each type of alcoholic drink did you have on each day? (Please put a number.) Other alcoholic drinks (please describe) (no. of glasses or measures)
Other
Is this week fairly typical of your alcohol drinking?
1
No
2
Yes
If yes, go to B22 below
qc_B21_b == 1
would you normally drink
1
More
2
Less
For your main meal of the day how often do you eat takeaway foods or have meals out?
1
Never or rarely
2
1 - 3 times a month
3
1 - 2 times a week
4
3-4 times a week
5
5-7 times a week
For your main meal of the day how often do you eat an oven/microwave ready or convenience meal (e.g. Menu Master lasagne, individual shepherds pie, ready prepared chilli con carne etc.)?
1
Never or rarely
2
1 - 3 times a month
3
1 - 2 times a week
4
3-4 times a week
5
5-7 times a week

SECTION C: RECENT EVENTS

Listed below are a number of events which may have brought changes in your life. Have any of these occurred since the study child was 2 1/2 years old? If so please assess how much effect it had on you.

Since the study child was 2 1/2 years old: Your partner died
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: One of your children died
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: A friend or relative died
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: One of your children was ill
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: Your partner was ill
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: A friend or relative was ill
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: You were admitted to hospital
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: You were in trouble with the law
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: You were divorced
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: You found that your partner didn't want your child
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: You were very ill
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: Your partner lost her job
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: Your partner had problems at work
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: You had problems at work
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: You lost your job
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: Your partner went away
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: Your partner was in trouble with the law
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: You and your partner separated
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: Your income was reduced
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: You argued with your partner
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: You argued with your family and friends
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: You moved house
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: Your partner was physically cruel to you
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: You became homeless
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: You had a major financial problem
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: You got married
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: Your partner was physically cruel to your children
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: You were physically cruel to your children
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: You attempted suicide
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: You were convicted of an offence
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: Your partner became pregnant
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: You started a new job
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: Your partner had a miscarriage
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: Your partner had an abortion
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: You took an examination
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: Your partner was emotionally cruel to you
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: Your partner was emotionally cruel to your children
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: You were emotionally cruel to your children
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: Your house or car was burgled
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: Your partner started a new job
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: A pet died
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Since the study child was 2 1/2 years old: You had an accident (please tick and describe)
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
Generic text
Is there anything else which is not on the list which has concerned you or required additional effort from you to cope in the last year?
1
Yes
2
No
If no, go to C44a below
qc_C43_a == 1
please describe:
Generic text
qc_C43_a == 1
How did this affect you?
1
a lot
2
moderately
3
mildly
4
not at all
Are you currently employed?
1
Yes
2
No
If no, go to section D on page 23
qc_C44_a == 1
What is your occupation?
Generic text
qc_C44_a == 1
Have you had the same type of job since this child was 2 1/2 years old?
1
Yes
2
No
qc_C44_a == 1
Do you work nights?
1
yes, always
2
yes, sometimes
3
no, never
qc_C44_a == 1
Do you ever leave home for several days as part of your work?
1
yes, often
2
yes, occasionally
3
no, never

SECTION D: YOUR HOUSEHOLD

How many people live in your household now? (including yourself) ... adults (over 18 years)
How many
How many people live in your household now? (including yourself) ... young adults (16-18 years)
How many
How many people live in your household now? (including yourself) ... children (less than 16 years)
How many
Please indicate who the adults over 18 are: yourself
1
Yes
Please indicate who the adults over 18 are: your partner
1
Yes
Please indicate who the adults over 18 are: your parent(s)
1
Yes
Please indicate who the adults over 18 are: your partner's parent(s)
1
Yes
Please indicate who the adults over 18 are: other relation(s) of yourself
1
Yes
Please indicate who the adults over 18 are: other relation(s) of your partner
1
Yes
Please indicate who the adults over 18 are: friend(s)
1
Yes
Please indicate who the adults over 18 are: lodger
1
Yes
Please indicate who the adults over 18 are: other (please tick and describe)
1
Yes
Other
Do you have a rule that smoking never happens in particular rooms?
1
no smoking in house at all
2
smoking only allowed in some rooms
3
smoking allowed anywhere
How many people living in your household (including yourself) are smokers?
How many
What is your present marital status?
1
never married
2
widowed
3
divorced
4
separated
5
married (once only)
6
married for second or third time
qc_D3_a == 5 || qc_D3_a == 6
what was the date of the most recent marriage?
Generic date

Please indicate how many of the children living with you have:

Number of children
you and your partner as their natural parents
you as their natural father (but their natural mother is not present)
your partner as the natural mother (but you are not their natural father)
Please indicate how many of the children living with you have: neither you nor your partner as natural parents (please describe whether you have adopted fostered etc.) Number of children
How many
Generic text

Are there other children of yourself or your partner who visit (whether to play or to stay)?

- Number of children

1 - No

2 - Yes

How many

1 - No

2 - Yes

How many
children of my partner but not me
children of myself but not my partner
children of me and my partner
Do you or your partner have any chronic illness or disabling condition?
1
Yes
2
No
If no, go to D7 below
qc_D6 == 1

please describe:

Nature of condition(s) Person(s) involved (self/partner)
Generic textGeneric text Generic textGeneric text
1
2
3
4
5
6
Do you have any pets?
1
Yes
2
No
If no, go to D8 on page 26
qc_D7_a == 1
How many of the following pets do you have? cats
How many
qc_D7_a == 1
How many of the following pets do you have? dogs
How many
qc_D7_a == 1
How many of the following pets do you have? rabbits
How many
qc_D7_a == 1
How many of the following pets do you have? rodents (mice, hamster, gerbil etc)
How many
qc_D7_a == 1
How many of the following pets do you have? birds (budgerigar, parrot, etc.)
How many
qc_D7_a == 1
How many of the following pets do you have? fish
How many
qc_D7_a == 1
How many of the following pets do you have? turtles/tortoises/terrapin
How many
qc_D7_a == 1
How many of the following pets do you have? other pets (please say how many and describe)
How many
Other
qc_D7_a == 1
Would you say that owning a pet has helped your health?
1
Yes improved it
2
No, made it worse
3
No effect
qc_D7_a == 1
How often do you take pets along when you visit friends or relatives?
1
Never
2
Occasionally
3
Sometimes
4
Often
5
Always
qc_D7_a == 1
How often are your feelings towards people affected by the way they react to your pets?
1
Never
2
Occasionally
3
Sometimes
4
Often
5
Always
qc_D7_a == 1
Do you keep a picture of your pet(s) with you or on display at home or at work?
1
Yes
2
No
Below are questions about financial matters. We realise this may be a sensitive subject. As with all our questions you may leave this section out if you want to.[If you can complete it though it will be of great help to the study].
On average, about how much is the take home family income each week (include social benefits etc.)?
1
less than £100
2
£100-£199
3
£200-£299
4
£300-£399
5
£400 or more
9
don't know
Out of this, how much do you pay for rent, loans or mortgage each week?
1
nothing
2
less than £20
3
£20-£39
4
£40-£59
5
£60-£79
6
£80 or more
9
don't know
About how much do you spend on food for the whole family each week?
1
less than £20
2
£20-£29
3
£30-£39
4
£40-£49
5
£50-£59
6
£60 or more
9
don't know
How much do you spend on child care each week (playgroup, childminder, baby sitter etc.)
1
nothing
2
less than £10
3
£10-£19
4
£20-£29
5
£30-£39
6
£40-£49
7
£50 or more
8
varies
9
don't know
Do you manage to save at all?
1
Yes
2
No
Do you receive any financial help from your parents or other relatives?
1
Yes
2
No
Do you give financial help to your parents or other relatives?
1
Yes
2
No

Now we would like you to think about your 4 year old study child's behaviour over the last six months.

-
Is considerate of other people's feelings
Is restless, overactive, cannot stay still for long
Often complains of headaches, stomach-aches or sickness
Shares readily with other children (treats, toys, pencils etc.)
Often has temper tantrums or hot tempers
Is rather solitary, tends to play alone
Is generally obedient, usually does what adults request
Has many worries, often seems worried
Is helpful if someone is hurt, upset or feeling ill
Is constantly fidgeting or squirming
Has at least one good friend
Often fights with other children or bullies them
Is often unhappy, down hearted or tearful
Is generally liked by other children
Is easily distracted, concentration wanders
Is nervous or clingy in new situations, easily loses confidence
Is kind to younger children
Often lies or cheats
Is picked on or bullied by other children
Often volunteers to help others (parents, teachers, other children)
Thinks things out before acting
Steals from home, school or elsewhere
Gets on better with adults than with other children
Has many fears, is easily scared
Sees tasks through to the end, has good attention span
You and your study child:

Below are some statements about relationships with children. Please indicate how you think these apply in your situation

-
I really love this child
I often get very irritated with this child
I don't mind the mess and noise that surrounds this child
This child makes me pretty happy
I have frequent battles of will with this child
This child is very affectionate to me
This child gets on my nerves
I feel very close to this child
Your partner and your study child:
Below are some statements about your partner's relationships with children. Please indicate how you think these apply in your situation.
7
Have no partner

SECTION E YOUR PARTNER

This section below is concerned with your relationship with your partner. (The partner will be referred to as 'she', although the questions refer to all partners).
How would you assess your partner's physical health?
1
always fit and well
2
mostly well and healthy
3
often feels unwell
4
hardly ever feels well
How many cigarettes per day does your partner currently smoke?
How many
Is your partner currently employed?
1
Yes
2
No
If no, go to E4a on page 31
qc_E3_a == 1
What is her occupation?
Generic text
qc_E3_a == 1
Has she had the same type of job since this child was 2 1/2 years old?
1
Yes
2
No
qc_E3_a == 1
Does she work nights?
1
yes, always
2
yes, sometimes
3
no, never
qc_E3_a == 1
Does she ever leave home for several days as part of her work?
1
yes, often
2
yes, occasionally
3
no, never
How many evenings a month do you go out and do things on your own or with your own friends?
1
none
2
once
3
2-3 times
4
4-7 times
5
8 or more times
How many times a month does your partner go out and do things on her own or with her own friends?
1
none
2
once
3
2-3 times
4
4-7 times
5
8 or more times

How often in a week, on average, would you and your partner:

-
discuss work or how the day has gone
laugh together
calmly talk over something (e.g. the news, a hobby or interest)
kiss or hug
make plans
talk over feelings or worries
Which of the following statements about alcohol best applies to you and you partner: You
1
Never drinks alcohol
2
Very occasionally (less than once a week)
3
Occasionally (at least once a week)
4
Drinks 1-2 glasses* nearly every day
5
Drinks 3-9 glasses* every day
6
Drinks at least 10 glasses* a day
9
Don't know
Which of the following statements about alcohol best applies to you and you partner: Your partner
1
Never drinks alcohol
2
Very occasionally (less than once a week)
3
Occasionally (at least once a week)
4
Drinks 1-2 glasses* nearly every day
5
Drinks 3-9 glasses* every day
6
Drinks at least 10 glasses* a day
9
Don't know
[*by glass we mean a pub measure (1oz) of spirits or 1/2 pint of beer or cider, a wine glass of wine etc.]
How many days in the past month did you have the equivalent of 2 pints of beer, 4 glasses of wine or 4 pub measures of spirit?
1
every day
2
more than 10 days
3
5-10 days
4
3-4 days
5
1-2 days
6
none
9
don't know

SECTION F: CHEMICALS IN YOUR ENVIRONMENT

In the last few months, how often have you used the following (whether at home or at work):

-
disinfectant
bleach
window cleaner
carpet shampoo
oven/drain cleaner
dry cleaning fluid
turpentine/white spirit
paint stripper
household paint or varnish
weed killers
pesticides/insect killers
aerosols or sprays, including hair spray)
hair dye/bleach
deodorants
air fresheners (spray, stick or aerosol)
ceramics/enamels
solder
dental amalgam
electroplating
glues
leather work
fabric/textiles
dyes
radiation (x-ray or other)
plastics
metal cleaners/degreasers, polishers
petrol
machining
photographic chemicals
electrical wiring
diesel
In the last few months, how often have you used the following (whether at home or at work): other chemical (please tick and describe)
1
Every day
2
Most days
3
About once a week
4
Less than once a week
5
Not at all
Other
Do you drive a car, van or lorry?
1
Yes
2
No
qc_F2 == 1
what type of fuel is used? diesel
1
Yes
qc_F2 == 1
what type of fuel is used? lead free petrol
1
Yes
qc_F2 == 1
what type of fuel is used? other petrol
1
Yes
How often during the day are you in a room or enclosed place where other people are smoking? weekdays
1
all the time
2
more than 5 hours
3
3-5 hours
4
1-2 hours
5
less than 1 hour
6
not at all
How often during the day are you in a room or enclosed place where other people are smoking? weekends
1
all the time
2
more than 5 hours
3
3-5 hours
4
1-2 hours
5
less than 1 hour
6
not at all
THANK YOU VERY MUCH FOR YOUR HELP
This questionnaire was completed by: child's father
1
Yes
This questionnaire was completed by: child's mother
1
Yes
This questionnaire was completed by: someone else (please describe)
1
Yes
Other
Please give the date on which you completed this questionnaire:
Generic date
Please give your date of birth:
Date of birth
Space for any additional comments you would like to make.
Long text
NB Please remember that we cannot respond personally to your comments unless they are signed.
When completed, please return the questionnaire to: Dr. Jean Golding, Children of the Nineties - ALSPAC Institute of Child Health
Name

Partner's New Questionnaire