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alspac_02_lahop
LIFESTYLE AND HEALTH OF PARTNER
All answers are confidential
This questionnaire is for the study child’s father or person taking the role of father.
This questionnaire is for the study child’s father or person taking the role of father.
It will help us to catch up with some current problems you may have, as well as some features of you lifestyle.
Some of the questions we are asking may seem remote from the health of your study child, but the answers will help us to plan for studying the changes that will be occuring in our children as they develop, and how these may be passed down from one generation to the next.
To answer simply tick the box which is most accurate in your opinion.
If you do not want to 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 is true for you.
THANK YOU FOR YOU HELP
SECTION A: DIZZINESS AND BALANCE
About how many times have you experienced each of the symptoms listed below during the past 12 months:
-
Felt that things are spinning or moving around, lasting less than 2 minutes
Felt that things are spinning or moving around, lasting up to 20 minutes
Felt that things are spinning or moving around, lasting 20 minutes to 1 hour
Felt that things are spinning or moving around, lasting several hours
Felt that things are spinning or moving around, lasting more than 12 hours
Felt unsteady, so severe that you actually fell
Felt nauseous (feeling sick), stomach churning
Felt light-headed, "swimmy" or giddy lasting less than 2 minutes
Felt light-headed, "swimmy" or giddy lasting up to 20 minutes
Felt light-headed, "swimmy" or giddy lasting 20 minutes to 1 hour
Felt light-headed, "swimmy" or giddy lasting several hours
Felt light-headed, "swimmy" or giddy lasting more than 12 hours
Vomited
Been unable to stand or walk properly without support because you were feeling dizzy
Felt unsteady, about to lose balance, lasting less than 2 minutes
Felt unsteady, about to lose balance, lasting up to 20 minutes
Felt unsteady, about to lose balance, lasting 20 minutes to 1 hour
Felt unsteady, about to lose balance, lasting several hours
Felt unsteady, about to lose balance, lasting more than 12 hours
How confident are you that you will not lose your balance and not become unsteady when you do the following nowadays:
-
Walk around the house
Walk up or down stairs
Bend over and pick up something off the floor
Reach for a small can/jar off a shelf at eye level
Stand on your tip toes and reach for something above your head
Stand on a chair and reach for something
Sweep the floor
Walk outside to a parked car
Get into or out of a car
Walk across a car park to a supermarket
Walk up or down a ramp
Walk in a crowded place, where people quickly walk past you
Are bumped into by people as you walk through a shopping centre
Step onto or off an escalator while holding onto the handrail
Step onto or off an escalator while holding onto parcels, which prevent you from holding onto the handrail
Walk outside on icy pavements

Do you have any other difficulty in walking?

1
Yes
2
No
If no, go to A4a below
If yes,
qc_A3_a == 1

Is this due to heart disease or breathing problems?

1
Yes
2
No
9
Don't know
If no,
qc_A3_b == 2

please describe cause

Generic text

Are you troubled by shortness of breath when hurrying on level ground or walking up a slight hill?

1
Yes
2
No

Do you get short of breath walking with other people of your own age on level ground?

1
Yes
2
No

Do you have to stop for breath when walking at your own pace on level ground?

1
Yes
2
No

Are you short of breath on washing or dressing?

1
Yes
2
No

Have you ever, without warning: Suddenly lost the power of an arm?

1
Yes
2
No

Have you ever, without warning: Suddenly lost the power of a leg?

1
Yes
2
No

Have you ever, without warning: Suddenly been unable to speak properly?

1
Yes
2
No

Have you ever, without warning: Suddenly lost consciousness for no apparent reason?

1
Yes
2
No

Space for comments:

Generic text
SECTION B: YOUR HEALTH

Have you ever had any of the following problems: hay fever

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never

Have you ever had any of the following problems: indigestion

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never

Have you ever had any of the following problems: bulimia

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never

Have you ever had any of the following problems: asthma

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never

Have you ever had any of the following problems: eczema

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never

Have you ever had any of the following problems: epilepsy

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never

Have you ever had any of the following problems: ME or chronic fatigue syndrome

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never

Have you ever had any of the following problems: migraine

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never

Have you ever had any of the following problems: back pain/slipped disc

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never

Have you ever had any of the following problems: kidney disease*

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never

Have you ever had any of the following problems: varicose veins

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never

Have you ever had any of the following problems: haemorrhoids/piles

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never

Have you ever had any of the following problems: rheumatism

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never

Have you ever had any of the following problems: arthritis

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never

Have you ever had any of the following problems: psoriasis

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never

Have you ever had any of the following problems: stomach ulcer

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never

Have you ever had any of the following problems: drug addiction

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never

Have you ever had any of the following problems: alcoholism

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never

Have you ever had any of the following problems: schizophrenia

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never

Have you ever had any of the following problems: anorexia nervosa

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never

Have you ever had any of the following problems: severe depression

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never

Have you ever had any of the following problems: other psychiatric problem*

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never

Have you ever had any of the following problems: other problem(s)* (please tick & describe)

1
Yes, had it recently (in past year)
2
Yes, in past, not recently
  • please tick appropriate box and describe below
Generic text

Have you ever had diabetes?

1
Yes
2
No
If no, go to B2b below
If yes,
qc_B2_a == 1

How is/was it treated?

1
insulin injections
2
other drugs
3
diet only

How old were you when you first developed it? ... years

Age

Have you ever had hypertension (high blood pressure)?

1
Yes
2
No
If no, go to B3 on page 10
If yes,
qc_B2_b == 1

How old were you when you first developed it? ... years

Age

Do you have hypertension nowadays?

1
Yes
2
No

Are there any problems for which you have regular treatment or medicine nowadays?

1
Yes
2
No
If no, go to B4 below
If yes,
qc_B3_a == 1
please describe these problems and regular treatment or medicine:
Problem Treatment or medicine
Generic textGeneric text Generic textGeneric text
1
2
3
4

Would you say that you were allergic to anything?

1
Yes
2
No
If no, go to B5 on page 11
If yes,
qc_B4_a == 1

is it to: cat

1
Yes
2
No

is it to: pollen

1
Yes
2
No

is it to: dust

1
Yes
2
No

is it to: insect bites or stings

1
Yes
2
No

is it to: medication (e.g. penicillin)

1
Yes
2
No

is it to: something else (Please tick & describe)

1
Yes
2
No
Other
Have you had any of the following in the past two years:
-
attacks of wheezing with whistling on the chest
a dry itchy rash
a blotchy blistery rash (hives)
sneezing attacks
runny nose
watery eyes
attacks of breathlessness
cough often during the night
cough often when you wake in the morning

Since your study child's 9th birthday have you been admitted to hospital?

1
Yes
2
No
If no, go to B7 on page 12
If yes,
qc_B6_a == 1

how many times?

How many

for how many different reasons?

How many
(_hospitalstay <= qc_B6_b) AND (_hospitalstay < 6)

Reason for each hospital stay:

Generic text

How long did you stay? ... nights

How many

Have you ever had any pain or discomfort in your chest?

1
Yes, in past year
2
Yes, but not in past year
3
No
If no, go to B8 on page 13
If yes,
qc_B7_a == 1

Do/did you get this pain or discomfort when you walk uphill or hurry?

1
Yes
2
No

Do/did you get the pain or discomfort when you walk at an ordinary pace on the level?

1
Yes
2
No

When you get/got pain or discomfort in your chest what do you do? (Please tick one box only)

1
stop
2
slow down
3
continue at the same pace

Does/did it go away when you stand still?

1
Yes
2
No
9
Don&#39;t know

How soon?

1
10 minutes or less
2
More than 10 minutes
9
Don&#39;t know

Where do/did you get this pain or discomfort? (Please mark the place(s) with an X on the diagram below).

If Yes, in past year or Yes, but not in past year to question B7a
qc_B7_a == 1 || qc_B7_a == 2

Have you ever had a severe pain across the front of your chest lasting for half an hour or more?

1
Yes
2
No
If no, go to B8 on page 13
If yes,
qc_B7_h == 1

Did you talk to a doctor about it?

1
Yes
2
No
If no, go to k below
If yes,
qc_B7_i == 1

What did they say it was?

Generic text

How many of these attacks have you had?

How many
In the past month, how often have you had any of the following:
-

1 - Almost all the time

2 - Sometimes

3 - Not at all

backache
headache or migraine
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 any of the following: In the past month: other problem (please describe)

1
Almost all the time
2
Sometimes
3
Not at all
Other
What forms of contraception are you and your partner using now?
-

1 - Yes

withdrawal
the pill
IUCD/coil
condom/sheath
calendar/rhythm method
diaphragm/cap
spermicide
I am no longer fertile (have been sterilised, e.g. have had a vasectomy)
my partner has been sterilised
none

What forms of contraception are you and your partner using now? other (please describe)

1
Yes
Other
SECTION C: ALL ABOUT YOUR WATERWORKS

During the day, how many times do you urinate (pass water or have a wee) on average?

1
1 - 6 times
2
7 - 8 times
3
9 - 10 times
4
11 - 12 times
5
13 or more times

During the night, how many times do you have to get up to urinate, on average?

1
None
2
Once
3
Twice
4
Three times
5
Four times or more

How often do you have to rush to the toilet to urinate?

1
Never
2
Occasionally
3
Sometimes
4
More often than not
5
Every time

Does urine leak before you can get to the toilet?

1
Never
2
Occasionally
3
Sometimes
4
Most times
5
Every time

Does urine leak when you are physically active, exert yourself, cough or sneeze?

1
Never
2
Occasionally
3
Sometimes
4
Most times
5
Every time

Do you ever leak urine for no obvious reason and without feeling that you want to go?

1
Never
2
Occasionally
3
Sometimes
4
Most of the time
5
All of the time

How often is there a delay before you can start to urinate?

1
Never
2
Occasionally
3
Sometimes
4
Most times
5
Every time

Do you have to strain to urinate?

1
Never
2
Occasionally
3
Sometimes
4
Most times
5
Every time

Do you stop and start more than once while you urinate without meaning to?

1
Never
2
Occasionally
3
Sometimes
4
Most times
5
Every time

How often do you leak urine when you are asleep?

1
Never
2
Occasionally
3
Sometimes
4
Most of the time
5
All of the time

Have you ever blocked up completely so that you could not urinate at all and had to have a catheter to drain the bladder?

1
Never
2
Yes, once
3
Yes, twice
4
Yes, more than twice

How often have you had a burning feeling when you urinate?

1
Never
2
Occasionally/once
3
Sometimes
4
Most times
5
Always

How often do you feel that your bladder has not emptied properly after you have urinated?

1
Never
2
Occasionally
3
Sometimes
4
Most of the time
5
All of the time

If you had to spend the rest of your life with any urinary symptoms that you may have now, how would you feel?

1
No particular symptoms
2
Perfectly happy
3
Pleased
4
Mostly satisfied
5
Mixed feelings
6
Mostly dissatisfied
7
Very unhappy
8
Desperate
SECTION D: ACCIDENTS AND INJURIES
Have you had any accidents of the following types in the last four years (since your study child's 7th birthday)?
-
Road traffic accident
Playing sport or games
At your place of work
Inside your home
Outside your home (e.g. in garden)
At another building
During a fight or argument
You were attacked

Have you had any accidents of the following types in the last four years (since your study child's 7th birthday)? Other type of accident (please tick & describe)

1
Yes &amp; stayed in hospital
2
Yes &amp; saw a doctor
3
Yes, but did not see a doctor
4
No, never happened
Other
Have you had any of the following injuries in the last four years (since your study child's 7th birthday)?
-
burnt
scalded
badly cut
stabbed
shot
nearly drowned
Have you had any of the following injuries in the last four years (since your study child's 7th birthday)?
-
dislocated hip, shoulder, knee, etc.
broken arm or hand
broken leg or foot
sexual assault
overdose of pills or medicine

Have you had any of the following injuries in the last four years (since your study child's 7th

birthday)? overdose of something else (please tick & describe)

1
Yes &amp; stayed in hospital
2
Yes &amp; saw a doctor
3
Yes, but did not see a doctor
4
No, never happened
Other

Have you had any of the following injuries in the last four years (since your study child's 7th

birthday)? concussion

1
Yes &amp; stayed in hospital
2
Yes &amp; saw a doctor
3
Yes, but did not see a doctor
4
No, never happened

Have you had any of the following injuries in the last four years (since your study child's 7th

birthday)? other injury (please tick & describe)

1
Yes &amp; stayed in hospital
2
Yes &amp; saw a doctor
3
Yes, but did not see a doctor
4
No, never happened
Other
If 'no' to all of these, go to E1 on page 26
qc_D1_a-h != 4 || qc_D1_i != 4 || qc_D2_a-f != 4 || qc_D2_g-k != 4 || qc_D2_l != 4 || qc_D2_m != 4 || qc_D2_n != 4
What physical problems did you have as a result of any of these accidents or injuries?
-
pain
reduction in movement
a facial scar or defect
less able to see or hear
inability to work

What physical problems did you have as a result of any of these accidents or injuries? other physical result (please tick & describe)

1
Yes &amp; still present
2
Yes but no longer present
3
No did not happen
Other
What emotional problems did you have as a result of any of these accidents or injuries?
-

1 - Yes &amp; still present

2 - Yes but no longer present

3 - No did not happen

loss of self confidence
feeling of depression
very tense
unable to sleep well
loss of appetite

What emotional problems did you have as a result of any of these accidents or injuries? something else (please tick & describe)

1
Yes &amp; still present
2
Yes but no longer present
3
No did not happen
Other
What other consequences of any of these accidents or injuries were there?
-
cost money
lost job
less earnings
problems at work
problems with partner or the family
problems with friends

What other consequences of any of these accidents or injuries were there? other problem (please tick & describe)

1
Yes &amp; still present
2
Yes but no longer present
3
No did not happen
Other
SECTION E: YOUR FEELINGS
The questions in this section ask you about your feelings and the way you behave. You have answered these questions in other questionnaires, but you might be feeling differently now.
Please indicate the way you feel:
-
Do you feel upset for no obvious reason?
Have you felt as though you might faint?
Do you feel uneasy and restless?
Do you sometimes feel panicky?
Do you worry a lot?
Do you feel strung-up inside?
Do you ever have the feeling you are going to pieces?
Do you have bad dreams which upset you when you wake up?
Your feelings in the past week.

I have been able to laugh and see the funny side of things:

1
As much as I always could
2
Not quite so much now
3
Definitely not so much now
4
Not at all
In the past week:

I have looked forward with enjoyment to things:

1
As much as I ever did
2
Rather less than I used to
3
Definitely less than I used to
4
Hardly at all

I have blamed myself unnecessarily when things went wrong:

1
Yes, most of the time
2
Yes, some of the time
3
Not very often
4
Never

I have been anxious or worried for no good reason:

1
No, not at all
2
Hardly ever
3
Yes, sometimes
4
Yes, often

I have felt scared or panicky for no good reason:

1
Yes, quite a lot
2
Yes, sometimes
3
No, not much
4
No, not at all
In the past week:

Things have been getting on top of me:

1
Yes, most of the time I haven&#39;t been able to cope
2
Yes, sometimes I haven&#39;t been coping as well as usual
3
No, most of the time I have coped quite well
4
No, I have been coping as well as ever

I have been so unhappy that I have had difficulty sleeping:

1
Yes, most of the time
2
Yes, sometimes
3
Not very often
4
No, not at all

I have felt sad or miserable:

1
Yes, most of the time
2
Yes, sometimes
3
Not very often
4
No, not at all

I have been so unhappy that I have been crying:

1
Yes, most of the time
2
Yes, quite often
3
Only occasionally
4
Never
In the past week:

The thought of harming myself has occured to me:

1
Yes, quite often
2
Sometimes
3
Hardly ever
4
Never

On the whole are there more good days than bad?

1
Yes, more good days
2
About half and half
3
No, more bad days
SECTION F: RECENT EVENTS
Listed below are a number of events which may have brought changes in your life. Have any of these occurred since your study child's 9th birthday?

Since the child's 9th birthday: Your wife/partner died

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: One of your children died

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: A friend or relative died

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: One of your children was ill

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: Your wife or partner was ill

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: A friend or relative was ill

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You were admitted to hospital

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You were in trouble with the law

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You were divorced

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You found that your wife/partner didn't want your child

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You were very ill

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: Your wife/partner lost her job

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: Your wife/partner had problems at work

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You had problems at work

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You lost your job

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: Your wife/partner went away

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: Your wife/partner was in trouble with the law

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You and your wife/partner separated

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: Your income was reduced

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You argued with your wife/partner

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You argued with your family and friends

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You moved house

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: Your wife/partner was physically cruel to you

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You became homeless

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You had a major financial problem

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You got married

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: Your wife/partner was physically cruel to your children

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You were physically cruel to your children

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You attempted suicide

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You were convicted of an offence

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: Your wife/partner became pregnant

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You started a new job

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You returned to work

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: Your wife/partner had a miscarriage

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: Your wife/partner had an abortion

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You took an examination

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: Your wife/partner was emotionally cruel to your children

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: Your wife/partner was emotionally cruel to your children

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You were emotionally cruel to your children

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: Your house or car was burgled

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You found a new partner

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: One of your children started school

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: Your wife/partner started a new job

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: A pet died

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period

Since the child's 9th birthday: You had an accident (please tick and describe)

1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
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 3 years?

1
Yes
2
No
If yes,
qc_F46_a == 1
please describe for each event:
what happened: When the study child was 9 or 10 Since the child&#39;s 11th birthday
Generic text

1 - Yes

1 - Yes

Generic text

1 - Yes

1 - Yes

Generic text

1 - Yes

1 - Yes

1
2
3

Has anything else occured which made you especially happy?

1
Yes
2
No
If yes,
qc_F47_a == 1
please describe for each event:
what happened: When the study child was 9 or 10 Since the child&#39;s 11th birthday
Generic text

1 - Yes

1 - Yes

Generic text

1 - Yes

1 - Yes

Generic text

1 - Yes

1 - Yes

1
2
3
SECTION G: ACTIVITIES AND LIFESTYLE

On average, over the past year, about how many hours sleep do you get: on work days ... hours ... minutes

How many
Minutes in hour

On average, over the past year, about how many hours sleep do you get: on weekends (If you normally go out to work at weekends, then answer for your days off) ... hours ... minutes

How many
Minutes in hour

Have you ever been a smoker?

1
Yes
2
No
If no, go to G3 on page 33
If yes,
qc_G2_a == 1

At what age did you start smoking regularly? ... years

Age

Which of the following have you ever smoked regularly? cigarettes

1
Yes

Which of the following have you ever smoked regularly? pipe

1
Yes

Which of the following have you ever smoked regularly? cigar

1
Yes

Which of the following have you ever smoked regularly? other

1
Yes

Have you now stopped smoking?

1
Yes
2
No
If no, go to G2e on page 33
If yes,
qc_G2_d == 1

how long ago? ... years ... months

Years Months

Have you smoked regularly in the last 2 weeks?

1
No
2
Yes, cigarettes
3
Yes, cigars
4
Yes, pipe
5
Yes, other (please describe)
Other

How many times per day have you smoked in the last 2 weeks?

30
30+
25
25-29
20
20-24
15
15-19
10
10-14
5
5-9
1
1-4
0
0

What brand of cigarette/tobacco do you smoke? brand

Generic text

What brand of cigarette/tobacco do you smoke? type:

1
filtered
2
unfiltered
3
roll-your-own
4
pipe/cigar

Does your live-in wife or partner smoke?

1
Don&#39;t have a wife/partner
2
No
3
Yes, cigarettes
4
Yes, cigars
5
Yes, pipe
6
Yes, other (please describe)
Other
If no, or don't have a wife or partner, go to G4 on page 34
If yes,
qc_G3_a == 3 || qc_G3_a == 4 || qc_G3_a == 5 || qc_G3_a == 6

About how many times per day does your wife or partner smoke at the moment?

30
30+
25
25-29
20
20-24
15
15-19
10
10-14
5
5-9
1
1-4
0
0

What brand and type of cigarette/tobacco does she usually smoke? brand

Generic text

What brand and type of cigarette/tobacco does she usually smoke? type:

1
filtered
2
unfiltered
3
roll-your-own
4
pipe/cigar

At what age did she start smoking? ... years

Age
99
don&#39;t know

Apart from yourself and your wife or partner, are there any other members of your household who smoke?

1
Yes
2
No
If yes,
qc_G4_a == 1

how many people?

How many

How often during the day are you in a room or enclosed place where 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 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
In the last few months, how often have you used the following whether at home or at work:
-
disinfectant
bleach
window cleaner
chemical carpet cleaner
oven/drain cleaner
dry cleaning fluid
turpentine/white spirit
paint stripper
household paint or varnish
weed killers
pesticides/insect killers
air fresheners (spray, stick or aerosol)
other aerosols or sprays including hair spray
deodorant or antiperspirant
make up
glue
nail varnish/acetone
metal cleaners/ degreasers, polishers
petrol
moth repellent (moth balls)

In the last few months, how often have you used the following whether at home or at work: In the last few months 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 have a mobile phone (i.e. one that can be used away from home)?

1
Yes
2
No
If yes,
qc_G7_a == 1

how often do you use it to make calls?

1
at least once a day
2
4-6 times a week
3
1-3 times a week
4
less than once a week

how often do people ring you on it?

1
at least once a day
2
4-6 times a week
3
1-3 times a week
4
less than once a week

This question concerns travelling, apart from when going to work: Which of the following do you use for most or all of the time:

1
Car
2
Public transport
3
Neither
This question concerns travelling, apart from when going to work: Please indicate the average number of journeys you make each week (apart from going to work):
Average number of journeys each week Average distance of most frequent journey
How manyHow many

1 - Less than 1/2 mile

2 - 1/2 -1 1/2 miles

3 - 1 1/2 -2 1/2 miles

4 - 2 1/2-3 1/2 miles

5 - 3 1/2-5 1/2 miles

6 - More than 5 1/2 miles

1 - Less than 1/2 mile

2 - 1/2 -1 1/2 miles

3 - 1 1/2 -2 1/2 miles

4 - 2 1/2-3 1/2 miles

5 - 3 1/2-5 1/2 miles

6 - More than 5 1/2 miles

How manyHow many

1 - Less than 1/2 mile

2 - 1/2 -1 1/2 miles

3 - 1 1/2 -2 1/2 miles

4 - 2 1/2-3 1/2 miles

5 - 3 1/2-5 1/2 miles

6 - More than 5 1/2 miles

1 - Less than 1/2 mile

2 - 1/2 -1 1/2 miles

3 - 1 1/2 -2 1/2 miles

4 - 2 1/2-3 1/2 miles

5 - 3 1/2-5 1/2 miles

6 - More than 5 1/2 miles

By bicycle
Walking
Please indicate the average hours of TV or Video watched per day over the past year:
Average per day over the past year
On a weekday before 6pm
On a weekday after 6pm
On a weekend day before 6pm
On a weekend day after 6pm

How many times do you climb up a flight of stairs (approx 10 steps) each day at home? Average per day over the past year On a weekday

1
None
2
1-5 times
3
6-10 times
4
11-15 times
5
16-20 times
6
More than 20 times

How many times do you climb up a flight of stairs (approx 10 steps) each day at home? Average per day over the past year On a weekend day

1
None
2
1-5 times
3
6-10 times
4
11-15 times
5
16-20 times
6
More than 20 times
How many hours each week approximately do you spend time doing the following:
Average per week over the past year
Preparing food, cooking and washing up
Shopping for food and groceries
Shopping and browsing in shops for other items (e.g. clothes, toys)
Cleaning the house
Doing the washing and ironing
Caring for pre-school children or babies at home (not as paid employment)
Caring for handicapped, elderly or disabled people at home (not as paid employment)
SECTION H: ACTIVITY AT WORK

Have you had any jobs or regular voluntary work in the past year?

1
Yes
2
No
If no, go to section I on page 46
qc_H1 == 2
SECTION I: RECREATION ACTIVITIES
Please tell us about the number of times you have done the following activities in the past year, and state the average time spent on each one:
Average time spent per episode: hours Average time spent per episode: minutes Number of times you did the activity in the past year
How manyhoursMinutes in hourMinutes in hour

1 - Every day

2 - 3-6 times a week

3 - Once or twice a week

4 - 1-3 times a month

5 - Less than once a month

6 - None

1 - Every day

2 - 3-6 times a week

3 - Once or twice a week

4 - 1-3 times a month

5 - Less than once a month

6 - None

How manyhoursMinutes in hourMinutes in hour

1 - Every day

2 - 3-6 times a week

3 - Once or twice a week

4 - 1-3 times a month

5 - Less than once a month

6 - None

1 - Every day

2 - 3-6 times a week

3 - Once or twice a week

4 - 1-3 times a month

5 - Less than once a month

6 - None

How manyhoursMinutes in hourMinutes in hour

1 - Every day

2 - 3-6 times a week

3 - Once or twice a week

4 - 1-3 times a month

5 - Less than once a month

6 - None

1 - Every day

2 - 3-6 times a week

3 - Once or twice a week

4 - 1-3 times a month

5 - Less than once a month

6 - None

Swimming-competitive or laps
Swimming-leisurely not laps
Backpacking or mountain climbing
Walking for pleasure (not as a means of transportation)
Racing or rough terrain cycling
Cycling for pleasure (not as a means of transportation)
Mowing the lawn
Watering the lawn or garden
Digging, shovelling or chopping wood
Weeding, pruning
DIY e.g. carpentry, home or car maintenance
High impact aerobics, step aerobics
Other types of aerobics
Exercises with weights
Conditioning exercises e.g. using an exercise bike or rowing machine
Floor exercises e.g. stretching, bending, keep fit
Dancing, e.g. ballroom, disco
Competitive running
Jogging
Bowling - indoor, lawn or 10 pin
Tennis or badminton
Squash
Table tennis
Golf
Football, rugby or hockey
Cricket
Rowing
Netball, volleyball, basketball
Fishing
Horse-riding
Snooker, billiards, darts
Musical instrument, playing, singing
Ice-skating
Sailing, windsurfing, boating
Winter sports e.g. skiing
Martial arts, boxing, wrestling
Other exercise (please tick and describe)

Please tell us about the number of times you have done the following activities in the past year, and state the average time spent on each one: Other exercise (please tick and describe)

Other
SECTION J: BUYING THINGS
How difficult at the moment do you find it to afford these items:
-
food
clothing
heating
rent or mortgage
things you need for your children
costs of educational courses (e.g. ballet, music, etc.)
medical (including dental care and eye tests)
child care
a week&#39;s annual holiday away from home
regular trips and outings for your child (e.g. with school, the family or someone else)

How difficult at the moment do you find it to afford these items: something else (please tick and describe)

1
Very difficult
2
Fairly difficult
3
Slightly difficult
Other

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

1
less than £120
2
£120 - £189
3
£190 - £239
4
£240 - £289
5
£290 - £359
6
£360 - £429
7
£430 - £479
8
£480 - £559
9
£560 - £799
10
£800 or more
11
Don&#39;t know

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

1
nothing
2
less than £40
3
£40 - £59
4
£60 - £79
5
£80-£99
6
£100- £119
7
£120 or more
9
don&#39;t know

About how much do you spend on electricity, gas, water, and telephone each week?

1
less than £20
2
£20 - £29
3
£30 - £39
4
£40 - £49
5
£50 - £59
6
£60-£79
7
£80 or more
9
don&#39;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 - £79
7
£80 - £99
8
£100 or more
9
don&#39;t know

About how much do you spend on clothing, hobbies, and entertainment each week?

1
less than £20
2
£20 - £29
3
£30 - £39
4
£40 - £49
5
£50 - £59
6
£60 -£79
7
£80 or more
9
don&#39;t know

About how much do you spend on childcare each week (e.g. after-school club, sitters, nursery)?

1
nothing
2
less than £20
3
£20 - £39
4
£40 - £59
5
£60 - £79
6
£80 - £99
7
£100 or more
8
varies
9
don&#39;t know

Do you manage to save at all?

1
Yes
2
No

Is your household currently in arrears of rent, mortgage, electricity, gas, water, telephone or council tax?

1
Yes
2
No

Has your family had to go into debt in the last 12 months to meet ordinary living expenses (e.g. rent, food, Xmas, or back-to-school expenses)?

1
Yes
2
No

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

1
Yes
2
No

Do you help your parents, other relatives or friends financially?

1
Yes
2
No

Which one of these statements best describes the way you feel about your cooking?

1
I always enjoy cooking
2
I enjoy cooking when I can take time over it
3
I cook only because I have to, not because I enjoy it
4
I avoid cooking if at all possible
5
I have no real feeling towards cooking

Do you think about any of these health issues when choosing food? Heart disease

1
Yes often
2
Yes, sometimes
3
No, not at all

Do you think about any of these health issues when choosing food? Cancer

1
Yes often
2
Yes, sometimes
3
No, not at all

Do you think about any of these health issues when choosing food? Your weight

1
Yes often
2
Yes, sometimes
3
No, not at all

Do you think about any of these health issues when choosing food? Food allergies/intolerance

1
Yes often
2
Yes, sometimes
3
No, not at all

Do you think about any of these health issues when choosing food? Healthy teeth

1
Yes often
2
Yes, sometimes
3
No, not at all

Do you think about any of these health issues when choosing food? Other (please tick and describe)

1
Yes often
2
Yes, sometimes
3
No, not at all
Other

Do you drink tea? (If you only drink herbal tea, answer No)

1
Yes
2
No
If no, go to J9 on page 54
If yes,
qc_J5_a == 1

How often is the tea you drink decaffeinated?

1
Always
2
Usually
3
Sometimes
4
Never
We would like to ask how much tea, on average, you drink per day: If possible, please tell us first about the size of your cups and mugs. It would help us if you measured, in a measuring jug, the amount of liquid that your usual cup and/or mug contains. This will be in 'fl.oz' or 'mls'.
- ... fl.oz or ... mls.

1 - Yes

1 - Yes

1 - Yes

Fluid ouncesFluid ouncesFluid ouncesMillilitresMillilitresMillilitres

1 - Yes

1 - Yes

1 - Yes

Fluid ouncesFluid ouncesFluid ouncesMillilitresMillilitresMillilitres

1 - Yes

1 - Yes

1 - Yes

Fluid ouncesFluid ouncesFluid ouncesMillilitresMillilitresMillilitres
I use a cup
I use a mug

How many cups of tea per day do you drink, on average?* ... cups a day

How many

How many mugs of tea per day do you drink, on average?* ... mugs a day

How many

How strong is the tea you normally drink?

1
Strong
2
Medium
3
Weak

Describe the type of tea that you drink most often (e.g. Tesco Premium, Typhoo, Sainsbury's Red Label, Tetley Decaffeinated):

Generic text

Do you drink coffee?

1
Yes
2
No
If no, go to Section K on page 56
qc_J9_a == 2
SECTION K:

This questionnaire was completed by: (tick all that apply) Child's biological father

1
Yes

This questionnaire was completed by: (tick all that apply) Father figure

1
Yes

This questionnaire was completed by: (tick all that apply) Someone else (please tick and describe)

1
Yes
Other

Please give the date on which you completed this questionnaire:

Date

Please give your date of birth:

Date of birth

Please give the date of birth of your study child:

Date of birth
THANK YOU VERY MUCH FOR YOUR HELP

Space for any additional comment you would like to make

Long text
NB. Please remember we cannot reply to any comment unless you sign it.
When completed, please return the questionnaire to: Professor Jean Golding Children of the Nineties - ALSPAC Institute of Child Health
End

alspac_02_lahop

LIFESTYLE AND HEALTH OF PARTNER
All answers are confidential
This questionnaire is for the study child’s father or person taking the role of father.
This questionnaire is for the study child’s father or person taking the role of father.
It will help us to catch up with some current problems you may have, as well as some features of you lifestyle.
Some of the questions we are asking may seem remote from the health of your study child, but the answers will help us to plan for studying the changes that will be occuring in our children as they develop, and how these may be passed down from one generation to the next.
To answer simply tick the box which is most accurate in your opinion.
If you do not want to 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 is true for you.
THANK YOU FOR YOU HELP

SECTION A: DIZZINESS AND BALANCE

About how many times have you experienced each of the symptoms listed below during the past 12 months:

-
Felt that things are spinning or moving around, lasting less than 2 minutes
Felt that things are spinning or moving around, lasting up to 20 minutes
Felt that things are spinning or moving around, lasting 20 minutes to 1 hour
Felt that things are spinning or moving around, lasting several hours
Felt that things are spinning or moving around, lasting more than 12 hours
Felt unsteady, so severe that you actually fell
Felt nauseous (feeling sick), stomach churning
Felt light-headed, &quot;swimmy&quot; or giddy lasting less than 2 minutes
Felt light-headed, &quot;swimmy&quot; or giddy lasting up to 20 minutes
Felt light-headed, &quot;swimmy&quot; or giddy lasting 20 minutes to 1 hour
Felt light-headed, &quot;swimmy&quot; or giddy lasting several hours
Felt light-headed, &quot;swimmy&quot; or giddy lasting more than 12 hours
Vomited
Been unable to stand or walk properly without support because you were feeling dizzy
Felt unsteady, about to lose balance, lasting less than 2 minutes
Felt unsteady, about to lose balance, lasting up to 20 minutes
Felt unsteady, about to lose balance, lasting 20 minutes to 1 hour
Felt unsteady, about to lose balance, lasting several hours
Felt unsteady, about to lose balance, lasting more than 12 hours

How confident are you that you will not lose your balance and not become unsteady when you do the following nowadays:

-
Walk around the house
Walk up or down stairs
Bend over and pick up something off the floor
Reach for a small can/jar off a shelf at eye level
Stand on your tip toes and reach for something above your head
Stand on a chair and reach for something
Sweep the floor
Walk outside to a parked car
Get into or out of a car
Walk across a car park to a supermarket
Walk up or down a ramp
Walk in a crowded place, where people quickly walk past you
Are bumped into by people as you walk through a shopping centre
Step onto or off an escalator while holding onto the handrail
Step onto or off an escalator while holding onto parcels, which prevent you from holding onto the handrail
Walk outside on icy pavements
Do you have any other difficulty in walking?
1
Yes
2
No
If no, go to A4a below
Is this due to heart disease or breathing problems?
1
Yes
2
No
9
Don&#39;t know
please describe cause
Generic text
Are you troubled by shortness of breath when hurrying on level ground or walking up a slight hill?
1
Yes
2
No
Do you get short of breath walking with other people of your own age on level ground?
1
Yes
2
No
Do you have to stop for breath when walking at your own pace on level ground?
1
Yes
2
No
Are you short of breath on washing or dressing?
1
Yes
2
No
Have you ever, without warning: Suddenly lost the power of an arm?
1
Yes
2
No
Have you ever, without warning: Suddenly lost the power of a leg?
1
Yes
2
No
Have you ever, without warning: Suddenly been unable to speak properly?
1
Yes
2
No
Have you ever, without warning: Suddenly lost consciousness for no apparent reason?
1
Yes
2
No
Space for comments:
Generic text

SECTION B: YOUR HEALTH

Have you ever had any of the following problems: hay fever
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never
Have you ever had any of the following problems: indigestion
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never
Have you ever had any of the following problems: bulimia
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never
Have you ever had any of the following problems: asthma
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never
Have you ever had any of the following problems: eczema
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never
Have you ever had any of the following problems: epilepsy
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never
Have you ever had any of the following problems: ME or chronic fatigue syndrome
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never
Have you ever had any of the following problems: migraine
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never
Have you ever had any of the following problems: back pain/slipped disc
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never
Have you ever had any of the following problems: kidney disease*
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never
Have you ever had any of the following problems: varicose veins
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never
Have you ever had any of the following problems: haemorrhoids/piles
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never
Have you ever had any of the following problems: rheumatism
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never
Have you ever had any of the following problems: arthritis
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never
Have you ever had any of the following problems: psoriasis
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never
Have you ever had any of the following problems: stomach ulcer
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never
Have you ever had any of the following problems: drug addiction
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never
Have you ever had any of the following problems: alcoholism
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never
Have you ever had any of the following problems: schizophrenia
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never
Have you ever had any of the following problems: anorexia nervosa
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never
Have you ever had any of the following problems: severe depression
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never
Have you ever had any of the following problems: other psychiatric problem*
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
3
No never
Have you ever had any of the following problems: other problem(s)* (please tick & describe)
1
Yes, had it recently (in past year)
2
Yes, in past, not recently
* please tick appropriate box and describe below
Generic text
Have you ever had diabetes?
1
Yes
2
No
If no, go to B2b below
How is/was it treated?
1
insulin injections
2
other drugs
3
diet only
How old were you when you first developed it? ... years
Age
Have you ever had hypertension (high blood pressure)?
1
Yes
2
No
If no, go to B3 on page 10
How old were you when you first developed it? ... years
Age
Do you have hypertension nowadays?
1
Yes
2
No
Are there any problems for which you have regular treatment or medicine nowadays?
1
Yes
2
No
If no, go to B4 below

please describe these problems and regular treatment or medicine:

Problem Treatment or medicine
Generic textGeneric text Generic textGeneric text
1
2
3
4
Would you say that you were allergic to anything?
1
Yes
2
No
If no, go to B5 on page 11
is it to: cat
1
Yes
2
No
is it to: pollen
1
Yes
2
No
is it to: dust
1
Yes
2
No
is it to: insect bites or stings
1
Yes
2
No
is it to: medication (e.g. penicillin)
1
Yes
2
No
is it to: something else (Please tick & describe)
1
Yes
2
No
Other

Have you had any of the following in the past two years:

-
attacks of wheezing with whistling on the chest
a dry itchy rash
a blotchy blistery rash (hives)
sneezing attacks
runny nose
watery eyes
attacks of breathlessness
cough often during the night
cough often when you wake in the morning
Since your study child's 9th birthday have you been admitted to hospital?
1
Yes
2
No
If no, go to B7 on page 12
how many times?
How many
for how many different reasons?
How many

(_hospitalstay <= qc_B6_b) AND (_hospitalstay < 6)

Reason for each hospital stay:
Generic text
How long did you stay? ... nights
How many
Have you ever had any pain or discomfort in your chest?
1
Yes, in past year
2
Yes, but not in past year
3
No
If no, go to B8 on page 13
Do/did you get this pain or discomfort when you walk uphill or hurry?
1
Yes
2
No
Do/did you get the pain or discomfort when you walk at an ordinary pace on the level?
1
Yes
2
No
When you get/got pain or discomfort in your chest what do you do? (Please tick one box only)
1
stop
2
slow down
3
continue at the same pace
Does/did it go away when you stand still?
1
Yes
2
No
9
Don&#39;t know
How soon?
1
10 minutes or less
2
More than 10 minutes
9
Don&#39;t know
Where do/did you get this pain or discomfort? (Please mark the place(s) with an X on the diagram below).
Have you ever had a severe pain across the front of your chest lasting for half an hour or more?
1
Yes
2
No
If no, go to B8 on page 13
Did you talk to a doctor about it?
1
Yes
2
No
If no, go to k below
What did they say it was?
Generic text
How many of these attacks have you had?
How many

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

-

1 - Almost all the time

2 - Sometimes

3 - Not at all

backache
headache or migraine
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 any of the following: In the past month: other problem (please describe)
1
Almost all the time
2
Sometimes
3
Not at all
Other

What forms of contraception are you and your partner using now?

-

1 - Yes

withdrawal
the pill
IUCD/coil
condom/sheath
calendar/rhythm method
diaphragm/cap
spermicide
I am no longer fertile (have been sterilised, e.g. have had a vasectomy)
my partner has been sterilised
none
What forms of contraception are you and your partner using now? other (please describe)
1
Yes
Other

SECTION C: ALL ABOUT YOUR WATERWORKS

During the day, how many times do you urinate (pass water or have a wee) on average?
1
1 - 6 times
2
7 - 8 times
3
9 - 10 times
4
11 - 12 times
5
13 or more times
During the night, how many times do you have to get up to urinate, on average?
1
None
2
Once
3
Twice
4
Three times
5
Four times or more
How often do you have to rush to the toilet to urinate?
1
Never
2
Occasionally
3
Sometimes
4
More often than not
5
Every time
Does urine leak before you can get to the toilet?
1
Never
2
Occasionally
3
Sometimes
4
Most times
5
Every time
Does urine leak when you are physically active, exert yourself, cough or sneeze?
1
Never
2
Occasionally
3
Sometimes
4
Most times
5
Every time
Do you ever leak urine for no obvious reason and without feeling that you want to go?
1
Never
2
Occasionally
3
Sometimes
4
Most of the time
5
All of the time
How often is there a delay before you can start to urinate?
1
Never
2
Occasionally
3
Sometimes
4
Most times
5
Every time
Do you have to strain to urinate?
1
Never
2
Occasionally
3
Sometimes
4
Most times
5
Every time
Do you stop and start more than once while you urinate without meaning to?
1
Never
2
Occasionally
3
Sometimes
4
Most times
5
Every time
How often do you leak urine when you are asleep?
1
Never
2
Occasionally
3
Sometimes
4
Most of the time
5
All of the time
Have you ever blocked up completely so that you could not urinate at all and had to have a catheter to drain the bladder?
1
Never
2
Yes, once
3
Yes, twice
4
Yes, more than twice
How often have you had a burning feeling when you urinate?
1
Never
2
Occasionally/once
3
Sometimes
4
Most times
5
Always
How often do you feel that your bladder has not emptied properly after you have urinated?
1
Never
2
Occasionally
3
Sometimes
4
Most of the time
5
All of the time
If you had to spend the rest of your life with any urinary symptoms that you may have now, how would you feel?
1
No particular symptoms
2
Perfectly happy
3
Pleased
4
Mostly satisfied
5
Mixed feelings
6
Mostly dissatisfied
7
Very unhappy
8
Desperate

SECTION D: ACCIDENTS AND INJURIES

Have you had any accidents of the following types in the last four years (since your study child's 7th birthday)?

-
Road traffic accident
Playing sport or games
At your place of work
Inside your home
Outside your home (e.g. in garden)
At another building
During a fight or argument
You were attacked
Have you had any accidents of the following types in the last four years (since your study child's 7th birthday)? Other type of accident (please tick & describe)
1
Yes &amp; stayed in hospital
2
Yes &amp; saw a doctor
3
Yes, but did not see a doctor
4
No, never happened
Other

Have you had any of the following injuries in the last four years (since your study child's 7th birthday)?

-
burnt
scalded
badly cut
stabbed
shot
nearly drowned

Have you had any of the following injuries in the last four years (since your study child's 7th birthday)?

-
dislocated hip, shoulder, knee, etc.
broken arm or hand
broken leg or foot
sexual assault
overdose of pills or medicine
Have you had any of the following injuries in the last four years (since your study child's 7th birthday)? overdose of something else (please tick & describe)
1
Yes &amp; stayed in hospital
2
Yes &amp; saw a doctor
3
Yes, but did not see a doctor
4
No, never happened
Other
Have you had any of the following injuries in the last four years (since your study child's 7th birthday)? concussion
1
Yes &amp; stayed in hospital
2
Yes &amp; saw a doctor
3
Yes, but did not see a doctor
4
No, never happened
Have you had any of the following injuries in the last four years (since your study child's 7th birthday)? other injury (please tick & describe)
1
Yes &amp; stayed in hospital
2
Yes &amp; saw a doctor
3
Yes, but did not see a doctor
4
No, never happened
Other

What physical problems did you have as a result of any of these accidents or injuries?

-
pain
reduction in movement
a facial scar or defect
less able to see or hear
inability to work
What physical problems did you have as a result of any of these accidents or injuries? other physical result (please tick & describe)
1
Yes &amp; still present
2
Yes but no longer present
3
No did not happen
Other

What emotional problems did you have as a result of any of these accidents or injuries?

-

1 - Yes &amp; still present

2 - Yes but no longer present

3 - No did not happen

loss of self confidence
feeling of depression
very tense
unable to sleep well
loss of appetite
What emotional problems did you have as a result of any of these accidents or injuries? something else (please tick & describe)
1
Yes &amp; still present
2
Yes but no longer present
3
No did not happen
Other

What other consequences of any of these accidents or injuries were there?

-
cost money
lost job
less earnings
problems at work
problems with partner or the family
problems with friends
What other consequences of any of these accidents or injuries were there? other problem (please tick & describe)
1
Yes &amp; still present
2
Yes but no longer present
3
No did not happen
Other

SECTION E: YOUR FEELINGS

The questions in this section ask you about your feelings and the way you behave. You have answered these questions in other questionnaires, but you might be feeling differently now.

Please indicate the way you feel:

-
Do you feel upset for no obvious reason?
Have you felt as though you might faint?
Do you feel uneasy and restless?
Do you sometimes feel panicky?
Do you worry a lot?
Do you feel strung-up inside?
Do you ever have the feeling you are going to pieces?
Do you have bad dreams which upset you when you wake up?

Your feelings in the past week.

I have been able to laugh and see the funny side of things:
1
As much as I always could
2
Not quite so much now
3
Definitely not so much now
4
Not at all
In the past week:
I have looked forward with enjoyment to things:
1
As much as I ever did
2
Rather less than I used to
3
Definitely less than I used to
4
Hardly at all
I have blamed myself unnecessarily when things went wrong:
1
Yes, most of the time
2
Yes, some of the time
3
Not very often
4
Never
I have been anxious or worried for no good reason:
1
No, not at all
2
Hardly ever
3
Yes, sometimes
4
Yes, often
I have felt scared or panicky for no good reason:
1
Yes, quite a lot
2
Yes, sometimes
3
No, not much
4
No, not at all
In the past week:
Things have been getting on top of me:
1
Yes, most of the time I haven&#39;t been able to cope
2
Yes, sometimes I haven&#39;t been coping as well as usual
3
No, most of the time I have coped quite well
4
No, I have been coping as well as ever
I have been so unhappy that I have had difficulty sleeping:
1
Yes, most of the time
2
Yes, sometimes
3
Not very often
4
No, not at all
I have felt sad or miserable:
1
Yes, most of the time
2
Yes, sometimes
3
Not very often
4
No, not at all
I have been so unhappy that I have been crying:
1
Yes, most of the time
2
Yes, quite often
3
Only occasionally
4
Never
In the past week:
The thought of harming myself has occured to me:
1
Yes, quite often
2
Sometimes
3
Hardly ever
4
Never
On the whole are there more good days than bad?
1
Yes, more good days
2
About half and half
3
No, more bad days

SECTION F: RECENT EVENTS

Listed below are a number of events which may have brought changes in your life. Have any of these occurred since your study child's 9th birthday?
Since the child's 9th birthday: Your wife/partner died
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: One of your children died
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: A friend or relative died
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: One of your children was ill
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: Your wife or partner was ill
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: A friend or relative was ill
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You were admitted to hospital
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You were in trouble with the law
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You were divorced
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You found that your wife/partner didn't want your child
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You were very ill
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: Your wife/partner lost her job
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: Your wife/partner had problems at work
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You had problems at work
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You lost your job
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: Your wife/partner went away
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: Your wife/partner was in trouble with the law
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You and your wife/partner separated
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: Your income was reduced
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You argued with your wife/partner
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You argued with your family and friends
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You moved house
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: Your wife/partner was physically cruel to you
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You became homeless
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You had a major financial problem
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You got married
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: Your wife/partner was physically cruel to your children
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You were physically cruel to your children
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You attempted suicide
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You were convicted of an offence
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: Your wife/partner became pregnant
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You started a new job
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You returned to work
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: Your wife/partner had a miscarriage
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: Your wife/partner had an abortion
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You took an examination
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: Your wife/partner was emotionally cruel to your children
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: Your wife/partner was emotionally cruel to your children
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You were emotionally cruel to your children
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: Your house or car was burgled
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You found a new partner
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: One of your children started school
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: Your wife/partner started a new job
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: A pet died
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
Since the child's 9th birthday: You had an accident (please tick and describe)
1
Yes, when the study child was 9 or 10
2
Yes, since the child&#39;s 11th birthday
4
No, did not happen in this period
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 3 years?
1
Yes
2
No

please describe for each event:

what happened: When the study child was 9 or 10 Since the child&#39;s 11th birthday
Generic text

1 - Yes

1 - Yes

Generic text

1 - Yes

1 - Yes

Generic text

1 - Yes

1 - Yes

1
2
3
Has anything else occured which made you especially happy?
1
Yes
2
No

please describe for each event:

what happened: When the study child was 9 or 10 Since the child&#39;s 11th birthday
Generic text

1 - Yes

1 - Yes

Generic text

1 - Yes

1 - Yes

Generic text

1 - Yes

1 - Yes

1
2
3

SECTION G: ACTIVITIES AND LIFESTYLE

On average, over the past year, about how many hours sleep do you get: on work days ... hours ... minutes
How many
Minutes in hour
On average, over the past year, about how many hours sleep do you get: on weekends (If you normally go out to work at weekends, then answer for your days off) ... hours ... minutes
How many
Minutes in hour
Have you ever been a smoker?
1
Yes
2
No
If no, go to G3 on page 33
At what age did you start smoking regularly? ... years
Age
Which of the following have you ever smoked regularly? cigarettes
1
Yes
Which of the following have you ever smoked regularly? pipe
1
Yes
Which of the following have you ever smoked regularly? cigar
1
Yes
Which of the following have you ever smoked regularly? other
1
Yes
Have you now stopped smoking?
1
Yes
2
No
If no, go to G2e on page 33
how long ago? ... years ... months
Years Months
Have you smoked regularly in the last 2 weeks?
1
No
2
Yes, cigarettes
3
Yes, cigars
4
Yes, pipe
5
Yes, other (please describe)
Other
How many times per day have you smoked in the last 2 weeks?
30
30+
25
25-29
20
20-24
15
15-19
10
10-14
5
5-9
1
1-4
0
0
What brand of cigarette/tobacco do you smoke? brand
Generic text
What brand of cigarette/tobacco do you smoke? type:
1
filtered
2
unfiltered
3
roll-your-own
4
pipe/cigar
Does your live-in wife or partner smoke?
1
Don&#39;t have a wife/partner
2
No
3
Yes, cigarettes
4
Yes, cigars
5
Yes, pipe
6
Yes, other (please describe)
Other
If no, or don't have a wife or partner, go to G4 on page 34
About how many times per day does your wife or partner smoke at the moment?
30
30+
25
25-29
20
20-24
15
15-19
10
10-14
5
5-9
1
1-4
0
0
What brand and type of cigarette/tobacco does she usually smoke? brand
Generic text
What brand and type of cigarette/tobacco does she usually smoke? type:
1
filtered
2
unfiltered
3
roll-your-own
4
pipe/cigar
At what age did she start smoking? ... years
Age
99
don&#39;t know
Apart from yourself and your wife or partner, are there any other members of your household who smoke?
1
Yes
2
No
how many people?
How many
How often during the day are you in a room or enclosed place where 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 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

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

-
disinfectant
bleach
window cleaner
chemical carpet cleaner
oven/drain cleaner
dry cleaning fluid
turpentine/white spirit
paint stripper
household paint or varnish
weed killers
pesticides/insect killers
air fresheners (spray, stick or aerosol)
other aerosols or sprays including hair spray
deodorant or antiperspirant
make up
glue
nail varnish/acetone
metal cleaners/ degreasers, polishers
petrol
moth repellent (moth balls)
In the last few months, how often have you used the following whether at home or at work: In the last few months 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 have a mobile phone (i.e. one that can be used away from home)?
1
Yes
2
No
how often do you use it to make calls?
1
at least once a day
2
4-6 times a week
3
1-3 times a week
4
less than once a week
how often do people ring you on it?
1
at least once a day
2
4-6 times a week
3
1-3 times a week
4
less than once a week
This question concerns travelling, apart from when going to work: Which of the following do you use for most or all of the time:
1
Car
2
Public transport
3
Neither

This question concerns travelling, apart from when going to work: Please indicate the average number of journeys you make each week (apart from going to work):

Average number of journeys each week Average distance of most frequent journey
How manyHow many

1 - Less than 1/2 mile

2 - 1/2 -1 1/2 miles

3 - 1 1/2 -2 1/2 miles

4 - 2 1/2-3 1/2 miles

5 - 3 1/2-5 1/2 miles

6 - More than 5 1/2 miles

1 - Less than 1/2 mile

2 - 1/2 -1 1/2 miles

3 - 1 1/2 -2 1/2 miles

4 - 2 1/2-3 1/2 miles

5 - 3 1/2-5 1/2 miles

6 - More than 5 1/2 miles

How manyHow many

1 - Less than 1/2 mile

2 - 1/2 -1 1/2 miles

3 - 1 1/2 -2 1/2 miles

4 - 2 1/2-3 1/2 miles

5 - 3 1/2-5 1/2 miles

6 - More than 5 1/2 miles

1 - Less than 1/2 mile

2 - 1/2 -1 1/2 miles

3 - 1 1/2 -2 1/2 miles

4 - 2 1/2-3 1/2 miles

5 - 3 1/2-5 1/2 miles

6 - More than 5 1/2 miles

By bicycle
Walking

Please indicate the average hours of TV or Video watched per day over the past year:

Average per day over the past year
On a weekday before 6pm
On a weekday after 6pm
On a weekend day before 6pm
On a weekend day after 6pm
How many times do you climb up a flight of stairs (approx 10 steps) each day at home? Average per day over the past year On a weekday
1
None
2
1-5 times
3
6-10 times
4
11-15 times
5
16-20 times
6
More than 20 times
How many times do you climb up a flight of stairs (approx 10 steps) each day at home? Average per day over the past year On a weekend day
1
None
2
1-5 times
3
6-10 times
4
11-15 times
5
16-20 times
6
More than 20 times

How many hours each week approximately do you spend time doing the following:

Average per week over the past year
Preparing food, cooking and washing up
Shopping for food and groceries
Shopping and browsing in shops for other items (e.g. clothes, toys)
Cleaning the house
Doing the washing and ironing
Caring for pre-school children or babies at home (not as paid employment)
Caring for handicapped, elderly or disabled people at home (not as paid employment)

SECTION H: ACTIVITY AT WORK

Have you had any jobs or regular voluntary work in the past year?
1
Yes
2
No

SECTION I: RECREATION ACTIVITIES

Please tell us about the number of times you have done the following activities in the past year, and state the average time spent on each one:

Average time spent per episode: hours Average time spent per episode: minutes Number of times you did the activity in the past year
How manyhoursMinutes in hourMinutes in hour

1 - Every day

2 - 3-6 times a week

3 - Once or twice a week

4 - 1-3 times a month

5 - Less than once a month

6 - None

1 - Every day

2 - 3-6 times a week

3 - Once or twice a week

4 - 1-3 times a month

5 - Less than once a month

6 - None

How manyhoursMinutes in hourMinutes in hour

1 - Every day

2 - 3-6 times a week

3 - Once or twice a week

4 - 1-3 times a month

5 - Less than once a month

6 - None

1 - Every day

2 - 3-6 times a week

3 - Once or twice a week

4 - 1-3 times a month

5 - Less than once a month

6 - None

How manyhoursMinutes in hourMinutes in hour

1 - Every day

2 - 3-6 times a week

3 - Once or twice a week

4 - 1-3 times a month

5 - Less than once a month

6 - None

1 - Every day

2 - 3-6 times a week

3 - Once or twice a week

4 - 1-3 times a month

5 - Less than once a month

6 - None

Swimming-competitive or laps
Swimming-leisurely not laps
Backpacking or mountain climbing
Walking for pleasure (not as a means of transportation)
Racing or rough terrain cycling
Cycling for pleasure (not as a means of transportation)
Mowing the lawn
Watering the lawn or garden
Digging, shovelling or chopping wood
Weeding, pruning
DIY e.g. carpentry, home or car maintenance
High impact aerobics, step aerobics
Other types of aerobics
Exercises with weights
Conditioning exercises e.g. using an exercise bike or rowing machine
Floor exercises e.g. stretching, bending, keep fit
Dancing, e.g. ballroom, disco
Competitive running
Jogging
Bowling - indoor, lawn or 10 pin
Tennis or badminton
Squash
Table tennis
Golf
Football, rugby or hockey
Cricket
Rowing
Netball, volleyball, basketball
Fishing
Horse-riding
Snooker, billiards, darts
Musical instrument, playing, singing
Ice-skating
Sailing, windsurfing, boating
Winter sports e.g. skiing
Martial arts, boxing, wrestling
Other exercise (please tick and describe)
Please tell us about the number of times you have done the following activities in the past year, and state the average time spent on each one: Other exercise (please tick and describe)
Other

SECTION J: BUYING THINGS

How difficult at the moment do you find it to afford these items:

-
food
clothing
heating
rent or mortgage
things you need for your children
costs of educational courses (e.g. ballet, music, etc.)
medical (including dental care and eye tests)
child care
a week&#39;s annual holiday away from home
regular trips and outings for your child (e.g. with school, the family or someone else)
How difficult at the moment do you find it to afford these items: something else (please tick and describe)
1
Very difficult
2
Fairly difficult
3
Slightly difficult
Other
On average, about how much is the take-home income of your household each week (include social benefits etc.)?
1
less than £120
2
£120 - £189
3
£190 - £239
4
£240 - £289
5
£290 - £359
6
£360 - £429
7
£430 - £479
8
£480 - £559
9
£560 - £799
10
£800 or more
11
Don&#39;t know
Out of this, how much do you pay for rent, loans or mortgage each week?
1
nothing
2
less than £40
3
£40 - £59
4
£60 - £79
5
£80-£99
6
£100- £119
7
£120 or more
9
don&#39;t know
About how much do you spend on electricity, gas, water, and telephone each week?
1
less than £20
2
£20 - £29
3
£30 - £39
4
£40 - £49
5
£50 - £59
6
£60-£79
7
£80 or more
9
don&#39;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 - £79
7
£80 - £99
8
£100 or more
9
don&#39;t know
About how much do you spend on clothing, hobbies, and entertainment each week?
1
less than £20
2
£20 - £29
3
£30 - £39
4
£40 - £49
5
£50 - £59
6
£60 -£79
7
£80 or more
9
don&#39;t know
About how much do you spend on childcare each week (e.g. after-school club, sitters, nursery)?
1
nothing
2
less than £20
3
£20 - £39
4
£40 - £59
5
£60 - £79
6
£80 - £99
7
£100 or more
8
varies
9
don&#39;t know
Do you manage to save at all?
1
Yes
2
No
Is your household currently in arrears of rent, mortgage, electricity, gas, water, telephone or council tax?
1
Yes
2
No
Has your family had to go into debt in the last 12 months to meet ordinary living expenses (e.g. rent, food, Xmas, or back-to-school expenses)?
1
Yes
2
No
Do you receive any financial help from your parents, other relatives or friends?
1
Yes
2
No
Do you help your parents, other relatives or friends financially?
1
Yes
2
No
Which one of these statements best describes the way you feel about your cooking?
1
I always enjoy cooking
2
I enjoy cooking when I can take time over it
3
I cook only because I have to, not because I enjoy it
4
I avoid cooking if at all possible
5
I have no real feeling towards cooking
Do you think about any of these health issues when choosing food? Heart disease
1
Yes often
2
Yes, sometimes
3
No, not at all
Do you think about any of these health issues when choosing food? Cancer
1
Yes often
2
Yes, sometimes
3
No, not at all
Do you think about any of these health issues when choosing food? Your weight
1
Yes often
2
Yes, sometimes
3
No, not at all
Do you think about any of these health issues when choosing food? Food allergies/intolerance
1
Yes often
2
Yes, sometimes
3
No, not at all
Do you think about any of these health issues when choosing food? Healthy teeth
1
Yes often
2
Yes, sometimes
3
No, not at all
Do you think about any of these health issues when choosing food? Other (please tick and describe)
1
Yes often
2
Yes, sometimes
3
No, not at all
Other
Do you drink tea? (If you only drink herbal tea, answer No)
1
Yes
2
No
If no, go to J9 on page 54
How often is the tea you drink decaffeinated?
1
Always
2
Usually
3
Sometimes
4
Never

We would like to ask how much tea, on average, you drink per day: If possible, please tell us first about the size of your cups and mugs. It would help us if you measured, in a measuring jug, the amount of liquid that your usual cup and/or mug contains. This will be in 'fl.oz' or 'mls'.

- ... fl.oz or ... mls.

1 - Yes

1 - Yes

1 - Yes

Fluid ouncesFluid ouncesFluid ouncesMillilitresMillilitresMillilitres

1 - Yes

1 - Yes

1 - Yes

Fluid ouncesFluid ouncesFluid ouncesMillilitresMillilitresMillilitres

1 - Yes

1 - Yes

1 - Yes

Fluid ouncesFluid ouncesFluid ouncesMillilitresMillilitresMillilitres
I use a cup
I use a mug
How many cups of tea per day do you drink, on average?* ... cups a day
How many
How many mugs of tea per day do you drink, on average?* ... mugs a day
How many
How strong is the tea you normally drink?
1
Strong
2
Medium
3
Weak
Describe the type of tea that you drink most often (e.g. Tesco Premium, Typhoo, Sainsbury's Red Label, Tetley Decaffeinated):
Generic text
Do you drink coffee?
1
Yes
2
No

SECTION K:

This questionnaire was completed by: (tick all that apply) Child's biological father
1
Yes
This questionnaire was completed by: (tick all that apply) Father figure
1
Yes
This questionnaire was completed by: (tick all that apply) Someone else (please tick and describe)
1
Yes
Other
Please give the date on which you completed this questionnaire:
Date
Please give your date of birth:
Date of birth
Please give the date of birth of your study child:
Date of birth
THANK YOU VERY MUCH FOR YOUR HELP
Space for any additional comment you would like to make
Long text
NB. Please remember we cannot reply to any comment unless you sign it.
When completed, please return the questionnaire to: Professor Jean Golding Children of the Nineties - ALSPAC Institute of Child Health
Name

Lifestyle and Health of Partner