Start
ncds_02_sc_1
National Child Development Study: 2002-3
Self-completion Booklet
In Confidence
We would like to ask you some questions before the nurse comes to see you.
Your answers to these questions will give us a better idea about your health and how it is influenced by your lifestyle and current circumstances.
Please do complete this booklet before the nurse comes to see you and give it to her when she visits.
A. SUN EXPOSURE
EVERYONE PLEASE ANSWER
How long per day do/did you usually spend outdoors during the daylight hours ...
-

1 - No time

2 - Less than 15 mins

3 - 15 to 30 mins

4 - 30 mins to 1 hour

5 - 1 to 2 hours

6 - 3 to 4 hours

7 - More than 4 hours

... last month?
... in Summer?
... in Winter?
In sunny weather, both in the UK and in other countries do you ...
-

1 - Often

2 - Sometimes

3 - Rarely

4 - Never

... protect your skin from the sun, for example with clothing or suncream?
... get blistering after being burned in the sun?
... actively seek a suntan?

What is the natural colour of your hair (or the original colour if now grey)?

1
Light blonde
2
Red
3
Dark blonde/light brown
4
Dark brown/black

Would you say your natural skin colour (on your inner arm) is ...

1
... light (white, fair or ruddy)
2
... medium (olive, light/medium brown)
3
... dark (dark brown, black)
B. PHYSICAL ACTIVITY
First we would like to ask you about activites connected with your main (or only) job.

In the past year have you been in paid employment or have you done regular, organised voluntary work?

1
Yes
2
No
If Yes to question B1 Answer B2
qc_B1 == 1
For the job you have spent most time doing in the year ...

Roughly how many miles is it from home to work? Write in ... miles

How many

How many times a week do you travel between home and work? (To work and from work counts as two journeys.) Write in ... times a week

How many

How do you usually travel to work? By motorised transport (car, motorbike, train etc.)

1
Always
2
Usually
3
Occasionally
4
Never/rarely

How do you usually travel to work? By bicycle

1
Always
2
Usually
3
Occasionally
4
Never/rarely

How do you usually travel to work? Walking

1
Always
2
Usually
3
Occasionally
4
Never/rarely
Now we would like to know about your activity at work.
Please answer questions B5 and B6 for your current, main job.
Have you done each activity at work in the last year?
cs_qB5_Y If you do any other activities at work which we have not included, please list them in the space below: cs_qB5_X cs_noyes Hours in week cs_noyes Hours in week

1 - No

2 - Yes

1 - No

2 - Yes

Sitting - light work e.g. desk work, or driving a car or truck 1 -
Sitting - light work e.g. desk work, or driving a car or truck 1 If yes, how many hours per week?
Sitting - light work e.g. desk work, or driving a car or truck 2 -
Sitting - light work e.g. desk work, or driving a car or truck 2 If yes, how many hours per week?
Sitting - moderate work e.g. working heavy levers or riding a mower or forklift truck 1 -
Sitting - moderate work e.g. working heavy levers or riding a mower or forklift truck 1 If yes, how many hours per week?
Sitting - moderate work e.g. working heavy levers or riding a mower or forklift truck 2 -
Sitting - moderate work e.g. working heavy levers or riding a mower or forklift truck 2 If yes, how many hours per week?
Standing - light work e.g. lab technician work or working at a shop counter 1 -
Standing - light work e.g. lab technician work or working at a shop counter 1 If yes, how many hours per week?
Standing - light work e.g. lab technician work or working at a shop counter 2 -
Standing - light work e.g. lab technician work or working at a shop counter 2 If yes, how many hours per week?
Standing - light/moderate work e.g. light welding or stocking shelves 1 -
Standing - light/moderate work e.g. light welding or stocking shelves 1 If yes, how many hours per week?
Standing - light/moderate work e.g. light welding or stocking shelves 2 -
Standing - light/moderate work e.g. light welding or stocking shelves 2 If yes, how many hours per week?
Standing - moderate work e.g. fast rate assembly line work or lifting up to 50 lbs every 5 minutes for a few seconds at a time 1 -
Standing - moderate work e.g. fast rate assembly line work or lifting up to 50 lbs every 5 minutes for a few seconds at a time 1 If yes, how many hours per week?
Standing - moderate work e.g. fast rate assembly line work or lifting up to 50 lbs every 5 minutes for a few seconds at a time 2 -
Standing - moderate work e.g. fast rate assembly line work or lifting up to 50 lbs every 5 minutes for a few seconds at a time 2 If yes, how many hours per week?
Standing - moderate/heavy work e.g. masonry/painting or lifting more than 50 lbs every 5 minutes for a few seconds at a time 1 -
Standing - moderate/heavy work e.g. masonry/painting or lifting more than 50 lbs every 5 minutes for a few seconds at a time 1 If yes, how many hours per week?
Standing - moderate/heavy work e.g. masonry/painting or lifting more than 50 lbs every 5 minutes for a few seconds at a time 2 -
Standing - moderate/heavy work e.g. masonry/painting or lifting more than 50 lbs every 5 minutes for a few seconds at a time 2 If yes, how many hours per week?
Walking at work - carrying nothing heavier than a briefcase e.g. moving about a shop 1 -
Walking at work - carrying nothing heavier than a briefcase e.g. moving about a shop 1 If yes, how many hours per week?
Walking at work - carrying nothing heavier than a briefcase e.g. moving about a shop 2 -
Walking at work - carrying nothing heavier than a briefcase e.g. moving about a shop 2 If yes, how many hours per week?
Walking - carrying something heavy 1 -
Walking - carrying something heavy 1 If yes, how many hours per week?
Walking - carrying something heavy 2 -
Walking - carrying something heavy 2 If yes, how many hours per week?
Moving, pushing heavy objects weighing over 75 lbs 1 -
Moving, pushing heavy objects weighing over 75 lbs 1 If yes, how many hours per week?
Moving, pushing heavy objects weighing over 75 lbs 2 -
Moving, pushing heavy objects weighing over 75 lbs 2 If yes, how many hours per week?

At work, how many times a day do you normally ... .... climb up a flight of stairs (10 steps) Number of times each day

How many

At work, how many times a day do you normally... ... climb up a ladder Number of times each day

How many
EVERYONE PLEASE ANSWER
Now we would like to ask you how you generally get about.

Would you say that ... ... apart from journeys to work, I travel by car most or all of the time

1
Agree
2
Disagree

Would you say that ... ... apart from journeys to work, I travel by public transport most or all of the time

1
Agree
2
Disagree
Apart from journeys to work, how many journeys do you make by bicycle and on foot in an average week? (To and from somewhere counts as two journeys.)
TOTAL NUMBER of journeys each week Number of journeys of less than 0.5 miles Number of journeys of 0.5 to 1.5 miles Number of journeys of 1.5 to 2.5 miles Number of journeys of 2.5 to 3.5 miles Number of journeys of 3.5 to 5.5 miles Number of journeys of more than 5.5 miles
How manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow many
By bicycle
Walking
C. HEARING
These questions are about your ears and your hearing. If you normally use a hearing aid, answer questions C1 to C6 as if you were NOT using it.

Do you have any difficulty with your hearing?

1
Yes
2
No

Do you find it very difficult to follow a conversation if there is background noise (such as TV, radio, children playing)?

1
Yes
2
No

How well do you hear someone talking to you when that person is sitting ... ... on your RIGHT SIDE in a quiet room?

1
With no difficulty
2
With slight difficulty
3
With moderate difficulty
4
With great difficulty
5
Cannot hear them at all

How well do you hear someone talking to you when that person is sitting ... ... on your LEFT SIDE in a quiet room?

1
With no difficulty
2
With slight difficulty
3
With moderate difficulty
4
With great difficulty
5
Cannot hear them at all

Do you have difficulty ... ... following TV programmes at a volume others find acceptable, without any aid to hearing?

1
No
2
Yes, slight difficulty
3
Yes, moderate difficulty
4
Yes, great difficulty

Do you have difficulty ... ... having a conversation with several people in a group?

1
No
2
Yes, slight difficulty
3
Yes, moderate difficulty
4
Yes, great difficulty

Do very loud noises annoy you?

1
Not at all
2
Slightly
3
Moderately
4
Severely

Nowadays, how much does any difficulty in hearing worry, annoy or upset you?

1
Do not have hearing difficulty
2
Not at all annoying
3
Slightly annoying
4
Moderately annoying
5
Severely annoying

Have you ever had an ear operation?

1
No, never
2
Yes, as a child (under 16 years)
3
Yes, as an adult (16 years or older)

Did any of your parents, children, brothers or sisters have great difficulty in hearing before the age of 55 years?

1
Yes
2
No/don't know

Have you ever worked in a place with a lot of dust?

1
No, never
2
Yes, in last 2 years
3
Yes, more than 2 years ago

Have you ever worked in a place that was so noisy that you had to shout to be heard?

1
No, never
2
Yes, for less than 1 year
3
Yes, for 1-5 years
4
Yes, for over 5 years
D. EYESIGHT
These questions are about your eyesight. Please think about your eyesight in the past month. If you use glasses, contact lenses or magnifiers for some activities, please answer according to how you can see when using them.

If you have had an eye infection, eye operation, an eyesight test, a change of glasses or a sudden change in your eyesight in the past month please write details below.

Generic text
Please read each question carefully and tick the answer that best applies to you.
Think about how your eyesight has made you feel in the past month.
-

1 - Not at all

2 - Very rarely

3 - A little of the time

4 - A fair amount of the time

5 - A lot of the time

6 - All the time

... have you felt embarrassed because of your eyesight?
... have you felt frustrated or annoyed because of your eyesight?
... have you felt lonely or isolated because of your eyesight?
... have you felt sad or low because of your eyesight?
... how often have you worried about your eyesight?
In the past month, how often has your eyesight made you concerned or worried about the following ...
-

1 - Not at all

2 - Very rarely

3 - A little of the time

4 - A fair amount of the time

5 - A lot of the time

6 - All the time

... your general safety at home?
... your general safety when out of your home?
... coping with everyday life?

In the past month, how often has your eyesight ... ... stopped you doing the things you want to do?

1
Not at all
2
Very rarely
3
A little of the time
4
A fair amount of the time
5
A lot of the time
6
All the time

In the past month, how often has your eyesight ... ... interfered with your life in general?

1
Not at all
2
Very rarely
3
A little of the time
4
A fair amount of the time
5
A lot of the time
6
All the time
E. PAIN

During the past month, have you had any ache or pain which has lasted for one day or longer? (Please do not include pain occurring only during menstrual periods or during the course of a feverish illness such as 'flu.)

1
Yes
2
No
If Yes to Question E1 Answer E2
qc_E1 == 1

Thinking about this pain, have you been aware of it for more than 3 months?

1
Yes
2
No

Below you will find four diagrams of the body. Please shade in all the places where you felt or feel the aches and pains.

F. WORK
EVERYONE PLEASE ANSWER
If you have a paid job, please apply these questions to your main job. Otherwise please apply these questions to your main activity (eg housework, caring for family members, voluntary work etc.).

Do you have to work very fast?

1
Often
2
Sometimes
3
Seldom
4
Never/Almost Never

Do you have to work very intensively?

1
Often
2
Sometimes
3
Seldom
4
Never/Almost Never

Do you have enough time to do everything?

1
Often
2
Sometimes
3
Seldom
4
Never/Almost Never

Do you have a possibility of learning new things through your work?

1
Often
2
Sometimes
3
Seldom
4
Never/Almost Never

Does your work demand a high level of skill or expertise?

1
Often
2
Sometimes
3
Seldom
4
Never/Almost Never

Do you have a choice in deciding HOW you do your work?

1
Often
2
Sometimes
3
Seldom
4
Never/Almost Never

Do you have a choice in deciding WHAT you do at work?

1
Often
2
Sometimes
3
Seldom
4
Never/Almost Never

Does your job provide you with a variety of interesting things?

1
Often
2
Sometimes
3
Seldom
4
Never/Almost Never
Job Characteristics:

Are you in paid work either full time or part time?

1
Yes
2
No
If Yes to question F9 Answer F10
qc_F9 == 1

How many hours do you work per average week in your main job, including work brought home? ... hours

Hours in week

Do you have any other paid employment in addition to your main job?

1
Yes
2
No

How secure do you feel your present job is?

1
Very secure
2
Secure
3
Not very secure
4
Very insecure

About your position at work, whether you are working at home or in a workplace away from home, how often does the following statement apply? I have a good deal of say in decisions about work.

1
Often
2
Sometimes
3
Seldom
4
Never/Almost Never

About consistency and clarity regarding your job. Do different groups at work demand things from you that you think are hard to combine?

1
Often
2
Sometimes
3
Seldom
4
Never
When you are having difficulties at work:
-

1 - Often

2 - Sometimes

3 - Seldom

4 - Never

How often do you get help and support from your colleagues?
How often are your colleagues willing to listen to your work-related problems?
How often is your immediate superior willing to listen to your problems?
G. HOUSEHOLD CIRCUMSTANCES
EVERYONE PLEASE ANSWER

Do you own or rent your home or is there some other arrangement?

1
Own - outright
2
Own – buying with help of a mortgage/loan
3
Pay part rent and part mortgage (shared/equity ownership)
4
Rent from local authority or housing association
5
Rent from private landlord, relative or other
6
Live here rent-free, including rent-free in relatives’/friends’ property
7
Squatting
8
Other arrangement

How many cars or vans are normally available for private use by you or any members of your household? (Include company vehicles if available for private use, but exclude vehicles solely for carriage of goods.)

1
None
2
One
3
Two
4
3 or more
If One, Two or 3 or more to question G2 Answer G3
qc_G2 == 2 || qc_G2 == 3 || qc_G2 == 4

Do (any of) you own this/these vehicle(s) or is it a company vehicle? (Include vehicles being bought on hire purchase.)

1
Owned by household
2
Company vehicle(s)
3
Both owned and company vehicles
EVERYONE PLEASE ANSWER

How often does it happen that you do not have enough money to afford the kind of food or clothing you/your family should have?

1
Always
2
Often
3
Sometimes
4
Seldom
5
Never

How much difficulty do you have in meeting the payment of bills?

1
Very great difficulty
2
Great difficulty
3
Some difficulty
4
Slight difficulty
5
Very little difficulty
H. SOCIAL LIFE
This section concerns people in your life who you feel close to and from whom you can obtain support (either emotional or practical) including close relatives and good friends.

How many people do you feel very close to? (It does not matter where they live or whether you have seen them recently.) Please write in how many people ... OR TICK:

How many
0
No-one
If No-one to Question H1 GO TO H6
qc_H1 == 0
Else

Thinking about the person you have felt closest to in the last 12 months please answer the following questions: Is this person your ...

1
husband/wife/partner
2
boyfriend/girlfriend
3
parent
4
brother/sister
5
son/daughter
6
other relative
7
neighbour
8
friend from work
9
other friend
10
other (please describe)
Other
How much in the last 12 months ...
-

1 - Not at all

2 - A little

3 - Quite a lot

4 - A great deal

... did this person give you information, suggestions and guidance that you found helpful?
... could you rely on this person (was this person there when you needed him/her?)
... did this person make you feel good about yourself?
... would you have liked more practical help with major things from this person?
... did you share interests, hobbies and fun with this person?
... did this person give you worries, problems and stress?
Still thinking about the person you have felt closest to, how much in the last 12 months ...
-

1 - Not at all

2 - A little

3 - Quite a lot

4 - A great deal

... did you want to confide in (talk frankly, share feelings with) this person?
... did you confide in this person?
... did you trust this person with your most personal worries and problems?
... would you have liked to confide more in this person?
... did talking to this person make things worse?
How much in the last 12 months ...
-

1 - Not at all

2 - A little

3 - Quite a lot

4 - A great deal

... did he/she talk about his/her personal worries with you?
... did you need practical help from this person with major things (e.g. look after you when ill, help with finances, children)?
... did this person give you practical help with major things?
... did this person give you practical help with small things when you needed it? (e.g. chores, shopping, watering plants, etc.)
EVERYONE PLEASE ANSWER
These questions are about relatives who live outside your household.

How often do you have regular contact with relatives outside your household, by visits, telephone, letters or emails? In total, is it ...

1
Almost daily
2
About once a week
3
About once a month
4
Once every few months
5
Never or almost never
0
OR TICK: I have no relatives outside my household
If Almost daily, About once a week, About once a month, Once every few months or Never or almost never to Question H6 Answer H7
qc_H6 == 1 || qc_H6 == 2 || qc_H6 == 3 || qc_H6 == 4 || qc_H6 == 5

How often do you visit or are you visited by relatives who live outside your household? In total, is it ...

1
Almost daily
2
About once a week
3
About once a month
4
Once every few months
5
Never or almost never
If Almost daily, About once a week or About once a month to Question H7 Answer H8
qc_H7 == 1 || qc_H7 == 2 || qc_H7 == 3

How many relatives do you see once a month or more?

1
None
2
One or two
3
Three to five
4
Six to ten
5
More than ten
EVERYONE PLEASE ANSWER

How often do you have regular contact with friends or acquaintances outside your household, by visits, telephone, letters or emails? In total, is it ...

1
Almost daily
2
About once a week
3
About once a month
4
Once every few months
5
Never or almost never
0
OR TICK: I have no friends or acquaintances outside my household
If Almost daily, About once a week, About once a month, Once every few months or Never or almost never to Question H9 Answer H10
qc_H9 == 1 || qc_H9 == 2 || qc_H9 == 3 || qc_H9 == 4 || qc_H9 == 5

How often do you visit or are you visited by friends or acquaintances who live outside your household? In total, is it ...

1
Almost daily
2
About once a week
3
About once a month
4
Once every few months
5
Never or almost never
If Almost daily, About once a week or About once a month to Question H10 Answer H11
qc_H10 == 1 || qc_H10 == 2 || qc_H10 == 3

How many friends or acquaintances do you see once a month or more?

1
None
2
One or two
3
Three to five
4
Six to ten
5
More than ten
EVERYONE PLEASE ANSWER

Are you an active member of: social or recreational groups, trade unions, commercial groups, professional organisations, political parties, sports clubs, cultural groups, pressure groups etc.?

1
Yes
2
No
If Yes to Question H12 Answer H13
qc_H12 == 1

Taking all the above organisations together, how many hours in an average month do you devote to activities of these organisations? Please write in number of hours

How many
Thank you for your help with answering these questions. Please keep this booklet and give it to the nurse when she visits.
End

ncds_02_sc_1

National Child Development Study: 2002-3
Self-completion Booklet
In Confidence
We would like to ask you some questions before the nurse comes to see you.
Your answers to these questions will give us a better idea about your health and how it is influenced by your lifestyle and current circumstances.
Please do complete this booklet before the nurse comes to see you and give it to her when she visits.

A. SUN EXPOSURE

EVERYONE PLEASE ANSWER

How long per day do/did you usually spend outdoors during the daylight hours ...

-

1 - No time

2 - Less than 15 mins

3 - 15 to 30 mins

4 - 30 mins to 1 hour

5 - 1 to 2 hours

6 - 3 to 4 hours

7 - More than 4 hours

... last month?
... in Summer?
... in Winter?

In sunny weather, both in the UK and in other countries do you ...

-

1 - Often

2 - Sometimes

3 - Rarely

4 - Never

... protect your skin from the sun, for example with clothing or suncream?
... get blistering after being burned in the sun?
... actively seek a suntan?
What is the natural colour of your hair (or the original colour if now grey)?
1
Light blonde
2
Red
3
Dark blonde/light brown
4
Dark brown/black
Would you say your natural skin colour (on your inner arm) is ...
1
... light (white, fair or ruddy)
2
... medium (olive, light/medium brown)
3
... dark (dark brown, black)

B. PHYSICAL ACTIVITY

First we would like to ask you about activites connected with your main (or only) job.
In the past year have you been in paid employment or have you done regular, organised voluntary work?
1
Yes
2
No
For the job you have spent most time doing in the year ...
Roughly how many miles is it from home to work? Write in ... miles
How many
How many times a week do you travel between home and work? (To work and from work counts as two journeys.) Write in ... times a week
How many
How do you usually travel to work? By motorised transport (car, motorbike, train etc.)
1
Always
2
Usually
3
Occasionally
4
Never/rarely
How do you usually travel to work? By bicycle
1
Always
2
Usually
3
Occasionally
4
Never/rarely
How do you usually travel to work? Walking
1
Always
2
Usually
3
Occasionally
4
Never/rarely
Now we would like to know about your activity at work.
Please answer questions B5 and B6 for your current, main job.

Have you done each activity at work in the last year?

cs_qB5_Y If you do any other activities at work which we have not included, please list them in the space below: cs_qB5_X cs_noyes Hours in week cs_noyes Hours in week

1 - No

2 - Yes

1 - No

2 - Yes

Sitting - light work e.g. desk work, or driving a car or truck 1 -
Sitting - light work e.g. desk work, or driving a car or truck 1 If yes, how many hours per week?
Sitting - light work e.g. desk work, or driving a car or truck 2 -
Sitting - light work e.g. desk work, or driving a car or truck 2 If yes, how many hours per week?
Sitting - moderate work e.g. working heavy levers or riding a mower or forklift truck 1 -
Sitting - moderate work e.g. working heavy levers or riding a mower or forklift truck 1 If yes, how many hours per week?
Sitting - moderate work e.g. working heavy levers or riding a mower or forklift truck 2 -
Sitting - moderate work e.g. working heavy levers or riding a mower or forklift truck 2 If yes, how many hours per week?
Standing - light work e.g. lab technician work or working at a shop counter 1 -
Standing - light work e.g. lab technician work or working at a shop counter 1 If yes, how many hours per week?
Standing - light work e.g. lab technician work or working at a shop counter 2 -
Standing - light work e.g. lab technician work or working at a shop counter 2 If yes, how many hours per week?
Standing - light/moderate work e.g. light welding or stocking shelves 1 -
Standing - light/moderate work e.g. light welding or stocking shelves 1 If yes, how many hours per week?
Standing - light/moderate work e.g. light welding or stocking shelves 2 -
Standing - light/moderate work e.g. light welding or stocking shelves 2 If yes, how many hours per week?
Standing - moderate work e.g. fast rate assembly line work or lifting up to 50 lbs every 5 minutes for a few seconds at a time 1 -
Standing - moderate work e.g. fast rate assembly line work or lifting up to 50 lbs every 5 minutes for a few seconds at a time 1 If yes, how many hours per week?
Standing - moderate work e.g. fast rate assembly line work or lifting up to 50 lbs every 5 minutes for a few seconds at a time 2 -
Standing - moderate work e.g. fast rate assembly line work or lifting up to 50 lbs every 5 minutes for a few seconds at a time 2 If yes, how many hours per week?
Standing - moderate/heavy work e.g. masonry/painting or lifting more than 50 lbs every 5 minutes for a few seconds at a time 1 -
Standing - moderate/heavy work e.g. masonry/painting or lifting more than 50 lbs every 5 minutes for a few seconds at a time 1 If yes, how many hours per week?
Standing - moderate/heavy work e.g. masonry/painting or lifting more than 50 lbs every 5 minutes for a few seconds at a time 2 -
Standing - moderate/heavy work e.g. masonry/painting or lifting more than 50 lbs every 5 minutes for a few seconds at a time 2 If yes, how many hours per week?
Walking at work - carrying nothing heavier than a briefcase e.g. moving about a shop 1 -
Walking at work - carrying nothing heavier than a briefcase e.g. moving about a shop 1 If yes, how many hours per week?
Walking at work - carrying nothing heavier than a briefcase e.g. moving about a shop 2 -
Walking at work - carrying nothing heavier than a briefcase e.g. moving about a shop 2 If yes, how many hours per week?
Walking - carrying something heavy 1 -
Walking - carrying something heavy 1 If yes, how many hours per week?
Walking - carrying something heavy 2 -
Walking - carrying something heavy 2 If yes, how many hours per week?
Moving, pushing heavy objects weighing over 75 lbs 1 -
Moving, pushing heavy objects weighing over 75 lbs 1 If yes, how many hours per week?
Moving, pushing heavy objects weighing over 75 lbs 2 -
Moving, pushing heavy objects weighing over 75 lbs 2 If yes, how many hours per week?
At work, how many times a day do you normally ... .... climb up a flight of stairs (10 steps) Number of times each day
How many
At work, how many times a day do you normally... ... climb up a ladder Number of times each day
How many
EVERYONE PLEASE ANSWER
Now we would like to ask you how you generally get about.
Would you say that ... ... apart from journeys to work, I travel by car most or all of the time
1
Agree
2
Disagree
Would you say that ... ... apart from journeys to work, I travel by public transport most or all of the time
1
Agree
2
Disagree

Apart from journeys to work, how many journeys do you make by bicycle and on foot in an average week? (To and from somewhere counts as two journeys.)

TOTAL NUMBER of journeys each week Number of journeys of less than 0.5 miles Number of journeys of 0.5 to 1.5 miles Number of journeys of 1.5 to 2.5 miles Number of journeys of 2.5 to 3.5 miles Number of journeys of 3.5 to 5.5 miles Number of journeys of more than 5.5 miles
How manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow many
By bicycle
Walking

C. HEARING

These questions are about your ears and your hearing. If you normally use a hearing aid, answer questions C1 to C6 as if you were NOT using it.
Do you have any difficulty with your hearing?
1
Yes
2
No
Do you find it very difficult to follow a conversation if there is background noise (such as TV, radio, children playing)?
1
Yes
2
No
How well do you hear someone talking to you when that person is sitting ... ... on your RIGHT SIDE in a quiet room?
1
With no difficulty
2
With slight difficulty
3
With moderate difficulty
4
With great difficulty
5
Cannot hear them at all
How well do you hear someone talking to you when that person is sitting ... ... on your LEFT SIDE in a quiet room?
1
With no difficulty
2
With slight difficulty
3
With moderate difficulty
4
With great difficulty
5
Cannot hear them at all
Do you have difficulty ... ... following TV programmes at a volume others find acceptable, without any aid to hearing?
1
No
2
Yes, slight difficulty
3
Yes, moderate difficulty
4
Yes, great difficulty
Do you have difficulty ... ... having a conversation with several people in a group?
1
No
2
Yes, slight difficulty
3
Yes, moderate difficulty
4
Yes, great difficulty
Do very loud noises annoy you?
1
Not at all
2
Slightly
3
Moderately
4
Severely
Nowadays, how much does any difficulty in hearing worry, annoy or upset you?
1
Do not have hearing difficulty
2
Not at all annoying
3
Slightly annoying
4
Moderately annoying
5
Severely annoying
Have you ever had an ear operation?
1
No, never
2
Yes, as a child (under 16 years)
3
Yes, as an adult (16 years or older)
Did any of your parents, children, brothers or sisters have great difficulty in hearing before the age of 55 years?
1
Yes
2
No/don't know
Have you ever worked in a place with a lot of dust?
1
No, never
2
Yes, in last 2 years
3
Yes, more than 2 years ago
Have you ever worked in a place that was so noisy that you had to shout to be heard?
1
No, never
2
Yes, for less than 1 year
3
Yes, for 1-5 years
4
Yes, for over 5 years

D. EYESIGHT

These questions are about your eyesight. Please think about your eyesight in the past month. If you use glasses, contact lenses or magnifiers for some activities, please answer according to how you can see when using them.
If you have had an eye infection, eye operation, an eyesight test, a change of glasses or a sudden change in your eyesight in the past month please write details below.
Generic text
Please read each question carefully and tick the answer that best applies to you.

Think about how your eyesight has made you feel in the past month.

-

1 - Not at all

2 - Very rarely

3 - A little of the time

4 - A fair amount of the time

5 - A lot of the time

6 - All the time

... have you felt embarrassed because of your eyesight?
... have you felt frustrated or annoyed because of your eyesight?
... have you felt lonely or isolated because of your eyesight?
... have you felt sad or low because of your eyesight?
... how often have you worried about your eyesight?

In the past month, how often has your eyesight made you concerned or worried about the following ...

-

1 - Not at all

2 - Very rarely

3 - A little of the time

4 - A fair amount of the time

5 - A lot of the time

6 - All the time

... your general safety at home?
... your general safety when out of your home?
... coping with everyday life?
In the past month, how often has your eyesight ... ... stopped you doing the things you want to do?
1
Not at all
2
Very rarely
3
A little of the time
4
A fair amount of the time
5
A lot of the time
6
All the time
In the past month, how often has your eyesight ... ... interfered with your life in general?
1
Not at all
2
Very rarely
3
A little of the time
4
A fair amount of the time
5
A lot of the time
6
All the time

E. PAIN

During the past month, have you had any ache or pain which has lasted for one day or longer? (Please do not include pain occurring only during menstrual periods or during the course of a feverish illness such as 'flu.)
1
Yes
2
No
Thinking about this pain, have you been aware of it for more than 3 months?
1
Yes
2
No
Below you will find four diagrams of the body. Please shade in all the places where you felt or feel the aches and pains.

F. WORK

EVERYONE PLEASE ANSWER
If you have a paid job, please apply these questions to your main job. Otherwise please apply these questions to your main activity (eg housework, caring for family members, voluntary work etc.).
Do you have to work very fast?
1
Often
2
Sometimes
3
Seldom
4
Never/Almost Never
Do you have to work very intensively?
1
Often
2
Sometimes
3
Seldom
4
Never/Almost Never
Do you have enough time to do everything?
1
Often
2
Sometimes
3
Seldom
4
Never/Almost Never
Do you have a possibility of learning new things through your work?
1
Often
2
Sometimes
3
Seldom
4
Never/Almost Never
Does your work demand a high level of skill or expertise?
1
Often
2
Sometimes
3
Seldom
4
Never/Almost Never
Do you have a choice in deciding HOW you do your work?
1
Often
2
Sometimes
3
Seldom
4
Never/Almost Never
Do you have a choice in deciding WHAT you do at work?
1
Often
2
Sometimes
3
Seldom
4
Never/Almost Never
Does your job provide you with a variety of interesting things?
1
Often
2
Sometimes
3
Seldom
4
Never/Almost Never
Job Characteristics:
Are you in paid work either full time or part time?
1
Yes
2
No
How many hours do you work per average week in your main job, including work brought home? ... hours
Hours in week
Do you have any other paid employment in addition to your main job?
1
Yes
2
No
How secure do you feel your present job is?
1
Very secure
2
Secure
3
Not very secure
4
Very insecure
About your position at work, whether you are working at home or in a workplace away from home, how often does the following statement apply? I have a good deal of say in decisions about work.
1
Often
2
Sometimes
3
Seldom
4
Never/Almost Never
About consistency and clarity regarding your job. Do different groups at work demand things from you that you think are hard to combine?
1
Often
2
Sometimes
3
Seldom
4
Never

When you are having difficulties at work:

-

1 - Often

2 - Sometimes

3 - Seldom

4 - Never

How often do you get help and support from your colleagues?
How often are your colleagues willing to listen to your work-related problems?
How often is your immediate superior willing to listen to your problems?

G. HOUSEHOLD CIRCUMSTANCES

EVERYONE PLEASE ANSWER
Do you own or rent your home or is there some other arrangement?
1
Own - outright
2
Own – buying with help of a mortgage/loan
3
Pay part rent and part mortgage (shared/equity ownership)
4
Rent from local authority or housing association
5
Rent from private landlord, relative or other
6
Live here rent-free, including rent-free in relatives’/friends’ property
7
Squatting
8
Other arrangement
How many cars or vans are normally available for private use by you or any members of your household? (Include company vehicles if available for private use, but exclude vehicles solely for carriage of goods.)
1
None
2
One
3
Two
4
3 or more
Do (any of) you own this/these vehicle(s) or is it a company vehicle? (Include vehicles being bought on hire purchase.)
1
Owned by household
2
Company vehicle(s)
3
Both owned and company vehicles
EVERYONE PLEASE ANSWER
How often does it happen that you do not have enough money to afford the kind of food or clothing you/your family should have?
1
Always
2
Often
3
Sometimes
4
Seldom
5
Never
How much difficulty do you have in meeting the payment of bills?
1
Very great difficulty
2
Great difficulty
3
Some difficulty
4
Slight difficulty
5
Very little difficulty

H. SOCIAL LIFE

This section concerns people in your life who you feel close to and from whom you can obtain support (either emotional or practical) including close relatives and good friends.
How many people do you feel very close to? (It does not matter where they live or whether you have seen them recently.) Please write in how many people ... OR TICK:
How many
0
No-one
Thinking about the person you have felt closest to in the last 12 months please answer the following questions: Is this person your ...
1
husband/wife/partner
2
boyfriend/girlfriend
3
parent
4
brother/sister
5
son/daughter
6
other relative
7
neighbour
8
friend from work
9
other friend
10
other (please describe)
Other

How much in the last 12 months ...

-

1 - Not at all

2 - A little

3 - Quite a lot

4 - A great deal

... did this person give you information, suggestions and guidance that you found helpful?
... could you rely on this person (was this person there when you needed him/her?)
... did this person make you feel good about yourself?
... would you have liked more practical help with major things from this person?
... did you share interests, hobbies and fun with this person?
... did this person give you worries, problems and stress?

Still thinking about the person you have felt closest to, how much in the last 12 months ...

-

1 - Not at all

2 - A little

3 - Quite a lot

4 - A great deal

... did you want to confide in (talk frankly, share feelings with) this person?
... did you confide in this person?
... did you trust this person with your most personal worries and problems?
... would you have liked to confide more in this person?
... did talking to this person make things worse?

How much in the last 12 months ...

-

1 - Not at all

2 - A little

3 - Quite a lot

4 - A great deal

... did he/she talk about his/her personal worries with you?
... did you need practical help from this person with major things (e.g. look after you when ill, help with finances, children)?
... did this person give you practical help with major things?
... did this person give you practical help with small things when you needed it? (e.g. chores, shopping, watering plants, etc.)
EVERYONE PLEASE ANSWER
These questions are about relatives who live outside your household.
How often do you have regular contact with relatives outside your household, by visits, telephone, letters or emails? In total, is it ...
1
Almost daily
2
About once a week
3
About once a month
4
Once every few months
5
Never or almost never
0
OR TICK: I have no relatives outside my household
How often do you visit or are you visited by relatives who live outside your household? In total, is it ...
1
Almost daily
2
About once a week
3
About once a month
4
Once every few months
5
Never or almost never
How many relatives do you see once a month or more?
1
None
2
One or two
3
Three to five
4
Six to ten
5
More than ten
EVERYONE PLEASE ANSWER
How often do you have regular contact with friends or acquaintances outside your household, by visits, telephone, letters or emails? In total, is it ...
1
Almost daily
2
About once a week
3
About once a month
4
Once every few months
5
Never or almost never
0
OR TICK: I have no friends or acquaintances outside my household
How often do you visit or are you visited by friends or acquaintances who live outside your household? In total, is it ...
1
Almost daily
2
About once a week
3
About once a month
4
Once every few months
5
Never or almost never
How many friends or acquaintances do you see once a month or more?
1
None
2
One or two
3
Three to five
4
Six to ten
5
More than ten
EVERYONE PLEASE ANSWER
Are you an active member of: social or recreational groups, trade unions, commercial groups, professional organisations, political parties, sports clubs, cultural groups, pressure groups etc.?
1
Yes
2
No
Taking all the above organisations together, how many hours in an average month do you devote to activities of these organisations? Please write in number of hours
How many
Thank you for your help with answering these questions. Please keep this booklet and give it to the nurse when she visits.
Name

NCDS Age 44 Biomedical Paper Self Completion One