Data Dictionary for rosint
Number of Blaise fields: 974
| Seq # | Var | Question | Data Type/Coding |
|---|---|---|---|
| 1 | ivisit | visit | |
| 2 | projid | ROS BASELINE Interview (v4.0 Rev 02/21/2022) Enter project ID number. | String[8] |
| 3 | visit | Enter visit code (check folder color): CODE F/U Year Folder 00 = Baseline (manilla) | String[2] |
| 4 | vervisit | Please verify visit. Visit = ^visitnum Is the folder ^folder? If not, please page up and correct visit code. | 1= Yes |
| 5 | formno | INTRODUCTION Form Number | String[6] |
| 6 | version | version Number. | String[4] |
| 7 | autodate | Automatic Date. | Date type |
| 8 | autotime | Automatic Time. | TimeType |
| 9 | autolog | Automatic Logged Date. | Date type |
| 10 | intid | INTERVIEWER ID | 100 .. 997 |
| 11 | compid | Laptop ID | String[20] |
| 12 | dateint | Date of interview | Date type |
| 13 | sex | 1. Record participant's sex. | 1= Male 2= Female |
| 14 | relord | 2. Record participant's religious order. | 201= Sisters of Charity, Chicago 202= Sisters of Charity, Dubuque 203= Sisters of Mercy, Chicago 204= Sisters of Mercy, Aurora 205= Holy Spirit Missionary Sisters, Techny 206= Sisters of St. Casimir, Chicago 207= Sisters of St. Joseph, LaGrange Park 208= Sisters of the Holy Family of Nazareth, Des Plaines 209= Sisters of St. Benedict, St. Cloud 210= Franciscan Sisters of Chicago 211= Sinsinawa Dominicans (WI and Chicago) 212= Felicians 213= Sisters of Mercy, Erie, PA 214= Benedictine Sisters of Erie 215= Sisters of the Presentation of the BVM 216= Benedictine Sisters of the Sacred Heart 217= Other 218= Other 219= Other 220= Handmaids of Mary, New York 221= Oblate sisters of Providence 222= Holy Family, New Orleans 223= Other 224= Other 225= Other |
| 15 | relvoc | 3. Record participant's religious vocation? | 1= Brother 2= Priest |
| 16 | mpo | 4. Male Participant's religious order? | 101= Servite 102= Benedictines St. John's 103= Benedictines Lisle 104= Divine Word Brothers and Priests 105= Brother of the Christian Schools (IL and Memphis) 106= Passionists 107= Augustinians 108= Dominicans 109= Franciscan Friars 110= Norbetins 111= Capuchins 112= Trappists 113= Maryknoll, CA 114= Maryknoll, NY 115= Other 116= Trappist, KY 117= Jesuits 118= Other 119= Other 120= Diocescan Priests of Biloxi 121= Other 122= Other 123= Other 124= Other 125= Other |
| 17 | dioc | 4a. Diocese | 151= Chicago Archdiocescan Priests 152= Joliet Priests 153= Rockford Priests 154= Milwaukee Priests 155= St. Paul, MN. Priests 156= St. Cloud, MN. Priests 157= Dubuque Priests 158= Gary Priests 159= Other 160= Other 161= Other 162= Other 163= Other 164= Other 165= Other 166= Other 167= Other 168= Other 169= Other 170= Other |
| 18 | autotm | [COMPUTER CLOCK TIME] | String[8] |
| 19 | validated | ||
| 20 | validateerror | ||
| 21 | errorposition | ||
| 22 | validated_hicn_cms | ||
| 23 | validated_rrb_pre1964 | ||
| 24 | validated_rrb_post1964 | ||
| 25 | hicnformats | ||
| 26 | hicn_alpha | ||
| 27 | hicn_numbers | ||
| 28 | strlen | ||
| 29 | hicn_trimmed | ||
| 30 | ssn_br | Do we need to obtain SSN from this participant? [INTERVIEWER: Check the face sheet. Enter YES if participant is able to provide the SSN. Enter NO if SSN is not to be collected.] | 1= Yes 2= No, already collected 3= No, face sheet stated NOT to ask Pt 4= No, Pt does not have it available or is not eligible 5= No, Pt has mild reluctance 6= No, Pt has moderate reluctance 7= No, Pt has strong reluctance |
| 31 | ssn | What is your social security number? [INTERVIEWER: Please enter the SSN in 000-00-0000 format.] | String[11] |
| 32 | ssn_c | [ENTER R. SOCIAL SECURITY NUMBER AGAIN] | String[11] |
| 33 | hicn_br | Do we need to obtain the old Medicare#(HICN) from this participant? [INTERVIEWER: Check the face sheet. Enter YES if participant is able to provide the HICN. Enter NO if HICN is not to be collected.] | 1= Yes 2= No, already collected 3= No, face sheet stated NOT to ask Pt 4= No, Pt does not have it available or is not eligible 5= No, Pt has mild reluctance 6= No, Pt has moderate reluctance 7= No, Pt has strong reluctance |
| 34 | hicn | What is your old medicare number(HICN) ? Please show me your card. [INTERVIEWER: valid HICN formats include 000000000A, 000000000C1, A000000000 or A000000.] | String[11] |
| 35 | hicn_c | [ENTER R. MEDICARE NUMBER(HICN) AGAIN] | String[11] |
| 36 | hicn_type | HICN Type: ^hicnFormats | String[15] |
| 37 | mbi_br | Do we need to obtain the new Medicare#(MBI) from this participant? [INTERVIEWER: Check the face sheet. Enter YES if participant is able to provide the MBI. Enter NO if MBI is not to be collected.] | 1= Yes 2= No, already collected 3= No, face sheet stated NOT to ask Pt 4= No, Pt does not have it available or is not eligible 5= No, Pt has mild reluctance 6= No, Pt has moderate reluctance 7= No, Pt has strong reluctance |
| 38 | mbi | What is your new medicare number(MBI) ? Please show me your card. [INTERVIEWER: Please enter the MBI in 01EG4-TE5-MK73 format.] | String[13] |
| 39 | mbi_c | [ENTER R. MEDICARE NUMBER(MBI) AGAIN] | String[13] |
| 40 | cntry | DEMOGRAPHICS First, we would like to get some general information about your background. 1. In what state or country were you born? | 1= U.S.A. 2= Other 3= Argentina 4= Belize 5= Bolivia 6= Brazil 7= Chile 8= Colombia 9= Costa Rica 10= Cuba 11= Dominican Republic 12= Ecuador 13= El Salvador 14= French Guiana 15= Guatemala 16= Guyana 17= Haiti 18= Honduras 19= Mexico 20= Nicaragua 21= Panama 22= Paraguay 23= Peru 24= Puerto Rico 25= Suriname 26= Uruguay 27= Venezuela |
| 41 | specfy | Specify Country: | String[30] |
| 42 | howlong | How many years have you lived in the United States? | 1 .. 130 |
| 43 | state | In what state were you born? | String[30] |
| 44 | city | 2. In what city or town? | String[30] |
| 45 | county | 3. And in what county (or province) were you born? | String[30] |
| 46 | vows | In What year did you take your final vows? | 1878 .. 2020 |
| 47 | ordn | In What year were you ordained? | 1878 .. 2020 |
| 48 | race | 7. With which group do you most closely identify yourself? | 1= White 2= Black, Negro, African-American 3= Native American, Indian 4= Eskimo 5= Aleut 6= Asian or Pacific Island |
| 49 | q4dem | What is your date of birth? (mo/day/yr) | Date type |
| 50 | spanish | : Are you of Spanish, Hispanic or Latino origin? That is, having origins from a Spanish-speaking or Latin American country? | 1= Yes 2= No |
| 51 | hispor | Are you of Mexican/Chicano/Mexican American, Puerto Rican, Cuban, Dominican, Central American, or South American origin? | 1= Mexican/Chicano/Mexican American 2= Puerto Rican 3= Cuban 4= Dominican 5= Central American(Belizean, Costa Rican, Guatemalan, Honduran, Nicaraguan, Panamanian, Salvadorian) 6= South American(Argentinian, Bolivian, Brazilian, Chilean, Columbian, Ecuadorian, Paraguayan, Peruvian, Uruguayan, Venezuelan) 50= Other |
| 52 | hisporx | Other (specify, please write in English): | String[30] |
| 53 | racepri | What is your race? [Please read options 1-5 to the participant] | 1= White 2= Black or African-American 3= American Indian or Alaska Native 4= Native Hawaiian or Other Pacific Islander 5= Asian 6= Other 7= Unknown |
| 54 | raceprix | Other, specify | String[30] |
| 55 | racesec_br | Did the participant indicate a second race? [You are not to ask this question of the participant. Only click yes to this question if the participant offered this information to you during the previous question.] | 1= Yes 2= No |
| 56 | racesec | Indicate the participant's second race | 1= White 2= Black or African-American 3= American Indian or Alaska Native 4= Native Hawaiian or Other Pacific Islander 5= Asian 6= Other 7= Unknown |
| 57 | racesecx | Other, specify | String[30] |
| 58 | raceter_br | Did the participant indicate a third race? [You are not to ask this question of the participant. Only click yes to this question if the participant offered this information to you during the previous question.] | 1= Yes 2= No |
| 59 | raceter | Indicate the participant's third race | 1= White 2= Black or African-American 3= American Indian or Alaska Native 4= Native Hawaiian or Other Pacific Islander 5= Asian 6= Other 7= Unknown |
| 60 | raceterx | Other, specify | String[30] |
| 61 | q1qua | QUALITY OF LIFE Now I have some general questions about your health. 1. As compared to other people your own age, would you say that your health is excellent, good, fair or poor? | 1= Excellent 2= Good 3= Fair 4= Poor |
| 62 | q2qua | 2. Now, thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good? [ENTER NUMBER OF DAYS] | 0 .. 30 |
| 63 | q3qua | 3. Now, thinking about your mental health, which includes stress, depression, or problems with your emotions. For how many days during the past 30 days was your mental health not good? [ENTER NUMBER OF DAYS] | 0 .. 30 |
| 64 | q4qua | 4. During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usual activities, such as self-care, work, or recreation? [ENTER NUMBER OF DAYS] | 0 .. 30 |
| 65 | heart | MEDICAL HISTORY - CARDIOVASCULAR DISEASE Now, I have some questions about a number of specific medical conditions. 1. Have you EVER been told by a doctor, nurse or therapist that you had a heart attack or coronary, or coronary thrombosis, or coronary occlusion, or myocardial infarction? | 1= Yes 2= Suspect or possible 3= No |
| 66 | multiple | 1a. Did you have only one or more than one? | 1= Only one 2= More than one |
| 67 | inhosp | 1b Were you hospitalized overnight or longer for this (last one)? | 1= Yes 2= No |
| 68 | hospyear | 1c. When was the last time? [ENTER YEAR] | 1878 .. 2020 |
| 69 | hospname | 1d. What was the name of the (last) hospital? [SPECIFY] | String[40] |
| 70 | chf | CONGESTIVE HEART FAILURE Have you ever been told by a doctor, nurse or therapist that you had congestive heart failure? | 1= Yes 2= Suspect or possible 3= No |
| 71 | cancer | CANCER OR MALIGNANCY 1. Have you EVER been told by a doctor, nurse or therapist that you had ... Cancer, malignancy or tumor of any type? | 1= Yes 2= Suspect or possible 3= No |
| 72 | ca1a | 1a. Where was it? [OR: Where was the most recent cancer that you had?] [SPECIFY] | String[20] |
| 73 | ca1b | 1b. Were you hospitalized overnight or longer for this? | 1= Yes 2= No |
| 74 | ca1c | 1c. When was the last time? [ENTER YEAR] | 1878 .. 2020 |
| 75 | ca1d | 1c. What was the name of the (last) hospital? [SPECIFY] | String[40] |
| 76 | diabetes | DIABETES 1. (Have you EVER been told by a doctor, nurse or therapist that you had ...) 2. Diabetes, or sugar in the urine, or high blood sugar? | 1= Yes 2= Suspect or possible 3= No |
| 77 | dbyr | 1a. When were you first told this? | 1878 .. 2020 |
| 78 | db1 | 2. Has a doctor, nurse or therapist, told you to take insulin or injections for your high blood sugar? | 1= Yes 2= No |
| 79 | db1a | 2a Are you currently taking insulin or injections? | 1= Yes 2= No |
| 80 | db3 | 3 Has a doctor, nurse, or therapist EVER told you to take medicine by mouth for your high blood sugar? | 1= Yes 2= No |
| 81 | db3a | 3a Are you currently doing this? | 1= Yes 2= No |
| 82 | highbp | HIGH BLOOD PRESSURE (Have you EVER been told by a doctor, nurse or therapist that you had ...) 1. High blood pressure? | 1= Yes 2= Suspect or possible 3= No |
| 83 | bp10 | 1a When were you first told this? [ENTER YEAR] | 1878 .. 2020 |
| 84 | bp30 | 2 Has a doctor, nurse, or therapist EVER told you to take medicine by mouth for your high blood pressure? | 1= Yes 2= No |
| 85 | bp3a | 2a Are you currently doing this? | 1= Yes 2= No |
| 86 | herpes | HERPES ZOSTER (Have you EVER been told by a doctor, nurse or therapist that you had ...) 1. Shingles or herpes zoster? | 1= Yes 2= Suspect or possible 3= No |
| 87 | thyroid | THYROID DISEASE (Have you EVER been told by a doctor, nurse or therapist that you had ...) 1. Thyroid disease? | 1= Yes 2= Suspect or possible 3= No |
| 88 | th5a | 1a. When were you first told this? [ENTER YEAR] | 1878 .. 2020 |
| 89 | th5b | 1b. Were you hospitalized overnight or longer for thyroid disease? | 1= Yes 2= No |
| 90 | th5c | 1c. When was the last time? [ENTER YEAR] | 1878 .. 2020 |
| 91 | th5d | 1c. What was the name of the (last) hospital? [SPECIFY] | String[40] |
| 92 | brokenhp | BROKEN HIP (Have you EVER been told by a doctor, nurse or therapist that you had ...) 1. A broken or fractured hip? | 1= Yes 2= Suspect or possible 3= No |
| 93 | hip6a | 1a. Were you ever hospitalized overnight or longer for this? | 1= Yes 2= No |
| 94 | hip6b | 1b. When was the last time? [ENTER YEAR] | 1878 .. 2020 |
| 95 | hip6c | 1b. What was the name of the (last) hospital? [SPECIFY] | String[40] |
| 96 | arthritis | Arthritis Have you ever been told by a doctor, nurse or therapist that you had osteoarthritis? | 1= Yes 2= Suspect or possible 3= No |
| 97 | gout | Have you ever been told by a doctor, nurse or therapist that you had gout? | 1= Yes 2= Suspect or possible 3= No |
| 98 | osteoporosis | Have you ever been told by a doctor, nurse or therapist that you had osteoporosis? | 1= Yes 2= Suspect or possible 3= No |
| 99 | joint_disease | Have you ever been told by a doctor, nurse or therapist that you had other joint disease (excluding cancer)? | 1= Yes 2= Suspect or possible 3= No |
| 100 | chespain | CHEST PAIN Now some questions about pains in your chest. 1. Have you EVER had any pain or discomfort in your chest? | 1= Yes 2= No |
| 101 | pressure | 1a. Have you had any pressure or heaviness in your chest? | 1= Yes 2= No |
| 102 | uphill0 | 2. Do you get this pain or discomfort when you walk uphill or hurry? | 1= Yes 2= No 3= Never walks uphill or hurries |
| 103 | level0 | 3. Do you get this pain or discomfort when you walk at an ordinary pace on the level? | 1= Yes 2= No |
| 104 | dowhat0 | 4. What do you do if you get this pain while you are walking? [IF CONTINUED AFTER TAKING NITROGLYCERIN,RECORD AS `Stop or slow down'] | 1= Stop or slow down 2= Take a nitroglycerin 3= Continue at the same pace |
| 105 | stand0 | 5. If you stand still, what happens to the pain? | 1= Relieved 2= Not relieved |
| 106 | howsoon0 | 5a. How soon is the pain relieved? | 1= 10 minutes or less 2= More than 10 minutes |
| 107 | mustern | 6a. Will you show me where it was? Sternum (middle or upper) | 1= Show 2= Not shown |
| 108 | lowstern | 6b. Sternum (lower) | 1= Show 2= Not shown |
| 109 | lantches | 6c. Left anterior chest | 1= Show 2= Not shown |
| 110 | leftarm | 6d. Left arm | 1= Show 2= Not shown |
| 111 | other00 | 7. Did you feel it anywhere else? | 1= Yes 2= No |
| 112 | where | 7a. Where? [SPECIFY] | String[30] |
| 113 | attack30 | 8. Have you EVER had a severe pain across the front of your chest lasting half an hour or more? | 1= Yes 2= No |
| 114 | seedoc | 9. Did you see a doctor because of the pain? | 1= Yes 2= No |
| 115 | docsaid | 9a. What did (s)he say it was? | String[40] |
| 116 | howmany0 | 10. How many of these attacks have you had? | 1 .. 99 |
| 117 | legpain | CLAUDICATION Now some questions about pains in your legs 1. Do you get pain in either leg while walking? | 1= Yes 2= No |
| 118 | standsit | 2. Does this pain ever begin when you are standing still or sitting? | 1= Yes 2= No |
| 119 | calf | 3. In what part of your leg do you feel it? [IF CALVES NOT MENTIONED ASK: `Anywhere else?' IF STILL NOT MENTIONED, CODE 2] | 1= Pain includes calf/calves 2= Pain does not include calf |
| 120 | uphill1 | 4. Do you get this pain when you walk uphill or hurry? | 1= Yes 2= No 3= Never walks uphill or hurries |
| 121 | level1 | 5. Do you get this pain when you walk at an ordinary pace on the level? | 1= Yes 2= No |
| 122 | disapp | 6. Does this pain ever disappear while you are still walking? | 1= Yes 2= No |
| 123 | dowhat1 | 7. What do you do if you get this pain while you are walking? | 1= Stop/slacken the pace 2= Continue at the same pace |
| 124 | stand1 | 8. What happens to the pain if you stand still? | 1= Relieved 2= Not relieved |
| 125 | howsoon1 | 8a. How soon is it relieved? | 1= 10 minutes or less 2= More than 10 minutes |
| 126 | hormadm | HORMONE REPLACEMENT Now I'd like to ask you about hormonal medications you may have used. Hormones are sometimes used by women around the time of their change of life, after surgery on their ovaries, to control heavy or irregular menstrual periods, or for prevention of disease such as bone loss. These medications include pills, injections, vaginal creams or suppositories, or skin patches. [Please enter c for first question.] | String[1] |
| 127 | hormones | 1. Did you ever take any type of estrogen hormonal medication, for example Premarin, Ogen or Estrace, or progesterone hormonal medication, for example, Provera? | 1= Yes 2= Suspect 3= No |
| 128 | pill | Were these estrogen or progesterone hormones in the form of a pill, injection, vaginal cream or suppository, or skin patch? 2. pill or other oral dosage form | 1= Yes 2= Suspect 3= No |
| 129 | shot | 3. injection (shot) | 1= Yes 2= Suspect 3= No |
| 130 | cos | 4. vaginal cream or suppository | 1= Yes 2= Suspect 3= No |
| 131 | patch | 5. skin patch | 1= Yes 2= Suspect 3= No |
| 132 | agefirst | 6. How old were you when you first took this/these medications? | 1 .. 115 |
| 133 | current | 7. Are you currently taking this/these medications? | 1= Yes 2= No |
| 134 | agelast | 7a. How old were you when you last took this/these medications? | 1 .. 115 |
| 135 | mensage | 8. At what age did you begin menstruating? | 1 .. 99 |
| 136 | menoage | 9. At what age did you stop menstruating? | 1 .. 99 |
| 137 | natura | 10. Was your menopause natural or caused by surgery? | 1= Natural 2= Surgery |
| 138 | whatwas | 10a. What was the surgery? | 1= Full Hysterectomy 2= Hysterectomy (partial) 3= Other |
| 139 | othspe00 | 10b. Specify: | String[40] |
| 140 | dizzy | DIZZINESS Now some questions about dizziness or lightheadedness. 1. Have you EVER had an episode of dizziness or lightheadedness? | 1= Yes 2= Suspect 3= No |
| 141 | freq0 | 2. How often, on average, do they occur? Would you say that they occur about once a year or less, several times a year, once a month, several times a month, once a week, or several times a week? | 1= once a year or less 2= several times a year 3= once a month 4= several times a month 5= once a week 6= several times a week |
| 142 | severity | 3. How severe, on average, are these episodes? Would you say they are usually not severe at all, slightly severe, somewhat severe, very severe, or extremely severe? | 1= not severe at all 2= slightly severe 3= somewhat severe 4= very severe 5= extremely severe |
| 143 | spin | 4. During any of these episodes, did you definitely feel as if either you or the room was actually spinning, turning or moving? | 1= Yes 2= Suspect 3= No |
| 144 | numspin | 4a. How many episodes like this have you had? Would you say one, or two to five, six to ten, or more than ten? | 1= One 2= two to five 3= six to ten 4= more than ten |
| 145 | timespin | 4b. How long, on average, does a typical episode last? Would you say less than 5 seconds, between 5 seconds and 5 minutes, between 5 minutes and 1 hour, between 1 hour and 2 days, or more than 2 days? | 1= < 5 seconds 2= 5 seconds - 5 minutes 3= > 5 minutes - 1 hour 4= > 1 hour - 2 days 5= > 2 days |
| 146 | dzdoctor | 4c. Have you ever seen a doctor because of an episode of dizziness? | 1= Yes 2= No |
| 147 | dzhosp | 4d. Were you hospitalized overnight or longer for this (last one)? | 1= Yes 2= No |
| 148 | dzhospyr | 4e. When was the last time? [ENTER YEAR] | 1878 .. 2020 |
| 149 | dzhospnm | 4f. What was the name of the (last) hospital? | String[40] |
| 150 | joints | JOINTS Now a few questions about your joints. 1. For the past year, that is since ^yearago, have you had pain or aching in any of your joints on most days for at least one month? | 1= Yes 2= No |
| 151 | neckpain | 2. ...Pain in your neck or back on most days for at least one month? | 1= Yes 2= No |
| 152 | neckpain2 | 2. ...Pain in your neck on most days for at least one month? | 1= Yes 2= No |
| 153 | backpain | 2a. ...Pain in your back on most days for at least one month? | 1= Yes 2= No |
| 154 | hippain | 3. ...Pain in or around either hip joint including the buttock, groin, and side of the upper thigh on most days for at least one month? | 1= Yes 2= No |
| 155 | kneepain | 4. ...Pain in or around the knees including the back of the knee on most days for at least one month? | 1= Yes 2= No |
| 156 | swelling | 5. ...Swelling at a joint, with pain present in the joint when touched, on most days for at least one month? | 1= Yes 2= No |
| 157 | stiff | 6. ...Stiffness in the joints and muscles when getting out of bed in the morning lasting for at least 15 minutes? | 1= Yes 2= No |
| 158 | feetpain | 7. ...Pain or aching in either of your feet on most days for at least one month? | 1= Yes 2= No |
| 159 | handpain | 8. ...Pain or aching in either of your hands, wrists or fingers on most days for at least one month? | 1= Yes 2= No |
| 160 | q1neur | NEUROPATHY Now I have some questions about numbness and tingling. Have you EVER had numbness or tingling [or asleep or burning] feeling of your feet or toes? | 1= Yes 2= Suspect 3= No |
| 161 | q2neur | Was this ___ on the right side, left side, or both sides? | 1= Right 2= Left 3= Both |
| 162 | q3neur | Have you EVER had numbness or tingling [or asleep or burning] feeling of your hands or fingers? | 1= Yes 2= Suspect 3= No |
| 163 | q4neur | Was this ___ on the right side, left side, or both sides? | 1= Right 2= Left 3= Both |
| 164 | q5neur | CERVICAL RADICULAPATHY Now I have some questions about neck pain. Have you ever had neck pain that lasted days weeks, or months? | 1= Yes 2= Suspect 3= No |
| 165 | q6neur | At a time while you were having pain in the neck, did you also have pain, numbness or tingling, or weakness in the arms or hands? | 1= Yes 2= Suspect 3= No |
| 166 | q7neur1 | Which of these problems did you have, pain, numbness or tingling, or weakness? [LIST ALL THAT APPLY] | 1= Pain 2= Numbness or tingling 3= Weakness |
| 167 | q7neur2 | Which of these problems did you have, pain, numbness or tingling, or weakness? [LIST ALL THAT APPLY] | See previous question |
| 168 | q7neur3 | Which of these problems did you have, pain, numbness or tingling, or weakness? [LIST ALL THAT APPLY] | See previous question |
| 169 | q8neur | Did this ___ occur on the right side, left side, or both sides? | 1= Right 2= Left 3= Both |
| 170 | q9neur | Now, when you have neck pain, how long, on average, does the neck pain typically last? Would you say less than a week, between one week and one month, between one and two months, between two and six months, or greater than six months? | 1= < a week 2= 1 week - 1 month 3= > 1 month - 2 months 4= > 2 months - 6 months 5= > 6 months |
| 171 | q10neur | How many different times have you had neck pain? | 1 .. 50 |
| 172 | q11neur | How severe, on average, is the neck pain? Would you say it is usually not severe at all, slightly severe, somewhat severe, very severe, or extremely severe? | 1= Not severe at all 2= Slightly severe 3= Somewhat severe 4= Very severe 5= Extremely severe |
| 173 | q12neur | Have you ever seen a doctor because of neck pain? | 1= Yes 2= No |
| 174 | q13neur | Have you ever had an x-ray or scan [CT or MRI] of the neck because of the pain? | 1= Yes 2= No |
| 175 | q14neur | When was the last time? [ENTER YEAR] | 1900 .. 2040 |
| 176 | q15neur | What was the name of the place (doctor's office, hospital or other place) at which the scan was performed? [ENTER NAME] | String[40] |
| 177 | q16neur | [ENTER LOCATION] | String[40] |
| 178 | q17neur | LUMBAR RADICULOPATHY Now I have some questions about low back pain. Have you ever had low back pain that lasted days to months? | 1= Yes 2= Suspect 3= No |
| 179 | q18neur | At a time while you were having low back pain, did you also have pain, numbness or tingling, or weakness in the legs or feet? | 1= Yes 2= Suspect 3= No |
| 180 | q19neur1 | Which of these problems did you have, pain, numbness or tingling, or weakness? [LIST ALL THAT APPLY] | 1= Pain 2= Numbness or tingling 3= Weakness |
| 181 | q19neur2 | Which of these problems did you have, pain, numbness or tingling, or weakness? [LIST ALL THAT APPLY] | See previous question |
| 182 | q19neur3 | Which of these problems did you have, pain, numbness or tingling, or weakness? [LIST ALL THAT APPLY] | See previous question |
| 183 | q20neur | Did this ___ occur on the right side, left side, or both sides? | 1= Right 2= Left 3= Both |
| 184 | q21neur | Now, when you have low back pain, how long, on average, does the low back pain typically last? Would you say less than a week, between one week and one month, between one and two months, between two and six months, or greater than six months? | 1= < a week 2= 1 week - 1 month 3= > 1 month - 2 months 4= > 2 months - 6 months 5= > 6 months |
| 185 | q22neur | How many different times have you had low back pain? | 1 .. 50 |
| 186 | q23neur | How severe, on average, is the low back pain? Would you say it is usually not severe at all, slightly severe, somewhat severe, very severe, or extremely severe? | 1= Not severe at all 2= Slightly severe 3= Somewhat severe 4= Very severe 5= Extremely severe |
| 187 | q24neur | Have you ever seen a doctor because of low back pain? | 1= Yes 2= No |
| 188 | q25neur | Have you ever had an x-ray or scan [CT or MRI] of the low back because of the pain? | 1= Yes 2= No |
| 189 | q26neur | When was the last time? [ENTER YEAR] | 1900 .. 2040 |
| 190 | q27neur | What was the name of the place (doctor's office, hospital or other place) at which the scan was performed? [ENTER NAME] | String[40] |
| 191 | q28neur | [ENTER LOCATION] | String[40] |
| 192 | q1md | The next few questions are about your feelings during the past week. For each of the following statements, please tell me if you felt that way much of the time during the past week. 1. I felt that everything I did was an effort. Have you felt this way much of the time during the past week? | 1= Yes 2= No |
| 193 | q2md | 2. My sleep was restless. (Have you felt this way much of the time during the past week?) | 1= Yes 2= No |
| 194 | q3md | 3. I felt depressed. (Have you felt this way much of the time during the past week?) | 1= Yes 2= No |
| 195 | q4md | 4. I was happy. (Have you felt this way much of the time during the past week?) | 1= Yes 2= No |
| 196 | q5md | 5. I felt lonely. (Have you felt this way much of the time during the past week?) | 1= Yes 2= No |
| 197 | q6md | 6. People were unfriendly. (Have you felt this way much of the time during the past week?) | 1= Yes 2= No |
| 198 | q7md | 7. I enjoyed life. (Have you felt this way much of the time during the past week?) | 1= Yes 2= No |
| 199 | q8md | 8. I felt sad. (Have you felt this way much of the time during the past week?) | 1= Yes 2= No |
| 200 | q9md | 9. I felt that people disliked me. (Have you felt this way much of the time during the past week?) | 1= Yes 2= No |
| 201 | q10md | 10. I could not get 'going'. (Have you felt this way much of the time during the past week?) | 1= Yes 2= No |
| 202 | q1slp | SLEEP Now I would like to get some information about how well you sleep 1. How often you have trouble falling asleep? Would you say it is - Very often, Often, Sometimes, Rarely or Never? | 1= Very Often 2= Often 3= Sometimes 4= Rarely 5= never |
| 203 | q2slp | 2. How often are you troubled by waking up during the night? | 1= Very Often 2= Often 3= Sometimes 4= Rarely 5= never |
| 204 | q4slp | 3. How often do you get so sleepy during the day or evening that you have to take a nap? | 1= Very Often 2= Often 3= Sometimes 4= Rarely 5= never |
| 205 | q5slp | 4. How often do you feel really rested when you wake up in the morning? | 1= Very Often 2= Often 3= Sometimes 4= Rarely 5= never |
| 206 | q6slp | How many hours do you usually sleep at night? | 0 .. 24 |
| 207 | q1dep | DEPRESSION Now I have few more questions about how you feel. 1. In the past month, has there been two weeks or more during which you felt sad, blue, depressed, or when you lost interest and pleasure in things you usually cared about or enjoyed? | 1= Yes 2= No |
| 208 | q1adep | During this period, did you experience any of the following problems? 1a. A change in your appetite | 1= Yes 2= No |
| 209 | q1bdep | 1b. A change in your pattern of sleeping | 1= Yes 2= No |
| 210 | q1cdep | 1c. A decrease in your energy level | 1= Yes 2= No |
| 211 | q1ddep | 1d. Trouble concentrating | 1= Yes 2= No |
| 212 | q1edep | 1e. Felt extremely guilty or worthless | 1= Yes 2= No |
| 213 | q1fdep | 1f. Felt extremely restless or agitated | 1= Yes 2= No |
| 214 | q1gdep | 1g. Lost your interest in favorite activities | 1= Yes 2= No |
| 215 | q1hdep | 1h. Felt that life was not worth living | 1= Yes 2= No |
| 216 | q2dep | 2. Did you tell a doctor or any other professional about it? | 1= Yes 2= No |
| 217 | q3dep | 3. In your lifetime, other than the past month, have you ever had two weeks or more during which you felt sad, blue, depressed, or when you lost interest and pleasure in things you usually cared about or enjoyed? | 1= Yes 2= No |
| 218 | q3aadep | During this period during which you felt depressed, did you experience any of the following problems? 3a. A change in your appetite | 1= Yes 2= No |
| 219 | q3abdep | 3ab. A change in your pattern of sleeping | 1= Yes 2= No |
| 220 | q3acdep | 3ac. A decrease in your energy level | 1= Yes 2= No |
| 221 | q3addep | 3ad. Trouble concentrating | 1= Yes 2= No |
| 222 | q3aedep | 3ae. Felt extremely guilty or worthless | 1= Yes 2= No |
| 223 | q3afdep | 3af. Felt extremely restless or agitated | 1= Yes 2= No |
| 224 | q3agdep | 3ag. Lost your interest in favorite activities | 1= Yes 2= No |
| 225 | q3ahdep | 3ah. Felt that life was not worth living | 1= Yes 2= No |
| 226 | q3bdep | 3b. In your lifetime, how many episodes like that have you had that lasted two weeks or more? [allow for two digits] [ENTER NUMBER] | 1 .. 99 |
| 227 | q3cdep | 3c. Have you ever seen a doctor because this (one of these) episode(s)? | 1= Yes 2= No |
| 228 | q3ddep | 3d. Were you ever hospitalized overnight or longer for this (one of these) episode(s)? | 1= Yes 2= No |
| 229 | q3edep | 3e. When was the last time? [ENTER YEAR] | 1900 .. 2040 |
| 230 | q3fdep | 3f. What was the name and location of the (last) hospital? | String[40] |
| 231 | swall | SWALLOWING Now I have some question about chewing and swallowing 1. How much difficulty, on average, do you have swallowing your food? Would you say you have - no difficulty at all, a little difficulty, some difficulty or a lot of difficulty? | 1= No difficulty at all 2= A little difficulty 3= Some difficulty 4= A lot of difficulty |
| 232 | movi | 2. How much difficulty, on average, do you have moving food out of your mouth into your throat to swallow? Would you say you have - no difficulty at all, a little difficulty, some difficulty or a lot of difficulty? | 1= No difficulty at all 2= A little difficulty 3= Some difficulty 4= A lot of difficulty |
| 233 | cough | 3. How often do you cough or choke when drinking or eating? Would you say never, rarely, sometimes, most of the time or almost always? | 1= Never 2= Rarely 3= Sometimes 4= Most of the time 5= Almost always |
| 234 | bring | 4. How often do you bring up food or liquid after you have swallowed it? | 1= Never 2= Rarely 3= Sometimes 4= Most of the time 5= Almost always |
| 235 | headinj | HEAD INJURY Now I have some questions about injuries. 1. Have you EVER had a head injury? | 1= Yes 2= No |
| 236 | headyear | 2. What year was the last time? | 1878 .. 2020 |
| 237 | lostcons | 3. Have you EVER lost consciousness because of a head injury? | 1= Yes 2= Suspect or possible 3= No |
| 238 | howmany1 | 3a. How many times? | 1 .. 50 |
| 239 | lasttime | 3b. What year was the last time? | 1878 .. 2020 |
| 240 | howlong1 | 3c. How long were you unconscious for this (last) head injury? Would you say less than 5 seconds, between 5 seconds and 5 minutes, between 5 minutes and 1 hour, between 1 hour and 2 days, or more than 2 days? | 1= < 5 seconds 2= 5 seconds - 5 minutes 3= > 5 minutes - 1 hour 4= > 1 hour - 2 days 5= > 2 days |
| 241 | hihosp | 4. Were you EVER hospitalized overnight or longer for a head injury? | 1= Yes 2= No |
| 242 | same1 | 4a. Was this the same event we just spoke about? | 1= Yes 2= No |
| 243 | hihospyr | 4b. When was it? [ENTER YEAR] | 1878 .. 2020 |
| 244 | hihospnm | 4c. What was the name of the (last) hospital? [HOSPITAL NAME] | String[40] |
| 245 | hihosloc | [LOCATION:] | String[40] |
| 246 | memory0 | Were any of the following signs/symptoms associated with this (last) event? [INTERVIEWER: `Last' event refers to the most recent hospitalization event.] 1. Memory loss or forgetfulness? | 1= Yes 2= Suspect 3= No |
| 247 | speech0 | 2. Language or speech change? | 1= Yes 2= Suspect 3= No |
| 248 | weaknes0 | 3. Weakness or paralysis of face, arms or legs? | 1= Yes 2= Suspect 3= No |
| 249 | side0 | 3a. Which side(s)? | 1= right only 2= left only 3= both |
| 250 | other01 | 4. Were there any other signs or symptoms associated with this (last) event? | 1= Yes 2= Suspect 3= No |
| 251 | othspe01 | 4a. Specify | String[40] |
| 252 | hiscan | 5. Did you EVER have a CT, MRI or other type of brain scan because of a head injury? | 1= Yes 2= No |
| 253 | same2 | Was this the same event we just spoke about? | 1= Yes 2= No |
| 254 | hiscanyr | 5a. When was this (the last time)? [ENTER YEAR] | 1878 .. 2020 |
| 255 | hiscanam | 5b. What was the name of the place (doctor's office, hospital or other place) at which the scan was performed? [NAME:] | String[40] |
| 256 | memory1 | Were any of the following signs/symptoms associated with this (last) event? [INTERVIEWER: `Last' event refers to the most recent hospitalization event.] 1. Memory loss or forgetfulness? | 1= Yes 2= Suspect 3= No |
| 257 | speech1 | 2. Language or speech change? | 1= Yes 2= Suspect 3= No |
| 258 | weaknes1 | 3. Weakness or paralysis of face, arms or legs? | 1= Yes 2= Suspect 3= No |
| 259 | side1 | 3a. Which side(s)? | 1= right only 2= left only 3= both |
| 260 | other02 | 4. Were there any other signs or symptoms associated with this (last) event? | 1= Yes 2= Suspect 3= No |
| 261 | othspe02 | 4a. Specify | String[40] |
| 262 | troubles | 6. Do you have any left over troubles from your head injury(s)? | 1= Yes 2= Suspect 3= No |
| 263 | specify | 6a Specify? | String[40] |
| 264 | hdrvehicle | ||
| 265 | hdrhitbyobject | ||
| 266 | hdrfalling | ||
| 267 | hdrsports | ||
| 268 | hdrabuse | ||
| 269 | hdrmilitary | ||
| 270 | hdrother | ||
| 271 | prevbisqdone | BRAIN INJURY SCREENING QUESTIONNAIRE Have the BISQ questions been previously completed for this participant? ^prevBisqDoneText | 1= Yes 2= No |
| 272 | bisqveh | BRAIN INJURY SCREENING QUESTIONNAIRE Now I have some questions about head injuries. ^lastInterviewText0en 1. Vehicle accident?(ex: MVA, pedestrian accident, motorcycle/ATV crash) | 1= Yes 2= No |
| 273 | bisqvehnum | ^hdrVehicle How many times did you receive a blow to the head, in a vehicle accident? | 1 .. 30 |
| 274 | bisqvehloc | ^hdrVehicle Did you lose consciousness? | 1= Yes 2= No |
| 275 | bisqvehlocnum | ^hdrVehicle How many times have you lost consciousness? | 1 .. 30 |
| 276 | bisqvehlocdur | ^hdrVehicle What was the longest duration? | 1= Don't know 2= Less than 5 seconds. 3= Less than 1 min. 4= 1-5 mins. 5= 6-10 mins. 6= 11-20 mins. 7= 21-30 mins. 8= 31-45 mins. 9= 46-60 mins. 10= 1 hour-23 hours 11= 1-2 days 12= 2 days-1 week 13= 1 week-1 month 14= More than 1 mo. |
| 277 | bisqvehlocyr1 | ^hdrVehicle In what year did this occur (1)? | 1900 .. 2050 |
| 278 | bisqvehlocyr2 | ^hdrVehicle In what year did this occur (2)? | 1900 .. 2050 |
| 279 | bisqvehlocyr3 | ^hdrVehicle In what year did this occur (3)? | 1900 .. 2050 |
| 280 | bisqvehlocyr4 | ^hdrVehicle In what year did this occur (4)? | 1900 .. 2050 |
| 281 | bisqvehlocyr5 | ^hdrVehicle In what year did this occur (5)? | 1900 .. 2050 |
| 282 | bisqvehdaze | ^hdrVehicle Were you dazed or confused? | 1= Yes 2= No |
| 283 | bisqvehdazenum | ^hdrVehicle How many times have you been dazed or confused? | 1 .. 30 |
| 284 | bisqvehdazedur | ^hdrVehicle What was the longest duration? | 1= Don't know 2= Less than 5 seconds. 3= Less than 1 min. 4= 1-5 mins. 5= 6-10 mins. 6= 11-20 mins. 7= 21-30 mins. 8= 31-45 mins. 9= 46-60 mins. 10= 1 hour-23 hours 11= 1-2 days 12= 2 days-1 week 13= 1 week-1 month 14= More than 1 mo. |
| 285 | bisqvehdazeyr1 | ^hdrVehicle In what year did this occur (1)? | 1900 .. 2050 |
| 286 | bisqvehdazeyr2 | ^hdrVehicle In what year did this occur (2)? | 1900 .. 2050 |
| 287 | bisqvehdazeyr3 | ^hdrVehicle In what year did this occur (3)? | 1900 .. 2050 |
| 288 | bisqvehdazeyr4 | ^hdrVehicle In what year did this occur (4)? | 1900 .. 2050 |
| 289 | bisqvehdazeyr5 | ^^hdrVehicle In what year did this occur (5)? | 1900 .. 2050 |
| 290 | bisqhit | ^lastInterviewText1en 2. Hit by an object?(ex: equipment, falling object) | 1= Yes 2= No |
| 291 | bisqhitnum | ^hdrHitByObject How many times did you receive a blow to the head, from a falling object? | 1 .. 30 |
| 292 | bisqhitloc | ^hdrHitByObject Did you lose consciousness? | 1= Yes 2= No |
| 293 | bisqhitlocnum | ^hdrHitByObject How many times have you lost consciousness? | 1 .. 30 |
| 294 | bisqhitlocdur | ^hdrHitByObject What was the longest duration? | 1= Don't know 2= Less than 5 seconds. 3= Less than 1 min. 4= 1-5 mins. 5= 6-10 mins. 6= 11-20 mins. 7= 21-30 mins. 8= 31-45 mins. 9= 46-60 mins. 10= 1 hour-23 hours 11= 1-2 days 12= 2 days-1 week 13= 1 week-1 month 14= More than 1 mo. |
| 295 | bisqhitlocyr1 | ^hdrHitByObject In what year did this occur (1)? | 1900 .. 2050 |
| 296 | bisqhitlocyr2 | ^hdrHitByObject In what year did this occur (2)? | 1900 .. 2050 |
| 297 | bisqhitlocyr3 | ^hdrHitByObject In what year did this occur (3)? | 1900 .. 2050 |
| 298 | bisqhitlocyr4 | ^hdrHitByObject In what year did this occur (4)? | 1900 .. 2050 |
| 299 | bisqhitlocyr5 | ^hdrHitByObject In what year did this occur (5)? | 1900 .. 2050 |
| 300 | bisqhitdaze | ^hdrHitByObject Were you dazed or confused? | 1= Yes 2= No |
| 301 | bisqhitdazenum | ^hdrHitByObject How many times have you been dazed or confused? | 1 .. 30 |
| 302 | bisqhitdazedur | ^hdrHitByObject What was the longest duration? | 1= Don't know 2= Less than 5 seconds. 3= Less than 1 min. 4= 1-5 mins. 5= 6-10 mins. 6= 11-20 mins. 7= 21-30 mins. 8= 31-45 mins. 9= 46-60 mins. 10= 1 hour-23 hours 11= 1-2 days 12= 2 days-1 week 13= 1 week-1 month 14= More than 1 mo. |
| 303 | bisqhitdazeyr1 | ^hdrHitByObject In what year did this occur (1)? | 1900 .. 2050 |
| 304 | bisqhitdazeyr2 | ^hdrHitByObject In what year did this occur (2)? | 1900 .. 2050 |
| 305 | bisqhitdazeyr3 | ^hdrHitByObject In what year did this occur (3)? | 1900 .. 2050 |
| 306 | bisqhitdazeyr4 | ^hdrHitByObject In what year did this occur (4)? | 1900 .. 2050 |
| 307 | bisqhitdazeyr5 | ^hdrHitByObject In what year did this occur (5)? | 1900 .. 2050 |
| 308 | bisqfall | ^lastInterviewText2en 3. Falling? (ex: down stairs, during a fainting spell, from a high place) | 1= Yes 2= No |
| 309 | bisqfallnum | ^hdrFalling How many times did you receive a blow to the head, in a fall? | 1 .. 30 |
| 310 | bisqfallloc | ^hdrFalling Did you lose consciousness? | 1= Yes 2= No |
| 311 | bisqfalllocnum | ^hdrFalling How many times have you lost consciousness? | 1 .. 30 |
| 312 | bisqfalllocdur | ^hdrFalling What was the longest duration? | 1= Don't know 2= Less than 5 seconds. 3= Less than 1 min. 4= 1-5 mins. 5= 6-10 mins. 6= 11-20 mins. 7= 21-30 mins. 8= 31-45 mins. 9= 46-60 mins. 10= 1 hour-23 hours 11= 1-2 days 12= 2 days-1 week 13= 1 week-1 month 14= More than 1 mo. |
| 313 | bisqfalllocyr1 | ^hdrFalling In what year did this occur (1)? | 1900 .. 2050 |
| 314 | bisqfalllocyr2 | ^hdrFalling In what year did this occur (2)? | 1900 .. 2050 |
| 315 | bisqfalllocyr3 | ^hdrFalling In what year did this occur (3)? | 1900 .. 2050 |
| 316 | bisqfalllocyr4 | ^hdrFalling In what year did this occur (4)? | 1900 .. 2050 |
| 317 | bisqfalllocyr5 | ^hdrFalling In what year did this occur (5)? | 1900 .. 2050 |
| 318 | bisqfalldaze | ^hdrFalling Were you dazed or confused? | 1= Yes 2= No |
| 319 | bisqfalldazenum | ^hdrFalling How many times have you been dazed or confused? | 1 .. 30 |
| 320 | bisqfalldazedur | ^hdrFalling What was the longest duration? | 1= Don't know 2= Less than 5 seconds. 3= Less than 1 min. 4= 1-5 mins. 5= 6-10 mins. 6= 11-20 mins. 7= 21-30 mins. 8= 31-45 mins. 9= 46-60 mins. 10= 1 hour-23 hours 11= 1-2 days 12= 2 days-1 week 13= 1 week-1 month 14= More than 1 mo. |
| 321 | bisqfalldazeyr1 | ^hdrFalling In what year did this occur (1)? | 1900 .. 2050 |
| 322 | bisqfalldazeyr2 | ^hdrFalling In what year did this occur (2)? | 1900 .. 2050 |
| 323 | bisqfalldazeyr3 | ^hdrFalling In what year did this occur (3)? | 1900 .. 2050 |
| 324 | bisqfalldazeyr4 | ^hdrFalling In what year did this occur (4)? | 1900 .. 2050 |
| 325 | bisqfalldazeyr5 | ^hdrFalling In what year did this occur (5)? | 1900 .. 2050 |
| 326 | bisqsprt | ^lastInterviewText3en 4. Sports/Leisure?(ex: sports, biking, skiing, on the playground) | 1= Yes 2= No |
| 327 | bisqsprtnum | ^hdrSports How many times did you receive a blow to the head, during a sports or leisure activity? | 1 .. 30 |
| 328 | bisqsprtloc | ^hdrSports Did you lose consciousness? | 1= Yes 2= No |
| 329 | bisqsprtlocnum | ^hdrSports How many times have you lost consciousness? | 1 .. 30 |
| 330 | bisqsprtlocdur | ^hdrSports What was the longest duration? | 1= Don't know 2= Less than 5 seconds. 3= Less than 1 min. 4= 1-5 mins. 5= 6-10 mins. 6= 11-20 mins. 7= 21-30 mins. 8= 31-45 mins. 9= 46-60 mins. 10= 1 hour-23 hours 11= 1-2 days 12= 2 days-1 week 13= 1 week-1 month 14= More than 1 mo. |
| 331 | bisqsprtlocyr1 | ^hdrSports In what year did this occur (1)? | 1900 .. 2050 |
| 332 | bisqsprtlocyr2 | ^hdrSports In what year did this occur (2)? | 1900 .. 2050 |
| 333 | bisqsprtlocyr3 | ^hdrSports In what year did this occur (3)? | 1900 .. 2050 |
| 334 | bisqsprtlocyr4 | ^hdrSports In what year did this occur (4)? | 1900 .. 2050 |
| 335 | bisqsprtlocyr5 | ^hdrSports In what year did this occur (5)? | 1900 .. 2050 |
| 336 | bisqsprtdaze | ^hdrSports Were you dazed or confused? | 1= Yes 2= No |
| 337 | bisqsprtdazenum | ^hdrSports How many times have you been dazed or confused? | 1 .. 30 |
| 338 | bisqsprtdazedur | ^hdrSports What was the longest duration? | 1= Don't know 2= Less than 5 seconds. 3= Less than 1 min. 4= 1-5 mins. 5= 6-10 mins. 6= 11-20 mins. 7= 21-30 mins. 8= 31-45 mins. 9= 46-60 mins. 10= 1 hour-23 hours 11= 1-2 days 12= 2 days-1 week 13= 1 week-1 month 14= More than 1 mo. |
| 339 | bisqsprtdazeyr1 | ^hdrSports In what year did this occur (1)? | 1900 .. 2050 |
| 340 | bisqsprtdazeyr2 | ^hdrSports In what year did this occur (2)? | 1900 .. 2050 |
| 341 | bisqsprtdazeyr3 | ^hdrSports In what year did this occur (3)? | 1900 .. 2050 |
| 342 | bisqsprtdazeyr4 | ^hdrSports In what year did this occur (4)? | 1900 .. 2050 |
| 343 | bisqsprtdazeyr5 | ^hdrSports In what year did this occur (5)? | 1900 .. 2050 |
| 344 | bisqphys | ^lastInterviewText4en 5. Physical Abuse/Assault?(ex: mugged) | 1= Yes 2= No |
| 345 | bisqphysnum | ^hdrAbuse How many times did you receive a blow to the head, from abuse or assault? | 1 .. 30 |
| 346 | bisqphysloc | ^hdrAbuse Did you lose consciousness? | 1= Yes 2= No |
| 347 | bisqphyslocnum | ^hdrAbuse How many times have you lost consciousness? | 1 .. 30 |
| 348 | bisqphyslocdur | ^hdrAbuse What was the longest duration? | 1= Don't know 2= Less than 5 seconds. 3= Less than 1 min. 4= 1-5 mins. 5= 6-10 mins. 6= 11-20 mins. 7= 21-30 mins. 8= 31-45 mins. 9= 46-60 mins. 10= 1 hour-23 hours 11= 1-2 days 12= 2 days-1 week 13= 1 week-1 month 14= More than 1 mo. |
| 349 | bisqphyslocyr1 | ^hdrAbuse In what year did this occur (1)? | 1900 .. 2050 |
| 350 | bisqphyslocyr2 | ^hdrAbuse In what year did this occur (2)? | 1900 .. 2050 |
| 351 | bisqphyslocyr3 | ^hdrAbuse In what year did this occur (3)? | 1900 .. 2050 |
| 352 | bisqphyslocyr4 | ^hdrAbuse In what year did this occur (4)? | 1900 .. 2050 |
| 353 | bisqphyslocyr5 | ^hdrAbuse In what year did this occur (5)? | 1900 .. 2050 |
| 354 | bisqphysdaze | ^hdrAbuse Were you dazed or confused? | 1= Yes 2= No |
| 355 | bisqphysdazenum | ^hdrAbuse How many times have you been dazed or confused? | 1 .. 30 |
| 356 | bisqphysdazedur | ^hdrAbuse What was the longest duration? | 1= Don't know 2= Less than 5 seconds. 3= Less than 1 min. 4= 1-5 mins. 5= 6-10 mins. 6= 11-20 mins. 7= 21-30 mins. 8= 31-45 mins. 9= 46-60 mins. 10= 1 hour-23 hours 11= 1-2 days 12= 2 days-1 week 13= 1 week-1 month 14= More than 1 mo. |
| 357 | bisqphysdazeyr1 | ^hdrAbuse In what year did this occur (1)? | 1900 .. 2050 |
| 358 | bisqphysdazeyr2 | ^hdrAbuse In what year did this occur (2)? | 1900 .. 2050 |
| 359 | bisqphysdazeyr3 | ^hdrAbuse In what year did this occur (3)? | 1900 .. 2050 |
| 360 | bisqphysdazeyr4 | ^hdrAbuse In what year did this occur (4)? | 1900 .. 2050 |
| 361 | bisqphysdazeyr5 | ^hdrAbuse In what year did this occur (5)? | 1900 .. 2050 |
| 362 | bisqmil | ^lastInterviewText5en 6. Military Service?(ex: training, blast injury) | 1= Yes 2= No |
| 363 | bisqmilnum | ^hdrMilitary How many times did you receive a blow to the head, during military service? | 1 .. 30 |
| 364 | bisqmilloc | ^hdrMilitary Did you lose consciousness? | 1= Yes 2= No |
| 365 | bisqmillocnum | ^hdrMilitary How many times have you lost consciousness? | 1 .. 30 |
| 366 | bisqmillocdur | ^hdrMilitary What was the longest duration? | 1= Don't know 2= Less than 5 seconds. 3= Less than 1 min. 4= 1-5 mins. 5= 6-10 mins. 6= 11-20 mins. 7= 21-30 mins. 8= 31-45 mins. 9= 46-60 mins. 10= 1 hour-23 hours 11= 1-2 days 12= 2 days-1 week 13= 1 week-1 month 14= More than 1 mo. |
| 367 | bisqmillocyr1 | ^hdrMilitary In what year did this occur (1)? | 1900 .. 2050 |
| 368 | bisqmillocyr2 | ^hdrMilitary In what year did this occur (2)? | 1900 .. 2050 |
| 369 | bisqmillocyr3 | ^hdrMilitary In what year did this occur (3)? | 1900 .. 2050 |
| 370 | bisqmillocyr4 | ^hdrMilitary In what year did this occur (4)? | 1900 .. 2050 |
| 371 | bisqmillocyr5 | ^hdrMilitary In what year did this occur (5)? | 1900 .. 2050 |
| 372 | bisqmildaze | ^hdrMilitary Were you dazed or confused? | 1= Yes 2= No |
| 373 | bisqmildazenum | ^hdrMilitary How many times have you been dazed or confused? | 1 .. 30 |
| 374 | bisqmildazedur | ^hdrMilitary What was the longest duration? | 1= Don't know 2= Less than 5 seconds. 3= Less than 1 min. 4= 1-5 mins. 5= 6-10 mins. 6= 11-20 mins. 7= 21-30 mins. 8= 31-45 mins. 9= 46-60 mins. 10= 1 hour-23 hours 11= 1-2 days 12= 2 days-1 week 13= 1 week-1 month 14= More than 1 mo. |
| 375 | bisqmildazeyr1 | ^hdrMilitary In what year did this occur (1)? | 1900 .. 2050 |
| 376 | bisqmildazeyr2 | ^hdrMilitary In what year did this occur (2)? | 1900 .. 2050 |
| 377 | bisqmildazeyr3 | ^hdrMilitary In what year did this occur (3)? | 1900 .. 2050 |
| 378 | bisqmildazeyr4 | ^hdrMilitary In what year did this occur (4)? | 1900 .. 2050 |
| 379 | bisqmildazeyr5 | ^hdrMilitary In what year did this occur (5)? | 1900 .. 2050 |
| 380 | bisqoth | ^lastInterviewText6en 7. In any other circumstances? | 1= Yes 2= No |
| 381 | bisqothsp | ^hdrOther Please specify: | String[255] |
| 382 | bisqothnum | ^hdrOther How many times did you receive a blow to the head, in a situation I have not mentioned? | 1 .. 30 |
| 383 | bisqothloc | ^hdrOther Did you lose consciousness? | 1= Yes 2= No |
| 384 | bisqothlocnum | ^hdrOther How many times have you lost consciousness? | 1 .. 30 |
| 385 | bisqothlocdur | ^hdrOther What was the longest duration? | 1= Don't know 2= Less than 5 seconds. 3= Less than 1 min. 4= 1-5 mins. 5= 6-10 mins. 6= 11-20 mins. 7= 21-30 mins. 8= 31-45 mins. 9= 46-60 mins. 10= 1 hour-23 hours 11= 1-2 days 12= 2 days-1 week 13= 1 week-1 month 14= More than 1 mo. |
| 386 | bisqothlocyr1 | ^hdrOther In what year did this occur (1)? | 1900 .. 2050 |
| 387 | bisqothlocyr2 | ^hdrOther In what year did this occur (2)? | 1900 .. 2050 |
| 388 | bisqothlocyr3 | ^hdrOther In what year did this occur (3)? | 1900 .. 2050 |
| 389 | bisqothlocyr4 | ^hdrOther In what year did this occur (4)? | 1900 .. 2050 |
| 390 | bisqothlocyr5 | ^hdrOther In what year did this occur (5)? | 1900 .. 2050 |
| 391 | bisqothdaze | ^hdrOther Were you dazed or confused? | 1= Yes 2= No |
| 392 | bisqothdazenum | ^hdrOther How many times have you been dazed or confused? | 1 .. 30 |
| 393 | bisqothdazedur | ^hdrOther What was the longest duration? | 1= Don't know 2= Less than 5 seconds. 3= Less than 1 min. 4= 1-5 mins. 5= 6-10 mins. 6= 11-20 mins. 7= 21-30 mins. 8= 31-45 mins. 9= 46-60 mins. 10= 1 hour-23 hours 11= 1-2 days 12= 2 days-1 week 13= 1 week-1 month 14= More than 1 mo. |
| 394 | bisqothdazeyr1 | ^hdrOther In what year did this occur (1)? | 1900 .. 2050 |
| 395 | bisqothdazeyr2 | ^hdrOther In what year did this occur (2)? | 1900 .. 2050 |
| 396 | bisqothdazeyr3 | ^hdrOther In what year did this occur (3)? | 1900 .. 2050 |
| 397 | bisqothdazeyr4 | ^hdrOther In what year did this occur (4)? | 1900 .. 2050 |
| 398 | bisqothdazeyr5 | ^hdrOther In what year did this occur (5)? | 1900 .. 2050 |
| 399 | q1inj | OTHER INJURIES 1. During the past year, have you had any other accidents or injuries? | 1= Yes 2= No |
| 400 | q1ainj | 1a. Did you have one injury or more than one injury? | 1= One 2= More than one |
| 401 | q2inj | [INTERVIEWER: IF MORE THAN ONE INJURY, THE FOLLOWING QUESTIONS REFER TO THE MOST SEVERE INJURY.] 2. Can you tell me where you were when the injury occurred? For example, were you in your bedroom, bathroom, dining room, or on the stairs, sidewalk, street...? | String[40] |
| 402 | q3inj | 3. What event directly led to the injury? For example, did you fall either off of something or while walking, or were you struck by an object...? | String[40] |
| 403 | q4inj | 4. What object or exposure directly inflicted the injury? For example, was it furniture, stairs, a wall, fire, a car...? | String[40] |
| 404 | q5inj | 5. How would you describe the nature of the injury? For example, was it a cut, bruise, sprain, fracture, burn...? | String[40] |
| 405 | q6inj | 6. Which part of the body was directly affected by the injury? For example, was it your eyes, hands, back...? | String[40] |
| 406 | q7inj | 7. Did you have to see a doctor or other medical practitioner? | 1= Yes 2= No |
| 407 | q7ainj | 7a. Were you hospitalized? | 1= Yes 2= No |
| 408 | q7binj | 7b. What was the name of the (last) hospital? | String[40] |
| 409 | q1cc | COGNITIVE COMPLAINTS Now I have some questions about your memory. 1. People find that they sometimes have more trouble remembering things as they get older. About how often do you have trouble remembering things? Would you say it is very often, often, sometimes, rarely or never? | 1= Very often 2= Often 3= Sometimes 4= Rarely 5= Never |
| 410 | q2cc | 2. Compared to 10 years ago, would you say that your memory is much worse, a little worse, the same, a little better or much better? | 1= Much worse 2= A little worse 3= The same 4= A little better 5= Much better |
| 411 | q3cc | 3. How often do you have any other problems with your thinking, such as trouble concentrating or finding words in conversations? Would you say it is very often, often, sometimes, rarely or never? | 1= Very often 2= Often 3= Sometimes 4= Rarely 5= Never |
| 412 | q3acc | 3a. Specify | String[30] |
| 413 | q3bcc | 3b. Compared to 10 years ago, would you say that these problems are much worse, a little worse, the same, a little better or much better? [INTERVIEWER: 'THESE' REFERS TO ALL OF THE PROBLEMS. IF SUBJECT INSISTS ON 'WHICH ONE' INSTRUCT HIM/HER TO REFER TO THE ONE WHICH MOST TROUBLES HIM/HER.] | 1= Much worse 2= A little worse 3= The same 4= A little better 5= Much better |
| 414 | q1edu | EDUCABILITY 1. Did you have difficulty attending regular schools, i.e., did you ever attend special schools or special classes in school? [INTERVIEWER: IGNORE SPECIAL SCHOOLS OR CLASSES RELATED TO HIGH ACADEMIC ACHIEVEMENT, E.G., ADVANCED PLACEMENT.] | 1= No problem in schools 2= Attended special classes 3= Attended special schools |
| 415 | q1aedu | 1a. Did you have difficulty with one particular subject such as reading or mathematics? | 1= Difficulty with reading 2= Difficulty with mathematics 3= Other difficulty |
| 416 | q1bedu | 1b. Specify | String[30] |
| 417 | per1 | PERSONALITY Now I have some more questions about how you would describe yourself. For each of the following statements, tell me the number of the answer that most closely represents your opinion. [SHOW PARTICIPANT CARD] 1. I am not a worrier. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 418 | per2 | 2. I like to have a lot of people around me. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 419 | per3 | 3. I don't like to waste my time daydreaming. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 420 | per4 | 4. I try to be courteous to everyone I meet. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 421 | per5 | 5. I keep my belongings clean and neat. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 422 | per6 | 6. I often feel inferior to others. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 423 | per7 | 7. I laugh easily. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 424 | per8 | 8. Once I find the right way to do something, I stick to it. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 425 | per9 | 9. I often get into arguments with my family and co-workers. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 426 | per10 | 10. I'm pretty good about pacing myself so as to get things done on time. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 427 | per11 | 11. When I'm under a great deal of stress, sometimes I feel like I'm going to pieces. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 428 | per12 | 12. I don't consider myself especially `light-hearted.' | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 429 | per13 | 13. I am intrigued by the patterns I find in art and nature. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 430 | per14 | 14. Some people think I'm selfish and egotistical. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 431 | per15 | 15. I am not a very methodical person. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 432 | per16 | 16. I rarely feel lonely or blue. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 433 | per17 | 17. I really enjoy talking to people. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 434 | per18 | 18. I believe letting students hear controversial speakers can only confuse and mislead them. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 435 | per19 | 19. I would rather cooperate with others than compete with them. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 436 | per20 | 20. I try to perform all the tasks assigned to me conscientiously. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 437 | per21 | 21. I often feel tense and jittery. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 438 | per22 | 22. I like to be where the action is. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 439 | per23 | 23. Poetry has little or no effect on me. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 440 | per24 | 24. I tend to be cynical and skeptical of others' intentions. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 441 | per25 | 25. I have a clear set of goals and work toward them in an orderly fashion. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 442 | per26 | 26. Sometimes I feel completely worthless. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 443 | per27 | 27. I usually prefer to do things alone. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 444 | per28 | 28. I often try new and foreign foods. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 445 | per29 | 29. I believe that most people will take advantage of you if you let them. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 446 | per30 | 30. I waste a lot of time before settling down to work. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 447 | per31 | 31. I rarely feel fearful or anxious. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 448 | per32 | 32. I often feel as if I'm bursting with energy. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 449 | per33 | 33. I seldom notice the moods or feelings that different environments produce. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 450 | per34 | 34. Most people I know like me. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 451 | per35 | 35. I work hard to accomplish my goals. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 452 | per36 | 36. I often get angry at the way people treat me. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 453 | per37 | 37. I am a cheerful, high-spirited person. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 454 | per38 | 38. I believe we should look to our religious authorities for decisions on moral issues. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 455 | per39 | 39. Some people think of me as cold and calculating. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 456 | per40 | 40. When I make a commitment, I can always be counted on to follow through. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 457 | per41 | 41. Too often, when things go wrong, I get discouraged and feel like giving up. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 458 | per42 | 42. I am not a cheerful optimist. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 459 | per43 | 43. Sometimes when I am reading poetry or looking at a work of art, I feel a chill or wave of excitement. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 460 | per44 | 44. I am hard-headed and tough-minded in my attitudes. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 461 | per45 | 45. Sometimes I'm not as dependable or reliable as I should be. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 462 | per46 | 46. I am seldom sad or depressed. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 463 | per47 | 47. My life is fast-paced. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 464 | per48 | 48. I have little interest in speculating on the nature of the universe or the human condition. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 465 | per49 | 49. I generally try to be thoughtful and considerate. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 466 | per50 | 50. I am a productive person who always gets the job done. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 467 | per51 | 51. I often feel helpless and want someone else to solve my problems. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 468 | per52 | 52. I am a very active person. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 469 | per53 | 53. I have a lot of intellectual curiosity. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 470 | per54 | 54. If I don't like people, I let them know it. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 471 | per55 | 55. I never seem to be able to get organized. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 472 | per56 | 56. At times I have been so ashamed I just wanted to hide. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 473 | per57 | 57. I would rather go my own way than be a leader of others. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 474 | per58 | 58. I often enjoy playing with theories or abstract ideas. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 475 | per59 | 59. If necessary, I am willing to manipulate people to get what I want. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 476 | per60 | 60. I strive for excellence in everything I do. | 1= Strongly disagree 2= Disagree 3= Neutral 4= Agree 5= Strongly agree |
| 477 | purpos1 | PURPOSE IN LIFE Now I am going to make some statements. You may agree or disagree with these statements. Using the 1 - 5 scale provided on this card [INTERVIEWER: show card], please indicate your agreement with each statement by giving the appropriate number between 1-5. 1. I feel good when I think of what I've done in the past and what I hope to do in the future. | 1= Strongly disagree 2= Disagree 3= Neither agree nor disagree 4= Agree 5= Strongly Agree |
| 478 | purpos2 | 2. I live life one day at a time and don't really think about the future. | 1= Strongly disagree 2= Disagree 3= Neither agree nor disagree 4= Agree 5= Strongly Agree |
| 479 | purpos3 | 3. I tend to focus on the present, because the future nearly always brings me problems. | 1= Strongly disagree 2= Disagree 3= Neither agree nor disagree 4= Agree 5= Strongly Agree |
| 480 | purpos4 | 4. I have a sense of direction and purpose in life. | 1= Strongly disagree 2= Disagree 3= Neither agree nor disagree 4= Agree 5= Strongly Agree |
| 481 | purpos5 | 5. My daily activities often seem trivial and unimportant to me. | 1= Strongly disagree 2= Disagree 3= Neither agree nor disagree 4= Agree 5= Strongly Agree |
| 482 | purpos6 | 6. I used to set goals for myself, but that now seems like a waste of time. | 1= Strongly disagree 2= Disagree 3= Neither agree nor disagree 4= Agree 5= Strongly Agree |
| 483 | purpos7 | 7. I enjoy making plans for the future and working them to a reality. | 1= Strongly disagree 2= Disagree 3= Neither agree nor disagree 4= Agree 5= Strongly Agree |
| 484 | purpos8 | 8. I am an active person in carrying out the plans I set for myself. | 1= Strongly disagree 2= Disagree 3= Neither agree nor disagree 4= Agree 5= Strongly Agree |
| 485 | purpos9 | 9. Some people wander aimlessly through life, but I am not one of them. | 1= Strongly disagree 2= Disagree 3= Neither agree nor disagree 4= Agree 5= Strongly Agree |
| 486 | purpos10 | 10. I sometimes feel as if I've done all there is to do in life. | 1= Strongly disagree 2= Disagree 3= Neither agree nor disagree 4= Agree 5= Strongly Agree |
| 487 | per61 | I keep my belongings clean and neat. | 1= Strongly disagree 2= Disagree 3= Neither agree nor disagree 4= Agree 5= Strongly Agree |
| 488 | per62 | I'm pretty good about pacing myself so as to get things done on time. | 1= Strongly disagree 2= Disagree 3= Neither agree nor disagree 4= Agree 5= Strongly Agree |
| 489 | per63 | I am not a very methodical person. | 1= Strongly disagree 2= Disagree 3= Neither agree nor disagree 4= Agree 5= Strongly Agree |
| 490 | per64 | I try to perform all the tasks assigned to me conscientiously. | 1= Strongly disagree 2= Disagree 3= Neither agree nor disagree 4= Agree 5= Strongly Agree |
| 491 | per65 | I have a clear set of goals and work toward them in an orderly fashion. | 1= Strongly disagree 2= Disagree 3= Neither agree nor disagree 4= Agree 5= Strongly Agree |
| 492 | per66 | I waste a lot of time before settling down to work. | 1= Strongly disagree 2= Disagree 3= Neither agree nor disagree 4= Agree 5= Strongly Agree |
| 493 | per67 | I work hard to accomplish my goals. | 1= Strongly disagree 2= Disagree 3= Neither agree nor disagree 4= Agree 5= Strongly Agree |
| 494 | per68 | When I make a commitment, I can always be counted on to follow through. | 1= Strongly disagree 2= Disagree 3= Neither agree nor disagree 4= Agree 5= Strongly Agree |
| 495 | per69 | Sometimes I'm not as dependable or reliable as I should be. | 1= Strongly disagree 2= Disagree 3= Neither agree nor disagree 4= Agree 5= Strongly Agree |
| 496 | per70 | I am a productive person who always gets the job done. | 1= Strongly disagree 2= Disagree 3= Neither agree nor disagree 4= Agree 5= Strongly Agree |
| 497 | per71 | I never seem to be able to get organized. | 1= Strongly disagree 2= Disagree 3= Neither agree nor disagree 4= Agree 5= Strongly Agree |
| 498 | per72 | I strive for excellence in everything I do. | 1= Strongly disagree 2= Disagree 3= Neither agree nor disagree 4= Agree 5= Strongly Agree |
| 499 | happy1 | INTERVIEWER SAY: Now I am going to make some statements. Again, you may agree or disagree with these statements but this time we will use a different scale. Using the 1 - 7 scale provided on this card [INTERVIEWER: show card], please indicate your agreement with each statement by giving the appropriate number between 1-7. Please be open and honest in your responding. In most ways my life is close to my ideal. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 500 | happy2 | The conditions of my life are excellent. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 501 | happy3 | I am satisfied with my life. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 502 | happy4 | So far I have gotten the important things I want in life. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 503 | happy5 | If I could live my life over, I would change almost nothing. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 504 | wellbe1 | Maintaining close relationships has been difficult and frustrating for me. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 505 | wellbe2 | People would describe me as a giving person, willing to share my time with others. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 506 | wellbe3 | I have not experienced many warm and trusting relationships with others. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 507 | wellbe4 | I like most parts of my personality. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 508 | wellbe5 | When I look at the story of my life, I am pleased with how things have turned out so far. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 509 | wellbe6 | In many ways I feel disappointed about my achievements in life. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 510 | wellbe7 | I tend to be influenced by people with strong opinions. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 511 | wellbe8 | I have confidence in my own opinions, even if they are different from those of others. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 512 | wellbe9 | I judge myself by what I think is important, not by the values of others. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 513 | wellbe10 | For me, life has been a continuous process of learning, changing, and growing. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 514 | wellbe11 | I think it is important to have new experiences that challenge how I think about myself and the world. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 515 | wellbe12 | I gave up trying to make big improvements or changes in my life a long time ago. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 516 | wellbe13 | The demands of everyday life often get me down. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 517 | wellbe14 | In general, I feel I am in charge of the situation in which I live. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 518 | wellbe15 | I am good at managing the responsibilities of daily life. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 519 | time1 | Many opportunities await me in the future. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 520 | time2 | I expect that I will set new goals in the future. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 521 | time3 | I have the sense that time is running out. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 522 | time4 | I can do anything I want in the future. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 523 | time5 | There are limited possibilities in my future. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 524 | time6 | As I get older, I experience time as more limited. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 525 | time7 | There is time left in my life to make new plans. | 1= Strongly agree 2= Agree 3= Slightly agree 4= Neither agree nor disagree 5= Slightly disagree 6= Disagree 7= Strongly disagree |
| 526 | satis1 | Now using a different scale, with 1 being very satisfied and 4 being not at all satisfied, how satisfied are you overall with your life? | 1= very satisfied 2= fairly satisfied 3= not very satisfied 4= not at all satisfied |
| 527 | satis2 | Using this scale, with 1 being very happy and 4 being not at all happy, overall, how happy are you? | 1= very happy 2= fairly happy 3= not very happy 4= not at all happy |
| 528 | an1 | ANXIETY A number of statements which people have used to describe themselves are given below. Read each statement, answer YES or NO to indicate how you GENERALLY feel. There are no right or wrong answers. Do not spend too much time on any one statement but give the answer which seems to describe how you generally feel. 1. I feel pleasant. | 1= Yes 2= No |
| 529 | an2 | 2. I feel nervous and restless. | 1= Yes 2= No |
| 530 | an3 | 3. I feel satisfied with myself. | 1= Yes 2= No |
| 531 | an4 | 4. I wish I could be as happy as others seem to be. | 1= Yes 2= No |
| 532 | an5 | 5. I feel like a failure. | 1= Yes 2= No |
| 533 | an6 | 6. I feel rested. | 1= Yes 2= No |
| 534 | an7 | 7. I am `calm, cool, and collected.' | 1= Yes 2= No |
| 535 | an8 | 8. I feel that difficulties are piling up so that I cannot overcome them. | 1= Yes 2= No |
| 536 | an9 | 9. I worry too much over something that really doesn't matter. | 1= Yes 2= No |
| 537 | an10 | 10. I am happy. | 1= Yes 2= No |
| 538 | an11 | 11. I have disturbing thoughts. | 1= Yes 2= No |
| 539 | an12 | 12. I lack self-confidence. | 1= Yes 2= No |
| 540 | an13 | 13. I feel secure. | 1= Yes 2= No |
| 541 | an14 | 14. I make decisions easily. | 1= Yes 2= No |
| 542 | an15 | 15. I feel inadequate. | 1= Yes 2= No |
| 543 | an16 | 16. I am content. | 1= Yes 2= No |
| 544 | an17 | 17. Some unimportant thought runs through my mind and bothers me. | 1= Yes 2= No |
| 545 | an18 | 18. I take disappointments so keenly that I can't put them out of my mind. | 1= Yes 2= No |
| 546 | an19 | 19. I am a steady person. | 1= Yes 2= No |
| 547 | an20 | 20. I get in a state of tension or turmoil as I think over my recent concerns and interests. | 1= Yes 2= No |
| 548 | anger1 | ANGER/HOSTILITY GENERALLY, I FEEL THAT .... 1. I am quick tempered. | 1= Yes 2= No |
| 549 | anger2 | 2. I have a fiery temper. | 1= Yes 2= No |
| 550 | anger3 | 3. I am a hotheaded person. | 1= Yes 2= No |
| 551 | anger4 | 4. I get angry when I'm slowed down by others' mistakes. | 1= Yes 2= No |
| 552 | anger5 | 5. I feel annoyed when I am not given recognition for doing good work. | 1= Yes 2= No |
| 553 | anger6 | 6. I fly off the handle. | 1= Yes 2= No |
| 554 | anger7 | 7. When I get mad, I say nasty things. | 1= Yes 2= No |
| 555 | anger8 | 8. It makes me furious when I am criticized in front of others. | 1= Yes 2= No |
| 556 | anger9 | 9. When I get frustrated, I feel like hitting someone. | 1= Yes 2= No |
| 557 | anger10 | 10. I feel infuriated when I do a good job and get a poor evaluation. | 1= Yes 2= No |
| 558 | angex1 | ANGER/EXPRESSION WHEN ANGRY OR FURIOUS.... 1. I control my temper. | 1= Yes 2= No |
| 559 | angex2 | 2. I express my anger. | 1= Yes 2= No |
| 560 | angex3 | 3. I keep things in. | 1= Yes 2= No |
| 561 | angex4 | 4. I am patient with others. | 1= Yes 2= No |
| 562 | angex5 | 5. I pout or sulk. | 1= Yes 2= No |
| 563 | angex6 | 6. I withdraw from people. | 1= Yes 2= No |
| 564 | angex7 | 7. I make sarcastic remarks to others. | 1= Yes 2= No |
| 565 | angex8 | 8. I keep my cool. | 1= Yes 2= No |
| 566 | angex9 | 9. I do things like slam doors. | 1= Yes 2= No |
| 567 | angex10 | 10. I boil inside, but I don't show it. | 1= Yes 2= No |
| 568 | angex11 | 11. I control my behavior. | 1= Yes 2= No |
| 569 | angex12 | 12. I argue with others. | 1= Yes 2= No |
| 570 | angex13 | 13. I tend to harbor grudges that I don't tell people about. | 1= Yes 2= No |
| 571 | angex14 | 14. I strike out at whatever infuriates me. | 1= Yes 2= No |
| 572 | angex15 | 15. I can stop myself from losing my temper. | 1= Yes 2= No |
| 573 | angex16 | 16. I am secretly quite critical of others. | 1= Yes 2= No |
| 574 | angex17 | 17. I am angrier than I am willing to admit. | 1= Yes 2= No |
| 575 | angex18 | 18. I calm down faster than most other people. | 1= Yes 2= No |
| 576 | angex19 | 19. I say nasty things. | 1= Yes 2= No |
| 577 | angex20 | 20. I try to be tolerant and understanding. | 1= Yes 2= No |
| 578 | angex21 | 21. I am irritated a great deal more than people are aware of. | 1= Yes 2= No |
| 579 | angex22 | 22. I lose my temper. | 1= Yes 2= No |
| 580 | angex23 | 23. If someone annoys me, I'm apt to tell him or her how I feel. | 1= Yes 2= No |
| 581 | angex24 | 24. I control my angry feelings. | 1= Yes 2= No |
| 582 | write | HANDEDNESS 1. Which hand do you usually use to write a letter? | 1= Right 2= Left 3= Either |
| 583 | cut | 2. Which hand do you usually use to cut paper or cloth with scissors? | 1= Right 2= Left 3= Either |
| 584 | q1smo | SMOKING We are interested in whether smoking or drinking beverages containing alcohol are linked to certain health problems and also whether they may have some beneficial effects. First, some questions about smoking. 1. Do you smoke cigarettes now? | 1= Yes 2= No |
| 585 | q1asmo | 1a. On the average, how many cigarettes a day do you usually smoke? [ENTER NUMBER OF CIGARETTES: 1 PACK = 20 CIGARETTES] | 1 .. 200 |
| 586 | q1bsmo | 1b. How old were you when you first smoked cigarettes regularly? [ENTER AGE] | 0 .. 115 |
| 587 | q2smo | 2. Did you ever smoke cigarettes regularly? | 1= Yes 2= No |
| 588 | q2asmo | 2a. On the average, how many cigarettes a day did you usually smoke? [ENTER NUMBER OF CIGARETTES: 1 PACK = 20 CIGARETTES] | 1 .. 200 |
| 589 | q2bsmo | 2b. How old were you when you last smoked cigarettes regularly? [ENTER AGE] | 0 .. 115 |
| 590 | q2csmo | 2c. How old were you when you first smoked cigarettes regularly? [ENTER AGE] | 0 .. 115 |
| 591 | q3smo | 3. During that period of your life when you were smoking the most, about how many cigarettes a day did you usually smoke? [ENTER NUMBER OF CIGARETTES: 1 PACK = 20 CIGARETTES] | 1 .. 200 |
| 592 | q4smo | 4. Altogether, about how many years did you smoke this much? [ENTER YEARS: 01 = 1 YEAR OR LESS] | 1 .. 115 |
| 593 | q1alc | ALCOHOL USE We also have some questions on beverages that contain alcohol which may have good or bad effects on health. Included among alcoholic beverages are beer, wine and liquor, such as whiskey, rum, gin, or vodka, or any other type of alcoholic beverages. 1. In your entire life, have you had at least 12 drinks of any kind of alcoholic beverage? | 1= Yes 2= No |
| 594 | q2alc | 2. In the past 12 months, did you have at least 12 drinks of any kind of alcoholic beverage? | 1= Yes 2= No |
| 595 | q2ialc | 2a. In any one year of your entire life, did you have at least 12 drinks of any kind of alcoholic beverage? | 1= Yes 2= No |
| 596 | q3alc | There are different types of alcoholic beverages and we would like to talk about one type at a time. 3. During the past 12 months, on average, how much beer did you drink? Six or more bottles or cans per day, 4 to 5 bottles or cans per day, 2 to 3 bottles or cans per day, 1 bottle or can per day, 5 to 6 bottles or cans per WEEK, 2 to 4 bottles or cans per week, 1 bottle or can per week, 1 to 3 bottles or cans per MONTH, or less than one bottle or can per month? | 1= 6+ bottles or cans per day 2= 4-5 bottles or cans per day 3= 2-3 bottles or cans per day 4= 1 bottle or can per day 5= 5-6 bottles or cans per week 6= 2-4 bottles or cans per week 7= 1 bottle or can per week 8= 1-3 bottles or cans per month 9= Less than one bottle or can per month |
| 597 | q4alc | 4. During the past 12 months, on average, how much wine did you drink? Six or more 4-oz. glasses per day, 4 to 5 4-oz. glasses per day, 2 to 3 4-oz. glasses per day, 1 4-oz. glass per day, 5 to 6 4-oz. glasses per WEEK, 2 to 4 4-oz. glasses per week, 1 4- oz. glass per week, 1 to 3 4-oz. glasses per MONTH, or less than one 4-oz. glass per month? | 1= 6+ glasses per day 2= 4-5 glasses per day 3= 2-3 glasses per day 4= 1 glass per day 5= 5-6 glasses per week 6= 2-4 glasses per week 7= 1 glass per week 8= 1-3 glasses per month 9= Less than one glass per month |
| 598 | q5alc | 5. During the past 12 months, on average, how much liquor did you drink? That is, drinks made with whiskey, vodka, gin, brandy or liqueurs. | 1= 6+ drinks per day 2= 4-5 drinks per day 3= 2-3 drinks per day 4= 1 drink per day 5= 5-6 drinks per week 6= 2-4 drinks per week 7= 1 drink per week 8= 1-3 drinks per month 9= Less than one drink per month |
| 599 | q6alc | 6. In your entire life, when you drank the most, about how often did you drink any type of alcoholic beverage, including beer, wine and liquor? | 1= 6+ drinks per day 2= 4-5 drinks per day 3= 2-3 drinks per day 4= 1 drink per day 5= 5-6 drinks per week 6= 2-4 drinks per week 7= 1 drink per week 8= 1-3 drinks per month 9= Less than one drink per month |
| 600 | q7alc | 7. For how many years did you drink this amount? [CODE: 01 FOR 1 YEAR OR LESS] | 1 .. 115 |
| 601 | q8alc | 8. What type of alcoholic beverage did you prefer to drink? | 1= Beer 2= Wine 3= Liquor 4= No preference |
| 602 | q1phy_intro | PHYSICAL ACTIVITIY We are also interested in any physical activities that you do. I have a list of different types of activities that we ask of everyone, but most people do only one or two. [PRESS ENTER TO CONTINUE.] | |
| 603 | q1phy | In the past 14 days, have you done any of the following exercises, sports, or physically active hobbies: 1. Walking for exercise? | 1= Yes 2= No |
| 604 | q1aphy | 1a. How many times in the past 14 days did you go walking for exercise? [ENTER NUMBER OF TIMES] | 1 .. 87 |
| 605 | q1bphy | 1b. On average, about how many minutes did you actually spend on each occasion? [ENTER NUMBER OF MINUTES] [CODE 1 Hour=60 min; 1.5 Hour=90 min; 2 Hours=120 min; 2.5 Hours=150 min; 3 Hours=180 min; 3.5 Hours=210 min; 4 Hours=240 min] | 1 .. 300 |
| 606 | q3phy | (In the past 14 days have you done) 3. Gardening or yard work? | 1= Yes 2= No |
| 607 | q3aphy | 3a. How many times in the past 14 days did you do gardening or yard work? [ENTER NUMBER OF TIMES] | 1 .. 87 |
| 608 | q3bphy | 3b. On average, about how many minutes did you actually spend on each occasion? [ENTER NUMBER OF MINUTES] [CODE 1 Hour=60 min; 1.5 Hour=90 min; 2 Hours=120 min; 2.5 Hours=150 min; 3 Hours=180 min; 3.5 Hours=210 min; 4 Hours=240 min] | 1 .. 300 |
| 609 | q5phy | (In the past 14 days have you done) 5. Calisthenics or general exercise? | 1= Yes 2= No |
| 610 | q5aphy | 5a. How many times in the past 14 days did you do calisthenics or general exercise? [ENTER NUMBER OF TIMES] | 1 .. 87 |
| 611 | q5bphy | 5b. On average, bout how many minutes did you actually spend on each occasion? [ENTER NUMBER OF MINUTES] [CODE 1 Hour=60 min; 1.5 Hour=90 min; 2 Hours=120 min; 2.5 Hours=150 min; 3 Hours=180 min; 3.5 Hours=210 min; 4 Hours=240 min] | 1 .. 300 |
| 612 | q8phy | (In the past 14 days have you done) 8. Bicycle riding (including stationary bikes)? | 1= Yes 2= No |
| 613 | q8aphy | 8a. How many times in the past 14 days did you go bicycle riding? [ENTER NUMBER OF TIMES] | 1 .. 87 |
| 614 | q8bphy | 8b. On average, about how many minutes did you actually spend on each occasion? [ENTER NUMBER OF MINUTES] [CODE 1 Hour=60 min; 1.5 Hour=90 min; 2 Hours=120 min; 2.5 Hours=150 min; 3 Hours=180 min; 3.5 Hours=210 min; 4 Hours=240 min] | 1 .. 300 |
| 615 | q9phy | (In the past 14 days have you done) 9. Swimming or water exercises? | 1= Yes 2= No |
| 616 | q9aphy | 9a. How many times in the past 14 days did you go swimming or do water exercises? [ENTER NUMBER OF TIMES] | 1 .. 87 |
| 617 | q9bphy | 9b. On average, about how many minutes did you actually spend on each occasion? [ENTER NUMBER OF MINUTES] [CODE 1 Hour=60 min; 1.5 Hour=90 min; 2 Hours=120 min; 2.5 Hours=150 min; 3 Hours=180 min; 3.5 Hours=210 min; 4 Hours=240 min] | 1 .. 300 |
| 618 | q10phy | 10. Have you done any other exercises, sports, or physically active hobbies in the past 2 weeks other than the ones listed above? | 1= Yes 2= No |
| 619 | q101phy | 10.1 [SPECIFY] | String[40] |
| 620 | q10aphy | 10a. How many times in the past 14 days did you do this? [ENTER NUMBER OF TIMES] | 1 .. 87 |
| 621 | q10bphy | 10b. On average, about how many minutes did you actually spend on each occasion? [ENTER NUMBER OF MINUTES] [CODE 1 Hour=60 min; 1.5 Hour=90 min; 2 Hours=120 min; 2.5 Hours=150 min; 3 Hours=180 min; 3.5 Hours=210 min; 4 Hours=240 min] | 1 .. 300 |
| 622 | q1fs | FUNCTIONAL STATUS We would also like to know how well you are able to do some physical activities that are important in day-to-day living but which many people have problems doing. First, I would like to know if you are able to do certain kinds of activities without help from another person. Are you ABLE to do heavy work around the house, like washing windows, walls, or floors without help? | 1= Yes 2= No |
| 623 | q2fs | Are you able to walk up and down stairs to the second floor without help? | 1= Yes 2= No |
| 624 | q3fs | Are you able to walk a half mile without help? | 1= Yes 2= No |
| 625 | q4fs | Now I'm going to ask you how difficult it is, on the average to do similar kinds of activities. For each thing, tell me whether you have: no difficulty at all, a little difficulty, some difficulty, a lot of difficulty, or just unable to do it. To begin, how much difficulty, if any, do you have pulling or pushing large objects like a living room chair? Would you say you have no difficulty at all, a little difficulty, some difficulty, a lot of difficulty or are you just unable to do it? | 1= No difficulty at all 2= A little difficulty 3= Some difficulty 4= A lot of difficulty 5= Just unable to do it |
| 626 | q5fs | What about stooping, crouching, or kneeling? (Do you have no difficulty at all, a little difficulty, some difficulty, a lot of difficulty, or are you just unable to do it?) | 1= No difficulty at all 2= A little difficulty 3= Some difficulty 4= A lot of difficulty 5= Just unable to do it |
| 627 | q6fs | Lifting or carrying weights over 10 pounds, like a very heavy bag of groceries? (Do you have no difficulty at all, a little difficulty, some difficulty, a lot of difficulty, or are you just unable to do it?) | 1= No difficulty at all 2= A little difficulty 3= Some difficulty 4= A lot of difficulty 5= Just unable to do it |
| 628 | q7fs | Reaching or extending arms above shoulder level? Do you have...? | 1= No difficulty at all 2= A little difficulty 3= Some difficulty 4= A lot of difficulty 5= Just unable to do it |
| 629 | q8fs | Either writing or handling or fingering small objects? Do you have...? | 1= No difficulty at all 2= A little difficulty 3= Some difficulty 4= A lot of difficulty 5= Just unable to do it |
| 630 | q9fs | Trimming, cutting or clipping your toenails? Do you have...? | 1= No difficulty at all 2= A little difficulty 3= Some difficulty 4= A lot of difficulty 5= Just unable to do it |
| 631 | q10fs | How much difficulty do you have finding shoes that are comfortable? Do you have...? | 1= No difficulty at all 2= A little difficulty 3= Some difficulty 4= A lot of difficulty 5= Just unable to do it |
| 632 | q11fs | Next, I would like to know if you need help do some different kinds of activities. At the present time, do you need help ... Walking across a small room? | 1= No Help 2= Help 3= Unable to do |
| 633 | q12fs | Bathing, either a sponge bath, tub bath or shower? | 1= No Help 2= Help 3= Unable to do |
| 634 | q14fs | Dressing, like putting on a shirt, buttoning and zipping, or putting on shoes? | 1= No Help 2= Help 3= Unable to do |
| 635 | q15fs | Eating like holding a fork, cutting food, or drinking from a glass? | 1= No Help 2= Help 3= Unable to do |
| 636 | q16fs | Getting from a bed to a chair? | 1= No Help 2= Help 3= Unable to do |
| 637 | q17fs | Using the toilet? | 1= No Help 2= Help 3= Unable to do |
| 638 | q1fun | Now I have a few more questions about activities people may or may not do. Although some things may actually be performed by someone else, just tell me whether you think you are able to do them. 1. Are you able to use the telephone - including looking up numbers and dialing - completely by yourself, or does someone else help you? | 1= No Help 2= Help 3= Unable to do |
| 639 | q2fun | 2. Are you able to shop for the groceries you need - either by going to the grocery store and picking them up or by having them delivered - completely by yourself, or does someone else help you? | 1= No Help 2= Help 3= Unable to do |
| 640 | q3fun | 3. Are you able to prepare your own meals completely by yourself, or does someone else help you? | 1= No Help 2= Help 3= Unable to do |
| 641 | q4fun | 4. Are you able to do the routine light housekeeping completely by yourself, or does someone else help you? | 1= No Help 2= Help 3= Unable to do |
| 642 | q5fun | 5. Are you able to do the periodic heavy housekeeping completely by yourself, or does someone else help you? | 1= No Help 2= Help 3= Unable to do |
| 643 | q6fun | 6. Are you able to do your own laundry completely by yourself, or does someone else help you? | 1= No Help 2= Help 3= Unable to do |
| 644 | q7fun | 7. Are you able to take your own prescribed medicines completely by yourself, or does someone else help you? | 1= No Help 2= Help 3= Unable to do |
| 645 | q8fun | 8. Are you able to take care of your own finances - including paying bills, writing checks, keeping track of income (but not necessarily preparing your own taxes) - completely by yourself, or does someone else help you? | 1= No Help 2= Help 3= Unable to do |
| 646 | q9fun | 9. Are you able to take care of your own social life - including talking to friends and relatives on the telephone, having people come in to visit, going to other people to visit - completely by yourself, or does someone else help you by making all the arrangements? | 1= No Help 2= Help 3= Unable to do |
| 647 | q10fun | 10. Are you able to take care of making your own doctors appointments and going to see your doctor and other health care providers completely by yourself, or does someone else help you by making the appointments or taking you there? | 1= No Help 2= Help 3= Unable to do |
| 648 | q11fun | 11. Are you able to do your own personal shopping, like for clothes, for personal things, or for household needs completely by yourself, or does someone else help you? | 1= No Help 2= Help 3= Unable to do |
| 649 | q12fun | 12. Are you able to travel around in your community to the places you might want to go, like to church or just to be outside completely by yourself, or does someone else help you? | 1= No Help 2= Help 3= Unable to do |
| 650 | introd | Next we would like to ask a few questions about common problems that people have as they grow older. We would appreciate your answers to these questions even though you may not have any problems. >>>>[HIT ENTER FOR NEXT QUESTION]<<<< | String[1] |
| 651 | q1ur | URINARY INCONTINENCE 1. How often during the last 12 months have you leaked urine or lost control of your urine - almost every day, several times a week, several times a month, once a month, less than once a month, or never? | 1= Almost everyday 2= Several times a week 3= Several times a month 4= Once a month 5= Less than once a month 6= Never |
| 652 | q2ur | 2. When you lose urine, how much usually leaks - a few drops, enough to wet your underwear, enough to wet your outer clothes, or enough to wet the floor? [PROBE IF PADS WORN:] Without the protection pads, how much urine would you lose?] | 1= A few drops 2= Enough to wet underwear 3= Enough to wet outer clothes 4= Enough to wet the floor |
| 653 | q3ur | 3. How much of a problem do you consider your urine loss to be - a big problem, a little problem, or no problem at all? | 1= A big problem 2= A little problem 3= No problem |
| 654 | q4ur | 4. In the past few months have you ever lost control of your bowels when you didn't want to? | 1= Yes 2= No |
| 655 | intrd1 | LIFESTYLE ACTIVITIES Now I have a few questions on different day-to-day activities that pertain to people in the general population. Some of them may be activities that you do, while others may be activities that you do not do. Please tell me, on average, how often you do each of the following? >>>>>[HIT ENTER FOR NEXT QUESTION]<<<<< | String[1] |
| 656 | q1act | 1. How often do you watch television? Would you say every day or almost every day, several times a week, several times a month, several times a year or once a year or less? [HAND CARD TO R. AND REPEAT CATEGORIES AS NECESSARY.] | 1= Every day or almost every day 2= Several times a week 3= Several times a month 4= Several times a year 5= Once a year or less |
| 657 | q1aact | 1a. How many hours each day, on average, do you watch television? [CODE: 01=1 HOUR OR LESS] | 1 .. 24 |
| 658 | q1bact | 1b. What sort of television programs do you spend the most time watching? Game shows, soap operas, news, educational programs, movies, dramas, adventures, comedies, sports, religious programs or some other type of program? | 1= Game shows 2= Soap operas 3= News 4= Educational programs 5= Movies 6= Dramas 7= Adventures 8= Comedies 9= Sports 10= Religious programs 11= Other |
| 659 | q1cact | [SPECIFY] | String[20] |
| 660 | q2act | 2. How often do you listen to the radio? Would you say...? | 1= Every day or almost every day 2= Several times a week 3= Several times a month 4= Several times a year 5= Once a year or less |
| 661 | q2aact | 2a. How many hours each day, on average, do you listen to the radio? [CODE: 01=1 HOUR OR LESS] | 1 .. 24 |
| 662 | q2bact | 2b. What sort of radio programs do you spend the most time listening to? Would you say talk shows, rock or rap music, pop or easy listening music, country western, jazz, classical music, news, sports, religious programs or some other type of program? | 1= Talk shows 2= Rock or rap music 3= Pop, easy listening, country western 4= Jazz 5= Classical music 6= News 7= Sports 8= Religious programs 9= Other |
| 663 | q2cact | 2c. [SPECIFY] | String[20] |
| 664 | q3act | 3. How often do you read newspapers? | 1= Every day or almost every day 2= Several times a week 3= Several times a month 4= Several times a year 5= Once a year or less |
| 665 | q3aact | 3a. What part of the newspaper do you spend the MOST time reading? Would you say the advertisements, the news pages, the women's pages, the sports pages, the business pages, the crossword or some other part? | 1= Advertisements 2= News pages 3= Women's pages 4= Sports pages 5= Business pages 6= Crossword 7= Other |
| 666 | q3oaact | 3a1. [SPECIFY] | String[20] |
| 667 | q4act | 4. How often do you read magazines? | 1= Every day or almost every day 2= Several times a week 3= Several times a month 4= Several times a year 5= Once a year or less |
| 668 | q4aact | 4a. Which magazines do you read the most? [RECORD UP TO 3 IN ORDER MENTIONED] | String[60] |
| 669 | q5act | 5. How often do you read books? | 1= Every day or almost every day 2= Several times a week 3= Several times a month 4= Several times a year 5= Once a year or less |
| 670 | q5aact | 5a. What sort of books do you read the most? Would you say novels or other fiction books, biographies or other nonfiction books, self-improvement books, the Bible or other religious books, books about hobbies, technical or business books or some other sort of books? | 1= Novels or other fiction books 2= Biographies or other non-fiction books 3= Self-improvement books 4= The Bible or other religious books 5= Books about hobbies 6= Technical or business books 7= Other |
| 671 | q5oact | 5a1. [SPECIFY] | String[20] |
| 672 | q6act | 6. How often do you play games such as cards, checkers, crosswords or other puzzles or games? | 1= Every day or almost every day 2= Several times a week 3= Several times a month 4= Several times a year 5= Once a year or less |
| 673 | q6aact | 6a. What games do you play the most? [RECORD UP TO 3 GAMES IN ORDER MENTIONED] | String[60] |
| 674 | q7act | 7. How often do you go to religious services? | 1= Every day or almost every day 2= Several times a week 3= Several times a month 4= Several times a year 5= Once a year or less |
| 675 | q8act | 8. How often do you go to museums? | 1= Every day or almost every day 2= Several times a week 3= Several times a month 4= Several times a year 5= Once a year or less |
| 676 | q1ch | CHILDHOOD Some experiences early in life may have something to do with health later in life. So we are asking everyone some questions about their childhood in order to identify those experiences which may be important. 1. Including yourself, how many people lived in your family's home when you were 2 years old? | 1 .. 76 |
| 677 | q2ch | 2. Of these people, how many were children under the age of 16? | 1 .. 76 |
| 678 | q3ch | CHILDHOOD Some experiences early in life may have something to do with health later in life. So we are asking everyone some questions about their childhood in order to identify those experiences which may be important. 3. How often did someone in your home read to you when you were a child? (Would you say every day or almost every day, several times a week, several times a month, several times a year, or once a year or less?) [RECORD THE HIGHEST FREQUENCY PERIOD] | 1= Every day or almost every day 2= Several times a week 3= Several times a month 4= Several times a year 5= Once a year or less |
| 679 | q4ch | 4. How often did someone in your home tell you stories when you were a child? (Would you say every day or almost every day, several times a week, several times a month, several times a year, or once a year or less?) [RECORD THE HIGHEST FREQUENCY PERIOD] | 1= Every day or almost every day 2= Several times a week 3= Several times a month 4= Several times a year 5= Once a year or less |
| 680 | q5ch | 5. How often did someone in your home play games with you when you were a child? By games I mean things like checkers or other board games, cards, puzzles, mind teasers, or any other similar games? (Would you say every day or almost every day, several times a week, several times a month, several times a year, or once a year or less?) [RECORD THE HIGHEST FREQUENCY PERIOD] | 1= Every day or almost every day 2= Several times a week 3= Several times a month 4= Several times a year 5= Once a year or less |
| 681 | q6ch | 6. How would you describe your family's financial situation when you were a very young child? Would you say very poor, somewhat poor, about average, somewhat well off, or very well off? | 1= Very poor 2= Somewhat poor 3= About average 4= Somewhat well off 5= Very well off |
| 682 | q7ch | 7. How often did you go without enough food to eat as a child? Would you say never, very rarely, rarely, sometimes, often, or almost always? | 1= Never 2= Very rarely 3= Rarely 4= Sometimes 5= Often 6= Almost always |
| 683 | q8ch | 8. Compared to other children your own age, how would you rate your overall health as a child? Excellent, good, fair, or poor? | 1= Excellent 2= Good 3= Fair 4= Poor |
| 684 | q9ch | 9. How many different communities did you live in during the first 15 years of your life? [PROBE: By different communities I mean distinctly different neighborhoods.] | 1 .. 76 |
| 685 | q1ani | ANIMAL EXPOSURE 1. In your entire life, altogether, how many years have you lived or worked around animals? | 1= never 2= 1 to 3 months 3= 4 to 6 months 4= 7 to 11 months 5= 1 to 2 years 6= 3 to 10 years 7= 11 years or more |
| 686 | q1a1ani | During the time that you lived or worked around animals, did you have direct contact with Chicken or fowl? | 1= Yes 2= No |
| 687 | q1a2ani | 1a2. (During the time that you lived or worked around animals, did you have direct contact with...) Cattle? | 1= Yes 2= No |
| 688 | q1a3ani | 1a3. (During the time that you lived or worked around animals, did you have direct contact with...) Horses? | 1= Yes 2= No |
| 689 | q1a4ani | 1a4. (During the time that you lived or worked around animals, did you have direct contact with...) Pigs? | 1= Yes 2= No |
| 690 | q1a5ani | 1a5. (During the time that you lived or worked around animals, did you have direct contact with...) Sheep? | 1= Yes 2= No |
| 691 | q1a6ani | 1a6. (During the time that you lived or worked around animals, did you have direct contact with...) Goats? | 1= Yes 2= No |
| 692 | q1a7ani | 1a7. (During the time that you lived or worked around animals, did you have direct contact with...) Dogs? | 1= Yes 2= No |
| 693 | q1a8ani | 1a8. (During the time that you lived or worked around animals, did you have direct contact with...) Cats? | 1= Yes 2= No |
| 694 | myob | PARENTAL HISTORY Now some questions about your natural or biologic parents. 1. In what year was your mother born? [ENTER YEAR] | 1840 .. 1960 |
| 695 | mofname | PARENTAL HISTORY Now some questions about your natural or biologic parents. What is/was your mother's full name? First Name | String[12] |
| 696 | momiddl | Mother Middle Name: [Press enter if none.] | String[18] |
| 697 | molname | Mother Last Name: | String[18] |
| 698 | mage_bir | 1a. How old was your mother when you were born? [ENTER YEARS OF AGE] | 10 .. 50 |
| 699 | mage_br2 | 1b. Do you know if she was less than 15 years old, 15 to 20 years, in her 20's, 30's or in her 40's? | 1= Less than 15 years 2= 15 to 20 years 3= 20's 4= 30's 5= 40's |
| 700 | mlive | 2. Is your mother still living? | 1= Yes 2= No |
| 701 | myod | 2a. In what year did she die? [ENTER YEAR] | 1893 .. 2020 |
| 702 | mage_die | 2b. How old was your mother when she died? [ENTER YEARS OF AGE] | 10 .. 115 |
| 703 | mage_cur | 2c. How old is she now? [ENTER YEARS OF AGE] | 75 .. 115 |
| 704 | children | 3. How many children did your mother have? [PROBE: Please include only those children born alive.] | 1 .. 30 |
| 705 | oldersib | 4. How many of these children were older than you? | 0 .. 30 |
| 706 | mwork | 5. What kind of work did your mother do most of her life? (What was her job called?) [SPECIFY] | String[30] |
| 707 | meduc | 6. What was the highest grade or year of regular school your mother completed? Elementary 0 1 2 3 4 5 6 7 8 High School 9 10 11 12 College 13 14 15 16 Graduate Professional 17 18 19 20 21 ... | 0 .. 30 |
| 708 | meduc2 | 6a. Would you say that she had no schooling, a few years, finished grammar school, had any high school, or any college? | 1= No schooling 2= A few years 3= Finished grammar school 4= Any high school 5= Any college |
| 709 | mpark | 7. ^diddoesm your natural or biologic mother have Parkinson's disease with shaking tremors of the hands and/or slowness in walking and moving? | 1= Yes 2= Suspect or possible 3= No |
| 710 | mdement | 8. ^diddoesm she (your natural or biologic mother) have a problem with memory loss, confusion or dementia? | 1= Yes 2= Suspect or possible 3= No |
| 711 | fafname | What is/was your father's full name? First Name: | String[12] |
| 712 | famiddl | Father Middle Name: [Press enter if none.] | String[18] |
| 713 | falname | Father Last Name: | String[18] |
| 714 | fyob | 9. In what year was your father born? [ENTER YEAR] | 1764 .. 1960 |
| 715 | fage_bir | 9a. How old was your father when you were born? [ENTER YEARS OF AGE] | 10 .. 115 |
| 716 | fage_br2 | 9b. Do you know if he was less than 15 years old, 15 to 20 years, in his 20's, 30's, 40's, or 50 or older? | 1= Less than 15 years 2= 15 to 20 years 3= 20's 4= 30's 5= 40's 6= 50+ |
| 717 | flive | 10. Is your father still living? | 1= Yes 2= No |
| 718 | fyod | 10a. In what year did he die? [ENTER YEAR] | 1778 .. 2020 |
| 719 | fage_die | 10b. How old was your father when he died? [ENTER YEARS OF AGE] | 10 .. 115 |
| 720 | fage_cur | 10c. How old is he now? [ENTER YEARS OF AGE] | 75 .. 115 |
| 721 | fwork | 11. What kind of work did your father do most of his life? (What was his job called?) [SPECIFY] | String[30] |
| 722 | feduc | 12. What was the highest grade or year of regular school your father completed? Elementary 0 1 2 3 4 5 6 7 8 High School 9 10 11 12 College 13 14 15 16 Graduate Professional 17 18 19 20 21 ... | 0 .. 30 |
| 723 | feduc2 | 12a. Would you say that he had no schooling, a few years, finished grammar school, had any high school, or any college? | 1= No schooling 2= A few years 3= Finished grammar school 4= Any high school 5= Any college |
| 724 | fpark | 13. ^diddoesf your natural or biologic father have Parkinson's disease with shaking tremors of the hands and/or slowness in walking and moving? | 1= Yes 2= Suspect or possible 3= No |
| 725 | fdement | 14. ^diddoesf he (your natural or biologic father) have a problem with memory loss, confusion or dementia? | 1= Yes 2= Suspect or possible 3= No |
| 726 | currjob | OCCUPATION 1. The kind of work we do can also affect our health, so we would like to get some information about your occupations. Because Nuns, Priests, and Brothers perform many different types of functions, we would like to know if you are currently working at a job? | 1= Yes 2= No |
| 727 | ftpt | 2. Full-time or part-time? | 1= Part-time 2= Full-time |
| 728 | cjobname | 3. What kind of work are you doing? (What is your job called?) (For example, registered nurse, personnel manager, supervisor, a teacher...) [JOB NAME] | String[30] |
| 729 | cjobduty | 4. What are your most important activities or duties? (For example, patient care, directing hiring policies, supervising, teaching...) [SPECIFY] | String[60] |
| 730 | retired | 5. Are you retired? (from a job?) | 1= Yes 2= No |
| 731 | yr_ret | 5a. In what year did you retire? | 1894 .. 2020 |
| 732 | lifejob | 6. What kind of work have you done most of your life? (What was your job called?) (For example, registered nurse, personnel manager, supervisor, teaching...) | 1= Same as current occupation 2= Not currently working; occupation specified 3= Different occupation from current one; 4= Never worked/disabled |
| 733 | ljobname | 6a. Specify occupation | String[30] |
| 734 | ljobduty | 6b. What were your most important activities or duties? (For example, patient care, directing hiring policies, supervising, teaching...) [SPECIFY] | String[60] |
| 735 | jobsuper | 7. Considering the time when you worked most recently and thinking of the person in your organization who had the most control over what you did on the job - which of these statements best describes how closely you were supervised - my supervisor decided both what I did and how I did it; my supervisor decided WHAT I did, but I decided HOW to do it; I had some freedom in deciding both what I did and how to do it; I was my own boss within general policies. | 1= Supervisor decided both what I did and how I did it. 2= Supervisor decided what I did, but I decided how to do it. 3= I had some freedom in deciding what I did and how to do it. 4= I was my own boss within general policies. |
| 736 | jobfree | 8. How free ^dodid you feel to disagree with him or her? Would you say you ^feelfelt completely free to disagree, quite a bit free to disagree, a little bit free to disagree or hardly free at all to disagree? | 1= Completely free 2= Quite a bit free 3= A little bit free 4= Hardly free at all |
| 737 | work30 | 9. What kind of work did you do when you were 30 years of age? (What is your job called?) (For example, registered nurse, personnel manager, supervisor, teacher...) | 1= Same as current occupation 2= Same as work done most of life 3= Different occupation from job(s) described previously 4= Other, not working |
| 738 | job30 | 9a. [SPECIFY OCCUPATION] | String[30] |
| 739 | oth30 | 9b. [SPECIFY REASON FOR NON-WORKING STATUS AT 30 YEARS OF AGE] | String[30] |
| 740 | duty30 | 9c. What were your most important activities or duties? (For example, patient care, directing hiring policies, supervising, teaching...) [SPECIFY] | String[60] |
| 741 | educat | 10. What is the highest grade or year of regular school you have completed? [CODE: Elementary 0 1 2 3 4 5 6 7 8 High School 9 10 11 12 College 13 14 15 16 Prof./Grad 17 18 19 20 21 ...] | 0 .. 30 |
| 742 | sn1 | SOCIAL NETWORKS Since our health can be affected by our relations with other people, I would like to ask some questions about your family, friends, and social activities. 1. First I'd like to ask you about people in your immediate community. How many close friends do you have in your community; that is, people that you really feel at ease with; people with whom you can talk about private and personal matters and can call upon for help? [ENTER NO. OF CLOSE FRIENDS] | 0 .. 76 |
| 743 | sn1b | 1a. How many of these close friends do you usually talk to at least once a month? [ENTER NO. OF CLOSE FRIENDS] | 0 .. 76 |
| 744 | sn2 | I'd also like to ask you about your relatives, people that you are related to by blood. Please include brothers, sisters, parents, aunts and uncles, and cousins. 2. How many relatives do you have that you feel really close to - people you feel at ease with, can talk to about private matters or call upon for help? [ENTER NO. OF CLOSE RELATIVES] | 0 .. 76 |
| 745 | sn2b | 2a. How many of these close relatives do you usually see at least once a month? [ENTER NO. OF CLOSE RELATIVES] | 0 .. 76 |
| 746 | sn3 | 3. Besides people that you are related to, and people in your immediate community, how many close friends do you have; that is, people that you feel at ease with, can talk to about private matters or can call upon for help? [ENTER NO. OF CLOSE FRIENDS] | 0 .. 76 |
| 747 | sn3a | 3a. Do you see ^friend2 at least once a month? | 1= Yes 2= No |
| 748 | sn3b | 3b. How many of your close friends do you see at least once a month? [ENTER NO. OF CLOSE FRIENDS] | 0 .. 76 |
| 749 | sn4 | 4. Do you participate in any activities or groups inside the house, such as optional Bible study, crafts or other activities? | 1= Yes 2= No |
| 750 | sn4a | 4a. About how often are you involved in activities with (this/these) group(s)? | 1= Less than once a month 2= 1 to 3 times/month 3= Once a week 4= 2 to 4 times a week 5= 5 or more times a week |
| 751 | sn5 | 5. Do you participate in any activities or groups outside the house, such as senior center, public service, etc.? | 1= Yes 2= No |
| 752 | sn5a | 5a. About how often are you involved in activities with (this/these) group(s)? | 1= Less than once a month 2= 1 to 3 times/month 3= Once a week 4= 2 to 4 times a week 5= 5 or more times a week |
| 753 | description_acc | Acculturation Although you may speak many languages, the following questions refer to only English and Spanish. [PRESS ENTER TO CONTINUE] | |
| 754 | acc_langreadspeak | 1. In general, what language(s) do you read and speak? | 1= Only Spanish 2= Spanish better 3= Both equally 4= English better than Spanish 5= Only English |
| 755 | acc_langchild | 2. What was the language(s) you used as a child? | 1= Only Spanish 2= More Spanish than English 3= Both equally 4= More English than Spanish 5= Only English |
| 756 | acc_langhome | 3. What language(s) do you usually speak at home? | 1= Only Spanish 2= More Spanish than English 3= Both equally 4= More English than Spanish 5= Only English |
| 757 | acc_langthink | 4. In which language(s) do you usually think? | 1= Only Spanish 2= More Spanish than English 3= Both equally 4= More English than Spanish 5= Only English |
| 758 | acc_langfriend | 5. What language(s) do you usually speak with your friends? | 1= Only Spanish 2= More Spanish than English 3= Both equally 4= More English than Spanish 5= Only English |
| 759 | acc_langmedia | 6. In general, what language(s) are the movies, T.V. and radio programs you prefer to watch and listen to? | 1= Only Spanish 2= More Spanish than English 3= Both equally 4= More English than Spanish 5= Only English |
| 760 | acc_friends | 7. Your close friends are... | 1= All Hispanic/Latino 2= More Hispanic/Latino than non-Hispanic/non-Latino 3= About half and half 4= More non-Hispanic/non-Latino than Hispanic/Latino 5= All non-Hispanic/non-Latino |
| 761 | acc_social | 8. You prefer going to social gatherings/parties at which people are... | 1= All Hispanic/Latino 2= More Hispanic/Latino than non-Hispanic/non-Latino 3= About half and half 4= More non-Hispanic/non-Latino than Hispanic/Latino 5= All non-Hispanic/non-Latino |
| 762 | acc_visitors | 9. The persons you visit or who visit you are... | 1= All Hispanic/Latino 2= More Hispanic/Latino than non-Hispanic/non-Latino 3= About half and half 4= More non-Hispanic/non-Latino than Hispanic/Latino 5= All non-Hispanic/non-Latino |
| 763 | acc_kidsfriend | 10. If you could choose your children's friends you would want them to be... | 1= All Hispanic/Latino 2= More Hispanic/Latino than non-Hispanic/non-Latino 3= About half and half 4= More non-Hispanic/non-Latino than Hispanic/Latino 5= All non-Hispanic/non-Latino |
| 764 | description_fam | Familism Please indicate how much you agree or disagree with these statements by choosing the answer from 1 (disagree a lot) to 5 (agree a lot) which best shows how you feel about each statement. [PRESS ENTER TO CONTINUE] | |
| 765 | fam_grandchild | 1. One should have the hope of living long enough to see his/her grandchildren grow up. | 1= Disagree a lot 2= Disagree 3= Don't disagree or agree 4= Agree 5= Agree a lot |
| 766 | fam_parliverel | 2. Aging parents should live with relatives. | 1= Disagree a lot 2= Disagree 3= Don't disagree or agree 4= Agree 5= Agree a lot |
| 767 | fam_helprel | 3. When someone has problems he/she can count on help from his/her relatives. | 1= Disagree a lot 2= Disagree 3= Don't disagree or agree 4= Agree 5= Agree a lot |
| 768 | fam_pleasepar | 4. Much of what a son or daughter does should be done to please the parents. | 1= Disagree a lot 2= Disagree 3= Don't disagree or agree 4= Agree 5= Agree a lot |
| 769 | fam_embrass | 5. One should be embarrassed about the bad things done by his/her brothers and sisters. | 1= Disagree a lot 2= Disagree 3= Don't disagree or agree 4= Agree 5= Agree a lot |
| 770 | fam_livepar | 6. Children should live in their parents' house until they get married. | 1= Disagree a lot 2= Disagree 3= Don't disagree or agree 4= Agree 5= Agree a lot |
| 771 | admin1 | PURDUE PEGBOARD -- ADMINISTRATION: [PLACE PEGBOARD IN FRONT OF R, WITH WELLS AT TOP AND PEGS IN FIRST AND LAST WELLS. SAY:] `I want to see how quickly you can place these pegs [POINT] into these holes [POINT] - like this without skipping any holes. [EXAMINER PLACES 4 PEGS WITH RIGHT HAND IN RIGHT-HAND COLUMN.] Now for practice you try it with your right hand.' [ALLOW SUBJECT TO PLACE 4 PEGS IN RIGHT COLUMN; ENCOURAGE WITH `good;' REPEAT PROCESS IF SUBJECT DOES NOT COMPLETE PRACTICE ITEMS SATISFACTORILY. THEN REPLACE PEGS.] >>>>> PRESS ENTER TO CONTINUE <<<<< | String[1] |
| 772 | admin2 | [SAY: ]`Good. You have the idea. Now, when I tell you to begin, pick up the pegs one at a time and place them in this column [POINT TO RIGHT-HAND COLUMN] with your RIGHT HAND as quickly as you can. Again, please do not skip any holes. Ready? Begin. '[START TIMER AS YOU SAY `BEGIN;' EACH TRIAL IS *30 SECONDS*. WATCH R; PROMPT TO PICK UP ONLY ONE PEG AT A TIME, TO USE ONLY ONE HAND AT A TIME, AND NOT TO SKIPHOLES, AS NECESSARY; IF R MAKES SIGNIFICANT ERRORS DURING TRIAL (E.G., USING BOTH HANDS, PLACING PEGS IN WRONG COLUMN, SKIPPING HOLES, ETC.) **IT IS PERMISSIBLE TO REPEAT 1 TRIAL**. IF NECESSARY, COVER ONE COLUMN OF HOLES WITH THE PANEL THAT SLIDES OVER THE WELLS. ONLY VERBALLY REMIND BEYOND THIS, HOWEVER. AT 30 SECONDS SAY:] `stop'. >>>>> PRESS ENTER FOR FIRST TRIAL <<<<< | String[1] |
| 773 | trial11 | 1. Trial 1, Right Hand [ENTER NUMBER OF PEGS CORRECTLY PLACED] | 0 .. 25 |
| 774 | trial21 | [AT COMPLETION OF TRIAL 1, REPLACE PEGS AND SAY:] `Now I want you to do the same thing with your LEFT HAND. Pick up the pegs one at a time and place them in this column [POINT TO LEFT-HAND COLUMN] with your left hand. Work as quickly as you can and do not skip any holes. Ready? Begin.' [TRIAL IS 30 SECONDS WITH SAME PROCEDURES AS TRIAL 1.] 2. Trial 2, Left Hand [ENTER NUMBER OF PEGS CORRECTLY PLACED] | 0 .. 25 |
| 775 | trial301 | [AT COMPLETION OF TRIAL 2, REPLACE PEGS AND SAY:] `Now I want you to do this again with your RIGHT HAND. Place the pegs one at a time in this column [POINT TO RIGHT-HAND COLUMN COLUMN] with your right hand. Work as quickly as you can and do not skip any holes. Ready? Begin.' [TRIAL IS 30 SECONDS WITH SAME PROCEDURES AS TRIAL 1.] 3. Trial 3, Right Hand [ENTER NUMBER OF PEGS CORRECTLY PLACED] | 0 .. 25 |
| 776 | trial4 | [AT COMPLETION OF TRIAL 3, REPLACE PEGS AND SAY:] `Now I want you to do this again with your LEFT HAND. Place the pegs one at a time in this column [POINT TO LEFT-HAND COLUMN] with your left hand. Work as quickly as you can and do not skip any holes. Ready? Begin.' [TRIAL IS 30 SECONDS WITH SAME PROCEDURES AS TRIAL 1.] 4. Trial 4, Left Hand [ENTER NUMBER OF PEGS CORRECTLY PLACED] | 0 .. 25 |
| 777 | glasses | VISION Now I have some questions about your eyesight and your hearing. 1. Do you wear eyeglasses, contact lenses or both? | 1= Eyeglasses 2= Contact lenses 3= Both 4= Neither |
| 778 | reading | 1a. Do you use ^eyes for reading and other close work? | 1= Yes 2= No |
| 779 | distant | 1b. Do you use ^eyes for seeing distant objects better? | 1= Yes 2= No |
| 780 | testaid | ^instruct 1c. Test taken with: | 1= Glasses 2= Contact lenses 3= Neither |
| 781 | trial10 | [INTERVIEWER: Visual acuity should be checked with both eyes open. Hold card 14 inches from subject and ask him/her to read the number on the card. Record number of correct responses.] 2. First trial: 20/70 | 1= All three correct 2= Two correct 3= One correct 4= None correct |
| 782 | trial1a | 2a. Second trial: 20/100 | 1= All three correct 2= Two correct 3= One correct 4= None correct |
| 783 | trial1b | 2b. Third trial: 20/200 | 1= All three correct 2= Two correct 3= One correct 4= None correct |
| 784 | trial1c | 2c. Fourth trial: 20/400 | 1= All three correct 2= Two correct 3= One correct 4= None correct |
| 785 | trial20 | 3. Second trial: 20/50 | 1= All three correct 2= Two correct 3= One correct 4= None correct |
| 786 | trial300 | 3a. Third trial: 20/40 | 1= All three correct 2= Two correct 3= One correct 4= None correct |
| 787 | hearaid | 4. Do you wear a hearing aid? | 1= Yes 2= No |
| 788 | freq1 | 4a. How often do you usually wear a hearing aid these days: practically always, frequently, occasionally, or almost never? | 1= Practically always 2= Frequently 3= Occasionally 4= Almost never |
| 789 | normal | 5. ^aid you usually hear and understand what a person says without seeing his or her face if that person talks in a normal voice to you in a quiet room? | 1= Yes 2= No |
| 790 | acrossrm | 5a. ^aid you usually hear and understand what a person says without seeing his or her face if that person shouts to you from across a quiet room? | 1= Yes 2= No |
| 791 | inear | 5b. ^aid you usually hear and understand what a person says without seeing his or her face if that person shouts in your better ear? | 1= Yes 2= No |
| 792 | htwt1 | HEIGHT AND WEIGHT Now I have some questions about your height and weight. 1. In the last year, have you gained or lost more than 10 pounds? [PROBE IF YES: Did you gain more than 10 pounds or lose more than 10 pounds or both?] | 1= Yes, lost > 10 lbs 2= Yes, gained > 10 lbs 3= Yes, gained and lost > 10 lbs 4= No changes |
| 793 | htwt2 | 2. What was your usual weight at age 25? [IN POUNDS] | 30 .. 800 |
| 794 | htwt3 | 3. At about 12 years of age, were you considered to be - much heavier than average, somewhat heavier than average, about average weight, somewhat thinner than average, or much thinner than average? | 1= Much heavier than average 2= Somewhat heavier than average 3= About average weight 4= Somewhat thinner than average 5= Much thinner than average |
| 795 | htwt4 | 4. At about 12 years of age, were you considered to be - much taller than average, somewhat taller than average, about average height, somewhat shorter than average, or much shorter than average? | 1= Much taller than average 2= Somewhat taller than average 3= About average height 4= Somewhat shorter than average 5= Much shorter than average |
| 796 | midarm | BLOODPRESSURE Now I would like to take some arm, height and weight measurements, and blood pressure readings. 1. MID-ARM CIRCUMFERENCE [IN cm] | 15.0 .. 78.0 |
| 797 | midfore | 1a. MID FOREARM CIRCUMFERENCE [IN cm] | 10.0 .. 78.0 |
| 798 | midleg | 1b. MID LEG CIRCUMFERENCE [IN cm] | 15.0 .. 99.0 |
| 799 | tricep1 | 2. FIRST TRICEPS SKINFOLD MEASUREMENT [IN mm] CODE 72 IF MEASUREMENT >= 67 mm] | 1 .. 72 |
| 800 | cuff | BLOODPRESSURE Now I would like to take some height and weight measurements, and blood pressure readings. 3. IS CUFF SIZE AVAILABLE? [IF CUFF NOT AVAILABLE, AT END OF INTERVIEW SET UP TIME TO RETURN FOR BLOOD PRESSURE MEASUREMENT] | 1= Yes 2= No |
| 801 | tricep2 | 4. SECOND TRICEPS SKINFOLD MEASUREMENT [IN mm] [CODE 72 IF MEASUREMENT >=67mm] | 1 .. 72 |
| 802 | pulsept | 5. PULSE OBLITERATION POINT [IN mmHg] | 50 .. 270 |
| 803 | pul | THE PEAK INFLATION LEVEL IS ^pulse [HIT ENTER FOR NEXT QUESTION] | 80 .. 300 |
| 804 | bp11 | 6. FIRST SITTING BLOOD PRESSURE READING [INTERVIEWER: The subject should be seated for five minutes prior to obtaining the seated blood pressure readings. ENTER SYSTOLIC/DIASTOLIC] | String[7] |
| 805 | bp2 | 7. SECOND SITTING BLOOD PRESSURE READING [INTERVIEWER: ENTER SYSTOLIC/DIASTOLIC] | String[7] |
| 806 | bp31 | 8. STANDING BLOOD PRESSURE READING [INTERVIEWER: ASK THE SUBJECT TO STAND. WAIT 60 SECONDS THEN REPEAT BLOOD PRESSURE READING. ENTER SYSTOLIC/DIASTOLIC] | String[7] |
| 807 | weight | 9. MEASURED WEIGHT [IN LBS] [CODE 333 IF MEASUREMENT IS >=300 lbs. CODE 888 IF PHYSICALLY UNABLE TO WEIGH] | 30 .. 888 |
| 808 | height | 10. MEASURED HEIGHT [IN FEET & INCHES] [CODE 888 IF PHYSICALLY UNABLE TO MEASURE HEIGHT] | String[5] |
| 809 | introk | PHYSICAL MEASUREMENTS Now I would like you to try to do different movements of your body that involve your arms and legs. I will first describe and show each movement to you. Then I'd like you to try it. Please be very careful and let me know if you need help. [INTERVIEWER: BOTH THE RESEARCH ASSISTANT AND NURSE SHOULD BE PRESENT IF THE SUBJECT NEEDS ASSISTANCE WITH THESE MEASUREMENTS. DEMONSTRATE AND DESCRIBE EACH POSITION. THEN ENTER NUMBER OF SECONDS THE SUBJECT HOLDS POSITION.] >>>>> PRESS ENTER FOR NEXT QUESTION <<<<</p | String[1] |
| 810 | move1 | 1. SEMI-TANDEM STAND (Eyes Open) [UP TO 10 SECONDS] [INTERVIEWER: DESCRIBE THE POSITION WHILE DEMONSTRATING.] [ENTER NUMBER OF SECONDS R HOLDS POSITION] [CODE 55.5=tried but unable] | 1.0 .. 55.5 |
| 811 | move2 | 2. FULL TANDEM STAND (Eyes Open) [INTERVIEWER: DESCRIBE THE POSITION WHILE DEMONSTRATING.] [ENTER NUMBER OF SECONDS R HOLDS POSITION] [CODE 55.5=tried but unable] | 1.0 .. 55.5 |
| 812 | move3 | 3. SIDE BY SIDE STAND (Eyes Open) [INTERVIEWER: DESCRIBE THE POSITION WHILE DEMONSTRATING.] [ENTER NUMBER OF SECONDS R HOLDS POSITION] [CODE 55.5=tried but unable] | 1.0 .. 55.5 |
| 813 | move4 | 4. SIDE BY SIDE STAND (Eyes Closed) [INTERVIEWER: DESCRIBE THE POSITION WHILE DEMONSTRATING.] [ENTER NUMBER OF SECONDS R HOLDS POSITION] [CODE 55.5=tried but unable] | 1.0 .. 55.5 |
| 814 | move5 | 5. HEEL STAND (Eyes Open) [INTERVIEWER: DESCRIBE THE POSITION WHILE DEMONSTRATING.] [ENTER NUMBER OF SECONDS R HOLDS POSITION] [CODE 55.5=tried but unable] | 1.0 .. 55.5 |
| 815 | move6 | 6. TOE STAND (Eyes Open) [INTERVIEWER: DESCRIBE THE POSITION WHILE DEMONSTRATING.] [ENTER NUMBER OF SECONDS R HOLDS POSITION] [CODE 55.5=tried but unable] | 1.0 .. 55.5 |
| 816 | move6a | 6a. STANDING ON RIGHT LEG (Eyes Open) [TRIAL ONE] [INTERVIEWER: DESCRIBE THE POSITION WHILE DEMONSTRATING.] [ENTER NUMBER OF SECONDS R HOLDS POSITION] [CODE 55.5=tried but unable] | 1.0 .. 55.5 |
| 817 | move6b | 6b. STANDING ON RIGHT LEG (Eyes Open) [TRIAL TWO] [INTERVIEWER: DESCRIBE THE POSITION WHILE DEMONSTRATING.] [ENTER NUMBER OF SECONDS R HOLDS POSITION] [CODE 55.5=tried but unable] | 1.0 .. 55.5 |
| 818 | move6c | 6c. STANDING ON LEFT LEG (Eyes Open) [TRIAL ONE] [INTERVIEWER: DESCRIBE THE POSITION WHILE DEMONSTRATING.] [ENTER NUMBER OF SECONDS R HOLDS POSITION] [CODE 55.5=tried but unable] | 1.0 .. 55.5 |
| 819 | move6d | 6d. STANDING ON LEFT LEG (Eyes Open) [TRIAL TWO] [INTERVIEWER: DESCRIBE THE POSITION WHILE DEMONSTRATING.] [ENTER NUMBER OF SECONDS R HOLDS POSITION] [CODE 55.5=tried but unable] | 1.0 .. 55.5 |
| 820 | move6e | 6e. TURNING (360 degrees) [TRIAL ONE] [INTERVIEWER: DESCRIBE THE POSITION WHILE DEMONSTRATING.] [ENTER NUMBER OF SECONDS R TAKES TO COMPLETE THE TURN] [CODE 555.5=tried but unable] | 1.0 .. 555.5 |
| 821 | move6f | 6f. TURNING (360 degrees) [TRIAL ONE] [INTERVIEWER: DESCRIBE THE POSITION WHILE DEMONSTRATING.] [ENTER NUMBER OF STEPS R TAKES TO COMPLETE THE TURN] [CODE 55=tried but unable] | 1 .. 55 |
| 822 | move6g | 6g. TURNING (360 degrees) [TRIAL TWO] [INTERVIEWER: DESCRIBE THE POSITION WHILE DEMONSTRATING.] [ENTER NUMBER OF SECONDS R TAKES TO COMPLETE THE TURN] [CODE 555.5=tried but unable] | 1.0 .. 555.5 |
| 823 | move6h | 6h. TURNING (360 degrees) [TRIAL TWO] [INTERVIEWER: DESCRIBE THE POSITION WHILE DEMONSTRATING.] [ENTER NUMBER OF STEPS R TAKES TO COMPLETE THE TURN] [CODE 55=tried but unable] | 1 .. 55 |
| 824 | move6i | 6i. [INTERVIEWER: RECORD AIDS USED FOR TURNING] | 1= No aid 2= Quad Cane 3= Other Cane 4= Walker 5= Wheelchair 6= Other |
| 825 | move6i1 | [SPECIFY] | String[20] |
| 826 | move7 | 7. MEASURED WALK [INTERVIEWER: EXTEND THE RULE TO THE 8' LENGTH IN AN AREA WHICH OFFERS AT LEAST 11' AND IDEALLY 12' OF WALKING SPACE. MARK STARTING LINE AND ENDING LINE WITH 18 INCH PIECE OF TAPE. Count the number of steps required to complete the course.] Was the course 8 feet in length? | 1= Yes 2= No |
| 827 | move7a | 7a. [INTERVIEWER: RECORD AIDS USED IN MEASURED WALK] | 1= No aid 2= Quad Cane 3= Other Cane 4= Walker 5= Wheelchair as walking aid 6= Other |
| 828 | move7a1 | 7b1. [SPECIFY] | String[20] |
| 829 | move7b | 7b. [INTERVIEWER: RECORD TIME FOR FIRST WALK (in seconds)] [CODE 555.5=tried but unable] | 1.0 .. 555.5 |
| 830 | move7c | 7c. How many steps were taken? | 1 .. 55 |
| 831 | move8 | 8. TANDEM WALK [INTERVIEWER: RECORD NUMBER OF ERRORS, e.g. SIDESTEPS] [CODE 55=TRIED BUT UNABLE] | 0 .. 55 |
| 832 | move9a | 9a. CHAIR STAND. [INTERVIEWER: DESCRIBE THE CHAIR STAND AND DEMONSTRATE.] ENTER NUMBER OF ATTEMPTS TO RISE (INCLUDING ROCKING/WEIGHT SHIFTING) | 0 .. 20 |
| 833 | move9b | 9b. ATTEMPT TO RISE. | 1= Rises without using arms 2= Rises using arms 3= Not attempted (no suitable chair) 55= Tried but unable |
| 834 | move10a | 10. REPEATED CHAIR STAND [INTERVIEWER: DESCRIBE REPEATED CHAIR STANDS WHILE DEMONSTRATING.] 10a. COMPLETION. | 1= One completed 2= Two completed 3= Three completed 4= Four completed 5= Five completed 13= Not attempted, no suitable chair 55= Tried, but unable |
| 835 | move10b | 10b. TIME IF 5 STANDS DONE SUCCESSFULLY [IN SECONDS] | 1.0 .. 99.0 |
| 836 | move9c | 10c. [RECORD CHAIR HEIGHT] [ENTER INCHES FROM FLOOR TO LOWEST POINT OF SEAT] | 3 .. 48 |
| 837 | move9d | 10d. Did the chair have arms? | 1= Yes 2= No |
| 838 | move11a | EXTERNAL SHOULDER ROTATION. [DESCRIBE EXERCISE WHILE DEMONSTRATING.] 11a. RIGHT SIDE: | 1= Performed fully 2= Performed partially; hand behind head 3= Performed partially; arm raised 4= Unable to do |
| 839 | move11b | 11b. LEFT SIDE: | 1= Performed fully 2= Performed partially; hand behind head 3= Performed partially; arm raised 4= Unable to do |
| 840 | autendtm | [COMPUTER CLOCK TIME] | String[8] |
| 841 | comment | Comments | String[120] |
| 846 | vegsign | 0 .. 8 | |
| 847 | mvegsign | 0 .. 8 | |
| 848 | cesd | 0 .. 10 | |
| 849 | mcesd | 0 .. 10 | |
| 850 | formcode | Please enter status code. 11 = COMPLETE 13 = COMPLETE, portion with proxy 12 = INCOMPLETE, refused 14 = INCOMPLETE, too impaired 21 = INCOMPLETE interim, complete later 73 = NOT TESTED, out of town 31 = NOT TESTED, moved 33 = NOT TESTED, refused 75 = NOT TESTED, hospitalized 76 = NOT TESTED, other 42 = DECEASED 43 = WITHDRAWN 44 = WITHDRAWN, Autopsy OK | 11 .. 76 |
| 851 | formpart | Was participant reluctant, and/or does participant have special needs? | 1= Yes 2= No |
| 852 | formcomm | Please explain reluctance or any other factors which may have affected this data. [Press enter if no comment needed.] | String[120] |
| 853 | statid | Please enter you staff id. | 100 .. 997 |
| 854 | formch | Has the form been modified? | 1= Yes 2= No |
| 855 | revidate | Enter the date that the form was modified. | Date type |
| 856 | revintd | Enter your staff id number. | 100 .. 997 |
| 857 | anydev | Are there any protocol deviations or missing data items to enter? | 1= Yes 2= No |
| 858 | numdev | How many total protocol deviations and tests with missing items to enter? | 1 .. 20 |
| 859 | reas00 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 860 | test00 | Enter test or procedure. | String[15] |
| 861 | item00 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 862 | code00 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 863 | oth00 | Enter other code used. | String[20] |
| 864 | expl00 | Explain what happened | String[100] |
| 865 | reas01 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 866 | test01 | Enter test or procedure. | String[15] |
| 867 | item01 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 868 | code01 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 869 | oth01 | Enter other code used. | String[20] |
| 870 | expl01 | Explain what happened | String[100] |
| 871 | reas02 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 872 | test02 | Enter test or procedure. | String[15] |
| 873 | item02 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 874 | code02 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 875 | oth02 | Enter other code used. | String[20] |
| 876 | expl02 | Explain what happened | String[100] |
| 877 | reas03 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 878 | test03 | Enter test or procedure. | String[15] |
| 879 | item03 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 880 | code03 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 881 | oth03 | Enter other code used. | String[20] |
| 882 | expl03 | Explain what happened | String[100] |
| 883 | reas04 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 884 | test04 | Enter test or procedure. | String[15] |
| 885 | item04 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 886 | code04 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 887 | oth04 | Enter other code used. | String[20] |
| 888 | expl04 | Explain what happened | String[100] |
| 889 | reas05 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 890 | test05 | Enter test or procedure. | String[15] |
| 891 | item05 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 892 | code05 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 893 | oth05 | Enter other code used. | String[20] |
| 894 | expl05 | Explain what happened | String[100] |
| 895 | reas06 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 896 | test06 | Enter test or procedure. | String[15] |
| 897 | item06 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 898 | code06 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 899 | oth06 | Enter other code used. | String[20] |
| 900 | expl06 | Explain what happened | String[100] |
| 901 | reas07 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 902 | test07 | Enter test or procedure. | String[15] |
| 903 | item07 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 904 | code07 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 905 | oth07 | Enter other code used. | String[20] |
| 906 | expl07 | Explain what happened | String[100] |
| 907 | reas08 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 908 | test08 | Enter test or procedure. | String[15] |
| 909 | item08 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 910 | code08 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 911 | oth08 | Enter other code used. | String[20] |
| 912 | expl08 | Explain what happened | String[100] |
| 913 | reas09 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 914 | test09 | Enter test or procedure. | String[15] |
| 915 | item09 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 916 | code09 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 917 | oth09 | Enter other code used. | String[20] |
| 918 | expl09 | Explain what happened | String[100] |
| 919 | reas10 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 920 | test10 | Enter test or procedure. | String[15] |
| 921 | item10 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 922 | code10 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 923 | oth10 | Enter other code used. | String[20] |
| 924 | expl10 | Explain what happened | String[100] |
| 925 | reas11 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 926 | test11 | Enter test or procedure. | String[15] |
| 927 | item11 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 928 | code11 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 929 | oth11 | Enter other code used. | String[20] |
| 930 | expl11 | Explain what happened | String[100] |
| 931 | reas12 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 932 | test12 | Enter test or procedure. | String[15] |
| 933 | item12 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 934 | code12 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 935 | oth12 | Enter other code used. | String[20] |
| 936 | expl12 | Explain what happened | String[100] |
| 937 | reas13 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 938 | test13 | Enter test or procedure. | String[15] |
| 939 | item13 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 940 | code13 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 941 | oth13 | Enter other code used. | String[20] |
| 942 | expl13 | Explain what happened | String[100] |
| 943 | reas14 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 944 | test14 | Enter test or procedure. | String[15] |
| 945 | item14 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 946 | code14 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 947 | oth14 | Enter other code used. | String[20] |
| 948 | expl14 | Explain what happened | String[100] |
| 949 | reas15 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 950 | test15 | Enter test or procedure. | String[15] |
| 951 | item15 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 952 | code15 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 953 | oth15 | Enter other code used. | String[20] |
| 954 | expl15 | Explain what happened | String[100] |
| 955 | reas16 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 956 | test16 | Enter test or procedure. | String[15] |
| 957 | item16 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 958 | code16 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 959 | oth16 | Enter other code used. | String[20] |
| 960 | expl16 | Explain what happened | String[100] |
| 961 | reas17 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 962 | test17 | Enter test or procedure. | String[15] |
| 963 | item17 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 964 | code17 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 965 | oth17 | Enter other code used. | String[20] |
| 966 | expl17 | Explain what happened | String[100] |
| 967 | reas18 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 968 | test18 | Enter test or procedure. | String[15] |
| 969 | item18 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 970 | code18 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 971 | oth18 | Enter other code used. | String[20] |
| 972 | expl18 | Explain what happened | String[100] |
| 973 | reas19 | Protocol Deviation or Missing Data? | 1= Protocol Deviation 2= Missing Data |
| 974 | test19 | Enter test or procedure. | String[15] |
| 975 | item19 | List items involved. [SEPARATE BY A COMMA] | String[20] |
| 976 | code19 | Enter data code used. | 1= Don't Know 2= Refusal 3= other |
| 977 | oth19 | Enter other code used. | String[20] |
| 978 | expl19 | Explain what happened | String[100] |