We bring to your attention a new website where you can buy propecia australia at a low price with fast delivery to Australia.

Arps for distribution.pdf

ALCOHOL-RELATED
PROBLEMS SURVEY

This survey is about the health of older people and their use of alcohol. Your information is valuable in helping us understand how to prevent This publication was made possible by a grant from the National Institutes of Health. The opinions expressed herein do not necessarily reflect the official position of the National Institutes of Health or any of its Institutes. Now, please turn to page 1 of this survey.
Arlene Fink, 2002. Please do not reproduce or distribute without permission: [email protected] SECTION 1: HEALTH PROBLEMS
This section is about your current health.
CHECK (þ) ONE BOX ON EACH LINE
1. Has a doctor or other health care worker
ever told you that you have:
a. High blood pressure
b. Congestive heart failure
c. Diabetes
d. Osteoporosis
e. Cirrhosis or another liver condition
f. Cancer of the mouth or throat
g. Breast cancer
i. Memory disorder or d ementing illness
DID YOU CHECK ONE ANSWER ON EACH LINE,
EVEN IF YOUR ANSWER IS “DON'T KNOW"?
Arlene Fink, 2002. Please do not reproduce or distribute without permission: [email protected] CHECK (þ) ONE BOX ON EACH LINE
2. In the past twelve months, has a doctor or
other health care worker told you that you
a. Hepatitis
b. Gastritis
c. Ulcer of the stomach or small intestine
e. Depression, anxiety or another emotional

3. Do you now use tobacco in any form, including cigarettes, cigars,

pipes, chewing tobacco, etc.?
CHECK (þ) ONE BOX
θ No, I used tobacco in the past, but I do not use it now. Arlene Fink, 2002. Please do not reproduce or distribute without permission: [email protected] 4. How much of the time during the past 12 months did you have any
of the following problems?
CHECK (þ) ONE BOX ON EACH LINE
A Little Some
a. Problems sleeping
b. Stomach pains
c. Heartburn
d. Nausea
e. Vomiting
f. Diarrhea
g. Nervousness
h. Memory problems
i. Feeling depressed
j. Tripping, bumping
k. Falling
l. Problems with bladder
DID YOU CHECK ONE ANSWER ON EACH LINE,
EVEN IF YOUR ANSWER IS“NONE OF THE TIME”?
Arlene Fink, 2002. Please do not reproduce or distribute without permission: [email protected] SECTION 2: MEDICATIONS
This section is about some medications you may be using.
5. How many different medications do you use at least once a week?
Count ALL, even if you get them without a doctor’s prescription.
(Do not count eye drops, vitamins, minerals, ointments.)

CHECK (þ) ONE BOX

6. Do you now take 2 or more regular or extra strength (325 mg or

more) aspirins EVERY DAY or ALMOST EVERY DAY?
CHECK (þ) ONE BOX
Arlene Fink, 2002. Please do not reproduce or distribute without permission: [email protected] CHECK (þ) ONE BOX ON EACH LINE
7. Do you now take any of these
medications at least ONCE A WEEK?
a. Sedatives or sleeping medicines such as
Ambien, Ativan, Halcion, chloral hydrate b. Tranquilizers such as Thorazine,
c. Narcotic medications such as Darvon,
DID YOU CHECK ONE ANSWER ON EACH LINE,
EVEN IF YOUR ANSWER IS“DON'T KNOW”?
Arlene Fink, 2002. Please do not reproduce or distribute without permission: [email protected] CHECK (þ) ONE BOX ON EACH LINE
8. Do you now take any of these medications EVERY
DAY or ALMOST EVERY DAY?
a. Ulcer and stomach medicines such as Zantac,
b. Arthritis and pain medicines such as Motrin
(Ibuprofen), Voltaren, Clinoril, Naprosyn, Tylenol, c. Tolinase, Diabinese or Orinase
d. Other blood pressure medicines such as Cardizem,
Vasotec, Lotensin, Atenolol, Cozaar, Novasc, water e. Nitrates such as Isordil, Nitropatch
f. Other medicines for the heart such as digoxin, Lasix
g. Coumadin (warfarin)
h. Seizure medicines such as Tegretol, Dilantin or
i. Depression medicines such as Elavil (amitriptyline),
Pamelor (nortriptyline), Paxil, Prozac, Zoloft j. Prescription antihistamines such as Claritin, Zyrtec,
k. Tylenol PM, Benadryl, Chlor-trimeton or other
DID YOU CHECK ONE ANSWER ON EACH LINE,
EVEN IF YOUR ANSWER IS“DON'T KNOW”?
Arlene Fink, 2002. Please do not reproduce or distribute without permission: [email protected] SECTION 3: RECENT ALCOHOL USE
This section is about alcohol use during the past 12 months.
The next questions ask you to count drinks. When you answer,
please count one drink of alcohol as equal to one of the
following:

or
or
or
or

9. During the past 12 months, how often did you have a drink
containing alcohol?
CHECK (þ) ONE BOX
ð Please go to page 12.
Arlene Fink, 2002. Please do not reproduce or distribute without permission: [email protected] 10. On days that you drank alcohol during the past 12 months, how
many drinks of alcohol (beer, wine, and/or hard liquor) did you
usually drink?

CHECK (þ) ONE BOX
11. During the past 12 months, how often did you have three or more
drinks of alcohol at one sitting?
CHECK (þ) ONE BOX
Arlene Fink, 2002. Please do not reproduce or distribute without permission: [email protected]

12. During the past 12 months, how often did you have four or more
drinks of alcohol at one sitting?
CHECK (þ) ONE BOX
13. Because of your alcohol use, how often in the past 12 months did
you fail to do what you were supposed to do?
CHECK (þ) ONE BOX
At least once a week, but less than daily At least once a month, but less than weekly Arlene Fink, 2002. Please do not reproduce or distribute without permission: [email protected] 14. Because of your alcohol use, how often in the past 12 months
were you unable to stop drinking once you started?
CHECK (þ) ONE BOX
At least once a week, but less than daily At least once a month, but less than weekly At least once a month, but less than weekly
15. Because of your alcohol use, how often in the past 12 months did

you feel guilty or sorry for something you did?
CHECK (þ) ONE BOX
At least once a week, but less than daily At least once a month, but less than weekly At least once a month, but less than weekly Arlene Fink, 2002. Please do not reproduce or distribute without permission: [email protected] 16. In the past 12 months, on how many days did you drive a car,
truck, or other vehicle within 2 hours of having three or more
drinks?

CHECK (þ) ONE BOX
I did not drive in the past 12 months 17. Has a doctor, other medical person, relative, friend, or anyone else
ever been concerned about your drinking or suggested that you
should cut down?

CHECK (þ) ONE BOX
Arlene Fink, 2002. Please do not reproduce or distribute without permission: [email protected] SECTION 4: The following question is about you in
general.


18. The following are physical
activities you might do during a typical
day. How much are you limited in these activities because of
your health?

CHECK (þ) ONE BOX ON EACH LINE
Not limited
Limited a lot
a. Climbing one flight of stairs
b. Walking one block
c. Bathing or dressing
19. How would you describe your current health status?
Excellent Ο
Very good Ο

20. Are you male or female?
Female Ο
Arlene Fink, 2002. Please do not reproduce or distribute without permission: [email protected] 21. What is your date of birth?

(Write in the date below. Example: 01 01 1935)
22. Which of the following best describes you?
White, not of Hispanic origin

Black, not of Hispanic origin


Hispanic

Asian or Pacific Islander
American Indian or Alaskan Native
Other, specify:_______________
23. What was the highest grade or year of education you completed and got
credit for?
Circle one only of the numbers below.
Grade School, Jr. High, High,
High School
College or Vocational School

Graduate or Professional
Arlene Fink, 2002. Please do not reproduce or distribute without permission: [email protected]

Source: http://olderpa.org/Resources/Documents/ARPS.pdf

Microsoft word - new microsoft word document.doc

Chapter – 7 Geostationary Satellite A geostationary orbit (GEO) is a geosynchronous orbit directly above the Earth's equator (0° latitude), with a period equal to the Earth's rotational period and an orbital eccentricity of approximately zero. From locations on the surface of the Earth, geostationary objects appear motionless in the sky, making the GEO an orbit of great interest to

unternehmenzentral.de

Pizza-Restaurant Schwetzingen Statistische Daten und Wirtschaftsdaten Profile Pizza-Restaurant Schwetzingen Christiane Ostermann Mannheim Niederfeldstr. 69 - 68199 Mannheim Bernd Klapproth Neckarau Luisenstr. 38 - 68199 Mannheim Pietro Amormino Hauptstr. 23 - 68526 Ladenburg Umberto Marcias Mannheimer Str. 14B - 68723 Oftersheim Michelina Montana Maxstr. 3358 - 67059 L

Copyright © 2010-2014 Medical Science