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24.If I had a little extra money I would spend it on: |
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2. If I had a lot of extra money I would spend it on: |
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3. Partner work family impact ( CONTACT _Con-34CF8B292 Diane Rohlman and Meagan Shaw) |
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1. In the past year has your spouse worked? |
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6. Would you like it if your spouse could work less or not working at all? Y N |
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8. My partner wishes that s/he did not have to work. |
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19. S/he has the extra time to work. |
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3. What type of payment arrangement do you have for your living quarters at your current home? If payment is only for utilities, consider it free. Do not read choice. Mark only one. |
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4. At this location how much do you pay for housing (including housing for your family, if they live with you)? |
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6. How much per hour (to nearest cent)?: _____________per hour |
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8. What was the amount your employer paid you on your last pay day? |
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14. In the last 12 months, with your current employer, has anyone given you training or instructions in the safe use of pesticides (through video, audio, cassette, classroom lectures, written material, informal talks or by any other means)? Y/N/don’t work in agriculture |
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15. In general, how often have you used the following types of childcare for your child(ren) while you work (FW)? |
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16. In the last month how often have you used the different types of childcare for your children while you work? |
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20. ...And the last time you used the health care provider, where did you go (what kind of place was it)? |
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21. And, ...the last time you used the health care provider, who paid the majority of the cost? |
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22. When you NEED to get health care in the USA what are the main difficulties you face? [CHECK ALL THAT APPLY] |
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5.Work-to-Family and Family-to-Work Conflict |
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6. Job Content Questionnaire |
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44.a. Did you do something to change the unfair treatment? y/n |
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9. Financial Stress Questionnaire |
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67.Think back over the past year and tell us how much difficulty you had with paying your bills. |
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68.Think again over the past 12 months. Generally, at the end of each month do you end up with: |
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1. How long did it usually take for you to fall asleep during the past 4 weeks? (Circle One) |
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2. On the average, how many hours did you sleep each night during the past 4 weeks? |
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Think about your eating habits over the past 4 weeks. About how often did you eat or drink each of the following foods? Remember breakfast, lunch, dinner, snacks, and eating out. Blacken in only one bubble for each food.
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1=never, 2=less than once, 3=1-3 times, 4=1-2 times per week, 5=3-4 times per week, 6=5-6 times per week, 7=once a day, 8=2 times per day 9=3-4 times per day 10=5 0r more times per day
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13. Trouble with muscles and joints |
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9. One or both ankles feet: N Y |
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18. One or both ankles feet: N Y |
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1. In general, would you say your health is: |
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3. Climbing several flights of stairs |
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5. Were limited in the kind of work or other activities |
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8. During the past 4 weeks, how much did pain interfere with your normal work (including both work outside the home and housework)? |
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16. Dedobbeleer and Beland's Climate Measure |
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1. How important do you think the workers' safety practices are to the management of your company? (Please check one answer) |
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2. How much do supervisors and other top management seem to care about your safety? (Please check one answer) |
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3. How much emphasis does the foreman place on safety practices on the job? (Please check one answer) |
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4. When you were hired by your present employer, were you given instructions on the safety policy, safety requirements of the company? Yes No |
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5. Are there regular job safety meetings at your present job site? Yes No |
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7. How much control do you feel you have yourself over what happens to your safety on the job? |
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17. Multidimensional scale of perceived social support |
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18. Perceived Stress Scale |
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