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Questions marked with an * are required Exit Survey
 
 
Number for office use only
   
 
 
 
* First Name : 
* Last Name : 
 
 
 
* What is your date of birth?
 
 
 
* Where were you born?
   
 
 
 
* What language do you speak at home?
   
 
 
 
* Which of the following best describes your ethnicity (Select all that apply)?
 
Caucasian
 
Indigenous Australian or Torres Strait Islander
 
African American
 
Central Asian
 
South East Asian
 
African
 
Hispanic
 
Native American
 
Indian
 
Asian
 
Would prefer not to say
 
Other
 

 
 
 
* What is the highest level of education you completed?
 
 
 
* Which of the following best describes your marital status?
 
Single
 
In a committed or de facto relationship (but not married)
 
Married
 
Separated but not divorced
 
Divorced
 
Widowed
 
Would prefer not to say
 
Other
 
 
 
In the following video, Laura will read information about a study on the induction of labour. Once you have watched it, complete the 6 multiple choice questions that will appear on the next page.
 
 
 
Please answer the following multiple choice questions as best as you can.
Please do not return to the previous page.


* What will happen if you don’t want to participate?
 
It will affect your treatment in the hospital.
 
It will not affect your treatment at the hospital.
 
You will be discharged early from the hospital.
 
You will be forcefully allocated to the gel group.
 
 
 
* What will happen if you agree to participate in this trial and are allocated to the gel group?
 
You will have the gel inserted into the vagina and you will stay in hospital while the gel works.
 
You will have the gel inserted into the vagina and you will be allowed to go home with instructions while the gel works.
 
You can request to change your allocation to the catheter group.
 
You will be given instructions on how to apply the gel at home, and will be asked to return to hospital when the contractions start.
 
 
 
* What will happen if you agree to participate in this trial and are allocated to the catheter group?
 
You will be given instructions how to insert catheter at home, and will be asked to return to hospital when the contractions start.
 
You can request to change your allocation to the gel group.
 
You will have the catheter inserted through the cervix, monitoring of yourself and the baby afterwards, then you will stay in hospital.
 
You will have the catheter inserted through the cervix, monitoring of yourself and the baby afterwards, then you will be allowed to go home while the catheter works.
 
 
 
* What is the main risk for the catheter group participant?
 
Nausea and vomiting.
 
Pain and discomfort at home.
 
Early rupture of membranes.
 
Bloating and constipation.
 
 
 
* Which of the following is NOT a risk associated with this study?
 
Increased risk of ceasarean section.
 
Pain and discomfort at home
 
Overcontraction of the uterus
 
Labour at home
 
 
 
* What are the benefits of participating in this study?
 
You will be given more medicine after delivery.
 
It will be great contribution to the clinical practice and will reduce the pregnancy inpatient cost and duration of hospital stay of the Foley’s catheter group.
 
You will be given 100 dollars for participating.
 
You have to stay in hospital for longer.
 
 
In the following video, Laura will read information about Mughal jewellery. Once you have watched it, complete the 6 multiple choice questions that will appear on the next page.
 
 
 
Please answer the following multiple choice questions as best as you can.
Please do not return to the previous page.


* The Mughal rule began in India during the 16th century and subsequently,
 
The art of jewelry-making flourished throughout this era.
 
The art of sculpture flourished throughout this era.
 
The art of photography and print making flourished throughout this era.
 
The art of painting flourished throughout this era.
 
 
 
* The royal emperors and empresses wore exquisite long earrings which could be termed today as one of the following :
 
Chandelier earrings.
 
Pearl stud.
 
Ear studs.
 
Stud earnings.
 
 
 
* In India, the enamelling process is known as
 
Meenakari.
 
Jadau.
 
Filigree.
 
Thewa.
 
 
 
* Mughal bangles are different from other Indian style bangles due to their:
 
Use of pure gold or enameled gold.
 
Use of gem stones and pearls.
 
Unique shape and prominent stone setting.
 
Silver coating.
 
 
 
* The rings designed for royal ladies had tiny mirrors installed for them to admire their reflections are known as:
 
Hip chains.
 
Index rings.
 
Anklets.
 
Thumb rings.
 
 
 
* Which statement clearly indicates that Mughal jewelry is here to stay now and forever?
 
Mughal jewelry is now every brides dream.
 
The armlets worn by royal ladies are as equally alluring as other jewelry pieces.
 
The waist-belts are chiseled out of gold and are put on the waists of emperors and empresses.
 
It is made from heavy stonework and elaborate enamelling.
 
 
In the following video, Laura will slowly read a list of words.

Try to remember as many words as you can.

Once you have watched it, complete the question that will appear on the next page.

A helpful method of remembering the words is to think whether that object will fit inside a shoebox.
 
 
 
 
Write down in the box below, as many of the words as you can remember. Please do not return to the previous page.
   
 
 
In the following video, Laura will slowly read a list of words.

Try to remember as many words as you can.

Once you have watched it, complete the 6 multiple choice questions that will appear on the next page.

A helpful method of remembering the words is to think whether that object will fit inside a shoebox.
 
 
 
 
Write down in the box below, as many of the words as you can remember. Please do not return to the previous page.
   
 
 
 
A number of statements which people have used to describe themselves are given below.

Read each statement and then circle the appropriate number to the right of the statement to indicate how you feel right now, that is, at this moment.

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 your present feelings best.

Answer the below questions in regards to how you are right now at this moment.
 
 
 
* I am calm:
 
Not at all.
 
Somewhat.
 
Moderately so.
 
Very much so.
 
 
 
* I feel secure:
 
Not at all.
 
Somewhat.
 
Moderately so.
 
Very much so.
 
 
 
* I am tense:
 
Not at all.
 
Somewhat.
 
Moderately so.
 
Very much so.
 
 
 
* I feel strained:
 
Not at all.
 
Somewhat.
 
Moderately so.
 
Very much so.
 
 
 
* I feel at ease:
 
Not at all.
 
Somewhat.
 
Moderately so.
 
Very much so.
 
 
 
* I feel upset:
 
Not at all.
 
Somewhat.
 
Moderately so.
 
Very much so.
 
 
 
* I am presently worrying over possible misfortunes:
 
Not at all.
 
Somewhat.
 
Moderately so.
 
Very much so.
 
 
 
* I feel satisfied:
 
Not at all.
 
Somewhat.
 
Moderately so.
 
Very much so.
 
 
 
* I feel frightened:
 
Not at all.
 
Somewhat.
 
Moderately so.
 
Very much so.
 
 
 
* I feel comfortable:
 
Not at all.
 
Somewhat.
 
Moderately so.
 
Very much so.
 
 
 
* I am self-confident:
 
Not at all.
 
Somewhat.
 
Moderately so.
 
Very much so.
 
 
 
* I feel nervous:
 
Not at all.
 
Somewhat.
 
Moderately so.
 
Very much so.
 
 
 
* I am jittery:
 
Not at all.
 
Somewhat.
 
Moderately so.
 
Very much so.
 
 
 
* I feel indecisive:
 
Not at all.
 
Somewhat.
 
Moderately so.
 
Very much so.
 
 
 
* I am relaxed:
 
Not at all.
 
Somewhat.
 
Moderately so.
 
Very much so.
 
 
 
* I feel content:
 
Not at all.
 
Somewhat.
 
Moderately so.
 
Very much so.
 
 
 
* I am worried:
 
Not at all.
 
Somewhat.
 
Moderately so.
 
Very much so.
 
 
 
* I feel confused:
 
Not at all.
 
Somewhat.
 
Moderately so.
 
Very much so.
 
 
 
* I feel steady:
 
Not at all.
 
Somewhat.
 
Moderately so.
 
Very much so.
 
 
 
* I feel pleasant:
 
Not at all.
 
Somewhat.
 
Moderately so.
 
Very much so.
 
 
 
A number of statements which people have used to describe themselves are given below.

Read each statement and then circle the appropriate number to the right of the statement to indicate how you generally feel.
 
 
 
I feel pleasant:
 
Almost never.
 
Sometimes.
 
Often.
 
Almost always.
 
 
 
I feel nervous and restless:
 
Almost never.
 
Sometimes.
 
Often.
 
Almost always.
 
 
 
I feel satisfied with myself:
 
Almost never.
 
Sometimes.
 
Often.
 
Almost always.
 
 
 
I wish I could be as happy as others seem to be:
 
Almost never.
 
Sometimes.
 
Often.
 
Almost always.
 
 
 
I feel like a failure
 
Almost never.
 
Sometimes.
 
Often.
 
Almost always.
 
 
 
I feel rested:
 
Almost never.
 
Sometimes.
 
Often.
 
Almost always.
 
 
 
I am "calm, cool, and collected":
 
Almost never.
 
Sometimes.
 
Often.
 
Almost always.
 
 
 
I feel that difficulties are piling up so that I cannot overcome them:
 
Almost never.
 
Sometimes.
 
Often.
 
Almost always.
 
 
 
I worry too much over something that really doesn't matter:
 
Almost never.
 
Sometimes.
 
Often.
 
Almost always.
 
 
 
I am happy:
 
Almost never.
 
Sometimes.
 
Often.
 
Almost always.
 
 
 
I have disturbing thoughts:
 
Almost never.
 
Sometimes.
 
Often.
 
Almost always.
 
 
 
I lack self confidence:
 
Almost never.
 
Sometimes.
 
Often.
 
Almost always.
 
 
 
I feel secure:
 
Almost never.
 
Sometimes.
 
Often.
 
Almost always.
 
 
 
I make decisions easily:
 
Almost never.
 
Sometimes.
 
Often.
 
Almost always.
 
 
 
I feel inadequate:
 
Almost never.
 
Sometimes.
 
Often.
 
Almost always.
 
 
 
I am content:
 
Almost never.
 
Sometimes.
 
Often.
 
Almost always.
 
 
 
Some unimportant thought runs through my mind and bothers me:
 
Almost never.
 
Sometimes.
 
Often.
 
Almost always.
 
 
 
I take disappointments so keenly that I can’t put them out of my mind:
 
Almost never.
 
Sometimes.
 
Often.
 
Almost always.
 
 
 
I am a steady person:
 
Almost never.
 
Sometimes.
 
Often.
 
Almost always.
 
 
 
I get in a state of tension or turmoil as I think over my recent concerns and interests:
 
Almost never.
 
Sometimes.
 
Often.
 
Almost always.
 
 
 
In this last section we are interested to know how you typically think in stressful situations.

Everybody copes with stress in different ways, so remember no answer is right or wrong.

Please read each hypothetical scenario and then indicate which of the statements beneath it represent how you think you would react if you were in such a situation.

Please read each question carefully and tick the box alongside all the statements that would describe what you would do.

You may pick as many, or as few, statements as you like.
 
 
 
Vividly imagine that you are afraid of the dentist and have to get some dental work done. Which of the following would you do?
Please tick all the statements that might apply to you.
 
I would ask the dentist exactly what he was going to do.
 
I would take an anti-anxiety drug or have a drink before going.
 
I would try to think about pleasant memories.
 
I would want the dentist to tell me when I would feel pain.
 
I would try to sleep.
 
I would watch all the dentist’s movements and listen for the sound of his drill.
 
I would watch the flow of water from my mouth to see if it contained blood.
 
I would want to do mental puzzles in my mind.

 
 
 
Vividly imagine that, due to a large drop in sales, it is rumoured that several people in your department at work will be dismissed. Your supervisor has handed in an evaluation of your work for the past year.

Please tick all the statements that might apply to you.
 
I would talk to my fellow workers to see whether they knew anything about what the supervisor’s evaluation of me said.
 
I would review the list of duties for my present job and try to work out if I had fulfilled all of them.
 
I would go to the movies to take my mind off things.
 
I would try to remember any arguments or disagreements I might have had with the supervisor that would have lowered his opinion of me.
 
I would push all thought of being dismissed out of my mind.
 
I would tell my spouse that I’d rather not discuss my chances of being dismissed.
 
I would try to think which employees in my department the supervisor might have thought had done the worst job.
 
I would continue doing my work as if nothing special was happening.

 
 
 
Vividly imagine that you are on an aeroplane, thirty minutes from your destination, when the plane unexpectedly goes into a deep dive and then suddenly levels off. After a short time, the pilot announces that nothing is wrong, although the rest of the ride may be rough. You, however, are not convinced that all is well.

Please tick all statements that might apply to you.
 
I would carefully read the information provided about safety procedures in the plane and make sure I knew where the emergency exists were.
 
I would make small talk with the passenger beside me.
 
I would watch the end of the movie, even if I had seen it before.
 
I would call for the flight attendant and ask exactly what the problem was.
 
I would order a drink or tranquilliser from the stewardess.
 
I would listen carefully to the engines for the unusual noises and would watch the crew to see if their behaviour was out of the ordinary.
 
I would talk to the passenger beside me about what might be wrong.
 
I would settle down and read a book or magazine or write a letter.

 
 
 
Vividly imagine that you are being held hostage by a group of armed terrorists in a public building. Which of the following would you do?

Please tick all the statements that might apply to you.
 
I would sit by myself and have as many daydreams and fantasies as I could.
 
I would stay alert and try to keep myself from falling asleep.
 
I would exchange life stories with the other hostages.
 
If there was a radio present, I would stay near it and listen to the news items about what the police were doing.
 
I would watch every movement of my captors and keep an eye on their weapons.
 
I would try to sleep as much as possible.
 
I would think about how nice it’s going to be when I get home.
 
I would make sure I knew where every possible exit was.