y9ciaqq1_1 |
1.1 Has your child had an itchy rash that is coming and going, which affected any of the following places: folds of the elbows, behind the knees, in front of the ankles, on the cheeks, or around the neck, ears or eyes since the Year 8 visit? |
y9ciaqq1_2 |
1.2 Have you used topical steroids or other topical medicines on your child’s skin since the Year 8 visit? e.g. Hydrocortisone, Dermasone, Triderm, Neoderm, Desowen, Elomet, Fucicort |
y9ciaqq1_2name |
If Q1.2=Yes, specify name of product: |
y9ciaqq1_2nameoth |
If Q1.2 Products=Other, specify: |
y9ciaqq1_2ageyr |
If Q1.2=Yes, specify age of usage: Years |
y9ciaqq1_3 |
1.3 Do you label the skin of your child as: |
y9ciaqq1_4 |
1.4 Has your child been diagnosed with eczema since the Year 8 visit? |
y9ciaqq1_5 |
1.5 Has your child had wheezing, i.e. whistling sound that is coming from the chest (does not include snoring) since the Year 8 visit? |
y9ciaqq1_5no |
If Q1.5=Yes, specify number of wheezing episodes: |
y9ciaqq1_6 |
1.6 Has your child’s chest sounded wheezy during or after exercise/physical activity, e.g. running since the Year 8 visit? |
y9ciaqq1_6no |
If Q1.6=Yes, specify number of wheezing episodes: |
y9ciaqq1_7 |
1.7 Has your child coughed during or after exercise/physical activity, e.g. running since the Year 8 visit? |
y9ciaqq1_7no |
If Q1.7=Yes, specify number of episodes with coughing: |
y9ciaqq1_8 |
1.8 Has your child been diagnosed with bronchitis since the Year 8 visit? *Bronchitis - respiratory infection causing wheeze, cough, fever, runny nose and breathing difficulty |
y9ciaqq1_8no |
If Q1.8=Yes, specify number of episodes: |
y9ciaqq1_9 |
1.9 Has your child been prescribed with nebulizer treatment since the Year 8 visit? |
y9ciaqq1_9name |
If Q1.9=Yes, specify name of drugs: |
y9ciaqq1_9no |
If Q1.9=Yes, specify episodes of usage: |
y9ciaqq1_10 |
1.10 Has your child been prescribed with inhaler treatment since the Year 8 visit? |
y9ciaqq1_10na |
If Q1.10=Yes, specify name of drugs |
y9ciaqq1_11 |
1.11 Has your child been diagnosed with pneumonia since the Year 8 visit? *Exclude bronchiolitis/bronchitis |
y9ciaqq1_11no |
If Q1.11=Yes, specify number of episodes: |
y9ciaqq1_12 |
1.12 Has your child been diagnosed with asthma since the Year 8 visit? |
y9ciaqq1_13 |
1.13 Has your child had recurrent prolonged coughs for at least 4 weeks since the Year 8 visit? |
y9ciaqq1_13_1 |
1.13.1 If Yes, on the average how often do these episodes occur? |
y9ciaqq1_14 |
1.14 Has your child had a dry cough at night, apart from a cough associated with a cold or chest infection since the Year 8 visit? |
y9ciaqq1_14no |
If Q1.14=Yes, specify number of episodes: |
y9ciaqq1_15 |
1.15 Has your child ever had sneezing, running nose, blocked or congested nose, that has lasted for 2 or more weeks duration since the Year 8 visit? |
y9ciaqq1_15_1 |
1.15.1 Number of episodes of two or more weeks since the Year 8 visit? |
y9ciaqq1_15_2 |
1.15.2 Duration of longest episode: |
y9ciaqq1_15_3 |
1.15.3 Are the nose symptoms accompanied by itchy-watery eyes? |
y9ciaqq1_16 |
1.16 Has your child had a problem with sneezing, or a runny, or blocked nose when he/she DID NOT have a cold or the flu since the Year 8 visit? |
y9ciaqq1_17 |
1.17 Has your child been diagnosed with allergic rhinitis since the Year 8 visit? |
y9ciaqq1_18 |
1.18 Has your child been treated with topical nasal steroids since the Year 8 visit? |
y9ciaqq1_18na |
If Q1.18=Yes, specify the drug: |
y9ciaqq1_19 |
1.19 Please rate the nasal congestion symptoms during your child’s most severe rhinitis episode: |
y9ciaqq1_20 |
1.20 Please rate the runny nose symptoms during your child’s most severe rhinitis episode: |
y9ciaqq1_21 |
1.21 Please rate the nasal itching symptoms during your child’s most severe rhinitis episode: |
y9ciaqq1_22 |
1.22 Please rate the sneezing symptoms during your child’s most severe rhinitis episode: |
y9ciaqq1_23 |
1.23 Rate how difficult it was to sleep due to nasal symptoms over the most severe rhinitis episode: |
y9ciaqq1_24 |
1.24 How badly did the nose symptom interfere with your child’s school attendance since the Year 8 visit? |
y9ciaqq1_25 |
1.25 Has your child been diagnosed by a doctor as having a middle ear infection since the Year 8 visit? |
y9ciaqq1_25no |
If Q1.25=Yes, specify number of episodes: |
y9ciaqq1_26 |
1.26 Have you ever been told by a doctor that your child has a hearing problem since the Year 8 visit? |
y9ciaqq1_26spec |
If Q1.26=Yes, specify |
y9ciaqq1_27 |
1.27 Has your child had a reaction (e.g. redness or itching) which you thought was due to some food that he/she had eaten since the Year 8 visit? |
y9ciaqq1_27_1a |
FOOD 1 Food suspected to have caused it |
y9ciaqq1_27_1a_oth |
If Food 1 - Other, please specify: |
y9ciaqq1_27_1a_frq |
Number of episodes |
y9ciaqq1_27_1a_obs___1 |
Observation Please select if applicable (choice=Skin rash) |
y9ciaqq1_27_1a_obs___2 |
Observation Please select if applicable (choice=Itching) |
y9ciaqq1_27_1a_obs___3 |
Observation Please select if applicable (choice=Swollen lips) |
y9ciaqq1_27_1a_obs___4 |
Observation Please select if applicable (choice=Swollen eyes) |
y9ciaqq1_27_1a_obs___5 |
Observation Please select if applicable (choice=Diarrhoea) |
y9ciaqq1_27_1a_obs___6 |
Observation Please select if applicable (choice=Vomitting) |
y9ciaqq1_27_1a_obs___7 |
Observation Please select if applicable (choice=Difficulty breathing) |
y9ciaqq1_27_1a_obs___8 |
Observation Please select if applicable (choice=Other) |
y9ciaqq1_27_1a_obsoth |
If Food 1 - Other Observation, please specify: |
y9ciaqq1_27_1a_dur |
How long after food was eaten that reaction appeared? |
y9ciaqq1_27_1a_take |
Is your child still taking this food now? |
y9ciaqq1_27_1a_hc |
Attendance at healthcare facility |
y9ciaqq1_27_1b |
FOOD 2 Food suspected to have caused it Select ‘Not Applicable’ if no other food |
y9ciaqq1_27_1b_oth |
If Food 2 - Other, please specify: |
y9ciaqq1_27_1b_frq |
Number of episodes |
y9ciaqq1_27_1b_obs___1 |
Observation Please select if applicable (choice=Skin rash) |
y9ciaqq1_27_1b_obs___2 |
Observation Please select if applicable (choice=Itching) |
y9ciaqq1_27_1b_obs___3 |
Observation Please select if applicable (choice=Swollen lips) |
y9ciaqq1_27_1b_obs___4 |
Observation Please select if applicable (choice=Swollen eyes) |
y9ciaqq1_27_1b_obs___5 |
Observation Please select if applicable (choice=Diarrhoea) |
y9ciaqq1_27_1b_obs___6 |
Observation Please select if applicable (choice=Vomitting) |
y9ciaqq1_27_1b_obs___7 |
Observation Please select if applicable (choice=Difficulty breathing) |
y9ciaqq1_27_1b_obs___8 |
Observation Please select if applicable (choice=Other) |
y9ciaqq1_27_1b_obsot |
If Food 2 - Other Observation, please specify: |
y9ciaqq1_27_1b_dur |
How long after food was eaten that reaction appeared? |
y9ciaqq1_27_1b_take |
Is your child still taking this food now? |
y9ciaqq1_27_1b_hc |
Attendance at healthcare facility |
y9ciaqq1_27_1c |
FOOD 3 Food suspected to have caused it Select ‘Not Applicable’ if no other food |
y9ciaqq1_27_1c_oth |
If Food 3 - Other, please specify: |
y9ciaqq1_27_1c_frq |
Number of episodes |
y9ciaqq1_27_1c_obs___1 |
Observation Please select if applicable (choice=Skin rash) |
y9ciaqq1_27_1c_obs___2 |
Observation Please select if applicable (choice=Itching) |
y9ciaqq1_27_1c_obs___3 |
Observation Please select if applicable (choice=Swollen lips) |
y9ciaqq1_27_1c_obs___4 |
Observation Please select if applicable (choice=Swollen eyes) |
y9ciaqq1_27_1c_obs___5 |
Observation Please select if applicable (choice=Diarrhoea) |
y9ciaqq1_27_1c_obs___6 |
Observation Please select if applicable (choice=Vomitting) |
y9ciaqq1_27_1c_obs___7 |
Observation Please select if applicable (choice=Difficulty breathing) |
y9ciaqq1_27_1c_obs___8 |
Observation Please select if applicable (choice=Other) |
y9ciaqq1_27_1c_obsth |
If Food 3 - Other Observation, please specify: |
y9ciaqq1_27_1c_dur |
How long after food was eaten that reaction appeared? |
y9ciaqq1_27_1c_take |
Is your child still taking this food now? |
y9ciaqq1_27_1c_hc |
Attendance at healthcare facility |
y9ciaqq1_27_1d |
FOOD 4 Food suspected to have caused it Select ‘Not Applicable’ if no other food |
y9ciaqq1_27_1d_oth |
If Food 4 - Other, please specify: |
y9ciaqq1_27_1d_frq |
Number of episodes |
y9ciaqq1_27_1d_obs___1 |
Observation Please select if applicable (choice=Skin rash) |
y9ciaqq1_27_1d_obs___2 |
Observation Please select if applicable (choice=Itching) |
y9ciaqq1_27_1d_obs___3 |
Observation Please select if applicable (choice=Swollen lips) |
y9ciaqq1_27_1d_obs___4 |
Observation Please select if applicable (choice=Swollen eyes) |
y9ciaqq1_27_1d_obs___5 |
Observation Please select if applicable (choice=Diarrhoea) |
y9ciaqq1_27_1d_obs___6 |
Observation Please select if applicable (choice=Vomitting) |
y9ciaqq1_27_1d_obs___7 |
Observation Please select if applicable (choice=Difficulty breathing) |
y9ciaqq1_27_1d_obs___8 |
Observation Please select if applicable (choice=Other) |
y9ciaqq1_27_1d_obsoth |
If Food 4 - Other Observation, please specify: |
y9ciaqq1_27_1d_dur |
How long after food was eaten that reaction appeared? |
y9ciaqq1_27_1d_take |
Is your child still taking this food now? |
y9ciaqq1_27_1d_hc |
Attendance at healthcare facility |
y9ciaqq1_28 |
1.28 Is your child currently avoiding any food due to known food allergy? |
y9ciaqq1_28_1 |
1.28.1 Peanut |
y9ciaqq1_28_2 |
1.28.2 Shrimp |
y9ciaqq1_28_3 |
1.28.3 Crab |
y9ciaqq1_28_4 |
1.28.4 Others |
y9ciaqq1_28_4specify |
If Yes, please specify: |
y9ciaqq1_29_1yn |
1.29.1 Peanut |
y9ciaqq1_29_2yn |
1.29.2 Shrimp |
y9ciaqq1_29_3yn |
1.29.3 Crab |
y9ciaqq1_30 |
1.30 Did your child have doctor-diagnosed eczema in the past but has outgrown it by now? |
y9ciaqq1_30spec |
If Q1.30=Yes, specify age of outgrowing eczema: |
y9ciaqq1_31 |
1.31 Did your child have doctor-diagnosed allergic rhinitis/ sensitive nose in the past but has outgrown it by now? |
y9ciaqq1_31spec |
If Q1.31=Yes, specify age of outgrowing allergic rhinitis: |
y9ciaqq1_32 |
1.32 Did your child have doctor-diagnosed asthma in the past but has outgrown it by now? |
y9ciaqq1_32spec |
If Q1.32=Yes, specify age of outgrowing asthma: |
y9ciaqq1_33 |
1.33 Did your child have doctor-diagnosed food allergy in the past but has outgrown it by now? |
y9ciaqq1_33spec |
If Q1.33=Yes, specify age of outgrowing food allergy: |
y9ciaqq1_34a |
1.34 Has your child ever been diagnosed by a doctor with allergy to house dust mite since birth? |
y9ciaqq1_34a_oth |
If Yes, please specify: |
y9ciaqq1_34b_1yr |
Episode 1 - Age (years) |
y9ciaqq1_34b_1out |
Episode 1 - Did the doctor suggest that your child should spend more time outdoor? |
y9ciaqq1_34b_2yr |
Episode 2 - Age (years) |
y9ciaqq1_34b_2out |
Episode 2 - Did the doctor suggest that your child should spend more time outdoor? |
y9ciaqq1_34b_3yr |
Episode 3 - Age (years) |
y9ciaqq1_34b_3out |
Episode 3 - Did the doctor suggest that your child should spend more time outdoor? |
y9ciaqq1_35a |
1.35 Did your child have abdominal pain, stomachache or bellyache (not related to eating or menstruation), for at least 4 days per month AND started more than 2 months ago? |
y9ciaqq1_35b___0 |
1.35.1 Where is the pain normally? (Can tick more than one) (choice=Around the Belly Button) |
y9ciaqq1_35b___1 |
1.35.1 Where is the pain normally? (Can tick more than one) (choice=Below the Belly Button) |
y9ciaqq1_35b___2 |
1.35.1 Where is the pain normally? (Can tick more than one) (choice=Above the Belly Button) |
y9ciaqq1_35c |
1.35.2. Did the pain or uncomfortable feeling happen around the time your child pooped? |
y9ciaqq1_35d |
1.35.3. Were your child’s poop either softer and more watery or more often than usual? |
y9ciaqq1_35e |
1.35.4. Were your child’s poops either harder or lumpier or less often than usual? |
y9ciaqq1_36a |
1.36 In the past month, on how many days did your child feel uncomfortably full, or feel nauseated or bloated after a normal-sized meal (the amount your child usually eats) OR not able to finish a normal-sized meal because he/she is too full? |
y9ciaqq1_34 |
1.37 Has your child had any surgery or imaging tests that required anaesthesia or sedation since the Year 8 visit? Type of anaesthesia 1. General anaesthesia (GA) - child fully asleep during procedure 2. Local anaesthesia (LA) - child fully awake during procedure with absence of sensation in part of the body 3. Sedation - child sleepy but able to respond/talk during procedure |
y9ciaqq1_34_1yr |
Surgery or Imaging test 1- Age (years) |
y9ciaqq1_34_1typ |
Surgery or Imaging test 1- Type of Surgery or Imaging test |
y9ciaqq1_34_1ana |
Surgery or Imaging test 1-Type of anaesthesia |
y9ciaqq1_34_2yr |
Surgery or Imaging test 2- Age (years) |
y9ciaqq1_34_2typ |
Surgery or Imaging test 2- Type of Surgery or Imaging test |
y9ciaqq1_34_2ana |
Surgery or Imaging test 2-Type of anaesthesia |
y9ciaqq1_34_3yr |
Surgery or Imaging test 3- Age (years) |
y9ciaqq1_34_3typ |
Surgery or Imaging test 3- Type of Surgery or Imaging test |
y9ciaqq1_34_3ana |
Surgery or Imaging test 3-Type of anaesthesia |
y9ciaqq1_35 |
1.38 Has your child had any admission to a hospital since the Year 8 visit? |
y9ciaqq1_35_1yr |
Hospital admission 1- Age (years) |
y9ciaqq1_35_1dur |
Hospital admission 1- Duration admitted (days) |
y9ciaqq1_35_1dia |
Hospital admission 1- Diagnosis |
y9ciaqq1_35_1hos |
Hospital admission 1- Hospital admitted to |
y9ciaqq1_35_2yr |
Hospital admission 2- Age (years) |
y9ciaqq1_35_2dur |
Hospital admission 2- Duration admitted (days) |
y9ciaqq1_35_2dia |
Hospital admission 2- Diagnosis |
y9ciaqq1_35_2hos |
Hospital admission 2- Hospital admitted to |
y9ciaqq1_35_3yr |
Hospital admission 3- Age (years) |
y9ciaqq1_35_3dur |
Hospital admission 3- Duration admitted (days) |
y9ciaqq1_35_3dia |
Hospital admission 3- Diagnosis |
y9ciaqq1_35_3hos |
Hospital admission 3- Hospital admitted to |
y9ciaqq1_36 |
1.39 Has your child been diagnosed with other medical conditions since the Year 8 visit? |
y9ciaqq1_36_1yr |
Medical condition 1- Age (years) |
y9ciaqq1_36_1dia |
Medical condition 1- Diagnosis |
y9ciaqq1_36_2yr |
Medical condition 2- Age (years) |
y9ciaqq1_36_2dia |
Medical condition 2- Diagnosis |
y9ciaqq1_36_3yr |
Medical condition 3- Age (years) |
y9ciaqq1_36_3dia |
Medical condition 3- Diagnosis |
y9ciaqq1_37 |
1.40 Has your child taken any long term medications (at least for a month) since the Year 8 visit? |
y9ciaqq1_37_1yr |
Long term medication 1- Age (years) |
y9ciaqq1_37_1med |
Long term medication 1- Type of Long term medication |
y9ciaqq1_37_1con |
Long term medication 1-Type of anaesthesia |
y9ciaqq1_37_2yr |
Long term medication 2- Age (years) |
y9ciaqq1_37_2med |
Long term medication 2- Type of Long term medication |
y9ciaqq1_37_2con |
Long term medication 2-Type of anaesthesia |
y9ciaqq1_37_3yr |
Long term medication 3- Age (years) |
y9ciaqq1_37_3med |
Long term medication 3- Type of Long term medication |
y9ciaqq1_37_3con |
Long term medication 3-Type of anaesthesia |
y9cqnndco |
DATA REMARKS |
y9_child_questionnaire_complete |
Complete? |