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1 |
[record_id] |
Record ID |
text |
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2 |
[record_id_942b10] |
Record ID |
text |
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3 |
[participant_id] |
Participant id |
text |
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4 |
[participant_name] |
Participant name |
text |
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5 |
[day] |
Day |
text |
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6 |
[date] |
Date |
text |
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7 |
[are_you_feeling_any_kind_o] |
Are you feeling any kind of difficulty? |
yesno |
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8 |
[if_yes_please_describe] |
If yes, please describe |
text |
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9 |
[are_you_still_consuming_al] |
Are you still consuming alcohol? |
yesno |
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10 |
[if_yes_are_you_consuming_i] |
If yes,are you consuming it everyday? |
yesno |
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11 |
[if_yes_how_much_do_you_dri] |
if yes ,How much do you drink per day ? |
text |
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12 |
[are_you_taking_any_other_s] |
Are you taking any other substance ? |
yesno |
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13 |
[if_yes_please] |
If yes, please |
text |
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14 |
[how_did_you_feel_after_inh] |
Section Header: Aroma questions
How did you feel after inhaling the stick ?
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text |
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15 |
[were_you_able_to_use_it] |
Were you able to use it ? |
yesno |
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16 |
[how_many_times_you_used_it] |
How many times you used it ? |
text |
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17 |
[how_did_you_feel_after_usi] |
How did you feel after using it ? |
slider (Min: 0, Max: 100) Slider labels: 0(worst), , 10(best) Custom alignment: RH |
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18 |
[how_did_you_feel_after_usi_2] |
How pleasant is the odor? |
slider (Min: 0, Max: 100) Slider labels: 0(unpleasant), , 10(pleasant ) Custom alignment: RH |
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19 |
[how_did_you_feel_after_usi_3] |
How intense is the odor? |
slider (Min: 0, Max: 100) Slider labels: 0(weak), , 10(strong) Custom alignment: RH |
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20 |
[any_emotion_evoked_by_this] |
Any emotion evoked by this odor? |
text Custom alignment: RH |
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21 |
[rate_the_emotional_intensi] |
Rate the emotional intensity |
slider (Min: 0, Max: 100) Slider labels: 0(less), , 10(more) Custom alignment: RH |
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22 |
[alcohol_craving_questionaire_1] |
Section Header:
Alcohol Craving Questionnaire Please indicate how much you agree or disagree with each of the following statements by placing a single checkmark (like this: X) along each line between STRONGLY DISAGREE and STRONGLY AGREE, The closer you place your checkmark to one end or the other indicates the strength of your disagreement or agreement. We are interested in how you are thinking or feeling right now as you are filling out this questionnaire. Please complete every item. शराब की लालसा प्रश्नावली कृपया बताएं कि आप निम्नलिखित कथनों में से प्रत्येक से कितना सहमत या असहमत हैं, इसके लिए आपको अत्यन्त असहमति और अत्यन्त सहमति के बीच उचित पंक्ति पर एक चेकमार्क (जैसे: X) लगाना होगा। आप अपने चेकमार्क को एक छोर या दूसरे छोर के जितना करीब रखेंगे, यह आपकी असहमति या सहमति की मात्रा को दर्शाता है। हमें इस बात में दिलचस्पी है कि आप इस प्रश्नावली को भरते समय अभी क्या सोच रहे हैं या कैसा महसूस कर रहे हैं। कृपया हर आइटम को पूरा करें।
If I had some alcohol, I would probably drink it.
अगर मेरे पास शराब होती तो मैं शायद उसे पी लेता / लेती।
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radio| 1 | Strongly disagree | | 2 | Strongly agree |
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23 |
[alcohol_craving_questionaire_2] |
I miss drinking
मुझे शराब पीने की याद आती है।
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radio| 1 | Strongly disagree | | 2 | Strongly agree |
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24 |
[alcohol_craving_questionaire_3] |
I am not making any plans to drink.
मैं शराब पीने की कोई योजना नहीं बना रहा / रही हूं।
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radio| 1 | Strongly disagree | | 2 | Strongly agree |
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25 |
[alcohol_craving_questionaire_4] |
I could not stop myself from drinking if I had some alcohol here.
अगर मुझे यहां शराब मिल जाती तो मैं खुद को पीने से नहीं रोक पाता / पाती।
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radio| 1 | Strongly disagree | | 2 | Strongly agree |
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26 |
[alcohol_craving_questionaire_5] |
I want to drink so bad, I can almost taste it.
मैं इतनी बुरी तरह पीना चाहता / चाहती हूँ कि मैं लगभग उसका स्वाद महसूस कर सकता / सकती हूँ।
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radio| 1 | Strongly disagree | | 2 | Strongly agree |
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27 |
[alcohol_craving_questionaire_6] |
I would feel less irritable if I used alcohol now.
अगर मैं अब शराब का सेवन करूँ तो मुझे कम चिड़चिड़ापन महसूस होगा।
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radio| 1 | Strongly disagree | | 2 | Strongly agree |
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28 |
[alcohol_craving_questionaire_7] |
If I used alcohol, I would feel less tense.
अगर मैं शराब पीता / पीती तो मुझे कम तनाव महसूस होता।
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radio| 1 | Strongly disagree | | 2 | Strongly agree |
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29 |
[alcohol_craving_questionaire_8] |
Drinking would not be very satisfying.
मुझे शराब पीने से बहुत संतुष्टि नहीं मिलेगी।
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radio| 1 | Strongly disagree | | 2 | Strongly agree |
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30 |
[alcohol_craving_questionaire_9] |
I would feel less restless if I drank alcohol.
अगर मैं शराब पीता / पीती तो मुझे कम बेचैनी महसूस होती।
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radio| 1 | Strongly disagree | | 2 | Strongly agree |
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31 |
[alcohol_craving_questionaire_10] |
If I were using alcohol, I would feel less nervous.
यदि मैं शराब पी रहा/रही होता/होती तो मुझे कम घबराहट महसूस होती।
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radio| 1 | Strongly disagree | | 2 | Strongly agree |
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32 |
[alcohol_craving_questionaire_11] |
It would be easy to pass up the chance to use alcohol.
शराब का सेवन करने का मौका छोड़ना आसान होगा।
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radio| 1 | Strongly disagree | | 2 | Strongly agree |
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33 |
[alcohol_craving_questionaire_12] |
Drinking would put me in a better mood.
शराब पीने से मेरा/मेरी मूड अच्छा हो जाएगा।
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radio| 1 | Strongly disagree | | 2 | Strongly agree |
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34 |
[alcohol_craving_questionaire_complete] |
Section Header: Form Status
Complete?
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dropdown| 0 | Incomplete | | 1 | Unverified | | 2 | Complete |
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