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… M12-927 Parkinson Anxiety Scale (PAS) Site Number Subject Number Examiner Initials Visit Examination Date ─ ─ Day Month Year 1 English for Australia Copyright of this scale and its translations is held by the authors (Leentjens AFG, Dujardin K, Pontone GM, Starkstein SE, Weintraub D, and Martinez-Martin P; 2014). The scale and its … always A.3. Being unable to relax  0. Not at all, or never  1. Very mild, or rarely  2. Mild, or sometimes  3. Moderate, or often  4. Severe, or (nearly) always M12-927 Parkinson Anxiety Scale (PAS) Site Number Subject Number Examiner Initials Visit Examination Date ─ ─ Day Month Year 2 English for Australia A.4. Excessive worrying about everyday matters  0. Not at all, or never  1. Very mild, or rarely  2. Mild, or sometimes  3. Moderate, or often  4. Severe, or (nearly) always A.5. … fear  0. Never  1. Rarely  2. Sometimes  3. Often  4. Nearly always B.2. Shortness of breath  0. Never  1. Rarely  2. Sometimes  3. Often  4. Nearly always M12-927 Parkinson Anxiety Scale (PAS) Site Number Subject Number Examiner Initials Visit Examination Date ─ ─ Day Month Year 3 English for Australia B.3. Heart palpitations or heart beating fast (not related to physical effort or activity)  0. Never  1. Rarely  2. Sometimes  3. Often  4. Nearly always B.4. Fear of losing control …

… UM – York Collaboration Fund APPLICATION FORM Please complete this application and send electronically as one PDF to Ms Nicole Kusters at ( nicole.kusters@maastrichtuniversity.nl ) Proposed Start and End Date:       Duration of Proposed Visit:       1. Applicant’s Details Title:       First name:       Surname:       Department or School:       Telephone Number:       Email:       2. Host’s Details Host’s Title:       First name:       Surname:       Host’s Department or School:       Position:       Telephone Number:       Email:       3. Aims and Objectives of visit (max 250 words) 4. Details of funding requested Guidelines for funding: (i) Travel: travel to airport, economy airfare (ii) Accommodation and subsistence costs Item Breakdown of costs Total Travel costs             Accommodation and Subsistence costs             Total applied for       5. Which area/s of strategic importance does your visit align with? 1. Agrifood 2. Imaging 3. Europe in a globalising world 4. Global South 5. Knowledge Partners – Data Science 6. Other (please state) Other Information Signed:       Date:       1 …