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C
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Dep
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Facu
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Un
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Pu
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s
tan
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g
an
d
h
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in
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th
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p
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ten
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f
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t
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d
PA
in
f
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s
ter
in
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p
s
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ch
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g
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esil
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h
as g
ain
ed
p
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in
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ch
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esil
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r
ep
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an
in
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p
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p
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in
th
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f
ac
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life
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s
tacle
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[
1
]
,
[
2
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.
I
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f
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[
3
]
,
[
4
]
.
T
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r
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s
p
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p
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tr
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p
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f
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al
g
r
o
wth
ca
n
p
lace
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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2
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6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
3
,
No
.
4
,
Dec
em
b
er
20
24
:
1
7
2
7
-
1
7
3
7
1728
co
n
s
id
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ab
le
s
tr
ain
o
n
s
tu
d
en
ts
’
m
en
tal
well
-
b
ein
g
[
5
]
–
[
8
]
.
Mo
r
eo
v
er
,
as
s
tu
d
en
ts
u
n
d
e
r
g
o
s
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n
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life
ch
an
g
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c
o
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n
ter
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s
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th
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s
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o
m
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im
p
er
ativ
e
f
o
r
th
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o
v
er
all
we
ll
-
b
ein
g
[
9
]
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[
1
0
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.
Sp
o
r
t
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d
PA,
in
th
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m
y
r
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d
f
o
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m
s
,
h
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e
th
e
p
o
ten
tial
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b
e
ca
taly
s
ts
f
o
r
b
u
ild
in
g
p
s
y
ch
o
lo
g
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r
esil
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ce
[
1
1
]
,
[
1
2
]
.
T
h
e
in
h
er
en
t
attr
ib
u
tes
o
f
th
ese
ac
tiv
ities
en
co
m
p
ass
s
ev
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al
cr
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f
ac
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e
in
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tr
u
m
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tal
in
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esil
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e
lo
p
m
en
t
[
1
3
]
.
Ad
d
itio
n
ally
,
r
e
g
u
lar
e
n
g
ag
e
m
en
t
i
n
PAs
co
n
t
r
ib
u
tes
to
im
p
r
o
v
ed
p
h
y
s
ical
h
ea
lth
,
wh
ich
,
in
tu
r
n
,
h
as
a
p
r
o
f
o
u
n
d
in
f
lu
e
n
ce
o
n
em
o
tio
n
al
well
-
b
ein
g
[
1
4
]
.
No
te
th
at
en
h
an
ce
d
p
h
y
s
ical
f
itn
ess
is
lin
k
ed
to
h
eig
h
ten
ed
s
elf
-
esteem
,
em
o
tio
n
a
l
s
tab
ilit
y
,
an
d
s
elf
-
ef
f
icac
y
,
all
o
f
wh
ich
u
n
d
er
p
in
r
esil
ien
ce
[
1
5
]
–
[
1
8
]
.
Fu
r
t
h
er
m
o
r
e,
s
p
o
r
ts
an
d
PA
o
f
f
er
a
s
tr
u
ctu
r
ed
an
d
s
u
p
p
o
r
tiv
e
en
v
i
r
o
n
m
en
t
th
at
f
o
s
ter
s
s
o
cial
in
ter
ac
tio
n
s
,
team
wo
r
k
,
an
d
p
o
s
itiv
e
r
elatio
n
s
h
ip
s
[
1
9
]
–
[
2
1
]
.
T
h
ese
s
ettin
g
s
s
er
v
e
as
p
latf
o
r
m
s
f
o
r
in
d
iv
id
u
als
to
d
ev
elo
p
s
tr
o
n
g
s
o
cial
b
o
n
d
s
an
d
s
u
p
p
o
r
t
n
e
two
r
k
s
[
2
2
]
,
[
2
3
]
.
T
h
e
ca
m
ar
ad
er
ie
an
d
s
h
ar
ed
o
b
jectiv
es
in
s
p
o
r
ts
o
f
ten
cu
lm
in
ate
in
a
wea
lth
o
f
em
o
tio
n
al
r
eso
u
r
ce
s
,
eq
u
ip
p
i
n
g
in
d
iv
i
d
u
als
to
with
s
tan
d
th
e
ch
allen
g
es
life
p
r
esen
ts
[
2
1
]
,
[
2
4
]
.
Mo
r
eo
v
e
r
,
th
e
s
k
ills
ac
q
u
ir
ed
in
th
e
s
p
o
r
tin
g
a
r
e
n
a
,
s
u
c
h
a
s
g
o
a
l
s
e
t
ti
n
g
,
d
i
s
c
i
p
li
n
e
,
a
n
d
p
e
r
s
e
v
e
r
a
n
c
e
,
t
r
a
n
s
l
a
te
s
e
a
m
l
es
s
l
y
t
o
t
h
e
c
h
a
ll
en
g
e
s
o
f
d
a
i
l
y
l
i
f
e
[
2
2
]
.
Sp
o
r
t
an
d
PA
ar
e
m
u
ltifa
ce
ted
ex
p
e
r
ien
ce
s
th
at
ex
ten
d
b
e
y
o
n
d
th
e
r
ea
lm
o
f
p
h
y
s
ical
f
itn
ess
.
T
h
e
b
en
ef
its
o
f
ex
er
cise
o
n
ca
r
d
io
v
ascu
lar
h
ea
lth
an
d
m
u
s
cu
lar
s
tr
en
g
th
ar
e
well
-
estab
lis
h
ed
.
Nev
er
th
eless
,
th
e
p
s
y
ch
o
lo
g
ical
ad
v
an
tag
es,
esp
ec
ially
in
ter
m
s
o
f
r
es
ilien
ce
,
r
em
ain
a
s
u
b
ject
o
f
ex
p
lo
r
atio
n
[
2
4
]
,
[
2
5
]
.
T
h
is
r
ev
iew
s
ee
k
s
to
u
n
r
av
el
th
e
n
u
an
ce
d
in
te
r
p
lay
b
etwe
en
p
ar
ticip
atio
n
in
s
p
o
r
ts
,
e
n
g
ag
em
en
t
in
PAs
,
an
d
th
e
cu
ltiv
atio
n
o
f
p
s
y
c
h
o
lo
g
ical
r
esil
ien
ce
am
o
n
g
s
tu
d
en
ts
.
Hen
ce
,
b
y
s
y
s
tem
atica
lly
s
y
n
th
e
s
izin
g
th
e
av
ailab
le
ev
id
en
ce
,
we
aim
to
p
r
o
v
i
d
e
an
o
v
er
v
iew
o
f
th
e
e
x
is
tin
g
k
n
o
wled
g
e
lan
d
s
ca
p
e,
s
h
ed
d
in
g
lig
h
t
o
n
th
e
m
ec
h
an
is
m
s
th
r
o
u
g
h
wh
ich
s
p
o
r
t
an
d
PA
m
ay
co
n
tr
ib
u
t
e
to
p
s
y
ch
o
l
o
g
ical
r
esil
ien
ce
am
o
n
g
s
tu
d
en
ts
.
Un
d
er
s
tan
d
in
g
h
o
w
s
tu
d
en
ts
ca
n
h
ar
n
ess
th
e
b
en
ef
its
o
f
s
p
o
r
t
an
d
PA
to
f
o
r
tify
th
eir
p
s
y
ch
o
lo
g
i
ca
l
r
esil
ien
ce
h
o
ld
s
th
e
p
o
ten
tial
to
g
u
id
e
t
h
e
d
ev
elo
p
m
en
t
o
f
tar
g
ete
d
wel
l
-
b
ein
g
p
r
o
g
r
am
s
with
in
ed
u
c
atio
n
al
in
s
titu
tio
n
s
.
T
h
u
s
,
b
y
el
u
cid
atin
g
th
is
r
ela
tio
n
s
h
ip
,
we
aim
t
o
c
o
n
tr
ib
u
te
to
t
h
e
h
o
lis
tic
u
n
d
er
s
tan
d
in
g
o
f
s
tu
d
e
n
t
m
e
n
tal
h
ea
lth
an
d
o
f
f
er
ev
id
e
n
ce
-
b
ase
d
r
ec
o
m
m
en
d
atio
n
s
f
o
r
p
r
o
m
o
tin
g
p
s
y
ch
o
lo
g
ical
r
esil
ien
ce
th
r
o
u
g
h
en
g
a
g
em
en
t
in
s
p
o
r
ts
an
d
PA.
2.
M
E
T
H
O
D
2
.
1
.
Sea
rc
h str
a
t
eg
y
a
nd
inclu
s
io
n c
rit
er
ia
f
o
r
s
y
s
t
em
a
t
ic
re
v
iew
I
n
co
n
d
u
ctin
g
th
is
s
y
s
tem
atic
r
ev
iew,
a
well
-
d
ef
i
n
e
d
s
ea
r
ch
s
tr
ateg
y
was
em
p
lo
y
ed
t
o
co
m
p
r
eh
e
n
s
iv
ely
ex
p
lo
r
e
th
e
r
elev
an
t
liter
atu
r
e.
T
h
e
p
r
ef
er
r
e
d
r
ep
o
r
tin
g
item
s
f
o
r
s
y
s
tem
ati
c
r
ev
iews
an
d
m
eta
-
an
aly
s
e
s
(
PR
I
SM
A)
f
lo
w
d
iag
r
am
g
u
id
ed
th
e
s
y
s
tem
atic
s
ea
r
ch
an
d
s
elec
tio
n
p
r
o
ce
s
s
,
p
r
o
v
id
in
g
a
tr
an
s
p
ar
en
t
v
is
u
aliza
tio
n
o
f
th
e
s
tu
d
y
s
elec
tio
n
p
r
o
ce
d
u
r
e.
T
h
e
p
r
im
ar
y
d
atab
ases
u
tili
ze
d
f
o
r
th
is
r
ev
iew
wer
e
Sco
p
u
s
an
d
E
B
SC
Oh
o
s
t.
T
h
e
in
clu
s
io
n
cr
iter
ia
wer
e
m
e
ticu
lo
u
s
ly
estab
lis
h
ed
to
en
s
u
r
e
th
e
r
elev
a
n
ce
an
d
q
u
ality
o
f
t
h
e
s
elec
ted
s
tu
d
ies.
Ar
ticles
h
ad
to
b
e
i
n
E
n
g
lis
h
an
d
p
u
b
lis
h
ed
wit
h
in
th
e
tim
elin
e
o
f
2
0
1
9
to
2
0
2
3
,
with
a
f
o
c
u
s
ex
clu
s
iv
ely
o
n
jo
u
r
n
al
ar
ticle
s
.
T
h
e
s
ea
r
ch
r
esu
lts
wer
e
th
o
r
o
u
g
h
ly
r
ev
iewe
d
,
co
n
s
id
er
in
g
th
e
f
u
ll
co
n
te
n
ts
,
ab
s
tr
ac
ts
,
an
d
titl
es
b
y
th
e
a
u
th
o
r
s
.
T
h
e
s
elec
tio
n
p
r
o
ce
s
s
p
r
io
r
itized
ar
ticles
th
at
d
em
o
n
s
tr
ated
a
d
ir
ec
t
alig
n
m
en
t
with
th
e
s
u
b
ject
m
atter
,
ass
ess
ed
th
e
s
tr
en
g
th
o
f
ev
id
en
ce
p
r
esen
ted
,
a
n
d
ev
a
l
u
ated
th
e
p
o
ten
tial
co
n
tr
ib
u
tio
n
o
f
ea
c
h
ar
ticle
to
th
e
o
v
er
all
r
ev
iew
o
b
jectiv
es.
R
ig
o
r
o
u
s
s
cr
u
tin
y
was a
p
p
lied
to
en
s
u
r
e
th
at
o
n
ly
s
tu
d
ies
m
ee
tin
g
th
e
p
r
ed
ef
i
n
e
d
cr
iter
ia
wer
e
in
clu
d
ed
i
n
th
e
f
in
al
s
y
s
tem
atic
r
ev
iew.
T
h
is
s
tr
in
g
en
t
s
elec
tio
n
p
r
o
ce
s
s
aim
ed
t
o
m
ain
tain
t
h
e
in
teg
r
ity
an
d
r
eliab
ilit
y
o
f
th
e
s
y
n
th
esized
e
v
id
en
ce
,
co
n
tr
ib
u
tin
g
to
a
co
m
p
r
eh
e
n
s
iv
e
an
d
r
o
b
u
s
t
u
n
d
er
s
tan
d
in
g
o
f
th
e
im
p
ac
t
o
f
s
tu
d
en
t
p
ar
ticip
atio
n
in
s
p
o
r
ts
an
d
p
h
y
s
ical
ac
tiv
ities
o
n
p
s
y
ch
o
lo
g
ical
r
esil
ien
ce
.
A
s
a
r
esu
lt,
1
5
ar
ticle
s
m
ee
tin
g
t
h
e
s
p
ec
if
ied
cr
iter
ia
h
a
v
e
b
ee
n
r
etain
ed
f
o
r
f
u
r
th
er
r
ev
iew
in
th
e
s
tu
d
y
.
2
.
2
.
Da
t
a
e
x
t
ra
ct
i
o
n a
nd
a
na
ly
s
is
Fo
r
th
e
d
ata
ex
tr
ac
tio
n
an
d
a
n
aly
s
is
p
h
ase
o
f
th
is
s
y
s
tem
atic
r
ev
iew,
a
m
eticu
lo
u
s
ap
p
r
o
ac
h
was
u
n
d
er
tak
e
n
to
e
n
s
u
r
e
th
e
th
o
r
o
u
g
h
ev
alu
atio
n
o
f
t
h
e
id
en
tifie
d
p
u
b
licatio
n
s
.
Ou
t
o
f
th
e
in
itial
p
o
o
l,
1
5
p
u
b
licatio
n
s
s
u
cc
ess
f
u
lly
m
et
th
e
p
r
ed
ef
in
e
d
cr
iter
ia
a
n
d
wer
e
in
clu
d
ed
in
th
e
f
in
al
an
aly
s
is
.
T
o
m
ain
tain
th
e
in
teg
r
ity
an
d
r
elev
a
n
ce
o
f
th
e
r
ev
iew,
a
s
tr
in
g
en
t
e
x
clu
s
io
n
cr
iter
io
n
was
ap
p
lied
t
o
elim
i
n
ate
r
ec
o
r
d
s
th
at
d
id
n
o
t
alig
n
with
th
e
s
tu
d
y
'
s
o
b
jectiv
es.
Sev
er
al
ex
clu
s
io
n
s
tep
s
wer
e
em
p
lo
y
ed
d
u
r
in
g
th
e
p
r
o
ce
s
s
.
No
n
-
E
n
g
lis
h
p
u
b
licatio
n
s
wer
e
i
n
itially
r
em
o
v
ed
t
o
en
s
u
r
e
co
n
s
is
ten
cy
a
n
d
co
h
er
e
n
ce
in
th
e
lan
g
u
ag
e
o
f
th
e
in
clu
d
e
d
s
tu
d
ies.
Ad
d
itio
n
ally
,
a
tem
p
o
r
al
c
r
iter
io
n
was
ap
p
lied
,
an
d
p
u
b
licatio
n
s
with
a
tim
elin
e
ea
r
lier
th
an
2
0
1
9
wer
e
ex
clu
d
ed
f
r
o
m
t
h
e
an
al
y
s
is
.
T
o
f
o
c
u
s
ex
clu
s
iv
ely
o
n
p
r
im
ar
y
r
esear
c
h
,
r
ev
iews,
b
o
o
k
s
,
an
d
co
n
f
er
en
c
e
p
r
o
ce
e
d
in
g
s
wer
e
s
y
s
tem
atica
lly
ex
clu
d
ed
.
Fu
r
th
er
r
ef
i
n
em
en
t
o
cc
u
r
r
e
d
d
u
r
in
g
t
h
e
f
u
ll
-
tex
t
r
ev
iew
p
h
a
s
e.
Pu
b
licatio
n
s
d
ee
m
ed
to
b
e
o
u
t
o
f
th
e
f
ield
,
p
o
s
s
ess
in
g
an
in
s
ig
n
if
ic
an
t
titl
e,
o
r
p
r
esen
tin
g
an
i
r
r
e
lev
an
t
ab
s
tr
ac
t
co
n
ce
r
n
in
g
th
e
s
tu
d
y
'
s
o
b
jectiv
es
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
A
s
ystema
tic
liter
a
tu
r
e
r
ev
iew
o
n
th
e
imp
a
ct
o
f p
a
r
ticip
a
tio
n
in
s
p
o
r
t a
n
d
…
(
Ha
s
lin
d
a
Hu
s
a
in
)
1729
wer
e
ex
clu
d
ed
.
T
h
is
r
ig
o
r
o
u
s
f
u
ll
-
tex
t r
ev
iew
p
r
o
ce
s
s
was in
t
eg
r
al
to
m
ain
tain
in
g
th
e
q
u
ality
an
d
r
elev
an
ce
o
f
th
e
in
clu
d
ed
s
tu
d
ies.
T
h
e
r
es
u
ltin
g
d
ataset
o
f
1
5
p
u
b
licati
o
n
s
,
s
u
b
jecte
d
to
a
m
eticu
lo
u
s
an
d
s
y
s
tem
atic
in
clu
s
io
n
p
r
o
ce
s
s
,
f
o
r
m
s
th
e
f
o
u
n
d
atio
n
f
o
r
th
e
s
u
b
s
eq
u
en
t
d
a
ta
an
aly
s
is
.
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h
e
s
elec
ted
s
tu
d
i
es
p
r
o
v
id
e
a
r
o
b
u
s
t
an
d
f
o
c
u
s
ed
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asis
f
o
r
ex
tr
ac
tin
g
m
ea
n
in
g
f
u
l
in
s
ig
h
ts
,
co
n
tr
ib
u
tin
g
to
a
co
m
p
r
eh
e
n
s
iv
e
s
y
n
th
esis
o
f
th
e
im
p
ac
t
o
f
s
tu
d
en
t
p
ar
ticip
atio
n
i
n
s
p
o
r
ts
an
d
p
h
y
s
ical
ac
tiv
ities
o
n
p
s
y
ch
o
lo
g
ica
l
r
esil
ien
ce
.
Fig
u
r
e
1
v
is
u
ally
illu
s
tr
ates
th
e
m
eticu
lo
u
s
s
cr
u
tin
y
u
n
d
e
r
t
ak
en
b
y
th
e
au
th
o
r
s
ac
r
o
s
s
a
c
o
m
p
ilatio
n
o
f
1
5
p
u
b
licatio
n
s
,
with
th
e
p
u
r
p
o
s
e
o
f
ex
tr
ac
tin
g
ass
er
tatio
n
s
an
d
m
a
ter
ials
g
er
m
an
e
to
th
e
s
u
b
ject
m
atter
o
f
th
e
p
r
esen
t stu
d
y
.
Fig
u
r
e
1
.
PR
I
SMA
f
lo
w
d
iag
r
am
o
f
th
e
p
r
o
p
o
s
ed
s
ea
r
ch
s
tu
d
y
[
2
6
]
3.
RE
SU
L
T
S
T
h
e
s
y
s
tem
atic
r
ev
iew
id
en
tif
ied
a
to
tal
o
f
1
5
s
tu
d
ies
an
d
e
x
tr
ac
ted
in
f
o
r
m
atio
n
o
n
au
th
o
r
s
,
ar
ticle
titl
es,
m
eth
o
d
o
lo
g
y
,
s
am
p
les,
an
aly
s
is
an
d
f
in
d
in
g
s
to
g
u
id
e
th
e
an
aly
s
is
o
n
th
e
s
tu
d
en
ts
im
p
ac
t
o
f
p
ar
ticip
atio
n
in
s
p
o
r
t
a
n
d
PA
o
n
p
s
y
ch
o
lo
g
ical
r
esil
ien
ce
.
B
ased
o
n
T
ab
le
1
(
s
ee
ap
p
en
d
i
x
)
,
w
e
r
ep
o
r
t
r
esu
lts
o
n
m
eth
o
d
o
l
o
g
ical
in
f
o
r
m
atio
n
o
f
th
e
s
tu
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ies
an
d
d
is
cu
s
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io
n
s
,
c
o
n
s
is
tin
g
o
f
t
h
r
ee
m
ai
n
th
em
es
as
d
is
cu
s
s
ed
in
th
e
d
is
cu
s
s
io
n
s
s
ec
tio
n
.
3
.
1
.
M
et
ho
do
lo
g
ic
a
l
info
rma
t
io
n o
f
t
he
s
t
ud
ies
T
h
e
m
eth
o
d
o
lo
g
ical
in
f
o
r
m
a
tio
n
o
f
th
e
s
tu
d
ies
in
clu
d
ed
in
th
is
s
y
s
tem
atic
r
ev
iew
p
r
o
v
id
es
a
co
m
p
r
eh
e
n
s
iv
e
o
v
er
v
iew
o
f
th
e
d
iv
er
s
e
ap
p
r
o
ac
h
es
em
p
lo
y
ed
to
i
n
v
esti
g
ate
th
e
r
e
latio
n
s
h
ip
b
etwe
en
p
ar
ticip
atio
n
in
s
p
o
r
ts
an
d
p
h
y
s
ical
ac
tiv
ities
an
d
p
s
y
ch
o
lo
g
i
ca
l
r
esil
ien
ce
.
Am
o
n
g
th
e
1
5
s
tu
d
ies
r
ev
iewe
d
,
1
0
s
tu
d
ies
ad
o
p
ted
a
q
u
an
titativ
e
r
esear
ch
d
esig
n
[2
7
]
–
[
3
6
]
s
ig
n
if
y
in
g
a
p
r
ev
alen
t
u
s
e
o
f
n
u
m
er
ical
d
ata
an
d
s
tatis
t
ical
an
aly
s
es
in
th
is
b
o
d
y
o
f
liter
atu
r
e.
No
tab
l
y
,
5
o
f
th
ese
s
tu
d
ies
ex
p
licitly
s
tated
th
at
th
ey
u
tili
ze
d
a
cr
o
s
s
-
s
ec
tio
n
al
s
tu
d
y
d
esig
n
[
3
7
]
–
[
4
1
]
em
p
h
asizin
g
a
s
n
ap
s
h
o
t
ap
p
r
o
ac
h
to
ex
am
in
e
th
e
v
ar
iab
les
o
f
in
ter
est
at
a
s
in
g
le
p
o
in
t in
tim
e.
T
h
e
s
am
p
les
u
s
ed
ac
r
o
s
s
th
e
s
tu
d
ies
wer
e
d
iv
er
s
e
an
d
in
clu
s
iv
e,
en
co
m
p
ass
in
g
a
r
an
g
e
o
f
p
ar
ticip
an
t
g
r
o
u
p
s
.
Un
d
er
g
r
ad
u
ate
s
tu
d
e
n
ts
,
v
o
lu
n
tar
y
p
ar
ticip
an
ts
,
u
n
iv
er
s
ity
s
tu
d
en
ts
,
p
r
im
ar
y
a
n
d
m
id
d
le
s
ch
o
o
l
s
tu
d
en
ts
,
co
lleg
e
s
tu
d
e
n
ts
,
m
e
d
ical
s
tu
d
en
ts
,
an
d
ad
o
lescen
ts
co
n
s
titu
ted
th
e
s
tu
d
y
p
o
p
u
lati
o
n
.
T
h
is
d
iv
er
s
ity
i
n
s
am
p
les r
ef
lects a
b
r
o
ad
ex
p
lo
r
atio
n
o
f
th
e
im
p
ac
t o
f
s
p
o
r
ts
a
n
d
p
h
y
s
ical
ac
tiv
ities
o
n
p
s
y
ch
o
lo
g
ical
r
esil
ien
ce
ac
r
o
s
s
v
ar
io
u
s
ed
u
ca
tio
n
al
l
ev
els.
T
h
e
s
am
p
le
s
izes
em
p
lo
y
ed
in
th
ese
s
tu
d
ies
ex
h
i
b
ited
co
n
s
id
er
ab
le
R
e
c
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=
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y
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
3
,
No
.
4
,
Dec
em
b
er
20
24
:
1
7
2
7
-
1
7
3
7
1730
v
ar
iab
ilit
y
,
r
a
n
g
in
g
f
r
o
m
1
2
5
to
6
7
,
8
2
1
p
ar
ticip
an
ts
.
T
h
is
wid
e
r
an
g
e
u
n
d
er
s
co
r
es
th
e
h
et
er
o
g
en
eity
in
s
tu
d
y
s
izes,
with
s
o
m
e
f
o
cu
s
in
g
o
n
s
m
aller
,
m
o
r
e
s
p
ec
i
f
ic
p
o
p
u
latio
n
s
an
d
o
th
er
s
in
v
o
lv
in
g
la
r
g
er
-
s
ca
le
in
v
esti
g
atio
n
s
.
I
n
ter
m
s
o
f
s
tatis
tical
an
aly
s
es,
th
e
s
tu
d
ies
em
p
lo
y
ed
a
r
ich
ar
r
ay
o
f
m
eth
o
d
s
to
e
x
p
lo
r
e
th
e
r
elatio
n
s
h
ip
s
u
n
d
er
in
v
esti
g
atio
n
.
T
h
ese
in
clu
d
e
d
tr
a
d
itio
n
al
an
aly
s
es
s
u
ch
as
o
n
e
-
way
an
aly
s
is
o
f
v
ar
ian
ce
(
ANOV
A)
,
t
-
test
,
co
r
r
elatio
n
,
an
d
r
e
g
r
ess
io
n
,
p
r
o
v
i
d
in
g
a
f
o
u
n
d
atio
n
al
u
n
d
er
s
tan
d
in
g
o
f
ass
o
ciatio
n
s
.
Ad
d
itio
n
ally
,
m
o
r
e
a
d
v
an
ce
d
tech
n
iq
u
es
,
s
u
ch
as
m
ed
iatio
n
an
d
m
o
d
er
atio
n
an
aly
s
es
wer
e
ap
p
lied
,
s
h
ed
d
in
g
lig
h
t
o
n
th
e
in
tr
icate
m
ec
h
a
n
is
m
s
at
p
lay
.
T
wo
-
lev
el
m
ix
ed
ef
f
ec
t
m
o
d
els,
lin
ea
r
r
eg
r
ess
io
n
,
o
n
e
-
way
AN
C
OV
A,
laten
t
p
r
o
f
ile
an
al
y
s
is
,
Ma
n
n
W
h
itn
ey
,
Kr
u
s
k
al
W
alli
s
,
f
ac
to
r
a
n
aly
s
is
,
an
d
M
ANCOV
A
wer
e
also
u
tili
ze
d
,
d
em
o
n
s
tr
atin
g
th
e
m
e
th
o
d
o
lo
g
ical
s
o
p
h
is
ticatio
n
o
f
th
e
r
ev
iewe
d
s
tu
d
ies.
T
h
is
m
eth
o
d
o
lo
g
ical
d
iv
er
s
ity
co
n
tr
ib
u
tes
to
a
n
u
an
ce
d
a
n
d
co
m
p
r
eh
en
s
iv
e
u
n
d
er
s
tan
d
in
g
o
f
th
e
co
m
p
lex
in
te
r
p
lay
b
etwe
en
s
p
o
r
ts
,
p
h
y
s
ical
ac
tiv
ities
,
an
d
p
s
y
ch
o
lo
g
ical
r
esil
ien
ce
.
T
h
e
i
n
clu
s
io
n
o
f
v
ar
i
o
u
s
s
tu
d
y
d
esig
n
s
,
p
ar
ticip
an
t
s
am
p
les,
an
d
an
aly
tical
a
p
p
r
o
ac
h
e
s
en
h
an
ce
s
th
e
r
o
b
u
s
tn
ess
an
d
g
en
er
aliza
b
ilit
y
o
f
th
e
f
in
d
in
g
s
s
y
n
th
esized
in
th
i
s
s
y
s
tem
atic
r
ev
iew.
4.
DIS
CU
SS
I
O
N
T
h
e
s
elec
ted
s
tu
d
ies
co
llectiv
ely
co
n
tr
ib
u
te
to
th
e
t
h
r
ee
o
v
e
r
ar
ch
in
g
th
e
m
es
th
at
g
u
id
e
o
u
r
an
aly
s
is
:
en
h
an
cin
g
p
o
s
itiv
e
m
en
tal
h
ea
lth
,
r
ed
u
cin
g
n
e
g
ativ
e
em
o
ti
o
n
s
,
an
d
m
itig
atin
g
d
ep
r
ess
io
n
an
d
an
x
iety
.
Her
e,
we
co
m
p
r
eh
e
n
s
iv
ely
d
is
cu
s
s
th
e
f
in
d
in
g
s
o
f
th
ese
s
tu
d
ies b
a
s
ed
o
n
th
r
ee
th
em
es.
4
.
1
.
E
nh
a
nce
po
s
it
iv
e
m
ent
a
l hea
lt
h
Sp
o
r
t a
n
d
PA e
m
er
g
ed
as a
p
r
o
ac
tiv
e
s
tr
ateg
y
to
p
r
ev
en
t
o
r
d
elay
m
e
n
tal
d
is
o
r
d
e
r
s
,
r
ec
o
g
n
ized
f
o
r
its
p
o
s
itiv
e
im
p
ac
t
o
n
m
e
n
tal
h
e
alth
an
d
in
tr
ea
tin
g
ex
is
tin
g
m
en
tal
illn
ess
es
[
2
7
]
,
[
3
0
]
,
[
4
1
]
.
R
eg
u
lar
ex
er
cise
co
n
tr
ib
u
tes
to
th
e
p
r
e
v
en
tio
n
an
d
d
elay
o
f
m
en
tal
d
is
o
r
d
e
r
s
th
r
o
u
g
h
v
ar
io
u
s
m
ec
h
a
n
is
m
s
.
I
n
ad
d
itio
n
,
th
e
en
g
ag
in
g
,
o
p
en
,
a
n
d
co
m
p
etitiv
e
n
atu
r
e
o
f
s
p
o
r
ts
p
r
o
v
i
d
es
an
id
ea
l
en
v
ir
o
n
m
e
n
t
f
o
r
cu
ltiv
atin
g
p
s
y
ch
o
l
o
g
ical
r
esil
ien
ce
in
s
tu
d
en
ts
[
3
3
]
,
[
4
1
]
.
E
x
is
tin
g
r
esear
ch
r
ec
o
g
n
izes
p
h
y
s
ical
ex
er
cise
as
a
s
i
g
n
if
ican
t
f
ac
to
r
in
en
h
an
cin
g
p
s
y
ch
o
lo
g
ical
r
esil
i
en
ce
,
citin
g
its
ca
p
ac
ity
to
r
ed
u
ce
s
tr
ess
r
e
s
p
o
n
s
es,
im
p
r
o
v
e
p
h
y
s
io
lo
g
ical
well
-
b
ein
g
as
well
as
p
s
y
ch
o
l
o
g
ica
l,
an
d
ac
t
as
a
b
u
f
f
er
a
g
ain
s
t
s
tr
ess
.
Desp
ite
en
co
u
n
ter
in
g
s
h
o
r
t
-
ter
m
c
h
allen
g
es
s
u
ch
as
p
r
ess
u
r
e,
co
m
p
etitio
n
,
an
d
f
r
u
s
tr
atio
n
d
u
r
in
g
PA,
s
t
u
d
en
ts
wh
o
s
u
cc
ess
f
u
lly
n
av
i
g
ate
th
ese
o
b
s
tacle
s
with
p
ee
r
an
d
teac
h
e
r
s
u
p
p
o
r
t
d
ev
el
o
p
a
m
o
r
e
f
lex
ib
le
attitu
d
e
a
n
d
im
p
r
o
v
ed
p
r
o
b
lem
-
s
o
lv
in
g
a
b
ilit
ies
[
3
3
]
,
[
4
1
]
.
W
e
ca
n
co
n
clu
d
e
th
at
s
u
cc
ess
f
u
lly
n
av
ig
atin
g
o
b
s
ta
cles
in
a
s
u
p
p
o
r
tiv
e
en
v
ir
o
n
m
en
t
co
n
tr
ib
u
tes
to
f
o
r
m
in
g
ad
ap
tiv
e
co
p
in
g
m
ec
h
an
is
m
s
.
T
h
e
m
u
ltifa
ce
ted
b
en
ef
its
o
f
s
p
o
r
t
an
d
PA
ex
ten
d
b
ey
o
n
d
p
s
y
ch
o
lo
g
ical
r
esil
ien
ce
,
in
cl
u
d
in
g
en
h
an
ce
d
s
leep
q
u
ality
,
atten
tio
n
o
r
ie
n
tatio
n
,
co
g
n
itiv
e
f
u
n
ctio
n
,
an
d
e
m
o
tio
n
al
r
e
g
u
latio
n
[
3
4
]
,
[
3
6
]
.
Mo
r
eo
v
e
r
,
r
e
g
u
la
r
en
g
ag
em
e
n
t
in
ch
allen
g
in
g
p
h
y
s
ical
p
r
ac
tices
s
tr
en
g
th
en
s
th
e
b
o
d
y
a
n
d
s
h
ap
es
p
er
s
o
n
a
lity
.
I
t
also
f
o
s
ter
s
team
wo
r
k
,
in
ter
p
e
r
s
o
n
al
co
m
m
u
n
icatio
n
s
k
ills
,
an
d
p
r
o
b
le
m
-
s
o
lv
in
g
tech
n
i
q
u
es,
p
ar
ticu
lar
ly
th
o
s
e
r
eq
u
ir
in
g
s
k
ill
ac
q
u
is
itio
n
an
d
d
ec
is
io
n
-
m
ak
in
g
,
a
n
d
f
o
s
ter
s
co
g
n
itiv
e
f
lex
ib
ilit
y
[
3
6
]
.
T
h
is
ad
a
p
tab
ilit
y
in
th
in
k
in
g
is
cr
u
cial
f
o
r
r
esil
ien
ce
,
allo
win
g
in
d
iv
i
d
u
als
to
a
p
p
r
o
ac
h
ch
allen
g
es
with
a
m
o
r
e
o
p
en
a
n
d
p
r
o
b
lem
-
s
o
lv
in
g
m
in
d
s
et.
Ov
er
all,
p
h
y
s
ical
ex
er
cise
co
n
tr
ib
u
tes
s
ig
n
if
ican
tly
t
o
th
e
h
o
lis
tic
d
ev
elo
p
m
en
t
o
f
s
tu
d
en
ts
,
im
p
r
o
v
in
g
th
eir
s
o
cial
ad
ap
tatio
n
s
k
ills
an
d
r
ed
u
cin
g
e
x
ter
n
alize
d
p
r
o
b
lem
b
eh
av
i
o
r
s
[
3
5
]
.
No
te
th
at
s
p
o
r
ts
an
d
PA
o
f
f
er
n
u
m
er
o
u
s
m
en
tal
h
ea
lth
b
e
n
ef
its
.
Hen
ce
,
it
is
es
s
en
tial
to
em
p
h
asize
th
at
th
ey
ar
e
n
o
t
s
tan
d
alo
n
e
s
o
lu
tio
n
s
.
Pro
f
ess
io
n
al
m
en
tal
h
ea
lth
ca
r
e
is
cr
u
cial
f
o
r
c
o
m
p
r
eh
e
n
s
iv
e
an
d
in
d
iv
id
u
alize
d
tr
ea
tm
e
n
t.
Ho
wev
er
,
th
e
ty
p
e
a
n
d
in
te
n
s
ity
o
f
ex
er
cise
m
ay
v
ar
y
am
o
n
g
in
d
iv
id
u
als,
an
d
a
p
er
s
o
n
alize
d
a
p
p
r
o
ac
h
,
co
n
s
i
d
er
in
g
th
e
s
p
ec
if
ic
n
ee
d
s
an
d
p
r
e
f
er
en
ce
s
o
f
ea
ch
p
er
s
o
n
,
is
k
ey
[
3
1
]
,
[
3
4
]
.
Fre
q
u
en
t
ex
er
cise
s
er
v
es
as
an
ef
f
ec
tiv
e
h
ea
lth
p
r
o
m
o
tio
n
s
tr
ateg
y
[
3
2
]
,
s
u
g
g
esti
n
g
th
at
th
e
q
u
an
tity
an
d
in
ten
s
ity
o
f
PA
p
lay
c
r
u
cial
r
o
les,
with
h
ig
h
er
r
esil
ien
ce
ass
o
ciate
d
with
a
m
in
im
u
m
o
f
7
5
m
in
u
tes
o
f
v
i
g
o
r
o
u
s
ac
tiv
ity
wee
k
ly
an
d
in
cr
ea
s
ed
g
r
it
o
b
s
er
v
ed
in
p
ar
ticip
an
ts
r
e
p
o
r
tin
g
at
least
3
0
0
m
in
u
tes
p
e
r
wee
k
.
Me
an
wh
ile,
th
e
r
esear
ch
f
in
d
i
n
g
s
s
u
g
g
est
th
at
p
r
o
m
o
tin
g
m
u
s
cle
-
s
tr
en
g
th
en
in
g
ex
er
cise
(
MSE
)
in
c
h
ild
r
en
an
d
ad
o
lescen
ts
co
u
ld
p
o
te
n
tially
en
h
an
ce
p
o
s
itiv
e
m
en
tal
h
ea
lth
[
3
7
]
.
Fu
r
t
h
er
m
o
r
e
,
en
g
ag
e
m
en
t
in
PA,
k
n
o
wn
to
im
p
r
o
v
e
ad
o
lescen
ts
’
well
-
b
ein
g
,
alig
n
s
with
th
e
n
o
tio
n
th
at
i
n
cr
ea
s
ed
MSE
p
ar
ticip
atio
n
c
o
u
ld
c
o
n
tr
ib
u
te
to
b
etter
m
en
tal
o
u
tco
m
es.
Ad
d
itio
n
all
y
,
MSE
e
x
h
ib
its
a
n
e
g
ativ
e
ass
o
ciatio
n
with
m
en
tal
h
ea
lt
h
d
is
o
r
d
er
s
.
T
h
ese
s
tu
d
ies
h
ig
h
lig
h
t
th
e
m
u
ltifa
c
eted
b
en
ef
its
o
f
r
eg
u
lar
s
p
o
r
t
an
d
PA
in
f
o
r
tify
in
g
p
s
y
ch
o
l
o
g
ical
r
esil
ien
ce
an
d
p
r
o
m
o
tin
g
well
-
b
ein
g
.
4
.
2
.
Reduce
neg
a
t
iv
e
em
o
t
io
n
E
n
g
ag
in
g
in
r
eg
u
lar
PA
is
as
s
o
ciate
d
with
a
p
o
s
itiv
e
co
p
in
g
m
ec
h
an
is
m
f
o
r
d
ea
lin
g
with
b
o
r
ed
o
m
d
u
r
in
g
leis
u
r
e
tim
e
[
2
8
]
.
T
h
i
s
ef
f
ec
t
in
clu
d
es
in
cr
ea
s
ed
p
o
s
itiv
e
m
o
o
d
s
,
r
ed
u
ce
d
r
is
k
o
f
d
ep
r
ess
io
n
,
an
d
im
p
r
o
v
e
d
co
g
n
itiv
e
an
d
m
en
t
al
h
ea
lth
[
2
7
]
.
No
te
th
at
th
e
r
ed
u
ctio
n
o
f
n
e
g
ativ
e
em
o
tio
n
al
s
tate
s
p
r
o
v
id
es
a
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
A
s
ystema
tic
liter
a
tu
r
e
r
ev
iew
o
n
th
e
imp
a
ct
o
f p
a
r
ticip
a
tio
n
in
s
p
o
r
t a
n
d
…
(
Ha
s
lin
d
a
Hu
s
a
in
)
1731
m
u
ltifa
ce
d
ap
p
r
o
ac
h
to
em
o
ti
o
n
al
well
-
b
ein
g
[
3
0
]
.
PA
co
n
tr
ib
u
tes
to
th
is
p
o
s
itiv
e
im
p
a
ct,
wh
ich
ac
ts
as
a
n
atu
r
al
m
o
o
d
en
h
an
ce
r
an
d
e
n
h
an
ce
s
em
o
tio
n
al
r
eg
u
latio
n
ab
ilit
y
[
4
0
]
.
He
n
ce
,
th
is
em
o
tio
n
al
r
eg
u
latio
n
is
in
teg
r
al
to
b
u
ild
in
g
r
esil
ien
ce
an
d
h
elp
i
n
g
s
tu
d
en
ts
co
p
e
with
ac
ad
em
ic
an
d
p
er
s
o
n
al
s
tr
ess
o
r
s
.
T
h
e
s
tu
d
y
by
Z
h
an
g
et
a
l.
[
4
0
]
r
ev
ea
le
d
a
p
o
s
itiv
e
an
d
s
ig
n
i
f
ican
t
ass
o
ciatio
n
b
etwe
e
n
ad
o
lescen
ts
’
p
ar
ticip
atio
n
i
n
PA,
p
a
r
ticu
l
ar
ly
o
r
g
an
ized
PA
an
d
th
eir
s
u
b
jectiv
e
well
-
b
ein
g
.
R
eg
u
lar
en
g
a
g
em
en
t
i
n
o
r
g
an
ized
PA
is
h
ig
h
lig
h
te
d
a
s
a
k
ey
f
ac
to
r
in
en
h
an
cin
g
a
d
o
lescen
ts
’
s
u
b
jectiv
e
well
-
b
ein
g
,
co
n
tr
i
b
u
tin
g
to
in
cr
ea
s
ed
p
o
s
itiv
e
em
o
tio
n
s
as we
ll a
s
life
s
atis
f
ac
tio
n
.
T
h
e
s
tu
d
y
u
n
d
e
r
s
co
r
ed
th
e
im
p
o
r
tan
ce
o
f
s
ch
o
o
l
-
b
ased
o
r
o
r
g
a
n
ized
PA
in
f
o
s
ter
in
g
ex
ter
n
al
d
ev
elo
p
m
en
t
ass
ets.
Fu
r
th
er
m
o
r
e
,
th
is
in
clu
d
es
s
c
h
o
o
l
co
n
n
ec
ted
n
ess
,
wh
ich
,
in
tu
r
n
,
p
o
s
itiv
ely
a
f
f
e
cts
ad
o
lescen
ts
’
s
u
b
jectiv
e
we
ll
-
b
ein
g
.
T
h
e
f
in
d
in
g
s
em
p
h
asize
th
e
s
ig
n
if
ica
n
ce
o
f
ad
o
lescen
ts
en
g
a
g
in
g
i
n
d
es
ir
ed
ac
tiv
ities
in
s
u
p
p
o
r
tiv
e
en
v
ir
o
n
m
e
n
ts
,
with
s
ch
o
o
l
-
b
ased
in
ter
v
en
tio
n
s
lik
e
p
h
y
s
ical
ed
u
ca
tio
n
class
es
an
d
g
u
id
a
n
ce
f
r
o
m
p
h
y
s
ical
ed
u
ca
tio
n
teac
h
er
s
p
lay
in
g
a
p
i
v
o
tal
r
o
le
in
estab
lis
h
in
g
a
p
o
s
itiv
e
an
d
e
n
r
ich
ed
en
v
ir
o
n
m
en
t.
Fu
r
th
er
m
o
r
e
,
PA
p
r
o
v
i
d
es
an
o
p
p
o
r
tu
n
ity
f
o
r
s
o
cial
in
ter
a
ctio
n
,
esp
ec
ially
i
n
g
r
o
u
p
o
r
t
ea
m
-
b
ased
ac
tiv
ities
,
f
o
s
ter
in
g
a
s
en
s
e
o
f
co
m
m
u
n
ity
a
n
d
s
u
p
p
o
r
t
[
3
1
]
.
So
cial
co
n
n
ec
tio
n
s
p
lay
a
v
it
al
r
o
le
in
em
o
tio
n
al
well
-
b
ein
g
,
a
n
d
th
e
ca
m
ar
ad
e
r
ie
b
u
ilt
th
r
o
u
g
h
s
h
ar
ed
PAs
ca
n
co
n
tr
ib
u
te
to
a
m
o
r
e
p
o
s
i
tiv
e
em
o
tio
n
al
s
tate
[
4
0
]
.
No
tab
ly
,
th
e
ac
t o
f
en
g
a
g
in
g
in
ex
er
cise
n
o
t
o
n
ly
ad
d
r
es
s
es
th
e
p
h
y
s
ical
asp
ec
ts
o
f
h
ea
lth
b
u
t
also
s
er
v
es
as
a
p
o
wer
f
u
l
to
o
l
f
o
r
m
a
n
ag
in
g
an
d
r
e
d
u
cin
g
n
eg
ativ
e
e
m
o
ti
o
n
al
s
tates,
o
f
f
er
in
g
in
d
iv
id
u
al
s
a
h
o
lis
tic
ap
p
r
o
ac
h
to
em
o
tio
n
al
well
-
b
ein
g
.
Mo
r
eo
v
er
,
PA
p
r
o
v
id
es
in
d
iv
i
d
u
a
ls
with
a
p
o
s
itiv
e
em
o
tio
n
al
ex
p
er
ien
ce
th
at
ca
n
s
ig
n
if
ican
tly
allev
iate
em
o
tio
n
al
s
tr
ess
[
3
5
]
.
T
h
is
p
o
s
itiv
e
em
o
tio
n
al
ex
p
e
r
ien
ce
co
n
tr
i
b
u
tes
to
th
e
lo
n
g
-
ter
m
en
h
an
ce
m
e
n
t
o
f
p
s
y
ch
o
lo
g
ical
r
esil
ien
ce
,
r
ep
r
esen
tin
g
an
in
cr
ea
s
ed
ab
ilit
y
to
with
s
tan
d
n
eg
ativ
e
em
o
tio
n
s
[
3
6
]
.
C
o
n
s
eq
u
en
tly
,
th
is
im
p
r
o
v
em
en
t
in
p
s
y
ch
o
lo
g
ical
r
esil
ien
ce
s
er
v
es
to
en
h
an
ce
o
v
er
all
m
en
tal
h
ea
lth
f
o
r
th
e
in
d
iv
id
u
al.
4
.
3
.
Reduce
depress
io
n a
nd
a
nx
iet
y
On
a
p
s
y
ch
o
lo
g
ical
lev
el,
p
ar
ti
cip
atin
g
in
s
p
o
r
ts
an
d
PAs
p
r
o
v
id
es
a
h
ea
lth
y
o
u
tlet
f
o
r
s
tr
ess
an
d
p
en
t
-
u
p
en
er
g
y
,
p
r
o
m
o
tin
g
a
s
en
s
e
o
f
ac
co
m
p
lis
h
m
en
t
a
n
d
o
v
e
r
all
well
-
b
ein
g
[
3
6
]
.
I
t
co
u
ld
s
er
v
e
as
a
b
u
f
f
er
ag
ain
s
t
s
tr
ess
an
d
s
tr
ess
-
r
elate
d
d
is
o
r
d
er
s
.
No
te
th
at
r
eg
u
lar
ex
er
ci
s
e
ca
n
s
er
v
e
as
a
f
o
r
m
o
f
m
in
d
f
u
ln
ess
,
allo
win
g
in
d
iv
id
u
als
to
b
e
p
r
esen
t
in
th
e
m
o
m
en
t
an
d
d
iv
er
t
th
eir
f
o
c
u
s
f
r
o
m
an
x
io
u
s
th
o
u
g
h
ts
.
Ad
d
itio
n
ally
,
th
e
s
o
cial
asp
ec
t
o
f
m
an
y
s
p
o
r
ts
an
d
PAs
f
o
s
ter
s
a
s
en
s
e
o
f
co
m
m
u
n
ity
an
d
s
u
p
p
o
r
t,
wh
ich
ca
n
b
e
in
s
tr
u
m
en
tal
in
co
m
b
atin
g
f
e
elin
g
s
o
f
is
o
latio
n
an
d
a
n
x
iety
[
2
7
]
.
T
h
er
ef
o
r
e,
co
n
tin
u
o
u
s
s
o
cial
co
n
n
ec
tio
n
s
th
r
o
u
g
h
s
p
o
r
t
an
d
PA
ac
t
as
a
cr
u
cial
em
o
tio
n
al
s
u
p
p
o
r
t
s
y
s
tem
,
p
r
o
v
id
in
g
s
tu
d
en
ts
with
av
e
n
u
es
to
c
o
p
e
ef
f
ec
tiv
ely
with
o
b
s
tacle
s
[
3
1
]
.
T
h
ese
co
n
n
ec
t
io
n
s
f
o
s
ter
a
s
en
s
e
o
f
b
elo
n
g
i
n
g
an
d
u
n
d
er
s
tan
d
in
g
,
k
e
y
ele
m
en
ts
in
f
o
r
tif
y
in
g
p
s
y
ch
o
lo
g
ical
r
esil
ien
ce
.
Hen
ce
,
s
h
ar
ed
ex
p
er
ien
ce
s
with
in
s
o
cial
n
etwo
r
k
s
c
o
n
tr
ib
u
te
to
d
ev
elo
p
in
g
a
d
ap
tiv
e
co
p
in
g
m
ec
h
an
is
m
s
,
r
ed
u
cin
g
an
x
iety
,
an
d
p
r
o
m
o
tin
g
em
o
ti
o
n
al
well
-
b
ein
g
[
2
7
]
.
T
h
e
r
e
s
u
l
t
o
f
t
h
e
c
u
r
r
e
n
t
s
t
u
d
y
a
f
f
i
r
m
s
a
s
t
r
o
n
g
c
o
r
r
e
l
a
ti
o
n
b
e
t
w
e
e
n
r
e
g
u
l
a
r
P
A
a
n
d
e
n
h
a
n
c
e
d
r
e
s
i
l
ie
n
ce
[
4
0
]
,
[
4
1
]
.
R
e
g
u
l
a
r
e
x
e
r
c
i
s
e
n
o
t
o
n
l
y
i
n
c
r
e
a
s
e
s
a
n
i
n
d
i
v
i
d
u
a
l
’
s
c
a
p
a
b
i
l
i
t
y
t
o
n
a
v
i
g
a
t
e
c
h
a
l
l
e
n
g
e
s
a
s
w
e
ll
a
s
a
d
a
p
t
e
f
f
e
c
t
i
v
e
l
y
b
u
t
a
ls
o
c
o
n
t
r
i
b
u
t
es t
o
o
v
e
r
a
l
l
w
e
l
l
-
b
ei
n
g
a
n
d
a
r
e
d
u
c
e
d
p
r
e
v
a
l
e
n
c
e
o
f
m
o
o
d
a
n
d
an
x
i
e
t
y
d
i
s
o
r
d
e
r
s
.
It
a
l
s
o
i
m
p
r
o
v
e
s
e
m
o
t
i
o
n
a
l
p
r
o
c
es
s
i
n
g
a
b
i
l
i
ti
es
t
o
a
l
le
v
i
a
t
e
d
e
p
r
e
s
s
i
o
n
a
n
d
a
n
x
i
e
t
y
.
T
h
i
s
h
ei
g
h
t
e
n
e
d
r
e
s
il
i
e
n
c
e
,
i
n
t
u
r
n
,
a
i
d
s
i
n
d
i
v
i
d
u
a
l
s
i
n
c
o
p
i
n
g
p
o
s
i
t
i
v
el
y
w
i
t
h
c
h
a
l
l
e
n
g
i
n
g
c
i
r
c
u
m
s
t
a
n
ce
s
a
n
d
h
el
p
s
c
u
l
ti
v
a
t
e
p
o
s
i
ti
v
e
p
s
y
c
h
o
l
o
g
i
c
a
l
q
u
al
i
ti
e
s
,
l
e
a
d
i
n
g
t
o
p
o
s
it
i
v
e
c
h
a
n
g
e
s
i
n
m
e
n
t
al
a
n
d
e
m
o
t
i
o
n
a
l
s
t
a
t
es
.
T
h
e
f
i
n
d
i
n
g
s
u
n
d
e
r
s
c
o
r
e
t
h
e
i
m
p
o
r
t
a
n
c
e
o
f
c
o
n
s
i
s
te
n
t
PA
i
n
b
o
o
s
t
i
n
g
p
e
r
s
o
n
al
c
o
m
p
e
t
e
n
c
e
i
n
p
h
y
s
i
c
al
t
as
k
s
a
n
d
f
o
r
t
i
f
y
i
n
g
t
h
e
a
b
i
li
t
y
t
o
c
o
p
e
w
i
t
h
p
s
y
c
h
o
l
o
g
i
ca
l
c
h
a
ll
e
n
g
e
s
.
T
h
i
s
p
o
s
it
i
v
e
i
m
p
ac
t
e
x
t
e
n
d
s
to
s
e
l
f
-
e
f
f
i
c
ac
y
a
n
d
p
s
y
c
h
o
l
o
g
ic
a
l
r
e
s
i
l
i
e
n
ce
a
c
r
o
s
s
v
a
r
i
o
u
s
a
s
p
e
c
ts
o
f
l
i
f
e
.
R
es
i
li
en
c
e
t
e
n
d
s
t
o
b
e
l
i
n
k
e
d
t
o
a
h
e
i
g
h
t
e
n
e
d
l
e
v
e
l
o
f
s
e
l
f
-
e
f
f
i
c
a
c
y
,
a
s
t
h
o
s
e
p
o
s
s
e
s
s
i
n
g
a
r
o
b
u
s
t
b
e
l
i
e
f
i
n
t
h
e
i
r
a
b
i
li
t
ie
s
a
r
e
i
n
c
l
i
n
e
d
t
o
c
o
n
f
r
o
n
t
c
h
a
ll
e
n
g
e
s
w
it
h
a
s
s
u
r
a
n
c
e
a
n
d
p
e
r
s
e
v
e
r
a
n
c
e
,
a
c
c
o
r
d
i
n
g
l
y
.
Sp
o
r
ts
an
d
PA
in
h
er
en
tly
in
v
o
lv
e
o
v
e
r
co
m
in
g
ch
allen
g
es
,
b
e
it
p
h
y
s
ical
o
r
m
en
tal.
Su
cc
ess
f
u
lly
n
av
ig
atin
g
th
ese
ch
allen
g
es,
e
s
p
ec
ially
with
th
e
s
u
p
p
o
r
t
o
f
p
ee
r
s
an
d
c
o
ac
h
es,
c
o
n
tr
ib
u
tes
to
th
e
d
ev
elo
p
m
en
t
o
f
r
esil
ien
ce
s
k
ills
.
Mo
r
eo
v
er
,
lear
n
in
g
to
co
p
e
wi
th
s
etb
ac
k
s
an
d
f
ailu
r
es
in
a
co
n
tr
o
lled
en
v
ir
o
n
m
e
n
t
p
r
ep
ar
e
s
in
d
iv
id
u
als
to
f
ac
e
life
’
s
d
if
f
i
cu
lties
with
g
r
ea
ter
ad
ap
ta
b
ilit
y
.
W
e
b
eliev
e
th
at
ac
h
iev
in
g
g
o
als
in
s
p
o
r
ts
an
d
PA,
wh
eth
er
p
er
s
o
n
al
o
r
team
-
o
r
ien
ted
,
in
s
till
s
a
s
en
s
e
o
f
ac
co
m
p
lis
h
m
en
t.
T
h
is
s
en
s
e
o
f
ac
h
iev
em
e
n
t
ca
n
co
u
n
ter
f
ee
lin
g
s
o
f
h
elp
less
n
ess
an
d
en
h
an
ce
s
elf
-
esteem
,
r
ed
u
cin
g
s
y
m
p
to
m
s
o
f
d
ep
r
ess
io
n
an
d
a
n
x
iety
.
I
n
ad
d
itio
n
,
r
e
g
u
lar
en
g
ag
em
e
n
t
in
th
ese
ac
tiv
ities
o
f
f
er
s
a
h
o
lis
tic
ap
p
r
o
ac
h
to
m
e
n
tal
well
-
b
ein
g
,
em
p
o
wer
in
g
in
d
iv
id
u
als to
m
a
n
ag
e
an
d
o
v
e
r
co
m
e
ch
allen
g
es wh
ile
b
u
ild
i
n
g
a
f
o
u
n
d
atio
n
o
f
p
s
y
ch
o
lo
g
i
ca
l r
esil
ien
ce
.
I
n
lig
h
t
o
f
th
e
c
o
m
p
ellin
g
e
v
id
en
ce
p
r
esen
te
d
in
th
is
s
y
s
tem
atic
r
ev
iew,
th
e
im
p
licatio
n
s
an
d
s
u
g
g
esti
o
n
s
f
o
r
f
u
r
t
h
er
r
esear
ch
an
d
p
r
ac
tical
ap
p
licatio
n
s
ar
e
p
r
o
f
o
u
n
d
.
Firstl
y
,
ed
u
ca
ti
o
n
al
in
s
titu
tio
n
s
an
d
p
o
licy
m
ak
er
s
s
h
o
u
ld
co
n
s
id
er
in
teg
r
atin
g
s
p
o
r
ts
an
d
PAs
i
n
to
co
m
p
r
e
h
en
s
iv
e
m
e
n
tal
h
e
alth
p
r
o
g
r
am
s
f
o
r
s
tu
d
en
ts
,
r
ec
o
g
n
izin
g
th
em
as
p
r
o
ac
tiv
e
s
tr
ateg
ies
to
p
r
e
v
en
t
o
r
d
elay
m
e
n
tal
d
is
o
r
d
er
s
.
T
h
is
in
clu
d
es
p
r
o
m
o
tin
g
o
r
g
an
ized
PAs
with
in
s
ch
o
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p
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asizin
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le
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f
o
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in
g
ex
ter
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t
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c
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a
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l
c
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e
c
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e
d
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s
s
,
s
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f
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a
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r
i
b
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d
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t
s
’
s
u
b
j
ec
t
i
v
e
w
e
l
l
-
b
ei
n
g
.
T
h
e
r
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f
o
r
e
,
t
a
i
l
o
r
i
n
g
in
ter
v
en
tio
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s
,
s
u
ch
as
p
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s
ica
l
ed
u
ca
tio
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class
es
an
d
g
u
i
d
a
n
ce
f
r
o
m
p
h
y
s
ical
ed
u
ca
tio
n
t
ea
ch
er
s
,
ca
n
p
la
y
a
p
iv
o
tal
r
o
le
in
cr
ea
tin
g
s
u
p
p
o
r
tiv
e
en
v
ir
o
n
m
en
ts
th
at
p
o
s
itiv
ely
im
p
ac
t stu
d
en
ts
’
p
s
y
c
h
o
lo
g
ical
well
-
b
ein
g
.
Evaluation Warning : The document was created with Spire.PDF for Python.
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Dec
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20
24
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1
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2
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a
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r
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s
p
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t
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h
a
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s
h
o
u
l
d
b
e
c
o
n
s
i
d
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r
e
d
i
n
d
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i
g
n
i
n
g
h
o
l
i
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c
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t
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s
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h
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p
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r
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a
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m
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p
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c
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s
s
i
n
g
a
b
i
l
i
t
i
e
s
t
o
a
l
l
e
v
i
a
t
e
d
e
p
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e
s
s
i
o
n
a
n
d
a
n
x
i
e
t
y
u
n
d
e
r
s
c
o
r
e
s
t
h
e
p
o
t
e
n
t
i
a
l
o
f
e
x
e
r
c
i
s
e
a
s
a
f
o
r
m
o
f
m
i
n
d
f
u
l
n
e
s
s
a
n
d
s
t
r
e
s
s
r
e
d
u
c
t
i
o
n
.
Ad
d
itio
n
ally
,
th
e
s
o
cial
asp
ec
t
o
f
s
p
o
r
ts
an
d
PAs
s
h
o
u
ld
b
e
lev
er
ag
ed
in
m
e
n
tal
h
ea
lth
p
r
o
m
o
tio
n
ef
f
o
r
ts
.
E
d
u
ca
tio
n
al
in
s
titu
tio
n
s
ca
n
f
ac
ilit
ate
s
o
cial
co
n
n
ec
tio
n
s
th
r
o
u
g
h
s
p
o
r
ts
,
cr
ea
tin
g
a
cr
u
cial
em
o
tio
n
al
s
u
p
p
o
r
t
s
y
s
tem
f
o
r
s
tu
d
e
n
ts
.
T
h
e
s
h
ar
ed
ex
p
e
r
i
en
ce
s
with
in
s
o
cial
n
etwo
r
k
s
co
n
tr
ib
u
te
s
ig
n
if
ican
tly
to
d
ev
elo
p
in
g
ad
ap
tiv
e
c
o
p
in
g
m
ec
h
an
is
m
s
,
r
ed
u
cin
g
an
x
iet
y
,
an
d
p
r
o
m
o
tin
g
em
o
tio
n
al
well
-
b
ein
g
.
Hen
ce
,
in
co
r
p
o
r
atin
g
th
ese
s
o
cial
el
em
en
ts
in
to
m
en
tal
h
ea
lth
i
n
ter
v
en
tio
n
s
ca
n
en
h
a
n
ce
th
eir
ef
f
ec
tiv
en
es
s
in
f
o
r
tify
in
g
p
s
y
ch
o
lo
g
ical
r
esil
ien
ce
.
B
u
ild
in
g
o
n
th
e
f
o
u
n
d
atio
n
o
f
th
is
s
y
s
tem
atic
liter
atu
r
e
r
ev
iew,
th
er
e
ar
e
s
ev
er
al
av
en
u
es
f
o
r
f
u
tu
r
e
r
esear
ch
th
at
ca
n
f
u
r
th
er
en
h
a
n
ce
th
e
u
n
d
e
r
s
tan
d
in
g
o
f
th
e
r
elatio
n
s
h
ip
b
etwe
en
s
tu
d
en
t p
ar
ticip
atio
n
in
s
p
o
r
ts
an
d
PAs
an
d
p
s
y
ch
o
lo
g
ical
r
e
s
ilien
ce
.
On
e
k
ey
r
ec
o
m
m
en
d
atio
n
is
to
i
n
co
r
p
o
r
ate
a
r
o
b
u
s
t
m
eth
o
d
o
lo
g
y
,
s
u
c
h
as
co
n
d
u
ctin
g
a
m
eta
-
r
eg
r
ess
io
n
an
aly
s
is
o
n
th
e
r
esear
c
h
r
e
s
u
lts
cited
in
th
e
r
ef
er
e
n
ce
s
.
T
h
is
m
eta
-
r
eg
r
ess
io
n
an
aly
s
is
co
u
ld
s
y
s
tem
atica
lly
ex
am
in
e
th
e
v
ar
y
i
n
g
im
p
ac
t
o
f
d
if
f
er
en
t
s
p
o
r
ts
an
d
ac
tiv
ity
t
y
p
es,
d
u
r
atio
n
,
an
d
in
ten
s
ity
o
n
p
s
y
ch
o
lo
g
ical
r
e
s
ilien
ce
.
T
h
e
in
clu
s
io
n
o
f
a
d
v
an
ce
d
an
al
y
tical
tech
n
iq
u
es,
s
u
ch
as
s
tr
u
ctu
r
al
eq
u
atio
n
m
o
d
ellin
g
m
ay
o
f
f
e
r
d
ee
p
er
in
s
ig
h
ts
in
to
th
e
co
m
p
l
ex
r
elatio
n
s
h
ip
s
b
etwe
en
v
ar
iab
les.
T
h
ese
m
eth
o
d
s
co
u
ld
p
r
o
v
id
e
a
m
o
r
e
n
u
a
n
c
ed
u
n
d
e
r
s
tan
d
in
g
o
f
th
e
m
ec
h
an
is
m
s
lin
k
in
g
s
p
o
r
ts
,
p
h
y
s
ical
ac
tiv
ities
,
an
d
p
s
y
ch
o
lo
g
ical
r
esil
ien
ce
.
Ad
d
itio
n
ally
,
f
u
tu
r
e
s
tu
d
ies
m
ay
ex
p
l
o
r
e
th
e
m
o
d
e
r
atin
g
e
f
f
ec
ts
o
f
d
em
o
g
r
ap
h
ic
f
ac
to
r
s
,
s
u
ch
as
ag
e,
g
en
d
er
,
an
d
s
o
cio
-
ec
o
n
o
m
ic
s
tatu
s
,
to
p
r
o
v
id
e
a
m
o
r
e
n
u
an
ce
d
u
n
d
er
s
tan
d
in
g
o
f
th
e
r
elatio
n
s
h
ip
.
Fu
r
th
er
m
o
r
e,
ad
o
p
tin
g
a
lo
n
g
itu
d
in
al
ap
p
r
o
ac
h
to
ass
ess
th
e
lo
n
g
-
ter
m
ef
f
ec
ts
o
f
s
p
o
r
ts
an
d
p
h
y
s
ical
ac
tiv
ities
o
n
p
s
y
ch
o
lo
g
ical
r
esil
ien
ce
wo
u
ld
co
n
tr
i
b
u
te
v
alu
a
b
le
in
s
ig
h
ts
.
B
y
im
p
lem
en
tin
g
th
e
s
e
m
eth
o
d
o
lo
g
ical
en
h
an
ce
m
e
n
ts
,
r
esear
ch
er
s
ca
n
co
n
tr
ib
u
te
to
t
h
e
r
e
f
in
em
en
t
o
f
s
tatis
tical
p
r
o
ce
d
u
r
al
v
ali
d
ity
an
d
r
eli
ab
ilit
y
,
ad
v
an
cin
g
th
e
f
ield
'
s
u
n
d
er
s
tan
d
in
g
o
f
th
e
ef
f
ec
tiv
en
ess
o
f
s
p
o
r
ts
an
d
p
h
y
s
ical
ac
tiv
i
ty
in
ter
v
en
tio
n
s
in
p
r
o
m
o
tin
g
p
s
y
ch
o
lo
g
ical
r
esil
i
en
ce
am
o
n
g
s
tu
d
en
ts
.
5.
CO
NCLU
SI
O
N
I
n
c
o
n
c
l
u
s
i
o
n
,
t
h
e
s
y
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t
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m
a
t
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c
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x
p
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f
o
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h
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t
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M
o
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d
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c
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m
p
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r
a
p
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t
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e
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c
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a
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v
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t
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s
,
e
m
p
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i
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h
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r
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f
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A
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AP
P
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NDI
X
T
ab
le
1
.
T
h
e
s
u
m
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[
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[
3
9
]
Y
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[
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v
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m
y
.
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