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I
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9
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n
m
e
n
t
a
l
s
t
a
t
e
m
a
y
a
r
i
s
e
s
uc
h
a
s
ps
y
c
h
o
l
o
g
i
c
a
l
d
i
s
t
r
e
s
s
,
o
v
e
r
a
nxi
e
t
y
,
to
de
pr
e
s
s
i
o
n
[
5]
.
Any
c
h
a
n
g
e
s
i
n
h
e
a
l
t
h
c
a
n
b
e
c
o
m
e
a
s
t
r
e
s
s
o
r
a
f
f
e
c
t
i
n
g
t
h
e
i
nd
i
vi
du
a
l
s
e
l
f
-
c
o
nc
e
pt
[
6]
.
B
o
dy
-
im
a
ge
,
o
n
e
o
f
s
e
lf
-
c
o
nc
e
pt
c
o
m
po
n
e
n
t
,
i
s
h
o
w
s
o
m
e
o
n
e
pe
r
c
e
i
v
e
s
t
h
e
s
i
z
e
,
a
ppe
a
r
a
n
c
e
,
pa
r
t
s
o
f
b
o
d
y
a
n
d
t
h
e
i
r
f
u
n
c
t
i
o
n
s
[
7]
.
P
o
s
i
t
i
v
e
a
n
d
a
ppr
o
pr
i
a
t
e
b
o
d
y
-
im
a
ge
i
s
o
n
e
o
f
t
h
e
c
h
a
r
a
c
t
e
r
i
s
t
i
c
s
o
f
h
e
a
l
t
hy
pe
r
s
o
na
l
i
t
y
[
6]
.
R
e
s
e
a
r
c
h
s
h
o
ws
t
h
a
t
a
g
oo
d
b
o
dy
-
i
m
a
ge
c
a
n
i
m
pr
o
v
e
o
n
e
'
s
qua
li
t
y
o
f
l
if
e
[
8,
9]
.
M
e
n
t
a
l
h
e
a
l
t
h
pr
o
bl
e
m
s
c
a
n
b
e
c
a
u
s
e
d
by
na
t
ur
a
l
d
i
s
a
s
t
e
r
s
s
uc
h
a
s
e
a
r
t
h
qua
ke
i
n
B
a
n
t
u
l
,
DI
Y,
I
n
do
n
e
s
i
a
.
Na
t
ur
a
l
d
i
s
a
s
t
e
r
s
h
a
v
e
a
n
i
m
p
a
c
t
o
n
b
o
th
p
hy
s
i
c
a
l
a
n
d
m
e
n
t
a
l
s
t
a
t
e
e
s
pe
c
i
a
ll
y
p
s
y
c
h
o
s
o
c
i
a
l
r
e
l
a
t
e
d
pr
o
bl
e
m
s
[
10]
.
T
h
e
ph
y
s
i
c
a
l
i
m
p
a
c
t
r
e
s
ul
ts
i
n
d
e
a
th
,
m
i
l
d
to
s
e
v
e
r
e
di
s
a
b
i
l
i
t
y
,
a
n
d
di
s
a
b
i
l
i
t
y
f
or
l
i
f
e
.
M
e
a
n
wh
i
l
e
,
th
e
i
m
pa
c
t
of
th
e
m
e
n
tal
p
r
ob
l
e
m
c
a
u
s
e
s
a
p
e
r
s
on
t
o
f
e
e
l
l
o
s
t,
d
o
n
o
t
w
a
n
t
t
o
g
e
t
a
l
on
g
,
f
e
e
l
m
e
a
n
i
n
gl
e
s
s
i
n
h
i
s
l
i
f
e
,
a
n
d
th
i
n
k
th
a
t
i
t
i
s
b
e
tt
e
r
t
o
d
i
e
th
a
n
s
u
r
v
i
v
e
.
S
om
e
on
e
wi
th
m
e
n
tal
p
r
ob
l
e
m
s
f
e
e
l
s
di
f
f
i
c
ul
t
t
o
a
c
c
e
p
t
r
e
a
l
i
t
y
.
T
h
e
s
y
m
p
tom
s
m
e
n
ti
on
e
d
a
b
ov
e
a
r
e
p
s
y
c
h
os
oc
i
a
l
p
r
ob
l
e
m
s
a
n
d
a
m
e
n
tal
di
s
or
d
e
r
[
1
1
,
1
2
]
.
Da
t
a
publ
i
s
he
d
by
t
he
He
a
l
t
h
M
i
ni
s
t
r
y
a
t
2009
[
13]
,
i
n
r
e
gu
l
a
r
m
e
e
t
i
n
g
a
t
19
publi
c
h
e
a
l
t
h
c
e
n
t
e
r
s
i
n
B
a
n
t
ul
R
e
ge
n
c
y
s
h
o
ws
t
h
a
t
t
h
e
n
u
m
be
r
o
f
p
a
t
i
e
n
t
s
t
r
e
a
t
e
d
i
n
de
pe
n
de
n
t
l
y
wa
s
543
pe
o
p
l
e
,
a
n
d
t
h
o
s
e
t
r
e
a
t
e
d
i
n
h
o
s
p
i
t
a
l
s
we
r
e
62
pe
o
p
l
e
.
T
hi
s
p
h
e
n
o
m
e
n
o
n
o
f
m
e
n
t
a
l
p
a
t
i
e
n
t
s
i
n
t
h
e
c
o
m
m
u
ni
t
y
c
o
m
e
s
f
r
o
m
r
e
t
u
r
n
e
d
pa
t
i
e
n
t
s
f
r
o
m
m
e
n
t
a
l
h
o
s
p
i
t
a
l
s
o
r
publi
c
h
o
s
p
i
t
a
l
s
a
f
t
e
r
de
c
l
a
r
e
d
s
t
a
bl
e
e
n
o
ugh
.
U
nf
o
r
t
un
a
t
e
l
y
,
m
o
s
t
f
a
mi
l
i
e
s
a
n
d
c
o
m
m
u
ni
t
i
e
s
a
r
e
n
o
t
pr
e
pa
r
e
d
to
gi
vi
ng
c
a
r
e
to
pa
t
i
e
n
t
s
a
t
h
o
m
e
[
14,
15]
.
M
e
n
t
a
l
h
e
a
l
t
h
pr
obl
e
m
s
i
n
t
h
e
c
o
m
m
uni
t
y
r
e
qui
r
e
a
pp
r
oa
c
h
e
s
a
n
d
s
tr
a
te
gi
e
s
i
n
v
o
l
vi
n
g
c
o
m
m
uni
t
y
s
u
pe
r
vi
s
e
d
h
e
a
l
t
h
w
or
k
e
r
s
.
C
o
m
m
uni
t
y
m
e
n
t
a
l
h
e
a
l
t
h
n
ur
s
i
n
g
(
C
M
HN
)
i
s
o
n
e
a
pp
r
oa
c
h
to
n
u
r
s
i
n
g
s
e
r
vi
c
e
s
to
p
a
t
i
e
n
t
s
c
a
r
r
i
e
d
ou
t
di
r
e
c
t
ly
on
pa
t
i
e
n
t
s
,
a
n
d
f
a
m
i
li
e
s
a
t
h
o
m
e
by
p
ubl
i
c
h
e
a
l
t
h
c
e
n
te
r
n
ur
s
e
s
a
s
s
i
s
ted
by
oth
e
r
h
e
a
l
t
h
w
or
ke
r
s
[
16
,
17]
.
I
n
m
e
e
t
i
n
g
t
h
e
ps
y
c
h
o
s
o
c
i
a
l
n
e
e
d
s
o
f
m
e
n
t
a
l
pa
t
i
e
n
t
s
,
n
ur
s
e
s
s
t
i
ll
f
o
l
l
o
w
t
h
e
pa
t
t
e
r
n
s
a
n
d
da
il
y
h
a
bi
t
s
f
o
r
t
h
e
r
e
a
r
e
n
o
pe
r
m
a
n
e
n
t
pr
o
c
e
dur
e
s
i
n
t
h
e
c
o
m
m
u
ni
t
y
o
n
a
n
o
n
go
i
n
g
b
a
s
i
s
.
T
o
h
a
n
d
l
e
t
hi
s
phe
no
m
e
n
o
n
,
pr
o
f
e
s
s
i
o
n
a
l
n
ur
s
e
s
a
r
e
ne
e
de
d,
w
hi
c
h
c
a
n
b
e
a
c
hi
e
v
e
d
by
g
i
v
i
ng
t
r
a
i
ni
ng
[
18]
.
T
r
a
i
ni
ng
t
o
i
m
pr
o
v
e
s
k
i
ll
s
a
n
d
kn
o
w
l
e
dge
h
a
s
b
e
e
n
im
p
l
e
m
e
n
t
e
d
a
c
r
o
s
s
a
w
i
de
r
a
n
ge
o
f
d
i
s
c
i
p
li
ne
s
i
nc
l
ud
i
n
g
m
e
d
i
c
i
ne
,
m
e
n
t
a
l
h
e
a
l
t
h
,
n
ur
s
i
ng,
s
o
c
i
a
l
wo
r
k
a
n
d
a
l
li
e
d
pr
o
f
e
s
s
i
o
n
s
.
I
t
h
a
s
b
e
e
n
s
a
i
d
t
h
a
t
a
c
t
i
v
e
s
t
r
a
t
e
gi
e
s
s
uc
h
a
s
t
r
a
i
ni
ng
i
s
m
o
r
e
e
f
f
e
c
t
i
v
e
[
19]
.
T
h
e
pur
po
s
e
o
f
t
hi
s
s
t
ud
y
wa
s
t
o
a
n
a
ly
z
e
t
h
e
e
f
f
e
c
t
s
o
f
pr
o
vi
d
i
ng
b
a
s
i
c
c
o
ur
s
e
c
o
mm
u
ni
t
y
m
e
n
t
a
l
h
e
a
l
t
h
n
ur
s
i
ng
(
B
C
-
C
M
HN
)
,
s
e
l
f
-
c
o
n
c
e
pt
a
s
s
e
s
s
m
e
n
t
gu
i
de
li
ne
(
S
C
A
G)
,
c
o
gni
t
i
ve
b
e
ha
vi
o
r
t
h
e
r
a
p
y
(
C
B
T
)
,
a
n
d
t
h
o
ugh
t
s
t
o
ppi
n
g
t
h
e
r
a
p
y
(
T
S
T
)
t
r
a
i
nin
g
f
o
r
n
ur
s
e
s
,
a
n
d
i
n
t
e
r
m
e
d
i
a
t
e
c
o
ur
s
e
c
o
m
m
u
ni
t
y
m
e
n
t
a
l
h
e
a
l
t
h
n
ur
s
i
n
g
(IC
-
C
M
HN
)
t
r
a
i
ni
n
g
f
o
r
c
o
m
m
u
nit
y
h
e
a
l
t
h
v
o
l
u
n
t
e
e
r
s
(
C
HV
s
)
t
o
t
h
e
b
o
d
y
i
m
a
ge
q
ua
l
i
t
y
o
f
pa
t
i
e
n
t
w
i
t
h
m
e
n
t
a
l
h
e
a
l
t
h
d
i
s
o
r
de
r
s
.
2.
RE
S
E
AR
CH
M
E
T
HO
D
T
hi
s
wa
s
a
qua
n
t
i
t
a
t
i
ve
qua
s
i
e
x
pe
r
i
m
e
n
t
a
l
r
e
s
e
a
r
c
h
,
w
i
t
h
r
e
s
e
a
r
c
h
de
s
i
g
n
n
o
n
e
qu
i
va
l
e
n
t
w
i
t
h
t
h
e
c
o
n
t
r
o
l
gr
o
up
pr
e
t
e
s
t
a
n
d
po
s
tt
e
s
t
de
s
i
g
n
.
T
h
e
r
e
s
e
a
r
c
h
wa
s
c
o
n
du
c
t
e
d
i
n
10
c
o
m
m
u
ni
t
y
h
e
a
l
t
h
c
e
n
t
e
r
s
i
n
B
a
n
t
u
l
R
e
ge
n
c
y
a
n
d
i
t
wa
s
pe
r
f
o
r
m
e
d
f
r
o
m
No
v
e
m
b
e
r
2012
to
F
e
b
r
ua
r
y
2013.
T
h
e
po
pul
a
ti
o
n
wa
s
pa
t
i
e
n
t
s
w
i
t
h
m
e
n
t
a
l
d
i
s
o
r
de
r
s
f
r
o
m
mi
l
d
to
s
e
v
e
r
e
a
t
m
a
i
n
t
e
n
a
n
c
e
a
n
d
h
e
a
l
t
h
pr
o
m
o
t
i
o
n
t
r
e
a
t
m
e
n
t
.
T
h
e
s
i
z
e
o
f
t
h
e
s
a
m
p
l
e
us
e
d
by
t
h
e
r
e
s
e
a
r
c
h
e
r
us
e
d
S
l
o
vi
n
t
h
e
o
r
y
[
20]
.
T
h
e
s
a
m
pl
e
s
i
z
e
u
s
e
d
b
y
th
e
r
e
s
e
a
r
c
h
e
r
w
a
s
e
v
a
l
u
e
:
2
0
%
(
0
.
0
2
)
f
r
om
th
e
to
ta
l
p
op
u
l
a
t
i
on
i
n
2
7
c
o
m
m
un
i
t
y
h
e
a
l
t
h
c
e
n
te
r
s
.
B
a
s
e
d
on
th
e
c
a
l
c
ul
a
t
i
on
,
i
t
w
a
s
ob
tai
n
e
d
:
4
9
.
2
9
r
ou
n
d
e
d
to
5
0
±
1
0
r
e
s
p
on
d
e
n
ts
,
a
n
d
th
e
r
e
f
or
e
,
i
t
r
e
s
ul
te
d
i
n
6
0
-
7
0
r
e
s
p
on
d
e
n
ts
.
T
h
e
n
um
b
e
r
of
m
e
n
tal
di
s
or
d
e
r
p
a
ti
e
n
ts
of
e
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289
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a
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1.
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bl
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1.
R
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M
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n s
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up
1. N
ur
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1
46
56
51
10
2. N
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e
2
31
57
44
26
3. N
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e
3
51
55
53
4
4. N
ur
s
e
4
33
55
44
22
5. N
ur
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5
37
58
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21
T
ot
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S
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or
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/M
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n
198/
39.6
281/
56.2
239/
47.8
83/
16.6
B
C
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nt
r
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l
G
r
o
up
1. N
ur
s
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6
34
41
37.5
7
2. N
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s
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7
35
50
42.5
15
3. N
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s
e
8
32
53
42.5
21
4. N
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s
e
9
38
47
42.5
9
5.
N
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s
e
10
44
49
46.5
5
T
ot
a
l
S
c
or
e
/M
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a
n
183/
36.6
240/
48
201.5/40.3
57/
11.4
T
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2.
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d
60
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t
s
f
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.
3.
2.
C
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it
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7.
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po
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12.
6
po
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4.
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s
.
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Evaluation Warning : The document was created with Spire.PDF for Python.
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vi
t
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s
[
18,
19]
.
T
h
e
C
M
H
N
t
r
a
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ni
ng
t
h
a
t
b
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B
y
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C
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ng,
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k
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w
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dge
[
23]
.
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ut
t
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nc
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m
e
a
ni
ng
f
u
l
i
nput
[
19,
24]
.
An
d
c
o
n
s
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d
e
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d
[
25
]
.
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h
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d
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f
f
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r
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c
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k
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n
c
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p
[
23]
.
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[
26]
wh
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[
7]
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291
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d
w
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f
a
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to
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t
r
a
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,
h
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nc
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m
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ly
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pr
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kn
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w
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dge
[
23]
.
I
n
t
h
e
t
r
a
i
ni
ng,
n
ur
s
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s
a
nd
C
HV
s
c
o
m
m
u
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c
a
t
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a
c
h
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h
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s
,
e
ns
ur
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x
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h
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n
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o
f
m
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r
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i
nf
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t
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f
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d
b
a
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(
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a
s
e
,
pa
t
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t
’
s
b
o
d
y
im
a
g
e
)
[
23]
.
T
h
e
t
r
a
i
ni
ngs
a
l
s
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ve
s
t
h
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ur
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s
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d
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nf
o
r
m
a
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o
n
[
27]
.
S
o
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e
ha
s
hi
s
o
wn
pe
r
c
e
pt
i
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b
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d
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im
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,
in
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l
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hi
s
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,
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d
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hi
s
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him
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lf
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ng
j
ud
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m
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t
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hi
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y
-
im
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[
7,
8]
.
I
f
t
h
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pe
r
c
e
pt
i
o
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o
n
hi
s
o
wn
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y
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[
8]
.
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[
28]
.
T
hi
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ly
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[
29,
30]
.
S
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s
s
u
c
h
a
s
a
n
o
r
e
xi
a
a
n
d
s
u
i
c
i
da
l
t
e
n
de
n
c
y
[
7,
25
]
.
B
o
dy
-
im
a
ge
p
a
r
t
l
y
d
e
pe
n
ds
o
n
b
o
d
y
s
t
a
t
e
.
P
e
o
p
l
e
c
o
m
m
o
nly
c
a
nn
o
t
r
a
pi
d
l
y
a
da
pt
t
o
phy
s
i
c
a
l
c
h
a
n
g
e
s
.
P
hy
s
i
c
a
l
c
h
a
n
ge
s
m
a
y
b
e
n
o
t
a
l
wa
y
s
i
nc
l
ud
e
d
i
n
a
n
i
d
e
a
l
b
o
d
y
-
im
a
ge
,
f
o
r
e
x
a
m
p
l
e
s
o
m
e
o
n
e
w
h
o
l
o
s
e
we
i
g
h
t
do
e
s
n
ot
c
o
n
s
i
de
r
him
s
e
l
f
a
s
s
k
i
nny
[
6]
.
T
h
e
r
e
s
u
l
t
s
h
o
we
d
b
ody
-
i
m
a
ge
c
a
n
c
h
a
n
ge
in
h
o
ur
s
,
da
y
s
,
we
e
k
s
,
o
r
m
o
n
t
hs
,
de
pe
n
d
i
ng
o
n
t
h
e
e
x
t
e
r
n
a
l
s
t
i
m
u
li
t
o
t
h
e
b
o
dy
a
n
d
a
c
t
ua
l
c
h
a
n
ge
s
i
n
a
ppe
a
r
a
n
c
e
,
s
t
r
uc
t
u
r
e
o
r
f
u
n
c
t
i
o
n
[
7]
.
T
h
e
e
x
t
e
r
n
a
l
s
t
i
m
u
l
us
i
n
t
hi
s
s
t
ud
y
wa
s
t
h
e
i
n
t
e
r
v
e
n
t
i
o
n
pe
r
f
o
r
m
e
d
by
t
h
e
r
e
s
e
a
r
c
h
e
r
c
o
n
s
i
s
t
i
n
g
o
f
t
r
a
i
ni
ng
s
o
n
I
C
-
C
M
HN
,
BC
-
C
M
HN
,
s
t
ud
y
o
n
s
e
lf
-
c
o
n
c
e
pt
,
C
B
T
a
n
d
T
S
.
F
ur
t
h
e
r
m
o
r
e
,
K
e
li
a
t
[
21]
vi
e
w
t
ha
t
o
n
e
o
f
s
t
r
e
s
s
o
r
a
f
f
e
c
t
i
n
g
b
o
d
y
-
i
m
a
ge
i
s
m
e
d
i
c
a
l
p
r
o
c
e
dur
e
o
r
tr
e
a
t
m
e
n
t
.
T
h
e
n
ur
s
e
s
s
t
a
t
e
d
t
h
a
t
B
C
-
C
M
HN
tr
a
i
ni
ng
i
n
t
h
e
t
r
e
a
t
m
e
n
t
gr
o
up
wa
s
e
a
s
i
ly
u
n
de
r
s
t
a
n
da
bl
e
s
i
nc
e
i
t
ha
s
be
e
n
c
o
n
duc
t
e
d
pr
e
vi
o
us
ly
dur
i
ng
t
h
e
r
e
h
a
bil
i
t
a
t
i
o
n
a
f
t
e
r
ea
r
t
h
qua
ke
.
A
t
f
i
r
s
t
,
t
h
e
b
o
d
y
i
m
a
ge
a
s
s
e
s
s
m
e
n
t
us
i
n
g
S
C
A
G
,
C
B
T
a
n
d
T
S
T
t
r
a
i
ni
ng
we
r
e
ha
r
d
t
o
f
o
l
l
o
w
b
e
c
a
us
e
t
h
e
m
a
t
e
r
i
a
l
s
we
r
e
n
o
t
f
a
mi
li
a
r
a
n
d
n
e
w
f
o
r
t
h
e
n
ur
s
e
s
i
n
t
h
e
c
o
m
m
u
ni
t
y
h
e
a
l
t
h
c
e
n
t
e
r
.
Ho
we
v
e
r
,
a
f
t
e
r
t
h
r
e
e
da
y
s
t
r
a
i
ni
ng,
t
h
e
pa
r
t
i
c
i
p
a
n
t
s
k
n
o
w
t
h
e
i
m
po
r
t
a
n
c
e
o
f
t
h
e
s
t
ud
y
c
o
n
c
e
pt
to
i
mp
l
e
m
e
n
t
,
a
s
t
h
e
r
e
a
r
e
a
l
o
t
o
f
i
nf
o
r
m
a
t
i
o
n
t
o
r
e
v
e
a
l
f
r
o
m
t
h
e
pa
t
i
e
n
t
s
,
e
s
pe
c
i
a
ll
y
r
e
l
a
t
e
d
to
s
e
l
f
-
p
e
r
c
e
pt
i
o
n
o
f
t
h
e
pa
t
i
e
n
t
,
s
uc
h
a
s
l
o
w
s
e
l
f
-
e
s
t
e
e
m
,
us
e
l
e
s
s
n
e
s
s
,
d
i
s
a
ppo
i
n
t
m
e
n
t
wi
t
h
t
h
e
r
e
a
l
i
t
y
a
n
d
f
e
e
li
ng
o
s
t
r
a
c
i
z
e
d
b
y
t
h
e
s
o
c
i
e
t
y
.
IC
-
C
M
HN
t
r
a
i
ni
ng
f
o
r
m
e
n
t
a
l
h
e
a
l
t
h
v
o
l
u
n
t
e
e
r
s
,
a
n
d
B
C
-
C
M
HN
,
s
t
ud
y
o
n
s
e
lf
-
c
o
n
c
e
pt
,
C
B
T
a
n
d
T
S
T
tr
a
i
ni
ng
f
o
r
n
ur
s
e
s
a
r
e
pe
r
f
o
r
m
e
d
w
i
t
h
a
we
l
l
-
pr
e
pa
r
e
d
pl
a
n
to
a
c
hi
e
ve
goo
d
r
e
s
ul
t
s
.
T
r
a
i
ni
ng
n
e
e
ds
to
b
e
p
l
a
nn
e
d
b
e
c
a
us
e
i
t
c
a
n
a
f
f
e
c
t
t
h
e
r
e
s
u
l
t
s
o
f
t
h
e
t
r
a
i
ni
ng
i
t
s
e
lf
[
31]
,
t
h
a
t
wh
e
n
a
t
r
a
i
ni
ng
i
s
n
o
t
de
s
i
g
ne
d
a
s
a
n
o
pp
o
r
t
un
i
t
y
t
o
i
m
pr
o
v
e
a
s
p
e
c
i
f
i
c
wo
r
k
pe
r
f
o
r
m
a
nc
e
,
t
h
e
n
ur
s
e
s
t
e
n
d
t
o
i
g
n
o
r
e
t
h
e
im
po
r
t
a
n
c
e
o
f
t
r
a
i
ni
ng
a
n
d
o
nl
y
a
f
e
w
c
ha
n
ge
s
c
a
n
b
e
s
e
e
n
o
n
t
h
e
i
r
wo
r
k
pe
r
f
o
r
m
a
n
c
e
[
19]
.
I
t
a
l
s
o
a
pp
l
i
e
s
to
n
ur
s
e
s
o
r
C
HV
s
i
n
t
hi
s
s
t
udy
,
s
t
a
t
e
d
t
h
a
t
t
h
e
y
w
il
l
f
e
e
l
b
o
r
e
d
w
i
t
h
t
h
e
t
r
a
i
n
i
ng
i
f
i
t
do
e
s
n
ot
o
f
f
e
r
a
dd
i
t
i
o
n
a
l
va
l
ue
s
t
o
t
h
e
m
,
n
o
t
to
m
e
n
t
i
o
n
i
f
t
h
e
t
r
a
i
ni
ng
h
a
s
f
e
e
t
h
e
y
h
a
ve
to
pa
y
.
4.
CONC
L
USI
ON
T
hi
s
r
e
s
e
a
r
c
h
c
o
n
c
l
ude
d
t
h
a
t
C
M
HN
t
r
a
i
ni
ng,
S
C
A
G
t
r
a
i
ni
ng,
C
B
T
a
n
d
T
S
T
t
r
a
i
ni
ng
f
o
r
n
ur
s
e
s
a
n
d
C
HV
s
c
o
u
l
d
im
pr
o
v
e
t
h
e
qua
li
t
y
o
f
b
o
d
y
-
im
a
ge
a
m
o
n
g
t
h
e
pa
t
i
e
n
t
s
w
i
t
h
m
e
n
t
a
l
d
i
s
o
r
de
r
s
.
B
a
s
e
d
o
n
t
h
e
d
i
s
c
us
s
i
o
n
a
b
o
v
e
,
i
t
i
s
r
e
c
o
m
m
e
n
de
d
t
h
a
t
t
h
e
a
ut
h
o
r
i
t
a
t
i
ve
po
l
i
c
y
m
a
ke
r
s
i
.
e
.
t
h
e
r
e
g
i
o
n
a
l
o
f
f
i
c
i
a
l
s
t
o
un
de
r
s
t
a
n
d
t
h
e
im
po
r
t
a
n
c
e
o
f
C
M
HN
pr
o
gr
a
m
s
o
t
h
e
y
c
a
n
a
ll
o
c
a
t
e
s
o
m
e
pa
r
t
o
f
t
h
e
L
o
c
a
l
Go
ve
r
nm
e
n
t
B
udge
t
f
o
r
C
M
HN
t
r
a
i
ni
n
g.
F
o
r
t
h
e
c
o
m
m
u
ni
t
y
h
e
a
l
t
h
c
e
n
t
e
r
,
i
t
i
s
s
ugge
s
t
e
d
to
m
a
ke
t
h
e
b
e
s
t
us
e
a
n
d
m
a
i
n
t
a
i
n
t
h
e
t
r
a
i
ni
ng
t
h
a
t
h
a
d
b
e
e
n
c
o
n
duc
t
e
d
by
t
h
e
r
e
s
e
a
r
c
h
e
r
,
s
o
i
t
c
a
n
s
uppo
r
t
t
h
e
pr
o
g
r
a
m
s
o
f
t
h
e
c
o
m
m
u
ni
t
y
h
e
a
l
t
h
c
e
n
t
e
r
,
e
s
pe
c
i
a
ll
y
i
n
t
h
e
m
a
n
a
ge
m
e
n
t
o
f
pa
t
i
e
n
t
s
w
i
t
h
m
e
n
t
a
l
d
i
s
o
r
de
r
s
i
n
t
h
e
c
o
m
m
u
ni
t
y
.
RE
F
E
R
E
NC
E
S
[
1
]
W
o
rl
d
H
e
al
t
h
O
rg
an
i
za
t
i
o
n
,
m
h
G
A
P
c
o
mm
u
n
i
t
y
t
o
o
l
k
i
t
:
fi
e
l
d
t
e
s
t
v
e
r
s
i
o
n
.
G
e
n
e
v
a:
W
o
rl
d
H
e
al
t
h
O
rg
an
i
za
t
i
o
n
,
2
0
1
9
.
[
2
]
S
.
L
.
V
i
d
e
b
e
c
k
,
“
P
s
y
c
h
i
a
t
r
i
c
m
e
n
t
a
l
h
e
a
l
t
h
n
u
r
s
i
n
g
,
”
P
h
i
l
a
d
e
l
p
h
i
a
:
W
o
l
t
e
r
s
K
l
u
w
e
r
:
L
i
p
p
i
n
c
o
t
t
W
i
l
l
i
a
m
s
&
W
i
l
k
i
n
s
,
2
0
1
1
.
[3
]
P.
T
j
,
“
Me
n
t
al
D
i
s
o
rd
e
rs
ar
e
N
o
t
R
e
al
:
U
s
i
n
g
Sk
e
p
t
i
c
i
s
m
an
d
Cri
t
i
c
a
l
T
h
i
n
k
i
n
g
t
o
Ch
a
l
l
en
g
e
K
ey
M
y
t
h
s
i
n
t
h
e
Sci
en
ce
o
f
M
e
n
t
al
H
e
a
l
t
h
,
”
J.
M
en
t
.
D
i
s
o
r
d
.
Tr
e
a
t
.
,
v
o
l
.
3
,
n
o
.
1
,
2
0
1
7
.
d
o
i
:
1
0
.
4
1
7
2
/
2
4
7
1
-
2
7
1
X
.
1
0
0
0
1
4
0
[4
]
C.
Y
o
u
n
g
,
C.
H
an
s
o
n
,
J
.
C.
Crai
g
,
K
.
Cl
ap
h
a
m,
an
d
A
.
W
i
l
l
i
a
m
s
o
n
,
“
Ps
y
ch
o
s
o
ci
al
fa
c
t
o
rs
as
s
o
c
i
at
e
d
w
i
t
h
t
h
e
me
n
t
al
h
e
al
t
h
o
f
i
n
d
i
g
en
o
u
s
c
h
i
l
d
r
e
n
l
i
v
i
n
g
i
n
h
i
g
h
i
n
co
m
e
co
u
n
t
ri
e
s
:
a
s
y
s
t
em
at
i
c
rev
i
ew
,
”
In
t
.
J.
E
q
u
i
t
y
H
ea
l
t
h
,
v
o
l
.
1
6
,
n
o
.
1
,
p
.
1
5
3
,
D
ec.
2
0
1
7
.
d
o
i
:
1
0
.
1
1
8
6
/
s
1
2
9
3
9
-
0
1
7
-
0
6
5
2
-
5
[5
]
G
.
H
as
s
an
,
P.
V
e
n
t
e
v
o
g
el
,
H
.
J
e
f
ee
-
Ba
h
l
o
u
l
,
A
.
Bar
k
i
l
-
Ote
o
,
an
d
L
.
J
.
K
i
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m
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.
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,
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a
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4
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5
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Ray
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.
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d
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.
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.
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6
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.
[1
7
]
J
.
Pe
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y
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L
.
Pal
me
r
,
P.
T
h
o
m
p
s
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n
,
A
.
W
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d
R.
Ch
ap
l
i
n
,
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an
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mm
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s
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s
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2
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7
.
[1
8
]
M.
Fu
k
a
d
a,
“
N
u
rs
i
n
g
C
o
m
p
e
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e
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cy
:
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[
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9
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T
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Fo
u
n
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,
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T
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H
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Fo
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]
.
A
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d
f
[
2
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]
M.
S.
D
ah
l
an
,
“
L
arg
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m
p
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d
Sa
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p
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R
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Ke
d
o
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,
”
3
rd
ed
.
J
ak
art
a:
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l
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a
M
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k
a
,
2
0
1
0
.
[2
1
]
B.
A
.
K
el
i
at
,
“
Ps
y
ch
o
s
o
ci
al
n
u
rs
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n
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m
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n
ag
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t
&
men
t
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e
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l
t
h
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ad
r
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:
CMH
N
(i
n
t
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r
med
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at
e
co
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r
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e
),
”
(
M
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n
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en
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w
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p
s
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k
o
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l
&
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kes
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a
t
a
n
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w
a
:
CM
H
N
(i
n
t
er
m
ed
i
a
t
e
co
u
r
s
e
),
”
J
ak
art
a:
EGC
,
2
0
1
1
.
[2
2
]
R.
I
b
rah
i
m
,
“
G
u
i
d
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