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lo
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p
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h
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lt
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ch
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llen
g
e
[
1
]
.
T
h
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o
r
e,
th
e
Mi
n
i
s
tr
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o
f
He
alth
in
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co
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[
2
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.
B
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ai
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m
p
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n
en
t
s
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tec
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ical,
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n
cl
u
d
in
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eq
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ip
m
e
n
t
a
n
d
s
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p
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lies
[
3
]
,
ii)
th
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s
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iii)
t
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an
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[
4
]
.
A
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f
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r
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o
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t
o
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t
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p
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v
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[
5
]
.
T
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an
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tate,
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o
f
ail
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r
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to
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cc
id
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s
[
6
]
.
T
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co
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ce
p
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p
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t
s
a
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y
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s
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Evaluation Warning : The document was created with Spire.PDF for Python.
I
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I
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J
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P
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Sci
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Vo
l.
1
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No
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1
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Ma
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ch
20
2
1
:
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1
–
6
7
62
i
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p
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m
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ted
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f
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s
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e
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f
p
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tectio
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t
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p
atien
ts
[
7
].
T
h
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b
asic
co
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c
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t
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p
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t
s
a
f
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tates
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w
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s
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h
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m
to
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en
d
an
g
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p
atie
n
ts
th
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m
s
elv
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s
[
5
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.
On
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th
at
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la
y
s
a
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d
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d
p
r
in
cip
les
h
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b
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co
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m
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n
it
y
[
8
]
.
Hen
ce
,
th
e
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o
f
t
h
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w
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k
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g
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d
eli
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to
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co
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m
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it
y
is
v
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y
i
n
f
lu
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n
tial.
T
h
e
w
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k
in
g
en
v
ir
o
n
m
e
n
t
d
is
cu
s
s
ed
in
t
h
is
r
esear
c
h
is
n
o
t
in
te
n
d
ed
to
lead
to
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p
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y
s
ica
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en
v
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m
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t,
b
u
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r
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t
h
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w
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k
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cli
m
ate
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t
h
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it
an
d
th
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h
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s
p
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L
a
k
e
[
9
]
d
ef
in
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t
h
e
w
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r
k
en
v
ir
o
n
m
e
n
t
as
a
s
e
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c
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ar
ac
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is
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a
t
s
u
p
p
o
r
t
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h
i
n
d
er
th
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f
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m
a
n
ce
.
A
cc
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r
d
in
g
to
Ger
s
h
o
n
[
10
]
s
af
et
y
cli
m
ate
a
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d
s
af
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w
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k
in
g
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n
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F
ig
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r
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1
[
1
0
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.
Fig
u
r
e
1
.
R
elatio
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s
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ip
b
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ati
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eter
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m
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t
a
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d
t
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p
atie
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t
s
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cli
m
ate.
W
it
h
t
h
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k
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t
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s
r
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s
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ip
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o
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ca
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ate
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at
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f
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ital
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m
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elate
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atie
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o
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it
m
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t
f
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th
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s
h
ip
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t
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eq
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o
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to
r
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atie
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m
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lized
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m
a
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m
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SOP
s
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asp
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ts
s
o
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h
at
it
lead
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to
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e
a
ch
iev
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m
e
n
t
o
f
p
atie
n
t
s
af
e
t
y
g
o
als.
So
cializa
tio
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a
n
d
tr
ain
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n
g
f
o
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all
e
m
p
lo
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s
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t
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ca
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cr
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g
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elate
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atien
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lti
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atel
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atie
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cli
m
ate
f
o
r
all
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ts
o
f
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er
v
ice
at
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s
p
it
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f
f
ec
tiv
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co
m
m
u
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is
th
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k
e
y
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cr
ea
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a
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li
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ate
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atien
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f
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m
u
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y
p
es
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r
eq
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ir
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a
p
o
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iti
v
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p
atien
t
s
af
et
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f
a
m
i
liar
izatio
n
[
1
1
]
.
E
f
f
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tiv
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co
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m
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ts
.
A
cc
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r
d
in
g
to
I
d
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is
et
a
l
.
[1
2
]
co
m
m
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n
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io
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b
ec
o
m
e
s
an
i
m
p
o
r
tan
t
p
ar
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th
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co
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m
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p
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ical
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ter
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I
n
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er
to
m
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m
a
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an
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all
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tio
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r
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P
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o
f
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m
p
lo
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in
th
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a
m
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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63
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b
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wee
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ele
m
e
n
ts
in
t
h
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w
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k
p
lac
e
[
1
3
]
.
T
h
is
co
m
m
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c
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tr
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lled
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to
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an
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in
ter
ac
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p
atter
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s
b
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w
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s
u
b
o
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d
in
ate
an
d
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p
atien
t.
B
y
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er
f
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f
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n
ct
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v
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co
m
m
u
n
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t
h
at
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x
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w
it
h
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t
h
e
i
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s
ti
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t
io
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/
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an
is
at
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o
f
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v
ices
ca
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b
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ascer
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d
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n
tal
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tate
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th
e
p
atien
t
s
[
1
4
].
T
h
er
e
a
r
e
t
w
o
k
i
n
d
s
o
f
co
m
m
u
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h
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ter
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ter
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co
m
m
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a
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d
ex
ter
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m
m
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s
.
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n
ter
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co
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e
co
m
m
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t
h
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w
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h
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th
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b
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it
o
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,
tr
aits
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le
to
th
e
o
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g
an
is
at
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al
s
tr
u
ct
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r
e
[
1
5
]
C
o
m
m
u
n
ica
tio
n
b
et
w
ee
n
tea
m
m
e
m
b
er
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m
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ter
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m
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s
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b
o
th
p
ar
ties
ar
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in
o
n
e
o
r
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a
n
is
at
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n
.
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x
ter
n
al
co
m
m
u
n
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is
t
h
e
co
m
m
u
n
ica
tio
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t
h
at
h
ap
p
en
b
et
w
ee
n
t
h
e
o
r
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a
n
i
s
atio
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an
d
th
e
ele
m
e
n
ts
o
u
ts
id
e
th
e
o
r
g
an
is
at
io
n
.
T
h
e
r
elatio
n
s
h
ip
b
et
w
ee
n
th
e
h
o
s
p
ital
s
ta
f
f
s
a
n
d
p
atien
ts
is
o
n
e
o
f
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t
y
p
e
s
o
f
ex
ter
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al
co
m
m
u
n
ica
tio
n
.
I
n
ter
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al
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m
m
u
n
ica
tio
n
s
a
n
d
ex
ter
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al
co
m
m
u
n
ica
tio
n
s
h
a
v
e
a
n
eq
u
all
y
i
m
p
o
r
ta
n
t
r
o
le
in
p
atien
t
s
af
e
t
y
.
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r
o
n
o
v
o
s
t
s
tated
th
at
m
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s
t
m
ed
ical
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r
o
r
s
o
cc
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in
th
e
co
m
m
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ca
tio
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g
ap
b
et
w
ee
n
tea
m
m
e
m
b
er
s
[
1
6
]
.
T
h
e
f
ailu
r
e
o
f
p
r
o
v
id
er
s
to
co
o
p
er
ate
o
r
co
m
m
u
n
ica
te
a
s
a
tea
m
is
o
n
e
o
f
th
e
f
ac
to
r
s
th
at
co
n
tr
ib
u
te
to
m
ed
ical
er
r
o
r
s
o
r
o
th
er
p
atien
t sa
f
et
y
in
cid
e
n
ts
[
1
7
]
.
T
h
e
d
if
f
er
e
n
ce
b
et
w
ee
n
a
h
o
s
p
ital
o
r
h
ea
lt
h
ca
r
e
p
r
o
v
id
er
in
d
u
s
tr
y
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d
o
t
h
er
f
ield
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s
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at
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f
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I
t c
an
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p
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h
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ar
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a
f
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m
o
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u
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t
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ar
ticip
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b
et
w
ee
n
t
h
e
m
an
a
g
e
m
e
n
t
b
o
d
ies
[
1
8
]
.
R
esear
ch
e
r
s
ag
r
ee
d
th
at
s
o
lid
tea
m
w
o
r
k
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eq
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ir
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to
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r
r
y
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u
t
t
h
eir
d
u
tie
s
p
r
o
p
er
ly
an
d
p
r
o
v
id
e
h
ea
lt
h
ass
is
tan
ce
to
p
a
tien
ts
.
Go
o
d
co
o
p
er
atio
n
is
n
ee
d
ed
f
o
r
all
elem
e
n
ts
o
f
th
e
h
o
s
p
ital
to
w
o
r
k
to
g
et
h
er
as
a
s
o
lid
tea
m
.
T
h
is
co
llab
o
r
atio
n
w
ill
r
esu
l
t
in
a
h
o
lis
tic
ca
r
e
f
o
r
p
atien
ts
.
Si
m
i
l
ar
l
y
,
in
th
e
ar
ea
s
o
f
s
a
f
et
y
,
p
at
ien
t
s
a
f
et
y
w
i
ll
n
o
t
b
e
lik
el
y
to
b
e
r
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lis
ed
if
th
e
r
e
is
n
o
co
o
p
er
atio
n
b
etw
ee
n
th
e
tea
m
m
e
m
b
er
s
o
f
ex
is
ti
n
g
s
er
v
ice
p
r
o
v
id
er
s
.
T
h
er
ef
o
r
e,
co
o
p
e
r
atio
n
s
h
o
u
ld
b
e
p
r
o
m
o
ted
to
t
h
e
tea
m
a
m
o
n
g
th
e
lead
er
s
a
n
d
s
ta
f
f
w
h
o
d
ea
l
w
it
h
t
h
e
p
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b
lic
d
ir
ec
tl
y
.
I
f
ev
er
y
t
h
in
g
w
o
r
k
s
w
ell
a
n
d
ev
er
y
o
n
e
i
s
co
n
n
ec
te
d
to
ea
ch
o
th
er
as
th
e
y
s
h
o
u
ld
b
e,
th
e
b
est
s
er
v
ice
q
u
alit
y
ca
n
b
e
p
r
o
v
id
ed
[
1
9
].
T
ea
m
w
o
r
k
i
s
t
h
e
p
r
o
ce
s
s
o
f
w
o
r
k
i
n
g
i
n
g
r
o
u
p
s
w
it
h
p
ar
ticip
atio
n
f
r
o
m
th
e
lead
er
,
d
iv
id
ed
r
esp
o
n
s
ib
ilit
y
,
s
h
ar
e
o
f
in
ter
est,
i
n
ten
s
i
v
e
co
m
m
u
n
icatio
n
,
f
o
cu
s
o
n
th
e
f
u
t
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r
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f
o
c
u
s
o
n
th
e
tas
k
,
cr
ea
tiv
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talen
t
an
d
r
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o
n
d
s
q
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ic
k
l
y
to
ac
h
iev
e
o
r
g
a
n
is
atio
n
al
g
o
al
s
[
2
0
]
.
E
f
f
ec
ti
v
e
tea
m
lead
er
s
e
n
co
u
r
ag
e
t
h
e
tea
m
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p
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f
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r
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u
s
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i
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v
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et.
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h
e
X
H
o
s
p
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s
to
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cr
ea
s
e
tea
m
w
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k
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n
p
r
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g
h
ea
lt
h
s
er
v
ice
s
t
h
at
p
r
io
r
itize
p
atien
t
s
af
et
y
.
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h
is
tea
m
w
o
r
k
ca
n
b
e
s
tr
e
n
g
th
e
n
ed
b
y
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o
ld
i
n
g
w
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k
s
h
o
p
s
,
ch
ar
ac
ter
b
u
i
ld
in
g
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d
r
o
u
tin
e
d
is
c
u
s
s
io
n
s
in
v
o
l
v
in
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m
e
n
ts
.
I
n
m
o
s
t
h
ea
l
th
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r
e
o
r
g
a
n
is
a
ti
o
n
s
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llab
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ativ
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ap
p
r
o
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a
k
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lt
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n
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in
t
h
e
w
a
y
th
e
o
r
g
an
is
atio
n
w
o
r
k
s
[
2
1
]
.
P
atien
t
s
af
et
y
n
ee
d
s
ef
f
o
r
t
f
r
o
m
th
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h
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le
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m
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t
h
e
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m
m
o
s
t
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f
f
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tiv
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l
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as
th
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a
m
e
p
u
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e
in
t
h
e
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k
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a
n
d
t
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i
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e
f
f
ec
t
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s
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av
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m
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n
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t
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tiv
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cr
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te
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p
p
o
r
tu
n
ities
f
o
r
er
r
o
r
/
er
r
o
r
[
2
2
].
2.
RE
S
E
ARCH
M
E
T
H
O
D
T
h
is
r
esear
ch
i
s
clas
s
i
f
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o
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al
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t
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d
y
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T
h
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a
p
p
r
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h
u
s
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th
i
s
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cr
o
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s
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s
ec
tio
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al
s
t
u
d
y
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d
er
s
ta
n
d
th
e
d
y
n
a
m
ics
o
f
t
h
e
co
r
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b
et
w
ee
n
in
d
ep
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e
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t
a
n
d
d
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en
t
v
ar
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r
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u
g
h
o
b
s
er
v
at
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an
d
d
ata
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co
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cu
r
r
en
tl
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n
t
h
is
s
tu
d
y
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a
n
al
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tical
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u
r
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w
il
l
b
e
co
n
d
u
cted
to
u
n
d
er
s
ta
n
d
th
e
e
m
p
lo
y
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s
’
p
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ce
p
tio
n
s
o
f
th
e
w
o
r
k
i
n
g
e
n
v
ir
o
n
m
en
t
r
eg
ar
d
in
g
p
atie
n
t
s
af
et
y
cli
m
ate.
T
h
e
r
esear
ch
s
a
m
p
le
s
w
er
e
e
m
p
lo
y
ee
s
o
f
X
Ho
s
p
ital
m
ed
ical
p
r
o
v
id
er
s
,
s
u
p
p
o
r
t
s
er
v
ices,
an
d
s
u
p
p
o
r
t
s
er
v
ices.
T
o
tal
n
u
m
b
er
o
f
s
a
m
p
le
i
s
7
1
p
eo
p
le,
w
h
ich
h
as q
u
ali
f
ied
th
e
m
in
i
m
u
m
s
u
r
v
e
y
s
a
m
p
le
o
f
3
0
p
eo
p
le
[
2
3
].
A
q
u
es
t
io
n
n
air
e
w
as
u
s
ed
to
d
eter
m
in
e
th
e
in
d
ep
en
d
e
n
t
v
a
r
iab
les.
T
h
e
q
u
esti
o
n
n
air
e
w
a
s
co
m
p
iled
b
ased
o
n
d
is
cu
s
s
io
n
s
w
it
h
s
o
m
e
o
f
t
h
e
lead
er
s
h
ip
an
d
m
a
n
ag
e
m
e
n
t
tea
m
m
e
m
b
er
s
o
f
t
h
e
h
o
s
p
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r
eg
ar
d
in
g
th
e
f
ac
to
r
s
th
at
ar
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x
p
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to
af
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p
atien
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s
a
f
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c
li
m
ate
in
th
e
X
H
o
s
p
ital.
T
h
e
q
u
esti
o
n
n
air
e
w
as
d
ev
elo
p
ed
to
d
escr
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w
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v
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b
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m
e
in
d
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r
s
to
f
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u
late
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.
T
h
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q
u
esti
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n
n
air
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w
as
th
en
ad
j
u
s
ted
to
P
atien
t
Saf
e
t
y
C
li
m
ate
o
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Hea
lt
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C
ar
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Or
g
an
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s
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to
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d
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h
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it
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b
et
w
ee
n
t
h
e
t
w
o
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s
u
r
ed
.
Evaluation Warning : The document was created with Spire.PDF for Python.
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co
n
d
u
cted
in
t
h
is
s
tu
d
y
w
er
e
q
u
es
tio
n
n
ai
r
es,
th
e
q
u
e
s
tio
n
n
air
e
co
llectio
n
,
co
d
in
g
,
d
ata
in
p
u
t,
an
d
d
ata
a
n
al
y
s
i
s
.
An
al
y
s
i
s
o
f
th
e
d
ata
is
a
co
n
t
i
n
u
at
io
n
o
f
d
ata
p
r
o
ce
s
s
i
n
g
s
ta
g
es.
Da
ta
an
a
l
y
s
is
is
th
e
p
r
o
ce
s
s
o
f
s
i
m
p
l
if
ica
tio
n
o
f
d
ata
in
to
a
f
o
r
m
t
h
at
is
ea
s
ier
to
r
ea
d
an
d
in
ter
p
r
et.
W
o
r
k
en
v
ir
o
n
m
en
t
p
r
ed
icted
f
r
o
m
s
u
b
v
ar
iab
le
c
o
m
m
u
n
icatio
n
a
n
d
tea
m
w
o
r
k
.
I
n
th
is
s
t
u
d
y
,
d
ata
an
al
y
s
is
i
n
clu
d
e
s
an
al
y
s
i
s
o
f
u
n
i
v
ar
iate,
a
n
d
b
iv
ar
iate
an
al
y
s
is
u
s
i
n
g
c
h
i sq
u
ar
e
test
.
3.
RE
SU
L
T
S
A
ND
D
I
SCU
SS
I
O
N
3
.
1
.
Resul
t
Dis
tr
ib
u
tio
n
o
f
r
e
s
p
o
n
d
en
t
s
'
p
er
ce
p
tio
n
s
o
f
t
h
e
w
o
r
k
e
n
v
ir
o
n
m
e
n
t
v
ar
iab
les
w
er
e
d
iv
id
ed
in
to
t
wo
ca
teg
o
r
ies:
g
o
o
d
an
d
les
s
g
o
o
d
.
W
o
r
k
en
v
ir
o
n
m
e
n
t
v
ar
iab
le
s
w
er
e
tr
an
s
lated
i
n
t
o
t
w
o
s
u
b
v
ar
iab
les,
t
h
o
s
e
ar
e
co
m
m
u
n
icatio
n
,
a
n
d
tea
m
w
o
r
k
.
T
h
e
v
ar
iab
le
an
al
y
s
is
ca
lcu
latio
n
o
f
th
e
w
o
r
k
e
n
v
ir
o
n
m
e
n
t
is
t
h
e
s
u
m
o
f
t
h
e
t
w
o
s
u
b
v
ar
iab
les ab
o
v
e
as
s
h
o
w
n
in
T
ab
le
1
.
T
ab
el
1
.
R
esp
o
n
d
en
ts
’
p
er
ce
p
tio
n
r
eg
ar
d
in
g
w
o
r
k
en
v
ir
o
n
m
e
n
t,
s
u
b
v
ar
iab
le
co
m
m
u
n
icatio
n
,
an
d
s
u
b
v
ar
iab
le
tea
m
w
o
r
k
V
a
r
i
a
b
e
l
a
n
d
s
u
b
v
a
r
i
a
b
e
l
A
mo
u
n
t
P
e
r
c
e
n
t
a
g
e
(
%)
W
o
r
k
e
v
i
r
o
n
me
n
t
G
o
o
d
L
e
ss
40
5
6
.
3
31
4
3
.
7
C
o
mm
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n
i
c
a
t
i
o
n
G
o
o
d
L
e
ss
52
7
3
.
2
19
2
6
.
8
T
e
a
m
w
o
r
k
S
u
p
p
o
r
t
D
o
e
s
n
o
t
su
p
p
o
r
t
53
7
4
.
6
18
25
.
4
I
n
t
h
e
w
o
r
k
en
v
ir
o
n
m
e
n
t
s
y
s
t
e
m
v
ar
iab
les,
t
h
e
r
e
s
u
l
ts
w
er
e
ca
teg
o
r
is
ed
b
ased
o
n
t
h
e
c
u
t
-
o
f
f
p
o
in
t
v
alu
e
s
m
ea
n
w
h
ic
h
s
h
o
w
e
d
th
at
4
0
(
5
6
.
3
%)
o
f
r
esp
o
n
d
en
ts
s
tated
a
g
o
o
d
w
o
r
k
in
g
en
v
ir
o
n
m
e
n
t.
A
p
p
r
o
x
i
m
atel
y
3
1
(
4
3
.
7
%)
o
f
r
esp
o
n
d
en
ts
s
tated
th
at
th
e
w
o
r
k
e
n
v
ir
o
n
m
e
n
t
is
les
s
th
a
n
g
o
o
d
.
Ho
w
e
v
er
,
w
h
e
n
it
is
s
ee
n
f
r
o
m
t
h
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r
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tio
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s
h
ip
o
f
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ch
s
u
b
v
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le
o
f
w
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k
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n
v
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n
m
e
n
t
v
ar
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les,
th
e
d
ep
en
d
en
t
v
ar
iab
le
is
as
f
o
llo
w
s
:
1
)
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n
th
e
co
m
m
u
n
icat
io
n
v
ar
iab
les,
th
e
r
es
u
lt
s
w
er
e
ca
teg
o
r
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ed
ac
co
r
d
in
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to
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cu
t
-
o
f
f
p
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t
o
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th
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ea
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alu
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w
h
ich
is
t
h
e
n
d
iv
id
ed
b
y
t
h
e
co
m
m
u
n
icatio
n
th
at
o
cc
u
r
s
eit
h
er
o
r
les
s
g
o
o
d
.
I
n
t
h
e
tab
le
ab
o
v
e,
5
2
(
7
3
.
2
%)
o
f
r
esp
o
n
d
en
ts
s
tated
th
at
th
e
ex
i
s
ti
n
g
co
m
m
u
n
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io
n
is
g
o
o
d
,
w
h
i
le
1
9
r
esp
o
n
d
en
ts
s
ta
ted
th
at
th
e
co
m
m
u
n
ica
tio
n
w
a
s
lack
i
n
g
.
2
)
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n
tea
m
w
o
r
k
v
ar
iab
le,
t
h
e
r
esu
lt
s
w
er
e
ca
te
g
o
r
is
ed
b
as
ed
o
n
th
e
c
u
t
-
o
f
f
p
o
i
n
t
o
f
m
ea
n
v
alu
e
s
,
w
h
ic
h
s
h
o
w
ed
th
at
5
3
r
esp
o
n
d
en
ts
(
7
4
.
6
%)
s
tated
th
at
th
e
tea
m
wo
r
k
is
g
o
o
d
.
W
h
ile
1
8
r
esp
o
n
d
en
t
s
(
2
5
.
4
%)
s
tated
th
at
t
h
er
e
is
a
lack
i
n
te
a
m
co
llab
o
r
atio
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.
T
h
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s
tatis
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icall
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ig
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t
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=
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H0
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s
u
m
m
ar
is
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as
s
h
o
w
n
in
T
ab
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2
.
Evaluation Warning : The document was created with Spire.PDF for Python.
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t
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t
h
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f
o
r
m
o
f
s
er
v
ices
p
r
o
v
id
ed
to
p
atien
ts
[
2
4
]
.
T
h
i
s
d
e
m
o
n
s
tr
ate
s
t
h
at
th
e
w
o
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o
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d
d
eter
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i
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th
e
p
atter
n
s
o
f
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ter
ac
tio
n
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h
at
w
ill
b
e
d
ev
elo
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ed
an
d
im
p
le
m
en
te
d
to
th
e
p
u
b
lic
(
co
n
s
u
m
er
s
)
.
T
h
e
r
esu
lts
o
f
t
h
is
s
t
u
d
y
i
n
d
i
ca
ted
th
at
t
h
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w
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g
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v
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t
h
as
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it
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ate.
A
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co
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ib
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g
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u
s
e
th
e
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w
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s
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p
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eq
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ir
es
g
o
o
d
tea
m
w
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r
k
.
T
h
is
i
s
in
ac
co
r
d
an
ce
w
i
th
t
h
e
s
t
u
d
y
b
y
Z
w
et
s
lo
o
t
et
a
l.
[2
5
]
w
h
ic
h
s
tated
th
at
tr
u
s
t
a
n
d
f
a
ir
n
es
s
i
n
th
e
w
o
r
k
p
lace
r
elate
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ir
ec
tl
y
to
th
e
co
n
s
u
m
er
.
I
n
th
is
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s
e,
it
w
a
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t d
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k
,
f
ac
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ar
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eq
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ter
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to
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2
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.
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th
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1
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co
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to
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w
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t
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er
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en
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ca
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s
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p
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tin
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m
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ev
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T
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ti
m
e
r
eq
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m
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an
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t
a
f
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w
m
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T
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p
atien
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eq
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w
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p
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esp
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C
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t
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b
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Nel
s
o
n
[
2
7
]
w
h
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m
en
tio
n
ed
t
h
at
t
h
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h
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ar
ch
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p
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(
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cr
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an
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p
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f
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[
2
8
].
T
h
e
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tim
u
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w
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k
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v
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2
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T
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Ger
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[
10
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,
s
af
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e
r
es
u
lts
o
f
r
esear
ch
b
y
C
u
r
r
ie
[
3
0
]
w
h
ic
h
s
tated
t
h
at
t
h
e
p
ati
en
t
s
af
e
t
y
cli
m
ate
is
p
o
s
itiv
e
l
y
i
n
f
l
u
en
ce
d
b
y
t
h
r
ee
d
i
m
en
s
i
o
n
s
:
i
)
A
s
u
p
p
o
r
tiv
e
en
v
ir
o
n
m
e
n
t
as
t
h
e
p
er
ce
p
tio
n
o
f
th
e
s
o
cial
en
v
ir
o
n
m
e
n
t
at
w
o
r
k
a
n
d
th
e
s
u
p
p
o
r
t
d
er
iv
ed
f
r
o
m
th
e
en
v
ir
o
n
m
e
n
t,
ii
)
in
v
o
lv
e
m
e
n
t
w
it
h
s
a
f
et
y
a
s
th
e
f
o
c
u
s
f
o
r
all
an
d
ev
er
y
o
n
e
in
v
o
lv
ed
in
p
ati
en
t
s
af
e
t
y
,
an
d
,
iii
)
co
m
m
u
n
icatio
n
a
s
t
h
e
p
er
ce
p
tio
n
o
f
th
e
s
h
ap
e
an
d
ac
cu
r
ac
y
o
f
co
m
m
u
n
icatio
n
r
eg
a
r
d
in
g
s
a
f
et
y
in
t
h
e
o
r
g
an
is
at
io
n
.
I
n
m
o
s
t
h
ea
lt
h
c
ar
e
o
r
g
an
is
a
tio
n
s
,
co
llab
o
r
ativ
e
tea
m
ap
p
r
o
ac
h
w
ill
m
a
k
e
a
ch
an
g
e
i
n
h
o
w
t
h
e
o
r
g
an
is
at
io
n
'
s
c
u
lt
u
r
e
is
d
ev
el
o
p
ed
.
P
atien
t
s
af
et
y
n
ee
d
s
tea
m
e
f
f
o
r
t,
th
e
m
o
s
t
e
f
f
ec
ti
v
e
tea
m
s
h
av
e
t
h
e
s
a
m
e
g
o
al
in
th
e
ir
w
o
r
k
,
t
h
eir
w
o
r
k
in
e
f
f
ec
tiv
e
tea
m
s
h
av
e
th
e
s
a
m
e
g
o
al
in
th
e
ir
w
o
r
k
a
n
d
th
e
ir
w
o
r
k
in
e
f
f
ec
ti
v
e
tea
m
s
cr
ea
ted
o
p
p
o
r
tu
n
ities
f
o
r
er
r
o
r
/
e
r
r
o
r
[
3
1
]
.
4.
CO
NCLU
SI
O
N
T
h
e
s
tatis
t
icall
y
s
ig
n
i
f
ica
n
t
b
iv
ar
iate
a
n
al
y
s
i
s
o
f
w
o
r
k
e
n
v
ir
o
n
m
e
n
t
(
w
h
ic
h
co
n
s
i
s
ts
o
f
co
m
m
u
n
icatio
n
a
n
d
tea
m
w
o
r
k
)
s
h
o
w
ed
p
=
0
.
0
4
6
.
T
h
e
v
alu
e
is
s
m
a
ller
th
a
n
α
(
0
.
0
5
)
,
th
u
s
it
ca
n
b
e
co
n
clu
d
ed
th
at
w
o
r
k
e
n
v
ir
o
n
m
en
t
f
ac
to
r
s
h
a
v
e
n
o
s
i
g
n
i
f
ica
n
t
r
elatio
n
s
h
ip
to
p
atien
t
s
a
f
et
y
in
X
Ho
s
p
ital.
T
h
e
p
r
o
o
f
o
f
h
y
p
o
t
h
esi
s
f
o
r
t
h
e
ab
o
v
e
r
es
u
lts
ar
e:
H0
:
t
h
er
e
is
n
o
r
ela
tio
n
s
h
ip
b
et
w
ee
n
th
e
w
o
r
k
i
n
g
en
v
ir
o
n
m
e
n
t
a
n
d
p
atien
t
s
af
e
t
y
cli
m
ate
H1
:
th
er
e
is
a
r
elatio
n
s
h
ip
b
et
w
ee
n
th
e
w
o
r
k
i
n
g
en
v
ir
o
n
m
e
n
t
an
d
p
a
tien
t
s
a
f
et
y
cli
m
ate.
R
es
u
lts
p
-
v
al
u
es
0
.
0
4
6
w
ith
α
o
f
0
.
0
5
,
m
ea
n
s
H0
is
r
ej
ec
ted
an
d
H1
is
ac
ce
p
ted
.
T
h
u
s
,
i
t
is
co
n
clu
d
ed
t
h
a
t
th
er
e
is
a
r
elatio
n
s
h
ip
b
et
w
e
en
th
e
w
o
r
k
in
g
e
n
v
ir
o
n
m
e
n
t
an
d
p
atien
t
s
a
f
et
y
cli
m
ate.
I
t
m
ea
n
s
th
a
t
w
o
r
k
en
v
ir
o
n
m
e
n
t p
la
y
ed
cr
u
cial
r
o
les in
m
a
n
ag
i
n
g
p
atin
et
s
af
et
y
cli
m
ate.
RE
F
E
R
E
NC
E
S
[1
]
W
o
rld
He
a
lt
h
Org
a
n
iza
ti
o
n
,
“
P
a
ti
e
n
t
sa
f
e
t
y
G
lo
b
a
l
A
c
ti
o
n
o
n
P
a
ti
e
n
t
S
a
f
e
t
y
,
”
W
o
rld
He
a
lt
h
Or
g
a
n
iza
ti
o
n
Exc
e
c
u
ti
v
e
Bo
a
rd
s,
2
0
1
8
.
[2
]
De
p
k
e
s
RI.
,
“
N
a
ti
o
n
a
l
Ho
sp
it
a
l
P
a
ti
e
n
t
S
a
f
e
t
y
G
u
id
e
li
n
e
s
(P
a
ti
e
n
t
S
a
f
e
t
y
)
/
Ped
o
ma
n
N
a
sio
n
a
l
Ke
se
la
ma
ta
n
Pa
sie
n
Ru
ma
h
S
a
k
it
(
Pa
ti
e
n
t
S
a
fety
)
,
”
J
a
k
a
rta
:
De
p
k
e
s R
I.
2
0
0
8
.
[3
]
Dja
ti
,
Rr.
A
.
P
.
,
Ca
h
a
y
a
n
ti
,
S
.
R
.,
Ch
a
iran
i,
E
.,
Ko
e
st
o
e
r,
R
H
.,
a
n
d
Ha
rto
n
o
,
D
M
.
,
“
W
h
e
n
L
C
A
A
p
p
li
e
s
T
o
He
a
lt
h
S
e
rv
ice
In
d
u
stry
,
”
J
o
u
rn
a
l
o
f
En
v
iro
n
me
n
ta
l
S
c
ien
c
e
a
n
d
S
u
sta
i
n
a
b
le
De
v
e
lo
p
me
n
t
,
v
o
l.
1
,
n
o
.
1
,
p
p
.
40
-
6
2
,
2
0
1
8
,
d
o
i:
h
tt
p
s://
d
o
i
.
o
rg
/1
0
.
7
4
5
4
/j
e
ss
d
.
v
1
i1
.
1
2
.
[4
]
V
a
n
d
e
r
S
c
h
a
a
f
,
T
.
W
.
,
“
Ne
a
r
M
iss Re
p
o
rti
n
g
i
n
t
h
e
Ch
e
m
ica
l
P
ro
c
e
ss
In
d
u
stry
,
”
Ph
DT
,
1
9
9
2
[5
]
M
c
L
in
to
n
,
S
.
S
.
,
Do
ll
a
rd
,
M
.
F
.
,
a
n
d
T
u
c
k
e
y
,
M
.
M
.
R,
“
Ne
w
p
e
rsp
e
c
ti
v
e
s
o
n
p
sy
c
h
o
so
c
ial
sa
fe
t
y
c
li
m
a
te
in
h
e
a
lt
h
c
a
re
:
A
m
ix
e
d
m
e
th
o
d
s ap
p
ro
a
c
h
,
”
S
a
fety
S
c
ien
c
e
,
v
o
l
.
1
0
9
,
p
p
.
2
3
6
-
2
4
5
,
2
0
1
8
[6
]
T
a
v
e
ra
s,
M
.
P
.
,
“
A
c
c
e
s
s
to
h
e
a
lt
h
c
a
re
a
n
d
P
a
ti
e
n
t
sa
f
e
t
y
:
A
m
o
d
e
l
f
o
r
m
e
a
su
re
m
e
n
t
a
n
d
a
n
a
ly
sis,
”
Un
ive
rs
it
y
o
f
M
ia
mi,
2
0
1
1
.
[7
]
P
o
tt
e
r,
R.
E.
,
Do
l
lard
,
M
.
F
.
,
Ow
e
n
,
M
.
S
.
,
O’K
e
e
ff
e
,
V
.
,
Ba
il
e
y
,
T
.
,
L
e
k
a
,
S
.
,
“
A
ss
e
ss
in
g
a
n
a
ti
o
n
a
l
w
o
rk
h
e
a
lt
h
a
n
d
sa
fe
t
y
p
o
li
c
y
in
terv
e
n
ti
o
n
u
sin
g
t
h
e
p
sy
c
h
o
so
c
ial
sa
f
e
t
y
c
li
m
a
te
f
r
a
m
e
w
o
rk
,
”
S
a
fety
S
c
ien
c
e
,
v
o
l.
1
0
0
,
p
p
.
9
1
-
1
0
2
.
2
0
1
7
.
[8
]
Mc
T
e
rn
a
n
,
W
.
P
.
,
D
o
ll
a
rd
,
M
.
F
.
,
L
a
M
o
n
tag
n
e
,
A
.
D,
“
De
p
re
ss
io
n
in
th
e
w
o
rk
p
lac
e
:
A
n
e
c
o
n
o
m
ic
c
o
st
a
n
a
ly
sis
o
f
d
e
p
re
ss
io
n
-
re
late
d
p
ro
d
u
c
ti
v
it
y
l
o
ss
a
tt
rib
u
ta
b
le
to
jo
b
stra
in
a
n
d
b
u
ll
y
in
g
,
”
W
o
rk
S
tre
ss
,
v
o
l.
2
7
,
n
o
.
4
,
p
p
.
3
2
1
-
3
3
8
,
2
0
1
3
.
[9
]
L
a
k
e
,
E.
T
.
,
“
De
v
e
lo
p
m
e
n
t
o
f
th
e
P
ra
c
ti
c
e
E
n
v
iro
n
m
e
n
t
S
c
a
le
o
f
th
e
Nu
rsin
g
W
o
rk
In
d
e
x
,
”
Res
e
a
rc
h
in
Nu
rs
in
g
&
He
a
lt
h
,
v
o
l.
2
5
,
n
o
.
3
,
p
p
.
1
7
6
-
1
8
8
,
2
0
0
2
.
[1
0
]
G
e
r
sh
o
n
,
R.
R.
M
.
,
Ka
rk
a
sh
ian
,
C.
D.,
G
ro
sc
h
,
J.W
.
,
M
u
rp
h
y
,
L.
R.
,
Ce
ju
d
o
,
A
.
E.
,
F
a
lan
a
g
a
n
,
P
.
A
.
,
Be
rn
a
c
k
i,
E.
,
Ka
tsin
g
,
C.
,
d
a
n
M
a
rti
n
,
L
.
,
“
H
o
sp
it
a
l
sa
f
e
t
y
Cli
m
a
te
a
n
d
it
s
re
a
l
ti
o
n
s
h
ip
w
it
h
sa
f
e
w
o
rk
p
ra
c
ti
c
e
s
a
n
d
w
o
rk
p
lac
e
e
x
p
o
su
e
in
c
id
e
n
ts,
”
J
o
u
rn
a
l
o
f
A
ss
o
c
ia
ti
o
n
fo
r
Pro
fes
sio
n
a
ls
in
In
fec
ti
o
n
C
o
n
tr
o
l
a
n
d
Ep
i
d
e
mio
l
o
g
y
In
c
,
v
o
l.
2
8
,
n
o
.
3
,
p
p
.
2
1
1
-
2
2
1
,
2
0
0
0
.
[1
1
]
M
e
rril
l,
K.C
.
,
“
T
h
e
re
latio
n
sh
i
p
a
m
o
n
g
n
u
rse
m
a
n
a
g
e
r
lea
d
e
rs
h
ip
sty
le,
sp
a
n
o
f
c
o
n
tro
l,
sta
f
f
n
u
rse
p
ra
c
ti
c
e
e
n
v
iro
n
m
e
n
t,
sa
f
e
t
y
Cli
m
a
te,
a
n
d
n
u
rse
-
se
n
siti
v
e
p
a
ti
e
n
t
o
u
tco
m
e
s,
”
Ph
D
T
h
e
sis.
Co
ll
e
g
e
o
f
Nu
rsin
g
,
Un
iv
e
rsit
y
o
f
Uta
h
,
2
0
1
1
.
[1
2
]
Id
ris,
M
.
A
.
,
Do
ll
a
r
d
,
M
.
F
.
,
C
o
w
a
rd
,
J.
,
Do
rm
a
n
n
,
C
.
,
“
P
sy
c
h
o
so
c
i
a
l
sa
f
e
t
y
c
li
m
a
te:
c
o
n
c
e
p
tu
a
l
d
isti
n
c
ti
v
e
n
e
ss
a
n
d
e
ffe
c
t
o
n
jo
b
d
e
m
a
n
d
s a
n
d
w
o
rk
e
r
p
sy
c
h
o
lo
g
ica
l
h
e
a
lt
h
,
”
S
a
fety
S
c
i
e
n
c
e
,
v
o
l.
5
0
,
n
o
.
1
,
p
p
.
1
9
-
28
,
2
0
1
1
.
[1
3
]
B
y
e
rs JF,
W
h
it
e
S
V
.
,
“
P
a
ti
e
n
t
sa
f
e
t
y
:
P
ri
n
c
ip
les
a
n
d
p
ra
c
ti
c
e
,
”
S
p
ri
n
g
e
r P
u
b
li
s
h
in
g
Co
m
p
a
n
y
,
2
0
0
4
.
[1
4
]
G
a
ll
a
g
h
e
r,
R
.
,
“
Co
m
p
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Evaluation Warning : The document was created with Spire.PDF for Python.
I
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67
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7
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[1
8
]
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.
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[1
9
]
Am
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].
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1
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2
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.
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3
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.
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4
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5
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.
[2
6
]
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ffm
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G
ib
b
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A
.
M
.
,
Jo
h
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.
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.
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d
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“
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l.
6
2
,
p
p
.
6
8
-
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8
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2
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1
4
.
[2
7
]
Ne
lso
n
,
S
h
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ll
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,
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t
a
l.
,
“
P
a
ti
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te:
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a
riatio
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P
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Qu
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Dire
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to
rs,
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In
ter
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Per
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In
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s Dise
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se
s
,
2
0
1
1
.
[2
8
]
M
c
Clu
re
,
M
.
L
.
a
n
d
Hi
n
sh
a
w
,
A
.
S
,
“
M
a
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it
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,
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sh
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to
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,
DC:
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ric
a
n
Nu
r
se
s
Pu
b
li
sh
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g
,
2
0
0
2
.
[2
9
]
Na
v
e
h
,
E.
,
Ka
tz
-
Na
v
o
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,
T
.
a
n
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S
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,
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“
T
re
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t
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rro
rs
in
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lt
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c
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re
:
A
sa
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m
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p
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,
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p
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9
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1
.
[3
0
]
Cu
rrie,
d
a
n
L
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e
,
“
A
ss
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in
g
sa
f
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p
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targ
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q
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ty
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m
p
ro
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in
terv
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ti
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s,
”
Pa
p
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r
P
re
se
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ted
a
t
NICE
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e
,
2
0
0
7
.
[3
1
]
Nu
ra
in
i,
T
.
,
No
v
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sta
ri,
E
.
a
n
d
Ye
tt
i,
K.
,
“
Ev
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v
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m
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m
e
n
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t
Dh
a
r
m
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is
Ca
n
c
e
r
Ho
sp
it
a
l,
”
AS
EA
N
J
o
u
r
n
a
l
o
f
Co
mm
u
n
i
ty
En
g
a
g
e
me
n
t,
v
o
l.
3
,
n
o
.
1
,
p
p
.
51
-
7
1
,
2
0
1
9
,
d
o
i
:
h
tt
p
s:/
/d
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rg
/1
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.
7
4
5
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e
.
v
3
i1
.
1
4
0
.
Evaluation Warning : The document was created with Spire.PDF for Python.