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Ass
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les
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a
lt
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i
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i
n
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ste
d
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n
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lea
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ff
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ted
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m
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s
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ti
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re
a
t
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r
f
o
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s
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l
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istres
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ti
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l
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ti
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n
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lt
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ra
m
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ld
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ll
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o
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ff
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ted
in
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iv
id
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a
l
s.
K
ey
w
o
r
d
s
:
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m
ale
i
n
cl
u
s
io
n
Me
n
tal
h
ea
lt
h
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co
m
m
u
n
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le
d
is
ea
s
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s
y
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h
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g
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l d
is
tr
ess
Qu
alit
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o
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li
f
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T
h
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n
o
p
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n
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c
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e
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rticle
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n
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r
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uth
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r
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m
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ain
Sch
o
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lt
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A
ll I
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n
s
t
itu
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o
f
Me
d
ical
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s
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asn
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ase
-
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,
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o
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NC
Ds)
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[
1
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[
4
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g
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[
5
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[
6
].
N
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c
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m
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d
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(
Q
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[
2
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,
[
7
],
[
8
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.
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d
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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P
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Sci.
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N:
2
252
-
8
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A
s
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men
t o
f h
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ela
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q
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f life
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[
9
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.
I
n
I
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d
i
a
,
t
h
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h
a
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a
n
d
m
e
n
tal
h
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lt
h
o
v
er
ti
m
e
[
10
],
[
11
]
.
I
t
is
a
s
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b
j
ec
tiv
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ass
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e
asu
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o
f
b
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r
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en
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f
d
is
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s
e
[
12
]
-
[
15
].
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[
16
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[
18
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.
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[
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t
d
o
w
n
t
h
e
a
m
o
u
n
t
o
f
ti
m
e
s
p
e
n
t
o
n
w
o
r
k
an
d
o
th
er
ac
tiv
ities
d
u
e
to
d
iab
etes?”,
o
r
“
Do
y
o
u
f
ee
l
w
o
r
n
o
u
t
d
u
e
to
y
o
u
r
lu
n
g
d
is
ea
s
e?
”.
I
t is th
u
s
w
o
r
t
h
m
en
tio
n
in
g
t
h
at
e
v
en
t
h
e
h
ig
h
est
m
ea
n
s
co
r
e
o
b
tain
ed
(
So
cial
f
u
n
ct
io
n
i
n
g
–
7
7
.
8
7
%)
i
m
p
lied
t
h
at
t
h
e
in
d
i
v
id
u
al
s
w
er
e
ab
le
to
ca
r
r
y
o
u
t
o
n
l
y
a
p
ar
t
o
f
e
f
f
icie
n
t
w
o
r
k
i
n
g
t
h
at
t
h
e
y
p
er
ce
iv
ed
th
e
m
s
el
v
es c
ap
ab
le
o
f
d
o
in
g
,
if
th
e
y
w
er
e
n
o
t s
u
f
f
er
in
g
f
r
o
m
th
e
d
is
ea
s
e.
3
.
2
.
Str
eng
t
hs
a
nd
li
m
it
a
t
io
ns
T
h
e
s
tu
d
y
h
a
s
ce
r
tain
li
m
itat
i
o
n
s
w
o
r
t
h
m
e
n
tio
n
i
n
g
.
Firs
tl
y
,
it
is
a
cr
o
s
s
-
s
ec
tio
n
al
s
t
u
d
y
d
esig
n
,
th
u
s
th
e
r
esp
o
n
d
e
n
ts
w
er
e
an
a
l
y
ze
d
at
a
g
iv
e
n
t
i
m
e
an
d
ca
u
s
a
l
r
e
latio
n
s
h
ip
co
u
ld
n
o
t
b
e
e
s
tab
li
s
h
ed
.
Seco
n
d
l
y
,
t
h
e
d
ata
co
llected
w
a
s
s
el
f
-
r
ep
o
r
ted
an
d
r
ec
all
b
ias
as
w
ell
a
s
o
m
is
s
io
n
s
m
a
y
h
a
v
e
o
cc
u
r
r
e
d
.
T
o
ad
d
r
ess
th
is
,
p
r
escr
ip
tio
n
s
an
d
m
ed
icatio
n
s
w
er
e
cr
o
s
s
-
c
h
ec
k
ed
w
it
h
t
h
e
in
f
o
r
m
a
tio
n
p
r
o
v
id
ed
.
T
h
ir
d
l
y
,
th
i
s
is
a
ce
n
ter
-
b
ased
s
tu
d
y
w
it
h
p
ar
ticip
an
ts
f
r
o
m
a
li
m
ited
g
eo
g
r
ap
h
ic
r
eg
io
n
,
t
h
u
s
its
v
alid
it
y
m
a
y
b
e
en
h
a
n
ce
d
w
it
h
s
i
m
ilar
s
t
u
d
ies
in
o
t
h
er
lo
ca
tio
n
s
.
Nev
er
t
h
ele
s
s
,
th
is
s
t
u
d
y
is
th
e
f
ir
s
t
ev
er
co
n
d
u
cted
in
th
i
s
p
ar
t
o
f
th
e
co
u
n
tr
y
to
p
r
o
v
id
e
an
a
s
s
e
s
s
m
en
t
o
f
HR
Qo
L
o
f
i
n
d
iv
id
u
als
s
u
f
f
er
in
g
f
r
o
m
N
C
D
s
an
d
co
u
ld
b
e
f
u
r
t
h
er
s
ca
led
u
p
to
o
b
tain
m
o
r
e
g
en
er
aliza
b
l
e
in
f
er
e
n
ce
s
.
4.
CO
NCLU
SI
O
N
T
h
is
s
tu
d
y
s
h
o
w
ed
th
at
m
ale
s
r
ec
o
r
d
e
d
h
ig
h
er
m
ea
n
s
co
r
es
th
an
f
e
m
ales
ac
r
o
s
s
all
d
o
m
ai
n
s
w
it
h
h
ig
h
s
tati
s
tical
s
i
g
n
if
ica
n
ce
f
o
r
B
o
d
ily
P
ain
,
V
italit
y
,
R
o
le
P
h
y
s
ical
a
n
d
Me
n
tal
Hea
lt
h
.
T
h
e
f
i
n
d
in
g
s
f
r
o
m
th
is
s
t
u
d
y
p
r
o
v
id
e
a
n
i
n
s
i
g
h
t
in
to
w
o
r
s
t
a
n
d
leas
t
af
f
ec
te
d
d
o
m
ai
n
s
o
f
r
eg
u
lar
li
f
e
f
u
n
ctio
n
s
d
u
e
to
n
o
n
-
co
m
m
u
n
ic
ab
le
d
is
ea
s
es.
I
t
th
u
s
p
r
o
v
id
es
an
o
p
p
o
r
tu
n
it
y
f
o
r
a
g
r
ea
ter
f
o
cu
s
o
n
e
m
o
t
io
n
al
d
is
tr
ess
an
d
g
e
n
er
al
h
ea
lt
h
ca
r
e
o
f
p
atie
n
ts
r
at
h
er
t
h
an
m
er
el
y
s
y
m
p
to
m
atic
tr
ea
t
m
en
t.
T
h
e
f
i
n
d
in
g
s
o
f
t
h
e
s
tu
d
y
co
u
ld
s
er
v
e
as
a
b
aselin
e
f
o
r
f
u
r
t
h
er
co
m
m
u
n
it
y
-
b
ased
s
tu
d
ie
s
f
o
r
a
g
r
ea
ter
g
eo
g
r
ap
h
ical
co
v
er
ag
e
an
d
g
en
er
aliza
b
ilit
y
.
An
o
th
er
s
co
p
e
p
r
esen
ted
t
h
r
o
u
g
h
t
h
e
s
t
u
d
y
f
i
n
d
in
g
s
i
n
d
icat
es
th
e
n
ee
d
o
f
a
m
o
r
e
ac
ti
v
e
i
n
clu
s
io
n
o
f
f
e
m
ale
s
in
t
h
e
o
n
g
o
i
n
g
n
atio
n
al
p
r
o
g
r
a
m
s
w
it
h
an
e
m
p
h
asi
s
o
n
ea
r
l
y
s
cr
ee
n
i
n
g
an
d
r
o
b
u
s
t
f
o
llo
w
u
p
s
.
An
i
n
teg
r
at
io
n
o
f
NC
D
co
n
tr
o
l
p
r
o
g
r
am
s
a
n
d
Natio
n
al
Me
n
tal
Hea
lt
h
P
r
o
g
r
am
,
w
it
h
ad
d
ed
co
m
p
o
n
en
t
s
to
co
p
e
w
it
h
e
m
o
tio
n
al
d
i
s
tr
ess
w
o
u
ld
aid
i
n
d
ev
elo
p
in
g
a
s
tr
o
n
g
m
et
h
o
d
o
lo
g
ical
s
ett
in
g
to
i
m
p
r
o
v
e
H
R
Qo
L
in
ch
r
o
n
ica
ll
y
af
f
ec
ted
in
d
iv
id
u
al
s
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8806
I
n
t.
J
.
P
u
b
lic
Hea
lth
Sci.,
Vo
l.
10
,
No
.
4
,
Dec
em
b
er
2021
:
7
24
–
7
29
728
RE
F
E
R
E
NC
E
S
[1
]
W
HO
,
“
No
n
c
o
m
m
u
n
ica
b
le
d
ise
a
se
s
,”
W
h
o
.
in
t.
2
0
1
8
,
[
On
li
n
e
]
.
Av
a
il
a
b
le
:
h
tt
p
s://
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ww
.
w
h
o
.
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t/
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e
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o
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/
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t
-
sh
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ts/d
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tail/
n
o
n
c
o
m
m
u
n
ica
b
le
-
d
ise
a
se
s#
:~
:t
e
x
t=N
o
n
c
o
m
m
u
n
ica
b
le%
2
0
d
ise
a
se
s%
2
0
(NCD
s)%
2
0
k
il
l%
2
0
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,
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n
d
%
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id
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le%
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c
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%
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o
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tri
e
s
.
[
c
it
e
d
2
S
e
p
tem
b
e
r
2
0
2
0
].
[2
]
M
.
Ka
ss
a
a
n
d
J.
G
ra
c
e
,
“
T
h
e
G
l
o
b
a
l
Bu
r
d
e
n
a
n
d
P
e
rsp
e
c
ti
v
e
s
o
n
No
n
-
Co
m
m
u
n
ica
b
le
Dise
a
s
e
s
(
NCD
s)
a
n
d
th
e
P
re
v
e
n
ti
o
n
,
Da
ta
A
v
a
il
a
b
il
it
y
a
n
d
S
y
ste
m
s
A
p
p
ro
a
c
h
o
f
NCD
s
in
L
o
w
-
r
e
so
u
rc
e
Co
u
n
tr
ies
,”
I
n
tec
h
Op
e
n
2
0
1
9
,
d
o
i
:
1
0
.
5
7
7
2
/
in
tec
h
o
p
e
n
.
8
9
5
1
6
.
[3
]
M.
M.
C
o
a
tes
e
t
a
l.
,
“
Bu
r
d
e
n
o
f
n
o
n
-
c
o
m
m
u
n
ica
b
le
d
ise
a
se
s
f
ro
m
in
f
e
c
ti
o
u
s
c
a
u
se
s
in
2
0
1
7
:
a
m
o
d
e
ll
in
g
stu
d
y
,”
T
h
e
L
a
n
c
e
t
Glo
b
a
l
He
a
lt
h
,
v
o
l
.
8
,
n
o
.
1
2
,
p
p
.
e
1
4
8
9
-
e
1
4
9
8
,
2
0
2
0
,
d
o
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0
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/s
2
2
1
4
-
1
0
9
x
(2
0
)
3
0
3
5
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-
2
.
[4
]
P.
A
ro
k
ias
a
m
y
,
“
In
d
ia'
s
e
sc
a
latin
g
b
u
rd
e
n
o
f
n
o
n
-
c
o
m
m
u
n
ica
b
le
d
ise
a
se
s
,”
T
h
e
L
a
n
c
e
t
Glo
b
a
l
He
a
lt
h
,
v
o
l.
6
,
n
o
.
1
2
,
p
p
.
e
1
2
6
2
-
e
1
2
6
3
,
2
0
1
8
,
d
o
i:
1
0
.
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0
1
6
/s2
2
1
4
-
1
0
9
x
(1
8
)3
0
4
4
8
-
0
.
[5
]
Na
ti
o
n
a
l
He
a
lt
h
P
o
rtal,
“
No
n
-
c
o
m
m
u
n
ica
b
le
Dise
a
se
s
,”
N
h
p
.
g
o
v
.
i
n
.
2
0
1
9
,
[
O
n
li
n
e
].
A
v
a
il
a
b
le
f
ro
m
:
h
tt
p
s:/
/www
.
n
h
p
.
g
o
v
.
in
/h
e
a
lt
h
ly
li
v
in
g
/n
c
d
2
0
1
9
#
:
~
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e
x
t=In
%
2
0
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n
d
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a
%
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C%
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e
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il
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.
[
c
it
e
d
2
S
e
p
tem
b
e
r
2
0
2
0
].
[6
]
S
.
Ne
th
a
n
,
D
.
S
in
h
a
,
a
n
d
R
.
M
e
h
ro
tra
“
No
n
-
Co
m
m
u
n
ica
b
le
Dise
a
se
Risk
F
a
c
to
rs
a
n
d
th
e
ir
T
re
n
d
s
in
In
d
ia
”
.
Asi
a
n
Pa
c
J
Ca
n
c
e
r P
re
v
.
,
v
o
l.
18
,
n
o
.
7
,
p
p
.
2
0
0
5
-
2
0
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0
,
2
0
1
7
,
d
o
i:
1
0
.
2
2
0
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4
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P
JC
P
.
2
0
1
7
.
1
8
.
7
.
2
0
0
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.
[7
]
L
.
V
.
W
il
d
e
r
e
t
a
l
.
,
“
He
a
lt
h
-
re
late
d
q
u
a
li
ty
o
f
li
f
e
in
p
a
ti
e
n
ts
w
it
h
n
o
n
-
c
o
m
m
u
n
ica
b
le
d
ise
a
se
:
stu
d
y
p
ro
to
c
o
l
o
f
a
c
ro
ss
-
se
c
ti
o
n
a
l
su
rv
e
y
,
”
B
M
J
Op
e
n
,
v
o
l.
10
,
n
o
.
9
,
p
p
.
1
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9,
2
0
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0
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d
o
i:
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0
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1
1
3
6
/b
m
jo
p
e
n
-
2
0
2
0
-
0
3
7
1
3
1
.
[8
]
A
.
T
.
En
d
a
rti
a
n
d
A
.
H
a
n
d
it
o
,
“
T
h
e
R
e
latio
n
sh
i
p
b
e
tw
e
e
n
No
n
-
Co
m
m
u
n
ica
b
le
Dise
a
se
s
Histo
ry
a
n
d
He
a
lt
h
-
Re
late
d
Qu
a
li
ty
o
f
L
i
f
e
,”
J
u
rn
a
l
Ke
se
h
a
t
a
n
M
a
sy
a
r
a
k
a
t
.
v
o
l.
12
,
n
o
.
1
,
p
p
.
1
2
0
-
1
3
0
,
2
0
1
6
,
d
o
i
:
1
0
.
1
5
2
9
4
/k
e
m
a
s.v
1
2
i1
.
4
8
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2019
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