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o
s
e
wh
o
do
n
ot
[
7]
.
Unf
o
r
t
un
a
t
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y
,
r
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e
a
r
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h
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s
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h
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s
wa
l
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to
s
c
h
oo
l
[
8]
.
A
c
t
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t
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s
po
r
t
a
t
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n
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f
r
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t
r
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v
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r
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we
ll
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b
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ng
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f
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hil
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a
n
d
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do
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e
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t
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ly
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l
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h
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l
a
t
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phy
s
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c
a
l
f
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t
n
e
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s
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o
m
po
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t
s
[
9]
.
S
ub
-
S
a
ha
r
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n
Af
r
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c
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n
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t
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ua
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t
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m
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h
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ni
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o
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[
10]
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T
he
s
e
,
c
o
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p
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d
w
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t
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u
r
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t
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nd
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[
1]
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his
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r
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nd
ha
s
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in
w
ha
t
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m
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h
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r
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o
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z
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d
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o
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e
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o
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t
r
a
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r
t
[
11
]
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vi
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c
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o
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ke
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f
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nd
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s
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m
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g
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o
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h
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u
b
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a
h
a
r
a
n
Af
r
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c
a
.
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i
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t
,
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we
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o
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o
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o
m
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t
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hil
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ur
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hil
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o
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o
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c
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l
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c
t
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t
y
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h
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s
[
12]
.
T
hi
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d,
t
h
e
r
e
a
r
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r
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l
a
t
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v
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ly
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o
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r
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a
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t
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t
r
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n
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r
t
a
t
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o
n
to
a
n
d
f
r
o
m
s
c
h
o
o
l
[
13
-
15]
.
Da
t
a
o
n
t
h
e
p
hy
s
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c
a
l
a
c
t
i
vi
t
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l
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ve
l
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a
n
d
y
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ut
h
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n
G
ha
n
a
a
r
e
s
c
a
r
c
e
.
T
h
e
r
e
s
u
l
t
s
o
f
Gh
a
n
a
’
s
2014
a
n
d
2016
r
e
por
t
c
a
r
ds
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n
phy
s
i
c
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l
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c
t
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t
y
f
o
r
c
hi
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f
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s
s
t
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r
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t
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a
[
16
-
17]
.
T
h
e
r
e
p
o
r
t
c
a
r
ds
s
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o
we
d
t
h
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t
Gh
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n
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gr
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de
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f
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n
d
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n
t
he
a
c
t
i
v
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t
r
a
n
s
po
r
t
a
t
i
o
n
c
a
t
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go
r
y
i
n
2014
a
n
d
2016
r
e
s
pe
c
t
i
v
e
ly
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Ho
we
v
e
r
,
t
h
e
2014
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i
nd
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ng
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s
b
a
s
e
d
o
n
a
s
t
udy
o
f
ur
b
a
n
hi
g
h
s
c
h
o
o
l
s
t
ude
n
t
s
[
18]
.
T
h
e
2016
r
e
po
r
t
c
a
r
d
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n
d
i
c
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t
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d
t
h
a
t
a
ppr
o
x
i
m
a
t
e
ly
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o
f
s
t
ude
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t
s
wa
l
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h
oo
l
w
hil
e
7%
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o
m
m
ut
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bi
c
y
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l
e
[
17]
.
T
o
e
n
s
ur
e
s
c
h
o
o
l
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a
ge
d
a
do
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t
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d
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f
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pu
l
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n
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l
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r
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m
[
19]
.
T
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t
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,
v
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f
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t
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to
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t
h
f
e
e
t
pa
r
a
l
l
e
l
a
n
d
h
a
n
ds
ha
n
g
i
ng
o
n
t
h
e
s
i
d
e
s
.
He
i
g
h
t
m
e
a
s
ur
e
d
i
n
c
e
n
t
i
m
e
t
e
r
s
wa
s
c
onv
e
r
t
e
d
to
m
e
t
e
r
s
f
o
r
c
o
m
put
i
n
g
B
M
I
.
T
h
e
r
e
s
e
a
r
c
h
e
r
s
m
e
a
s
ur
e
d
b
o
d
y
w
e
i
g
h
t
w
i
t
h
a
T
e
f
a
l
G
l
a
s
s
C
l
a
s
s
i
c
(
M
o
de
l
P
1101V)
B
a
t
h
r
oo
m
S
c
a
l
e
t
o
t
h
e
n
e
a
r
e
s
t
0.
1
k
i
l
o
gr
a
m
(
kg)
.
C
hi
l
dr
e
n
s
t
oo
d
o
n
t
h
e
s
c
a
l
e
i
n
l
i
g
ht
c
l
o
t
h
e
s
a
n
d
w
i
t
h
o
ut
s
h
o
e
s
o
n
,
a
n
d
w
i
t
h
t
h
e
i
r
a
r
m
s
by
t
he
s
i
d
e
s
.
B
M
I
wa
s
c
a
l
c
u
l
a
t
e
d
by
d
i
vi
d
i
ng
t
he
pe
r
s
o
n’
s
we
i
g
h
t
(
kg)
by
t
h
e
h
e
i
g
h
t
(
m
)
s
qua
r
e
d
(
kg/
m
2
)
.
F
o
r
a
ge
s
5
-
19
y
e
a
r
s
,
B
M
I
-
f
o
r
-
a
ge
c
ut
-
o
f
f
s
[
23]
we
r
e
us
e
d
to
c
l
a
s
s
i
f
y
B
M
I
.
T
h
e
v
a
l
u
e
s
<
-
2
S
D,
<
1
S
D,
m
e
d
i
a
n
,
>+1
S
D,
a
n
d
>
+
2
S
D
w
e
r
e
c
l
a
s
s
i
f
i
e
d
a
s
t
hi
nn
e
s
s
,
u
n
de
r
we
i
g
h
t
,
n
o
r
m
a
l
r
a
n
ge
,
o
v
e
r
we
i
g
h
t
,
a
nd
o
b
e
s
e
r
e
s
pe
c
t
i
ve
ly
.
F
o
r
pa
r
t
i
c
i
pa
n
t
s
20
y
e
a
r
s
a
n
d
a
bo
v
e
,
B
M
I
v
a
l
ue
s
o
f
<
16.
00,
<
18.
5,
18.
5
–
24.
9,
>
25.
00,
a
n
d
>
30.
00
we
r
e
c
l
a
s
s
i
f
i
e
d
a
s
t
hi
n
n
e
s
s
,
un
de
r
we
i
g
h
t
,
n
o
r
m
a
l
r
a
n
ge
,
o
v
e
r
we
i
g
h
t
,
a
n
d
o
b
e
s
e
r
e
s
pe
c
t
i
ve
ly
[
23]
.
2.
3.
Var
iab
les
T
h
e
r
e
s
po
n
s
e
v
a
r
i
a
bl
e
f
o
r
t
h
e
s
t
udy
wa
s
t
h
e
r
e
c
o
m
m
e
n
de
d
da
il
y
n
u
m
be
r
o
f
s
t
e
ps
(
10,
000
s
t
e
ps
)
.
N
i
n
e
(
9)
pr
e
d
i
c
t
o
r
s
we
r
e
us
e
d
(
r
e
f
e
r
t
o
A
ppe
n
d
i
x
A
)
:
C
hil
d’
s
s
e
x
,
e
duc
a
t
i
o
n
a
l
l
e
v
e
l
,
B
M
I
,
m
o
de
o
f
t
r
a
n
s
po
r
t,
r
e
g
i
o
n
,
a
c
t
i
v
e
t
r
a
ns
po
r
t
,
b
o
dy
we
i
g
h
t
,
h
e
i
g
h
t
,
a
n
d
a
ge
.
B
e
f
o
r
e
f
i
t
t
i
n
g
t
he
l
o
g
i
t
m
o
de
l
,
t
h
e
d
a
t
a
s
e
t
wa
s
d
i
vi
de
d
i
n
t
o
t
w
o
s
e
t
s
:
T
r
a
i
ni
n
g
a
n
d
t
e
s
t
i
n
g.
T
h
e
t
r
a
i
ni
ng
s
e
t
whi
c
h
c
o
n
s
t
i
t
ut
e
d
70%
o
f
t
h
e
e
n
t
i
r
e
da
t
a
s
e
t
wa
s
us
e
d
to
s
pe
c
i
f
y
t
he
pr
e
d
i
c
t
i
v
e
m
o
d
e
l
a
n
d
t
h
e
r
e
m
a
i
n
i
ng
30%
wa
s
us
e
d
a
s
a
t
e
s
t
i
n
g
s
e
t
to
pe
r
f
o
r
m
o
ut
-
of
-
s
a
m
p
l
e
v
a
li
da
t
i
o
n
o
f
t
h
e
pr
e
d
i
c
t
i
v
e
a
c
c
ur
a
c
y
o
f
t
h
e
m
o
de
l
.
2.
3.
1.
L
og
it
m
od
e
l
L
e
t
r
e
pr
e
s
e
n
t
r
a
n
do
m
va
r
i
a
bl
e
s
t
a
ki
n
g
v
a
l
ue
s
∈
(
0
,
1
)
wi
t
h
pr
o
b
a
bi
li
t
y
1
−
a
n
d
r
e
s
pe
c
t
i
ve
ly
.
T
hi
s
im
p
li
e
s
:
(
)
=
(
1
−
)
(
1)
S
uppo
s
e
t
h
e
l
o
g
i
t
o
f
pr
o
b
a
bi
li
t
y
o
f
i
s
g
i
v
e
n
by
:
log
(
1
−
)
=
⇒
=
1
+
(
2)
T
h
e
pr
e
d
i
c
t
i
v
e
f
o
r
m
o
f
(
2)
c
a
n
b
e
wr
i
t
t
e
n
a
s
:
(
|
)
=
1
1
+
−
(
3
)
W
h
e
r
e
a
n
d
a
r
e
v
e
c
t
or
s
o
f
pr
e
d
i
c
t
o
r
s
a
n
d
s
l
o
pe
s
r
e
s
pe
c
t
i
v
e
ly
.
T
o
e
s
t
i
m
a
t
e
(
2
)
,
t
h
e
l
o
g
l
i
ke
li
h
o
o
d
i
s
g
i
v
e
n
by
:
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t
.
J
.
P
ubl
i
c
He
a
l
t
h
S
c
i
.
I
S
S
N:
2252
-
8806
P
r
e
v
alen
c
e
of
ac
ti
v
e
s
c
hool
tr
ans
por
tat
ion
in
the
u
ppe
r
e
as
t
and
uppe
r
w
e
s
t
r
e
gions
of
Ghana
(
Se
idu
Sof
o
)
121
(
)
=
log
[
∏
(
)
=
1
]
,
=
∑
[
log
(
)
+
(
1
−
)
log
(
1
−
)
]
,
=
1
(
4)
=
∑
[
log
(
(
|
)
)
+
(
1
−
)
log
(
1
−
(
|
)
)
]
.
=
1
L
e
t
∇
(
)
=
(
)
a
n
d
(
)
=
2
(
)
r
e
pr
e
s
e
n
t
t
h
e
gr
a
d
i
e
n
t
o
f
t
h
e
l
o
g
l
i
k
e
l
i
h
oo
d
a
n
d
t
h
e
h
e
s
s
i
a
n
m
a
t
r
i
x
r
e
s
pe
c
t
i
v
e
ly
.
No
c
l
o
s
e
d
-
f
o
r
m
s
o
l
ut
i
o
n
,
s
o
r
e
s
o
r
t
to
Ne
wto
n
R
a
p
h
s
o
n’
s
a
l
go
r
i
t
hm
f
o
r
a
ppr
o
xi
m
a
t
e
s
o
l
ut
i
o
n
.
Ne
wto
n
R
a
phs
o
n’
s
a
l
go
r
i
t
hm
[
24]
i
s
g
i
v
e
n
a
s
f
o
l
l
o
w
s
:
a.
S
t
a
r
t
f
r
o
m
s
o
m
e
i
ni
t
i
a
l
v
a
l
ue
s
0
.
b.
S
e
t
=
−
1
(
−
1
)
−
1
∇
(
−
1
)
(
a
l
o
o
p)
.
c.
R
e
pe
a
t
s
t
e
p
2
un
t
i
l
i
s
c
l
o
s
e
t
o
−
1
.
I
nf
e
r
e
nc
e
i
s
c
a
r
r
i
e
d
o
u
t
a
s
f
o
l
l
o
w
s
:
√
(
̂
−
)
→
(
0
,
(
)
−
1
)
as
→
∞
,
(
5)
wh
e
r
e
(
)
=
−
(
)
i
s
f
i
s
h
e
r
i
nf
o
r
m
a
t
i
o
n
a
n
d
(
)
−
1
i
s
t
h
e
v
a
r
i
a
nc
e
-
c
o
v
a
r
i
a
n
c
e
m
a
t
r
i
x
.
2.
3.
2.
P
r
e
d
ict
ion
m
e
t
r
ics
A
c
o
nf
u
s
i
o
n
m
a
t
r
i
x
c
o
n
t
a
i
ns
i
nf
o
r
m
a
t
i
o
n
a
b
o
ut
a
c
t
ua
l
a
n
d
pr
e
d
i
c
t
e
d
c
l
a
s
s
if
i
c
a
t
i
o
n
s
do
ne
b
y
a
c
l
a
s
s
if
i
c
a
t
i
o
n
s
y
s
t
e
m
.
T
a
bl
e
1
s
h
o
ws
t
h
e
c
o
nf
u
s
i
o
n
m
a
t
r
i
x
f
o
r
a
t
w
o
-
c
l
a
s
s
c
l
a
s
s
if
i
e
r
.
T
he
t
r
ue
p
o
s
i
t
i
v
e
r
a
t
e
(
T
P
R
)
i
s
g
i
ve
n
by
t
h
e
r
a
t
i
o
o
f
t
h
e
t
r
ue
p
o
s
i
t
i
v
e
(
TP
)
to
t
h
e
s
u
m
o
f
t
h
e
tr
ue
p
o
s
i
t
i
v
e
a
n
d
f
a
l
s
e
n
e
ga
t
i
v
e
(
FN
)
.
T
h
e
f
a
l
s
e
po
s
i
t
i
v
e
r
a
t
e
(
F
P
R
)
i
s
o
b
t
a
i
n
e
d
a
s
t
h
e
r
a
ti
o
o
f
t
h
e
f
a
l
s
e
po
s
i
t
i
v
e
(
FP
)
to
t
h
e
s
u
m
o
f
t
h
e
f
a
l
s
e
po
s
i
t
i
v
e
a
n
d
t
r
ue
n
e
ga
t
i
v
e
(
TN
).
T
a
bl
e
1
.
C
o
n
f
u
s
i
o
n
m
a
t
r
i
x
P
r
e
di
c
t
e
d C
la
s
s
T
ot
a
l
R
a
te
̂
=
1
̂
=
0
A
c
tu
a
l
C
la
s
s
=
1
TP
FN
+
=
+
=
0
FP
TN
+
=
+
A
t
d
i
f
f
e
r
e
n
t
t
h
r
e
s
h
o
l
d
s
s
a
y
0.
00,
0.
01,
…
,
1.
00,
a
gr
a
ph
o
f
T
P
R
(
s
e
n
s
i
t
i
v
i
t
y
)
a
ga
i
ns
t
F
P
R
(1
-
s
pe
c
i
f
i
c
i
t
y
)
i
s
p
l
o
tt
e
d
to
o
b
t
a
i
n
t
h
e
r
e
c
e
i
ve
r
ope
r
a
t
i
n
g
c
h
a
r
a
c
t
e
r
i
s
t
i
c
(
R
OC
)
c
ur
ve
.
Nu
m
e
r
i
c
a
ll
y
,
t
h
e
a
r
e
a
un
de
r
t
h
e
R
OC
c
ur
v
e
a
l
s
o
r
e
f
e
r
r
e
d
to
a
s
t
h
e
a
r
e
a
un
de
r
c
ur
ve
(
A
UC
)
.
T
h
e
A
UC
m
e
a
s
ur
e
s
t
h
e
p
r
e
d
i
c
t
i
o
n
a
c
c
ur
a
c
y
o
f
t
h
e
l
o
g
i
t
m
o
de
l
.
2.
4.
Dat
a
a
n
al
ys
is
T
h
e
a
ut
h
o
r
s
us
e
d
t
wo
-
wa
y
t
a
bl
e
s
t
o
s
h
o
w
t
h
e
f
r
e
q
ue
n
c
i
e
s
a
n
d
p
e
r
c
e
n
t
a
ge
s
by
w
hi
c
h
pa
r
t
i
c
i
pa
n
t
s
m
e
t
o
r
di
d
n
o
t
m
e
e
t
t
h
e
r
e
c
o
m
m
e
n
d
e
d
da
il
y
n
u
mb
e
r
o
f
s
t
e
ps
a
n
d
t
h
e
pr
e
d
i
c
t
o
r
v
a
r
i
a
bl
e
s
.
I
n
a
dd
i
t
i
o
n
,
t
h
e
c
o
n
d
i
t
i
o
na
l
pe
r
c
e
n
t
a
ge
d
i
s
t
r
i
b
ut
i
o
n
o
f
e
a
c
h
c
a
t
e
g
o
r
i
c
a
l
pr
e
d
i
c
t
o
r
v
a
r
i
a
bl
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5.
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CA
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F
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CHOO
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29]
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Gh
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(
Se
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125
6.
F
UT
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[
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h
2019:
11
8
–
12
6
126
[1
7
]
O
c
an
s
ey
,
R.
;
A
r
y
ee
t
ey
,
R.
,
So
fo
,
S.
;
N
azzar
,
A
.
;
D
el
al
i
,
M.
;
Pam
b
o
,
P.
;
e
t
al
.
;
“
Re
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fro
m
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,
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J
o
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.
[1
8
]
A
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ey
,
R.
;
“
E
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me
n
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al
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cal
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E
as
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L
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n
:
A
q
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t
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t
,
”
G
h
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P
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4
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.
[1
9
]
Mi
n
i
s
t
ry
o
f
H
e
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l
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h
;
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D
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”
2
0
0
9
.
MO
H
:
A
cc
ra.
[2
0
]
So
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s
;
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m
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.
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.
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1
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2
0
1
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ro
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s
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p
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.
[2
1
]
G
ro
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p
,
K
.
;
J
an
s
s
en
,
I
.
;
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ck
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t
,
W
.
,
“
A
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ran
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n
Can
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h
:
Sh
o
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j
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y
b
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rn
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In
j
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1
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2012
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3
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[2
2
]
W
as
h
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t
o
n
U
n
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rs
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t
y
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St
.
L
o
u
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s
;
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My
H
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a
l
t
h
:
A
c
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,
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.
d
.
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s
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2
0
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5
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9
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c
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v
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-
Ch
art
.
p
d
f
.
[2
3
]
W
o
rl
d
H
e
al
t
h
O
rg
an
i
zat
i
o
n
;
“
BMI
-
fo
r
-
a
g
e
:
5
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1
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ars
,
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fi
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at
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n
,
”
2
0
0
7
.
Re
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d
D
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ro
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.
[2
4
]
Ch
arp
e
n
t
i
e
r
,
A
.
;
“
Co
m
p
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t
at
i
o
n
a
l
a
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t
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ar
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al
s
c
i
en
ce
i
n
R,
”
2
0
1
5
.
Bo
c
a
Rat
o
n
,
F
L
:
T
a
y
l
o
r
an
d
Fra
n
c
i
s
G
ro
u
p
.
[2
5
]
U
t
t
s
,
J
.
M.
;
“
Se
ei
n
g
t
h
ro
u
g
h
s
t
at
i
s
t
i
c
s
(4
t
h
E
d
.
)”
2
0
1
5
.
St
am
fo
r
d
,
CT
:
C
e
n
g
ag
e
l
e
arn
i
n
g
.
[2
6
]
A
r
y
ee
t
ey
,
R.
;
L
art
ey
,
A
.
;
Marq
u
i
s
,
G
.
S;
N
t
i
,
H
.
;
Co
l
ec
r
aft
E
.
;
Bro
w
n
P.
;
“
Pre
v
al
e
n
ce
an
d
p
re
d
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c
t
o
rs
o
f
o
v
e
r
w
ei
g
h
t
an
d
o
b
e
s
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t
y
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mo
n
g
s
ch
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l
-
a
g
e
d
ch
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l
d
r
en
i
n
u
rb
an
G
h
an
a,
”
B
M
C
O
b
es
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t
y,
v
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l
.
4
,
n
o
.
3
8
,
p
p
.
1
-
8
,
2
0
1
7
.
D
O
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:
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0
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1
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4
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4
-
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[2
7
]
G
h
an
a
St
at
i
s
t
i
c
al
Se
r
v
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ce
;
“
G
h
an
a
m
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l
t
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p
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d
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c
at
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c
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u
rv
ey
w
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t
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an
e
n
h
an
ced
m
a
l
ari
a
m
o
d
u
l
e
an
d
b
i
o
m
ark
e
r,
(F
i
n
a
l
R
e
p
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rt
),
”
2
0
1
1
.
G
h
an
a
St
at
i
s
t
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c
al
S
e
rv
i
ce,
A
cc
ra
,
G
h
an
a
.
[2
8
]
K
w
ab
l
a,
M.
P.
;
G
y
an
,
C.
;
Z
o
t
o
r,
F.
;
“
N
u
t
ri
t
i
o
n
al
s
t
at
u
s
o
f
in
-
s
ch
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l
ch
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l
d
r
en
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n
d
i
t
s
as
s
o
c
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at
e
d
fa
c
t
o
r
s
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n
D
en
k
y
em
b
o
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r
D
i
s
t
ri
c
t
,
E
as
t
e
r
n
R
e
g
i
o
n
,
G
h
a
n
a:
C
o
m
p
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n
g
s
ch
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l
s
w
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t
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f
ee
d
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d
n
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n
-
s
c
h
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l
f
ee
d
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n
g
p
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l
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ci
es
,
”
Nu
t
r
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t
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o
n
Jo
u
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n
a
l
,
v
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l
.
1
7
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o
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8
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p
p
.
1
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8
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O
I
:
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1
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/
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1
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6.
[2
9
]
H
ad
d
a
d
,
L
.
;
Ca
me
r
o
n
,
L
.
;
Barn
e
t
t
,
I
.
;
“
T
h
e
d
o
u
b
l
e
b
u
r
d
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o
f
m
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l
n
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t
i
o
n
i
n
SE
A
s
i
a
an
d
t
h
e
Pa
c
i
fi
c:
p
ri
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ri
t
i
e
s
,
p
o
l
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c
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s
a
n
d
p
o
l
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t
i
c
s
,
”
H
ea
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t
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P
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l
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cy
P
l
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n
,
v
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l
.
3
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o
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9
,
p
p
.
1193
–
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0
6
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2
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D
O
I:
h
t
t
p
s
:
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.
[3
0
]
Pre
n
t
i
ce,
A
.
;
W
ard
,
K
.
;
G
o
l
d
b
e
r
g
,
G
.
;
J
arj
o
u
,
L
.
M.
;
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o
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,
S
.
E
.
;
F
u
l
f
o
rd
,
A
.
J
.
;
e
t
al
.
;
“
Cri
t
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c
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fo
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n
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t
ri
t
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e
rv
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t
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s
ag
ai
n
s
t
s
t
u
n
t
i
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g
,
”
A
m
er
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ca
n
J
o
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r
n
a
l
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Cl
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n
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ca
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Nu
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r
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l
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9
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n
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1
1
2
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0
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2
3
3
2
.
[3
1
]
Cas
al
e
,
D
.
;
D
e
s
m
o
n
d
,
C.
;
“
Re
co
v
e
r
y
fr
o
m
s
t
u
n
t
i
n
g
an
d
c
o
g
n
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t
i
v
e
o
u
t
co
me
s
i
n
y
o
u
n
g
ch
i
l
d
r
en
:
E
v
i
d
e
n
ce
fro
m
t
h
e
So
u
t
h
A
fri
c
a
n
B
i
rt
h
t
o
T
w
e
n
t
y
Co
h
o
rt
St
u
d
y
,
”
Jo
u
r
n
a
l
o
f
D
evel
o
p
m
en
t
a
l
O
r
i
g
i
n
s
o
f
H
ea
l
t
h
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n
d
D
i
s
ea
s
e,
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l
.
7
,
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o
.
2
,
p
p
.
1
6
3
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7
1
,
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0
1
6
.
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O
I
:
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t
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4
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7
4
4
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5
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7
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2
1
.
[3
2
]
T
e
l
a
m
a,
R
.
;
Y
an
g
,
X
.
;
V
i
i
k
ar
i
,
J
.
;
V
a
l
i
m
a
k
i
I.
;
W
an
n
e
O
.
;
Rai
t
ak
ar
i
O
.
;
“
Ph
y
s
i
c
al
a
c
t
i
v
i
t
y
fro
m
ch
i
l
d
h
o
o
d
t
o
ad
u
l
t
h
o
o
d
:
A
2
1
-
y
e
ar
t
ra
c
k
i
n
g
s
t
u
d
y
,
”
A
m
er
i
ca
n
Jo
u
r
n
a
l
o
f
P
r
e
ven
t
i
ve
M
ed
i
ci
n
e,
v
o
l
.
2
8
,
n
o
.
3
,
p
p
.
2
6
7
-
2
7
3
,
2
0
0
5
.
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O
I
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t
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s
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j
.
am
e
p
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e
.
2
0
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4
.
1
2
.
0
0
3
.
[3
3
]
Mo
g
r
e
,
V
.
;
M
w
i
n
l
en
aa,
P.
P.
;
“
I
m
p
a
c
t
o
f
p
h
y
s
i
c
al
a
c
t
i
v
i
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l
e
v
el
s
an
d
d
i
e
t
o
n
ce
n
t
ral
o
b
e
s
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t
y
a
m
o
n
g
c
i
v
i
l
s
e
r
v
an
t
s
i
n
T
am
al
e
me
t
ro
p
o
l
i
s
,
”
Jo
u
r
n
a
l
o
f
M
ed
i
ca
l
a
n
d
B
i
o
m
ed
i
c
a
l
S
ci
en
ce
s
,
v
o
l
.
1
,
n
o
.
2
,
p
p
.
1
-
9
,
2
0
1
2
.
[3
4
]
W
o
rl
d
H
e
al
t
h
O
rg
an
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