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The sy
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ig
it
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l
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t
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re
n
u
rse
s
to
f
o
rm
d
ig
it
a
l
c
it
ize
n
sh
i
p
.
T
h
is
st
u
d
y
a
ime
d
to
a
n
a
l
y
z
e
th
e
c
o
rre
lati
o
n
b
e
twe
e
n
d
ig
it
a
l
k
n
o
wle
d
g
e
a
n
d
m
in
d
se
t
with
d
i
g
it
a
l
sk
il
ls,
li
tera
c
y
,
a
n
d
c
it
ize
n
sh
ip
a
m
o
n
g
n
u
rsin
g
st
u
d
e
n
ts.
T
h
e
m
in
d
s
p
o
n
g
e
th
e
o
ry
wa
s
u
se
d
in
stu
d
y
c
o
n
c
e
p
tu
a
li
z
a
ti
o
n
a
n
d
re
su
lt
s in
te
rp
re
tatio
n
.
Th
is
q
u
a
n
ti
tativ
e
stu
d
y
u
ti
li
z
e
d
a
c
ro
ss
-
se
c
ti
o
n
a
l
d
e
sig
n
.
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h
e
p
o
p
u
latio
n
wa
s
a
ll
n
u
rsi
n
g
stu
d
e
n
t
s
in
two
p
riv
a
te
n
u
rsin
g
in
sti
tu
ti
o
n
s
l
o
c
a
ted
in
Ba
n
g
k
o
k
,
T
h
a
il
a
n
d
(
n
=
4
7
6
)
a
n
d
S
u
ra
b
a
y
a
,
In
d
o
n
e
sia
(n
=
1
7
9
)
.
S
a
m
p
les
we
re
th
e
t
o
tal
p
o
p
u
la
ti
o
n
.
S
e
lf
-
d
e
v
e
lo
p
e
d
,
v
a
li
d
,
a
n
d
re
li
a
b
le
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stru
m
e
n
t
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s
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se
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in
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a
ta
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n
.
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rip
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n
d
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o
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io
n
tes
t
we
re
u
se
d
in
d
a
ta
a
n
a
ly
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s
(α
<
.
0
5
).
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in
d
in
g
s
sh
o
we
d
th
a
t
d
ig
i
tal
k
n
o
wle
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g
e
d
i
d
n
o
t
c
o
rre
late
wi
th
d
i
g
it
a
l
m
in
d
se
t
(
p
=
.
9
4
),
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u
t
it
wa
s
we
a
k
l
y
c
o
rre
late
d
wit
h
d
i
g
it
a
l
s
k
il
ls,
li
t
e
ra
c
y
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a
n
d
c
it
ize
n
sh
ip
(ρ
=
.
1
2
-
.
1
6
;
p
<
.
0
5
).
Dig
it
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l
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i
n
d
se
t
wa
s
stro
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g
l
y
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o
rre
late
d
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ig
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tera
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n
d
c
it
ize
n
sh
ip
(ρ
=
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5
6
-
.
6
0
;
p
<
.
0
5
).
Di
g
it
a
l
s
k
il
ls
h
a
d
a
stro
n
g
c
o
rre
lati
o
n
wit
h
d
i
g
it
a
l
l
i
tera
c
y
a
n
d
c
it
ize
n
sh
ip
(ρ
=
.
5
8
-
.
6
7
;
p
<
.
0
5
),
wh
il
e
d
i
g
it
a
l
li
tera
c
y
wa
s
stro
n
g
l
y
c
o
rre
late
d
wi
th
d
i
g
it
a
l
c
i
ti
z
e
n
sh
ip
(ρ
=
.
5
9
;
p
=
<
.
0
5
).
Th
e
sy
n
e
rg
y
o
f
d
ig
it
a
l
m
in
d
se
t,
sk
il
ls,
a
n
d
li
t
e
ra
c
y
a
re
re
c
o
m
m
e
n
d
e
d
to
su
p
p
o
rt
th
e
d
ig
it
a
l
c
it
ize
n
sh
i
p
fo
rm
a
ti
o
n
.
W
e
stro
n
g
l
y
re
c
o
m
m
e
n
d
th
e
imp
lem
e
n
tatio
n
o
f
c
o
ll
a
b
o
ra
ti
v
e
lea
rn
i
n
g
m
e
th
o
d
in
n
u
rsin
g
e
d
u
c
a
ti
o
n
.
T
h
is
m
e
th
o
d
p
r
o
m
o
te
s
th
e
i
n
fo
rm
a
ti
o
n
fil
teri
n
g
a
n
d
e
x
c
h
a
n
g
in
g
b
e
h
a
v
i
o
rs am
o
n
g
stu
d
e
n
ts i
m
p
o
rt
a
n
t
fo
r
d
i
g
it
a
l
n
u
rsin
g
.
K
ey
w
o
r
d
s
:
Dig
ital c
itizen
s
h
ip
Dig
ital
k
n
o
wled
g
e
Dig
ital liter
ac
y
Dig
ital m
in
d
s
et
Dig
ital sk
ills
T
h
is i
s
a
n
o
p
e
n
a
c
c
e
ss
a
rticle
u
n
d
e
r th
e
CC B
Y
-
SA
li
c
e
n
se
.
C
o
r
r
e
s
p
o
nd
ing
A
uth
o
r
:
J
in
tan
a
Ar
ts
an
th
ia
Facu
lty
o
f
Nu
r
s
in
g
,
Sain
t L
o
u
i
s
C
o
lleg
e
19
Sath
o
n
R
o
a
d
,
Kh
wae
n
g
Ya
n
Naw
a,
Kh
et
Sath
o
n
,
B
an
g
k
o
k
-
1
0
1
2
0
,
T
h
ailan
d
E
m
ail:
jin
tan
a.
a
@
s
lc
.
ac
.
th
1.
I
NT
RO
D
UCT
I
O
N
I
n
to
d
ay
'
s
d
ig
ital
ag
e,
ef
f
icien
cy
is
n
o
t
s
o
lely
ab
o
u
t
tech
n
o
lo
g
y
;
it
is
ab
o
u
t
h
ar
m
o
n
izin
g
th
e
s
y
n
er
g
y
b
etwe
en
p
eo
p
le
an
d
tech
n
o
lo
g
y
.
Fo
r
n
u
r
s
in
g
s
tu
d
en
ts
,
d
ev
elo
p
in
g
a
d
ig
ital
m
in
d
s
et
is
n
o
t
ju
s
t
a
s
k
ill;
it
is
a
m
in
d
s
et
th
at
p
r
o
p
els
th
em
to
in
co
r
p
o
r
ate
tech
n
o
lo
g
y
in
to
th
eir
d
aily
r
o
les
s
ea
m
less
ly
,
ex
tr
ac
tin
g
m
ea
n
in
g
f
u
l
v
alu
e
an
d
en
h
an
cin
g
th
e
o
v
er
a
ll
q
u
ality
o
f
ca
r
e
[
1
]
.
B
y
em
b
r
ac
in
g
th
ese
p
r
in
cip
les,
n
u
r
s
in
g
s
tu
d
en
ts
ca
n
tr
u
ly
h
ar
n
ess
th
e
p
o
wer
o
f
th
e
d
ig
ital
er
a,
r
ev
o
lu
tio
n
izin
g
h
ea
lth
ca
r
e
d
eliv
er
y
an
d
im
p
r
o
v
in
g
p
atien
t
o
u
tco
m
es
.
A
d
ig
ital
m
in
d
s
et
is
n
o
t
ju
s
t
an
ess
en
tial
to
o
l;
it
i
s
a
tr
an
s
f
o
r
m
ativ
e
attitu
d
e,
a
way
o
f
th
in
k
in
g
th
at
em
p
o
wer
s
in
d
iv
id
u
als
an
d
o
r
g
an
izatio
n
s
to
id
en
tify
o
p
p
o
r
tu
n
ities
with
in
th
e
ev
er
-
ev
o
lv
in
g
tech
n
o
lo
g
ical
lan
d
s
ca
p
e
[
2
]
.
T
h
is
d
ig
ital m
in
d
s
et
co
m
p
r
is
es sev
er
al
k
ey
co
m
p
o
n
en
ts
[
3
]
,
s
u
ch
as
:
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
Th
e
s
yn
erg
y
o
f d
ig
ita
l k
n
o
w
led
g
e,
min
d
s
et,
s
kills
,
a
n
d
liter
a
cy
in
…
(
N
i P
u
tu
Wu
la
n
P
u
r
n
a
ma
S
a
r
i
)
453
−
Ab
u
n
d
an
ce
m
en
tality
r
ef
er
s
to
th
e
co
n
ce
p
t o
f
v
iewin
g
tech
n
o
lo
g
y
as a
n
u
n
lim
ited
r
eso
u
r
ce
f
o
r
in
n
o
v
atio
n
.
I
t
en
co
u
r
ag
es
n
u
r
s
in
g
s
tu
d
en
ts
to
ex
p
lo
r
e
v
ar
io
u
s
d
ig
ital
s
o
lu
tio
n
s
f
o
s
ter
in
g
cr
ea
tiv
ity
an
d
o
u
t
-
of
-
th
e
-
box
th
in
k
in
g
.
−
A
g
r
o
wth
m
in
d
s
et
is
th
e
b
elief
th
at
s
k
ills
an
d
in
tellig
en
ce
ca
n
b
e
d
ev
elo
p
ed
th
r
o
u
g
h
d
ed
icatio
n
an
d
h
ar
d
wo
r
k
.
Nu
r
s
in
g
s
tu
d
en
ts
with
a
g
r
o
wth
m
in
d
s
et
ar
e
m
o
r
e
in
clin
ed
to
em
b
r
ac
e
ch
allen
g
es,
lear
n
f
r
o
m
f
ailu
r
es,
an
d
co
n
tin
u
o
u
s
ly
ad
ap
t to
n
ew
tech
n
o
lo
g
ies
.
−
T
h
e
ag
ile
a
p
p
r
o
a
ch
in
v
o
lv
es b
ein
g
f
lex
ib
le
an
d
r
esp
o
n
s
iv
e
to
ch
an
g
e
s.
−
C
o
m
f
o
r
t
with
a
m
b
ig
u
ity
is
th
e
ab
ilit
y
to
n
av
ig
ate
am
b
ig
u
ity
,
esp
ec
ially
in
th
e
f
ac
e
o
f
n
ew
d
ig
ital to
o
ls
an
d
tech
n
o
lo
g
ies
.
Nu
r
s
in
g
s
tu
d
en
ts
s
h
o
u
ld
f
ee
l c
o
m
f
o
r
tab
le
ex
p
er
im
en
tin
g
,
lear
n
in
g
,
an
d
ad
ap
tin
g
in
u
n
ce
r
tain
s
itu
atio
n
s
.
−
E
x
p
lo
r
er
’
s
m
in
d
is
th
e
p
r
o
ac
tiv
ely
s
ee
k
o
u
t
n
ew
tech
n
o
lo
g
ies,
en
g
ag
e
in
co
n
tin
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o
u
s
lear
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g
,
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d
r
em
ain
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r
io
u
s
ab
o
u
t h
o
w
d
ig
ital so
lu
tio
n
s
ca
n
im
p
r
o
v
e
p
atien
t o
u
tco
m
es a
n
d
s
tr
ea
m
lin
e
h
ea
lth
ca
r
e
p
r
o
ce
s
s
es
.
−
A
co
llab
o
r
ativ
e
a
p
p
r
o
ac
h
is
a
co
llab
o
r
ativ
e
ef
f
o
r
t
to
wo
r
k
s
ea
m
less
ly
with
in
ter
d
is
cip
lin
ar
y
team
s
,
in
clu
d
in
g
in
f
o
r
m
atio
n
an
d
tech
n
o
lo
g
y
(
IT
)
p
r
o
f
ess
io
n
als,
to
in
teg
r
ate
tech
n
o
lo
g
y
in
to
h
ea
lth
ca
r
e
p
r
ac
tices
ef
f
ec
tiv
ely
.
−
E
m
b
r
ac
in
g
d
iv
er
s
ity
is
ess
en
tial
in
th
e
d
ig
ital
ag
e.
Nu
r
s
in
g
p
r
o
f
ess
io
n
als
s
h
o
u
ld
ap
p
r
ec
iate
th
e
v
ar
iety
o
f
d
ig
ital
to
o
ls
av
ailab
le,
u
n
d
er
s
tan
d
in
g
th
at
d
if
f
er
en
t
p
atien
ts
an
d
h
ea
lth
ca
r
e
co
n
tex
ts
m
ay
r
eq
u
ir
e
tailo
r
ed
tech
n
o
lo
g
ical
ap
p
r
o
ac
h
es.
L
ec
tu
r
er
s
’
teac
h
in
g
s
tr
ateg
ies
ca
n
h
elp
n
u
r
s
in
g
s
tu
d
en
ts
g
et
th
e
r
ig
h
t
m
in
d
s
et
as
th
ey
b
eg
in
th
eir
s
tu
d
ies
b
y
en
co
u
r
ag
in
g
th
em
to
m
o
v
e
o
u
t
o
f
th
eir
co
m
f
o
r
t
zo
n
es
[
4
]
.
T
h
u
s
,
n
u
r
s
in
g
lectu
r
er
s
p
lay
a
cr
u
cial
r
o
le
in
s
h
ap
in
g
th
e
d
ig
ital
m
in
d
s
et
o
f
n
u
r
s
in
g
s
tu
d
en
ts
v
ia
th
e
th
r
ee
lear
n
in
g
m
o
d
a
liti
es
in
n
u
r
s
in
g
ed
u
ca
tio
n
,
s
u
ch
as c
lass
r
o
o
m
m
ee
tin
g
s
,
s
k
ill lab
o
r
ato
r
y
p
r
ac
tices,
an
d
clin
ical
in
ter
n
s
h
ip
s
.
I
n
to
d
ay
'
s
r
ap
id
ly
ad
v
an
cin
g
d
ig
ital
er
a,
cu
ltiv
atin
g
d
ig
ital
s
k
ills
h
as
b
ec
o
m
e
in
d
is
p
en
s
ab
le,
p
ar
ticu
lar
ly
f
o
r
n
u
r
s
in
g
s
tu
d
en
ts
wh
o
will
p
lay
a
p
iv
o
tal
r
o
le
in
en
h
an
cin
g
th
e
q
u
ality
o
f
h
ea
lth
ca
r
e
th
r
o
u
g
h
tech
n
o
lo
g
y
in
teg
r
atio
n
in
th
e
f
u
tu
r
e
[
5
]
.
Dig
ital s
k
ills
en
co
m
p
ass
two
ess
en
tial a
s
p
ec
ts
: m
ed
iu
m
-
r
elate
d
s
k
ills
,
wh
ich
in
v
o
lv
e
o
p
er
atio
n
al
an
d
f
o
r
m
al
p
r
o
f
icien
cies,
an
d
co
n
ten
t
-
r
elate
d
s
k
ills
,
wh
ich
en
co
m
p
ass
in
f
o
r
m
atio
n
an
d
s
tr
ateg
ic
ca
p
ab
ilit
ies.
T
h
ese
s
k
ills
ar
e
in
cr
ed
ib
ly
v
er
s
atile
an
d
ap
p
licab
le
ac
r
o
s
s
a
b
r
o
ad
s
p
ec
tr
u
m
o
f
p
r
o
f
ess
io
n
s
,
co
n
s
titu
tin
g
th
e
m
o
s
t
tr
an
s
f
er
ab
le
g
en
er
ic
s
k
ills
.
I
n
th
e
co
n
tem
p
o
r
ar
y
wo
r
k
p
lace
,
th
ey
ar
e
h
ig
h
ly
p
r
ized
an
d
r
elev
an
t
to
ap
p
r
o
x
im
ately
9
0
%
o
f
o
cc
u
p
atio
n
s
[
6
]
.
I
n
s
tr
u
m
en
tal
s
k
ills
in
v
o
lv
e
th
e
ad
ep
t
o
p
er
atio
n
al
m
an
ip
u
latio
n
o
f
tech
n
o
lo
g
y
,
wh
ile
s
tr
u
ctu
r
al
s
k
ills
p
er
tain
to
th
e
u
n
d
er
s
tan
d
in
g
o
f
in
f
o
r
m
atio
n
o
r
g
an
izatio
n
.
Ad
d
itio
n
ally
,
s
tr
ateg
ic
s
k
ills
en
co
m
p
ass
p
r
o
ac
tiv
e
in
f
o
r
m
atio
n
-
s
ee
k
in
g
,
d
ec
is
io
n
-
m
ak
in
g
b
ased
o
n
g
ath
er
ed
in
f
o
r
m
atio
n
,
an
d
th
e
ab
ilit
y
to
s
ca
n
f
o
r
p
er
tin
en
t d
ata
[
7
]
.
An
in
itial
s
tu
d
y
by
Sar
i
et
a
l.
[
8
]
,
tar
g
etin
g
n
u
r
s
in
g
s
tu
d
en
ts
in
B
an
g
k
o
k
,
T
h
ailan
d
,
an
d
Su
r
ab
ay
a,
I
n
d
o
n
esia,
f
o
u
n
d
th
at
th
e
b
asic
d
ig
ital
s
k
ills
wer
e
h
ig
h
er
in
B
an
g
k
o
k
co
m
p
ar
ed
to
Su
r
ab
ay
a,
b
u
t
at
th
e
s
am
e
h
ig
h
lev
el.
T
h
e
d
ig
ital
s
k
ills
wer
e
r
elativ
ely
at
a
m
o
r
e
s
im
ilar
lev
el
in
Su
r
ab
ay
a
co
m
p
ar
ed
to
B
an
g
k
o
k
.
R
esu
lts
o
f
th
e
in
f
er
en
tial
an
aly
s
is
s
h
o
wed
th
at
th
er
e
was
n
o
s
ig
n
if
ican
t
d
if
f
er
en
ce
in
b
asic
d
ig
ital
s
k
ills
b
etwe
en
n
u
r
s
in
g
s
tu
d
en
ts
in
b
o
th
s
ites
,
as
th
ey
r
ep
o
r
ted
h
ig
h
f
lu
en
cy
lev
els
in
u
s
in
g
d
ig
ital
d
ev
ices
(
B
an
g
k
o
k
v
s
.
Su
r
ab
ay
a=
5
3
.
4
%
v
s
.
8
2
.
7
%),
an
d
th
e
d
ig
ital
p
r
o
b
lem
-
s
o
lv
in
g
s
k
ills
wer
e
p
r
o
v
ed
to
b
e
th
e
m
o
s
t
d
if
f
icu
lt
s
k
ill
to
m
aster
(
B
an
g
k
o
k
v
s
.
Su
r
ab
ay
a=
2
.
3
%
v
s
.
1
4
.
5
%).
R
esu
lts
o
f
th
is
in
itial
s
tu
d
y
u
r
g
e
u
s
to
co
n
d
u
ct
th
e
cu
r
r
en
t
s
tu
d
y
b
ec
au
s
e
it
was
f
o
u
n
d
th
at
th
e
d
ig
ital
s
k
ills
am
o
n
g
n
u
r
s
in
g
s
tu
d
en
ts
wer
e
n
o
t
ad
eq
u
ate
in
s
o
m
e
asp
ec
ts
,
r
aisi
n
g
th
e
p
o
s
s
ib
ilit
ies
o
f
im
p
ac
ts
o
n
d
ig
ital liter
ac
y
an
d
citizen
s
h
ip
in
p
ar
ticu
lar
.
I
n
th
e
r
ea
lm
o
f
h
ea
lth
ca
r
e,
d
ig
ital
s
k
ills
h
o
ld
p
ar
am
o
u
n
t
im
p
o
r
tan
ce
.
T
h
ey
em
p
o
wer
th
e
h
ea
lth
ca
r
e
wo
r
k
f
o
r
ce
to
en
h
an
ce
ex
is
tin
g
p
r
o
ce
s
s
es
an
d
ex
ec
u
te
th
eir
p
r
im
ar
y
r
esp
o
n
s
ib
ilit
ies
m
o
r
e
ef
f
ec
tiv
ely
.
T
h
is
is
p
ar
ticu
lar
ly
s
ig
n
if
ican
t
in
-
p
atien
t
ca
r
e,
wh
er
e
p
r
o
f
ess
io
n
als
b
ea
r
th
e
ac
co
u
n
tab
ilit
y
an
d
r
esp
o
n
s
ib
ilit
y
f
o
r
cr
u
cial
asp
ec
ts
s
u
ch
as
p
atien
t
d
ata
an
d
p
ap
er
wo
r
k
.
T
h
ese
r
esp
o
n
s
ib
ilit
ies
d
em
an
d
m
eticu
lo
u
s
h
an
d
lin
g
,
ca
u
tio
n
,
an
d
ca
r
e
[
9
]
.
Dig
ital
s
k
ills
n
o
t
o
n
ly
f
ac
ilit
ate
th
e
s
ea
m
less
ex
ec
u
tio
n
o
f
th
ese
d
u
ties
b
u
t
also
en
s
u
r
e
th
eir
ac
cu
r
ate
an
d
s
ec
u
r
e
m
an
ag
em
en
t.
Ma
s
ter
in
g
m
ed
iu
m
-
r
elate
d
an
d
co
n
ten
t
-
r
elate
d
d
ig
ital
s
k
ills
n
o
t
o
n
ly
en
s
u
r
es
p
r
o
f
icien
t
u
s
e
o
f
tech
n
o
lo
g
y
b
u
t
also
s
h
ap
es
th
e
f
u
tu
r
e
o
f
n
u
r
s
in
g
ed
u
ca
tio
n
an
d
p
r
ac
tice,
em
p
o
wer
in
g
n
u
r
s
in
g
s
tu
d
en
ts
to
ex
ce
l in
th
eir
r
o
les an
d
co
n
tr
ib
u
te
m
ea
n
in
g
f
u
lly
to
h
ea
lth
ca
r
e.
Dig
ital
l
iter
ac
y
is
th
e
f
u
n
d
am
en
tal
b
asics
o
f
d
ig
ital
to
o
ls
an
d
tech
n
o
lo
g
ies.
Nu
r
s
in
g
s
tu
d
en
ts
n
ee
d
to
b
e
p
r
o
f
icien
t
in
n
av
ig
atin
g
d
ig
ital
in
ter
f
ac
es,
u
n
d
er
s
tan
d
in
g
d
ata
p
r
iv
ac
y
,
an
d
u
tili
zin
g
s
o
f
twar
e
s
p
ec
if
ic
to
h
ea
lth
ca
r
e
s
ettin
g
s
.
I
n
th
e
r
ea
lm
o
f
n
u
r
s
in
g
ed
u
ca
tio
n
,
r
e
s
ea
r
ch
er
s
h
av
e
ex
ten
s
iv
ely
ex
p
lo
r
ed
th
e
d
ig
ital
liter
ac
y
o
f
n
u
r
s
in
g
s
tu
d
en
ts
s
tar
tin
g
f
r
o
m
th
e
ir
p
r
e
-
r
eg
is
tr
atio
n
p
er
io
d
.
Var
io
u
s
s
tu
d
ies
co
n
s
is
ten
tly
h
ig
h
lig
h
t
th
e
cr
u
cial
r
o
le
o
f
d
ig
ital
liter
ac
y
as
a
f
o
u
n
d
atio
n
al
elem
en
t
an
d
a
k
ey
d
eter
m
in
an
t
o
f
ac
ad
em
i
c
s
u
cc
ess
.
Ad
eq
u
ate
d
ig
ital
liter
ac
y
am
o
n
g
n
u
r
s
in
g
s
tu
d
en
ts
s
ig
n
if
ican
tly
en
h
an
ce
s
th
eir
ca
p
ab
ilit
ies
in
elec
tr
o
n
ic
d
o
cu
m
en
tatio
n
,
co
llab
o
r
ativ
e
team
wo
r
k
,
an
d
in
f
o
r
m
atio
n
r
etr
iev
al
to
s
u
p
p
o
r
t
ev
id
en
ce
-
b
ased
p
r
ac
tice
[
1
0
]
.
D
i
g
i
t
a
l
c
i
t
i
z
e
n
s
h
i
p
e
n
c
o
m
p
a
s
s
e
s
a
c
o
m
p
r
e
h
e
n
s
i
v
e
s
e
t
o
f
s
k
i
l
l
s
e
s
s
e
n
t
i
a
l
f
o
r
n
a
v
i
g
a
t
i
n
g
t
h
e
o
n
l
i
n
e
w
o
r
l
d
e
f
f
e
c
t
i
v
e
l
y
w
i
t
h
r
e
s
p
o
n
s
i
b
i
l
i
t
y
.
T
h
e
r
e
a
r
e
e
i
g
h
t
c
o
m
p
o
n
e
n
t
s
d
e
f
i
n
e
a
w
e
l
l
-
r
o
u
n
d
e
d
d
i
g
i
t
a
l
c
i
t
i
z
e
n
[
1
1
]
,
s
u
c
h
a
s
:
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
4
,
No
.
1
,
Ma
r
ch
20
2
5
:
4
5
2
-
4
59
454
−
C
itizen
i
d
en
tity
is
th
e
cu
ltiv
atin
g
a
p
o
s
itiv
e
an
d
tr
u
th
f
u
l
s
elf
-
im
ag
e
o
n
s
o
cial
m
ed
ia,
b
ein
g
ac
co
u
n
tab
le
f
o
r
ac
tio
n
s
,
an
d
ad
h
er
in
g
to
leg
al
an
d
eth
ical
s
tan
d
ar
d
s
.
−
Scr
ee
n
t
im
e
m
an
ag
em
en
t
is
th
e
s
tr
ik
in
g
b
alan
ce
b
etwe
en
o
n
lin
e
ac
tiv
ities
an
d
r
ea
l
-
life
r
esp
o
n
s
ib
ilit
ies,
d
em
o
n
s
tr
atin
g
s
elf
-
co
n
tr
o
l in
b
o
th
o
n
lin
e
an
d
o
f
f
lin
e
co
n
te
x
ts
.
−
C
y
b
er
-
b
u
lly
in
g
m
an
ag
em
en
t
is
d
ev
elo
p
in
g
th
e
ab
ilit
y
to
h
an
d
le,
p
r
ev
en
t,
an
d
b
u
ild
r
esil
ien
ce
ag
ain
s
t
cy
b
er
-
b
u
lly
in
g
with
o
u
t su
cc
u
m
b
in
g
to
em
o
tio
n
al
r
ea
ctio
n
s
.
−
C
y
b
er
-
s
ec
u
r
ity
m
an
ag
em
en
t
is
s
af
eg
u
ar
d
in
g
ag
ain
s
t
d
ata
th
ef
t
an
d
o
n
lin
e
attac
k
s
b
y
im
p
lem
en
tin
g
s
ec
u
r
ity
m
ea
s
u
r
es su
ch
as r
o
b
u
s
t p
ass
wo
r
d
p
r
ac
tices
.
−
Priv
ac
y
m
an
ag
em
en
t
is
th
e
en
s
u
r
in
g
p
er
s
o
n
al
an
d
o
th
er
s
'
p
r
iv
ac
y
o
n
lin
e,
em
p
h
asizin
g
in
f
o
r
m
atio
n
s
ec
u
r
ity
an
d
r
esp
o
n
s
ib
le
s
h
ar
in
g
p
r
a
ctice
s
.
−
C
r
itical
th
in
k
in
g
is
th
e
an
aly
s
in
g
an
d
d
is
ce
r
n
in
g
ac
cu
r
ate
in
f
o
r
m
atio
n
,
ap
p
ly
in
g
ju
d
g
m
en
t,
an
d
v
er
if
y
in
g
th
e
au
th
en
ticity
o
f
co
n
ten
t,
in
clu
d
in
g
ev
alu
atin
g
ed
ited
im
ag
es c
r
itically
.
−
Dig
ital
f
o
o
tp
r
in
t
a
war
en
ess
r
ef
er
s
to
r
ec
o
g
n
izin
g
th
at
th
e
d
ig
ital
wo
r
ld
leav
es tr
ac
es a
n
d
u
n
d
er
s
tan
d
in
g
th
e
p
o
ten
tial im
p
ac
t o
n
f
u
tu
r
e
o
p
p
o
r
tu
n
ities
an
d
life
s
ty
le
ch
o
ices
.
−
D
ig
ital
em
p
ath
y
is
th
e
d
em
o
n
s
tr
atin
g
co
m
p
ass
io
n
an
d
f
o
s
ter
in
g
p
o
s
itiv
e
in
ter
ac
tio
n
s
o
n
lin
e,
p
r
o
m
o
tin
g
m
u
tu
al
ass
is
tan
ce
an
d
u
n
d
er
s
tan
d
in
g
am
o
n
g
p
ee
r
s
.
T
h
e
m
in
d
s
p
o
n
g
e
th
eo
r
y
(
MT
)
was
u
s
ed
in
s
tu
d
y
co
n
ce
p
tu
al
izatio
n
an
d
r
esu
lts
in
ter
p
r
etatio
n
.
MT
is
th
e
h
u
m
a
n
m
in
d
’
s
in
f
o
r
m
atio
n
-
p
r
o
c
ess
in
g
th
eo
r
y
wh
ich
co
n
s
is
ts
o
f
f
iv
e
co
r
e
p
illar
s
,
s
u
c
h
as:
i
)
m
in
d
s
et,
ii
)
co
m
f
o
r
t
zo
n
e,
iii
)
m
u
lti
-
f
ilter
i
n
g
s
y
s
tem
,
iv
)
cu
ltu
r
al
an
d
id
eo
lo
g
ical
s
ettin
g
,
an
d
v
)
cu
ltu
r
al
v
alu
es
[
1
2
]
.
MT
r
elate
s
to
s
elf
-
af
f
ir
m
atio
n
th
eo
r
y
,
3
D
m
u
lti
-
f
ilter
in
g
p
r
o
ce
s
s
,
in
f
o
r
m
atio
n
p
r
o
ce
s
s
in
g
m
o
d
el,
in
d
u
ctiv
e
attitu
d
e,
an
d
m
o
d
el
o
f
ac
c
u
ltu
r
atio
n
,
wh
ich
m
ay
ex
p
lain
m
an
y
s
o
cio
-
cu
ltu
r
al
is
s
u
es
an
d
v
ar
io
u
s
m
en
tal
p
r
o
d
u
cts
lead
in
g
to
c
o
m
p
lex
h
u
m
an
b
eh
av
io
r
an
d
s
o
cio
p
s
y
ch
o
lo
g
ical
p
h
en
o
m
en
a
[
1
3
]
.
I
n
th
is
s
tu
d
y
,
MT
v
iews
th
e
d
ig
ital
m
in
d
s
et
as
a
s
et
o
f
co
r
e
v
alu
es
r
elate
d
to
d
ig
ital
tech
n
o
lo
g
ies.
New
tech
n
o
lo
g
y
in
f
o
r
m
atio
n
will
b
e
p
r
o
ce
ed
b
y
a
c
o
llectio
n
o
f
in
f
o
r
m
atio
n
c
u
m
p
r
o
ce
s
s
o
r
in
th
e
h
u
m
an
m
in
d
.
T
h
e
s
u
b
jectiv
e
b
en
ef
it
-
co
s
t
ju
d
g
m
en
ts
ar
e
u
s
ed
t
o
f
ilte
r
th
e
n
ew
in
f
o
r
m
atio
n
o
n
n
ew
/ex
is
ted
tech
n
o
lo
g
ies
wh
ich
ca
ta
ly
zin
g
th
e
tech
n
o
lo
g
y
a
d
o
p
tio
n
-
ejec
tio
n
p
r
o
ce
s
s
es.
T
h
e
aim
o
f
t
h
is
s
tu
d
y
was
t
o
an
al
y
ze
t
h
e
co
r
r
elat
io
n
b
etwe
en
d
i
g
ital
k
n
o
wled
g
e
an
d
m
in
d
s
et
with
d
ig
ital
s
k
ills
,
liter
ac
y
,
a
n
d
c
itizen
s
h
ip
am
o
n
g
n
u
r
s
in
g
s
tu
d
en
ts
.
MT
will
b
e
u
s
ef
u
l
f
o
r
ex
p
lain
in
g
th
e
p
h
e
n
o
m
en
a
o
f
d
i
g
ital
k
n
o
wled
g
e
,
m
in
d
s
et,
s
k
ills
,
l
iter
ac
y
,
an
d
citizen
s
h
ip
am
o
n
g
n
u
r
s
in
g
s
tu
d
e
n
ts
in
th
e
er
a
o
f
h
ea
lth
ca
r
e
I
T
a
d
v
an
ce
m
en
t c
u
r
r
en
tly
.
2.
M
E
T
H
O
D
T
h
i
s
s
t
u
d
y
e
m
p
l
o
y
e
d
a
q
u
a
n
t
it
at
i
v
e
r
e
s
e
a
r
c
h
p
a
r
a
d
i
g
m
,
e
m
p
l
o
y
i
n
g
a
n
o
b
s
e
r
v
a
t
i
o
n
a
l
a
n
a
l
y
t
ic
al
a
p
p
r
o
a
c
h
t
h
r
o
u
g
h
a
c
r
o
s
s
-
s
e
c
ti
o
n
a
l
s
u
r
v
ey
.
Th
i
s
s
t
u
d
y
f
o
c
u
s
e
d
o
n
c
a
p
t
u
r
i
n
g
t
h
e
p
h
e
n
o
m
e
n
a
o
f
t
h
e
d
i
g
it
a
l
k
n
o
w
l
e
d
g
e
a
n
d
m
i
n
d
s
e
t
i
m
p
li
c
a
ti
n
g
o
n
t
h
e
d
i
g
i
t
a
l
s
k
i
l
ls
,
l
it
e
r
a
c
y
,
a
n
d
c
i
t
i
ze
n
s
h
i
p
i
n
n
u
r
s
i
n
g
s
t
u
d
e
n
ts
’
p
o
p
u
l
a
t
i
o
n
b
y
s
p
r
e
a
d
i
n
g
q
u
e
s
t
i
o
n
n
a
i
r
es
.
T
h
e
p
r
i
m
a
r
y
o
u
t
c
o
m
e
o
f
t
h
i
s
s
t
u
d
y
is
t
h
e
i
n
f
o
r
m
a
t
i
v
e
d
a
t
a
o
f
n
u
r
s
i
n
g
s
t
u
d
e
n
t
s
i
n
d
i
g
i
t
al
p
e
r
s
p
e
c
t
i
v
e
.
T
h
e
s
e
c
o
n
d
a
r
y
o
u
t
c
o
m
e
i
s
t
h
e
c
o
r
r
e
l
a
ti
o
n
a
l
a
n
a
l
y
s
is
a
m
o
n
g
i
m
p
o
r
t
a
n
t
c
o
n
c
e
p
t
s
o
f
d
i
g
i
t
a
l
know
l
e
d
g
e
a
n
d
m
i
n
d
s
e
t
w
it
h
d
i
g
i
t
a
l
s
k
i
ll
s
,
l
i
te
r
a
c
y
,
a
n
d
c
it
iz
e
n
s
h
i
p
i
n
n
u
r
s
i
n
g
s
t
u
d
e
n
t
s
.
Po
t
e
n
t
i
a
l
c
o
n
f
o
u
n
d
e
r
s
w
e
r
e
a
s
s
es
s
e
d
t
h
r
o
u
g
h
s
t
a
t
is
ti
ca
l
a
n
a
l
y
s
i
s
t
o
a
d
j
u
s
t
t
h
e
i
r
p
o
t
e
n
t
i
a
l
i
m
p
ac
t
o
n
t
h
e
s
t
u
d
y
o
u
t
c
o
m
e
s
.
T
h
e
s
tu
d
y
tar
g
etted
all
u
n
d
er
g
r
ad
u
ated
n
u
r
s
in
g
s
tu
d
en
ts
wh
o
s
e
s
tatu
s
was a
ctiv
e
in
th
e
en
r
o
llm
en
t
o
f
2
0
2
2
/2
0
2
3
ac
ad
em
ic
y
ea
r
.
T
h
e
d
ata
co
llectio
n
p
r
o
ce
d
u
r
e
was c
o
n
d
u
cted
b
etwe
en
Feb
r
u
ar
y
-
Ap
r
il 2
0
2
3
.
T
h
er
e
wer
e
two
p
r
iv
ate
n
u
r
s
in
g
in
s
titu
tio
n
s
in
B
an
g
k
o
k
,
T
h
ailan
d
,
an
d
Su
r
ab
ay
a,
I
n
d
o
n
esia,
b
ein
g
th
e
s
tu
d
y
s
ites
.
T
h
er
e
wer
e
6
5
5
r
esp
o
n
d
en
ts
p
ar
ticip
ated
in
th
is
s
tu
d
y
;
476
r
esp
o
n
d
en
ts
wer
e
T
h
ai
p
eo
p
le,
an
d
179
r
esp
o
n
d
en
ts
wer
e
I
n
d
o
n
esian
.
R
esp
o
n
d
en
t
s
wh
o
d
en
ied
in
f
o
r
m
ed
co
n
s
en
t
wer
e
u
n
ab
le
to
f
ill
in
th
e
q
u
esti
o
n
n
air
es
.
R
esp
o
n
d
en
ts
wh
o
h
ad
p
ar
ticip
ated
in
th
e
on
-
ca
m
p
u
s
tr
y
-
o
u
t
q
u
esti
o
n
n
air
e
test
in
g
wer
e
ex
clu
d
ed
.
Ad
d
itio
n
ally
,
d
is
co
n
tin
u
atio
n
cr
iter
ia
wer
e
ap
p
lied
to
r
esp
o
n
d
en
t
s
p
r
o
v
id
in
g
in
co
m
p
lete
r
esp
o
n
s
es.
Self
-
d
ev
elo
p
ed
in
s
tr
u
m
en
t
was
u
s
ed
in
d
ata
co
llectio
n
p
r
o
ce
s
s
.
I
t
was
d
iv
id
e
d
in
to
s
ix
s
ec
tio
n
s
m
ea
s
u
r
in
g
th
e
d
em
o
g
r
ap
h
y
ch
ar
ac
ter
is
tics
,
d
ig
ital k
n
o
wled
g
e,
m
in
d
s
et,
s
k
ills
,
liter
ac
y
,
an
d
citizen
s
h
ip
am
o
n
g
n
u
r
s
in
g
s
tu
d
en
ts
.
Th
is
in
s
tr
u
m
en
t
was
m
eticu
lo
u
s
ly
cr
af
ted
th
r
o
u
g
h
an
ex
ten
s
iv
e
liter
atu
r
e
r
ev
iew
an
d
th
e
in
v
alu
ab
le
in
s
ig
h
ts
o
f
th
r
ee
ex
p
er
t
p
r
o
f
ess
io
n
als.
A
f
iv
e
-
p
o
in
t
L
ik
er
t
s
ca
le
r
an
g
in
g
f
r
o
m
1
to
5
,
1
f
o
r
less
co
n
f
id
en
t
to
5
f
o
r
s
tr
o
n
g
ly
co
n
f
id
en
t,
w
er
e
u
s
ed
to
d
if
f
er
en
tiate
r
esp
o
n
s
es
am
o
n
g
r
esp
o
n
d
en
ts
in
all
s
ec
tio
n
s
,
ex
ce
p
t
f
o
r
th
e
f
ir
s
t
s
ec
tio
n
o
f
d
em
o
g
r
ap
h
y
ch
ar
ac
ter
is
tics
.
E
ac
h
r
esp
o
n
s
e
was
ca
teg
o
r
ized
in
to
less
(
s
ca
le
1
an
d
2
)
,
m
o
d
er
ate
(
s
ca
le
3
)
,
an
d
h
ig
h
(
s
ca
le
4
an
d
5
)
lev
els
f
o
r
d
eter
m
in
in
g
th
e
d
eg
r
ee
o
f
m
ea
s
u
r
ed
v
ar
iab
les.
T
h
e
ex
p
er
ts
'
ev
alu
a
tio
n
s
wer
e
g
au
g
ed
by
u
s
in
g
th
e
i
n
d
ex
o
f
item
o
b
jectiv
es
co
n
g
r
u
en
ce
(
I
OC
)
,
y
ield
ed
a
co
m
m
en
d
ab
le
s
co
r
e
o
f
.
7
8
,
af
f
ir
m
in
g
th
e
to
o
l'
s
v
alid
ity
.
T
o
ass
ess
r
eliab
ilit
y
,
th
e
in
s
tr
u
m
en
t
u
n
d
er
wen
t
r
ig
o
r
o
u
s
s
cr
u
tin
y
.
E
m
p
lo
y
in
g
th
e
in
ter
n
al
co
n
s
is
ten
cy
m
eth
o
d
,
s
p
ec
i
f
ically
th
e
C
r
o
n
b
ac
h
'
s
alp
h
a,
th
e
in
s
tr
u
m
en
t
d
em
o
n
s
tr
ated
a
h
ig
h
lev
el
o
f
r
eliab
ilit
y
,
b
o
asti
n
g
a
s
u
b
s
tan
tial
s
co
r
e
o
f
.
8
5
.
Fu
r
th
er
m
o
r
e,
th
e
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
Th
e
s
yn
erg
y
o
f d
ig
ita
l k
n
o
w
led
g
e,
min
d
s
et,
s
kills
,
a
n
d
liter
a
cy
in
…
(
N
i P
u
tu
Wu
la
n
P
u
r
n
a
ma
S
a
r
i
)
455
s
ec
o
n
d
s
ec
tio
n
o
f
d
ig
ital
k
n
o
wled
g
e
d
is
p
lay
ed
a
r
eliab
ilit
y
co
ef
f
icien
t
(
KR
)
o
f
.
6
,
r
ein
f
o
r
cin
g
th
e
in
s
tr
u
m
en
t'
s
cr
ed
ib
ilit
y
an
d
tr
u
s
two
r
th
in
ess
in
ca
p
tu
r
in
g
ac
cu
r
ate
d
ata
f
o
r
th
e
s
tu
d
y
.
Data
an
aly
s
is
u
s
ed
d
escr
ip
tiv
e
s
tatis
tic
s
an
d
co
r
r
elatio
n
te
s
t
.
Miss
in
g
d
ata
wer
e
m
a
n
ag
ed
u
s
in
g
m
u
ltip
le
im
p
u
tatio
n
tech
n
iq
u
es,
an
d
s
en
s
itiv
ity
an
aly
s
es
wer
e
co
n
d
u
cted
to
ass
ess
th
e
r
o
b
u
s
tn
ess
o
f
th
e
r
esu
lts
.
Data
wa
s
an
aly
ze
d
f
o
r
n
o
r
m
al
d
is
tr
ib
u
tio
n
b
y
u
s
in
g
Ko
lm
o
g
o
r
o
v
-
Sm
ir
n
o
v
t
est
(
K
-
S
T
est)
,
en
d
ed
u
p
with
th
e
d
ata
d
en
ied
n
o
r
m
al
d
is
tr
ib
u
tio
n
(
all
p
<.
0
5
)
.
Descr
ip
tiv
e
s
tatis
tic
s
,
in
clu
d
in
g
m
ea
n
s
an
d
s
tan
d
ar
d
d
ev
iatio
n
s
(
SDs
)
,
wer
e
ca
lcu
l
ated
f
o
r
co
n
tin
u
o
u
s
v
ar
ia
b
les.
Sp
ec
if
y
th
e
in
f
er
en
tial
s
tatis
tical
test
s
em
p
lo
y
ed
in
th
is
s
tu
d
y
wer
e
R
an
k
Sp
e
ar
m
an
c
o
r
r
elatio
n
test
am
o
n
g
v
ar
iab
les
o
f
d
i
g
ital
k
n
o
wled
g
e,
m
in
d
s
et,
s
k
ills
,
liter
ac
y
,
an
d
citizen
s
h
ip
to
r
e
v
ea
l
s
ig
n
if
ican
t
co
r
r
elatio
n
s
(
α
<.
0
5
)
.
Su
b
g
r
o
u
p
a
n
aly
s
es
wer
e
co
n
d
u
cted
b
ased
on
s
tu
d
y
s
ite
to
e
x
p
lo
r
e
v
ar
iati
o
n
s
.
Th
is
s
tu
d
y
p
r
o
t
o
co
l
was
ap
p
r
o
v
ed
b
y
th
e
E
th
ic
al
C
o
m
m
i
ttee
o
f
Sain
t
L
o
u
is
C
o
lleg
e
,
B
an
g
k
o
k
,
T
h
ailan
d
,
u
n
d
er
r
ef
er
e
n
ce
n
u
m
b
er
o
f
E.
0
1
7
/2
0
2
2
wh
ich
w
as
is
s
u
ed
o
n
J
u
ly
14
,
2
0
2
2
.
B
ef
o
r
e
p
ar
ticip
atio
n
,
in
d
iv
id
u
als
wer
e
p
r
o
v
id
ed
with
d
etail
in
f
o
r
m
atio
n
o
n
t
h
e
s
tu
d
y
aim
,
d
ata
c
o
llectio
n
p
r
o
ce
d
u
r
es,
an
d
p
o
ten
tial
r
is
k
s
-
b
en
ef
its
.
T
h
e
in
f
o
r
m
e
d
c
o
n
s
en
t
was
o
b
tain
e
d
v
o
lu
n
tar
i
ly
th
r
o
u
g
h
a
s
ig
n
ed
co
n
s
en
t
f
o
r
m
wh
ich
d
id
n
o
t
af
f
ec
t
an
y
in
d
iv
id
u
al
g
r
ad
in
g
.
R
esp
o
n
d
en
ts
wer
e
f
r
ee
to
wit
h
d
r
aw
f
r
o
m
p
a
r
ticip
atio
n
d
u
e
to
p
er
s
o
n
al
r
ea
s
o
n
s
at
an
y
tim
e
with
n
o
co
n
s
eq
u
en
ce
.
Data
co
n
f
id
en
tiality
w
as
s
tr
ictly
m
ain
tain
ed
.
I
n
f
o
r
m
atio
n
p
r
o
v
id
ed
b
y
r
esp
o
n
d
en
t
s
r
em
ain
ed
co
n
f
id
e
n
tial
u
n
less
an
ex
p
licit
co
n
s
en
t
was
g
iv
en
f
o
r
d
is
clo
s
u
r
e.
R
e
s
p
o
n
d
en
t
s
h
a
d
th
e
o
p
tio
n
to
r
e
m
ain
an
o
n
y
m
o
u
s
,
an
d
th
ey
co
u
ld
in
q
u
ir
e,
r
ef
u
s
e,
o
r
ag
r
ee
to
p
a
r
ticip
ate
in
th
is
s
tu
d
y
.
T
h
o
s
e
co
n
s
en
tin
g
to
p
ar
ticip
ate
wer
e
r
eq
u
ir
e
d
to
s
ig
n
a
f
o
r
m
al
c
o
n
s
en
t
f
o
r
m
o
r
p
r
o
v
i
d
e
v
er
b
al
co
n
s
en
t
wh
ich
was
r
ec
o
r
d
e
d
f
o
r
d
o
c
u
m
en
tatio
n
p
u
r
p
o
s
es.
3.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
Am
o
n
g
6
5
5
r
esp
o
n
d
e
n
ts
,
th
e
m
ajo
r
ity
was
f
em
ale
with
Me
an
ag
e
o
f
2
0
.
8
5
y
ea
r
s
o
ld
w
h
o
u
s
ed
two
g
ad
g
ets
in
av
er
ag
e
f
o
r
ac
ce
s
s
in
g
an
d
e
x
ch
an
g
in
g
d
i
g
ital
in
f
o
r
m
atio
n
.
R
es
u
lts
s
h
o
wed
th
at
th
e
d
ata
g
r
o
u
p
o
f
b
o
th
s
i
tes
was
n
o
t
d
if
f
er
in
ter
m
s
o
f
d
ig
ital
k
n
o
wled
g
e
,
m
in
d
s
et,
s
k
ills
,
liter
ac
y
,
an
d
citi
ze
n
s
h
ip
s
o
th
at
we
co
m
b
in
ed
all
d
ata
an
d
an
aly
ze
d
th
em
alto
g
et
h
er
.
T
a
b
le
1
ex
p
lain
s
th
e
r
esu
ts
o
f
d
escr
ip
tiv
e
s
tatis
t
ics.
T
a
b
l
e
1
.
R
es
u
l
ts
o
f
d
e
s
c
r
i
p
t
i
v
e
s
t
a
ti
s
t
i
cs
N
M
i
n
i
m
u
m
M
a
x
i
m
u
m
M
e
a
n
SD
I
n
t
e
r
p
r
e
t
a
t
i
o
n
D
i
g
i
t
a
l
k
n
o
w
l
e
d
g
e
655
.
0
0
9
.
0
0
5
.
1
2
1
.
7
7
m
o
d
e
r
a
t
e
D
i
g
i
t
a
l
l
i
t
e
r
a
c
y
655
6
2
.
0
0
1
6
0
.
0
0
1
2
3
.
4
9
1
8
.
4
9
h
i
g
h
D
i
g
i
t
a
l
m
i
n
d
s
e
t
655
3
7
.
0
0
1
0
5
.
0
0
7
9
.
4
7
9
.
2
1
h
i
g
h
D
i
g
i
t
a
l
s
k
i
l
l
s
655
9
.
0
0
3
0
.
0
0
2
4
.
4
9
3
.
6
5
h
i
g
h
D
i
g
i
t
a
l
c
i
t
i
z
e
n
s
h
i
p
655
3
0
.
0
0
1
0
5
.
0
0
6
7
.
2
4
1
2
.
5
5
m
o
d
e
r
a
t
e
T
ab
le
1
s
h
o
wed
th
at
m
o
s
t
r
es
p
o
n
d
e
n
ts
h
ad
a
m
o
d
e
r
ate
lev
el
o
f
d
ig
ital
k
n
o
wled
g
e
a
n
d
c
itizen
s
h
ip
,
an
d
a
h
ig
h
le
v
el
o
f
d
ig
ital
m
in
d
s
et,
s
k
ills
,
an
d
liter
ac
y
.
B
ased
o
n
SD
v
alu
e
,
th
e
m
o
s
t
v
ar
ied
d
ata
was
th
e
d
ig
ital
liter
ac
y
,
wh
ile
th
e
m
o
s
t
h
o
m
o
g
en
o
u
s
d
ata
was
th
e
d
ig
ital
k
n
o
wled
g
e.
T
ab
le
2
ex
p
l
ain
s
th
e
r
esu
lts
o
f
co
r
r
elatio
n
test
.
T
ab
le
2
.
R
esu
lts
o
f
r
an
k
s
p
ea
r
m
an
co
r
r
elatio
n
test
D
i
g
i
t
a
l
k
n
o
w
l
e
d
g
e
D
i
g
i
t
a
l
m
i
n
d
s
e
t
D
i
g
i
t
a
l
s
k
i
l
l
s
D
i
g
i
t
a
l
l
i
t
e
r
a
c
y
D
i
g
i
t
a
l
c
i
t
i
z
e
n
sh
i
p
D
i
g
i
t
a
l
k
n
o
w
l
e
d
g
e
ρ
=
1
.
0
0
;
p
=
N
A
#
p
=
.
9
4
’
ρ
=
.
1
3
;
p
=
.
0
0
*
ρ
=
.
1
2
;
p
=
.
0
0
*
ρ
=
.
1
6
;
p
=
.
0
0
*
D
i
g
i
t
a
l
m
i
n
d
s
e
t
p
=
.
9
4
’
ρ
=
1
.
0
0
;
p
=
N
A
#
ρ
=
.
5
8
;
p
=
.
0
0
*
*
ρ
=
.
6
0
;
p
=
.
0
0
*
*
ρ
=
.
5
6
;
p
=
.
0
0
*
*
D
i
g
i
t
a
l
s
k
i
l
l
s
ρ
=
.
1
3
;
p
=
.
0
0
*
ρ
=
.
5
8
;
p
=
.
0
0
*
*
ρ
=
1
.
0
0
;
p
=
N
A
#
ρ
=
.
6
7
;
p
=
.
0
0
*
*
ρ
=
.
5
8
;
p
=
.
0
0
*
*
D
i
g
i
t
a
l
l
i
t
e
r
a
c
y
ρ
=
.
1
2
;
p
=
.
0
0
*
ρ
=
.
6
0
;
p
=
.
0
0
*
*
ρ
=
.
6
7
;
p
=
.
0
0
*
*
ρ
=
1
.
0
0
;
p
=
N
A
#
ρ
=
.
5
9
;
p
=
.
0
0
*
*
D
i
g
i
t
a
l
c
i
t
i
z
e
n
s
h
i
p
ρ
=
.
1
6
;
p
=
.
0
0
*
ρ
=
.
5
6
;
p
=
.
0
0
*
*
ρ
=
.
5
8
;
p
=
.
0
0
*
*
ρ
=
.
5
9
;
p
=
.
0
0
ρ
=
1
.
0
0
;
p
=
N
A
#
N
o
t
e
s
:
‘
m
e
a
n
s
n
o
c
o
r
r
e
l
a
t
i
o
n
;
*
m
e
a
n
s
w
e
a
k
b
u
t
s
i
g
n
i
f
i
c
a
n
t
c
o
r
r
e
l
a
t
i
o
n
;
*
*
m
e
a
n
s
s
t
r
o
n
g
a
n
d
s
i
g
n
i
f
i
c
a
n
t
c
o
r
r
e
l
a
t
i
o
n
;
#
m
e
a
n
s
a
b
s
o
l
u
t
e
c
o
r
r
e
l
a
t
i
o
n
.
T
ab
le
2
s
h
o
we
d
th
at
d
i
g
ital
k
n
o
wled
g
e
h
ad
n
o
co
r
r
elatio
n
with
d
ig
ital
m
in
d
s
et
(
p
=
.
9
4
)
,
b
u
t
it
was
wea
k
ly
co
r
r
elate
d
with
d
i
g
ital
s
k
ills
,
liter
ac
y
,
an
d
citize
n
s
h
ip
(
ρ
=.
1
2
-
.
1
6
;
p
<.
0
5
)
.
Di
g
ital
m
in
d
s
et
was
s
tr
o
n
g
ly
c
o
r
r
elate
d
with
d
ig
ita
l
s
k
ills
,
liter
ac
y
,
an
d
citizen
s
h
ip
(
ρ
=.
5
6
-
.
6
0
;
p
<.
0
5
)
.
Dig
ital
s
k
ills
h
ad
a
s
tr
o
n
g
co
r
r
elatio
n
with
d
ig
ital
liter
ac
y
a
n
d
citizen
s
h
ip
(
ρ
=.
5
8
-
.6
7
;
p
<.
0
5
)
,
wh
ile
d
ig
ital
liter
ac
y
was
s
tr
o
n
g
ly
co
r
r
elate
d
with
d
ig
ital
citizen
s
h
ip
(
ρ
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5
9
;
p
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.
0
5
)
.
T
h
e
s
tr
o
n
g
est
co
r
r
elatio
n
was
f
o
u
n
d
b
etwe
en
d
ig
ital
s
k
ills
an
d
d
ig
ital liter
ac
y
(
ρ
=.
6
7
; p
=
<.
0
5
)
,
wh
ile
d
ig
ital liter
ac
y
h
a
d
th
e
s
tr
o
n
g
est co
r
r
elatio
n
wit
h
d
ig
ital c
itizen
s
h
ip
am
o
n
g
o
th
er
s
(
ρ
=.
5
9
;
p
=<
.
0
5
)
.
As
th
e
d
ig
ital
m
i
n
d
s
et
an
d
s
k
ills
h
ad
a
s
tr
o
n
g
c
o
r
r
elatio
n
with
d
ig
ital
liter
ac
y
Evaluation Warning : The document was created with Spire.PDF for Python.
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,
it
m
ea
n
s
th
at
th
e
s
y
n
er
g
y
o
f
d
ig
ital
m
in
d
s
et,
s
k
ills
,
an
d
liter
ac
y
we
r
e
p
o
wer
f
u
l
in
th
e
f
o
r
m
atio
n
o
f
d
ig
ital c
iti
ze
n
s
h
ip
am
o
n
g
n
u
r
s
in
g
s
tu
d
en
ts
.
T
h
e
d
ata
f
r
o
m
b
o
th
s
ites
d
em
o
n
s
tr
ated
u
n
i
f
o
r
m
ity
in
asp
ec
t
s
o
f
d
ig
ital
k
n
o
wled
g
e,
m
in
d
s
et,
s
k
ills
,
liter
ac
y
,
an
d
citizen
s
h
ip
.
T
h
is
s
u
g
g
ests
a
c
o
m
m
o
n
b
aselin
e
o
f
d
ig
ital
c
o
m
p
eten
c
y
am
o
n
g
n
u
r
s
in
g
s
tu
d
en
ts
f
r
o
m
t
h
ese
two
r
eg
io
n
s
,
an
d
also
s
u
g
g
ests
th
at
ce
r
tain
d
ig
ital
s
k
ills
an
d
attitu
d
es
ar
e
u
n
iv
er
s
ally
p
r
e
v
alen
t
am
o
n
g
n
u
r
s
in
g
s
tu
d
en
ts
,
tr
an
s
ce
n
d
in
g
r
eg
i
o
n
al
d
if
f
e
r
en
ce
s
.
T
h
is
h
ig
h
lig
h
ts
th
e
u
n
iv
er
s
ality
o
f
ce
r
tain
d
ig
ital
s
k
ills
an
d
attitu
d
es
wit
h
in
th
is
d
em
o
g
r
ap
h
ic.
B
y
an
aly
zin
g
a
d
ata
s
et
o
f
6
5
5
n
u
r
s
in
g
s
tu
d
en
ts
,
we
wer
e
ab
le
to
d
is
ce
r
n
p
atter
n
s
an
d
co
r
r
elatio
n
s
r
elate
d
to
d
ig
ital
k
n
o
wled
g
e,
m
in
d
s
et,
s
k
ills
,
liter
ac
y
,
an
d
citizen
s
h
ip
in
th
is
p
o
p
u
latio
n
.
T
h
e
f
in
d
i
n
g
s
s
h
ed
lig
h
t
o
n
th
e
in
ter
co
n
n
ec
tio
n
s
b
etwe
en
th
ese
v
ar
iab
les,
o
f
f
er
in
g
v
al
u
ab
le
in
s
ig
h
ts
in
to
th
e
d
ig
ita
l la
n
d
s
c
ap
e
o
f
n
u
r
s
in
g
s
tu
d
e
n
ts
.
T
h
e
s
ig
n
if
ican
t
co
r
r
elatio
n
s
f
o
u
n
d
b
etwe
en
d
i
f
f
er
en
t
asp
ec
ts
o
f
d
ig
ital
co
m
p
eten
cy
a
r
e
p
ar
ticu
lar
ly
illu
m
in
atin
g
.
Dig
ital
k
n
o
wled
g
e
h
as
a
wea
k
co
r
r
elatio
n
wi
th
d
ig
ital
s
k
ills
,
liter
ac
y
,
an
d
citizen
s
h
ip
am
o
n
g
n
u
r
s
in
g
s
tu
d
en
t
s
.
T
h
is
im
p
lies
th
at
n
u
r
s
in
g
s
tu
d
en
ts
with
a
v
er
y
d
iv
er
s
e
b
ac
k
g
r
o
u
n
d
s
m
ig
h
t
h
av
e
v
ar
io
u
s
lev
els
o
f
d
ig
ital
k
n
o
wled
g
e
in
f
lu
en
cin
g
t
h
eir
o
v
e
r
all
d
ig
ital
ca
p
ab
ilit
ies
in
ter
m
s
o
f
d
ig
ital
s
k
ills
,
liter
ac
y
,
an
d
citizen
s
h
ip
.
Nu
r
s
in
g
s
tu
d
en
ts
with
h
ig
h
er
d
i
g
ital
k
n
o
wled
g
e
ar
e
m
o
r
e
li
k
ely
to
p
o
s
s
es
s
ad
v
an
ce
d
d
i
g
ital
liter
ac
y
an
d
s
k
ills
.
Ov
er
all,
d
ig
ital
k
n
o
wled
g
e
was
f
o
u
n
d
in
a
m
o
d
er
ate
lev
el
in
th
e
m
a
jo
r
ity
.
T
ea
ch
in
g
o
f
d
ig
ital
k
n
o
wled
g
e
an
d
co
m
p
e
ten
cies
s
h
o
u
ld
b
e
f
ir
m
ly
im
p
l
em
en
ted
in
n
u
r
s
in
g
ed
u
ca
tio
n
to
f
o
r
m
d
i
g
itally
co
m
p
eten
t
f
u
tu
r
e
n
u
r
s
es
[
1
4
]
,
b
u
t
it
is
im
p
o
r
tan
t
to
lay
m
o
r
e
em
p
h
asis
o
n
teac
h
in
g
t
h
e
r
eq
u
i
r
ed
d
i
g
ital
co
m
p
eten
cies
[
1
5
]
.
Dig
ital
h
e
alth
m
o
d
u
le
m
ay
b
e
a
n
ef
f
ec
t
iv
e
m
ed
ia
f
o
r
lear
n
in
g
b
ec
a
u
s
e
it
was
p
r
o
v
en
to
s
u
f
f
icien
tly
tr
an
s
f
er
k
n
o
wled
g
e
ab
o
u
t
d
ig
ital
h
ea
lth
[
1
4
]
.
Oth
er
th
an
d
ig
ital
h
ea
lth
,
th
e
n
u
r
s
in
g
in
f
o
r
m
atics
m
o
d
u
le
ca
n
e
q
u
ip
th
e
s
tu
d
en
ts
with
d
ig
ital
h
ea
lth
k
n
o
wled
g
e
an
d
n
av
ig
atio
n
s
k
ills
o
f
h
ea
lth
in
f
o
r
m
atio
n
s
y
s
tem
s
an
d
tech
n
o
lo
g
ical
a
d
v
an
ce
m
en
t [
1
6
]
.
Un
f
o
r
tu
n
atel
y
,
d
ig
ital
k
n
o
wled
g
e
ca
n
n
o
t
d
eter
m
in
e
th
e
d
ig
ital
m
in
d
s
et,
as
b
o
th
v
ar
iab
le
s
wer
e
n
o
t
s
ig
n
if
ican
tly
co
r
r
elate
d
.
T
h
er
e
is
a
p
o
s
s
ib
ilit
y
th
at
th
is
wa
s
ca
u
s
ed
b
y
th
e
i
n
co
n
s
is
ten
t
alig
n
m
en
t
b
etwe
en
p
er
s
o
n
al,
ac
ad
e
m
ic
,
an
d
p
r
o
f
e
s
s
io
n
al
d
ig
ital
s
p
ac
es
am
o
n
g
n
u
r
s
in
g
s
tu
d
en
ts
[
1
7
]
.
To
f
o
r
m
a
s
p
ec
if
ic
m
in
d
s
et,
th
e
p
o
s
s
ess
ed
k
n
o
wled
g
e
n
ee
d
s
to
b
e
r
elev
an
t.
T
h
e
i
n
s
ig
n
if
ican
t
co
r
r
elatio
n
b
etwe
en
d
ig
ital
k
n
o
wled
g
e
an
d
m
in
d
s
et
h
er
e
m
ea
n
s
th
e
f
ix
e
d
k
n
o
wled
g
e
h
as
r
esu
lted
in
a
d
iv
er
s
e
d
ig
ital
m
in
d
s
et.
T
h
is
was
p
r
o
v
ed
b
y
co
m
p
ar
in
g
th
e
SD
v
alu
es
(
d
i
g
ital
k
n
o
wled
g
e<
d
ig
ital
m
i
n
d
s
et:
1
.
7
7
<
9
.
2
1
)
.
An
o
th
er
r
ea
s
o
n
is
th
at
th
e
r
esp
o
n
d
en
ts
h
av
e
m
o
r
e
f
o
cu
s
o
n
th
e
ea
s
e
o
f
u
s
e
asp
ec
t
th
an
th
e
b
en
ef
its
o
f
ad
o
p
tin
g
tech
n
o
lo
g
y
.
A
s
tu
d
y
o
n
7
0
2
Mo
r
o
cc
an
n
u
r
s
in
g
s
tu
d
e
n
ts
s
h
o
wed
th
at
th
e
ef
f
ec
t
o
f
p
e
r
ce
iv
ed
b
en
e
f
its
is
co
n
d
itio
n
al
o
n
th
e
ea
s
e
o
f
u
s
e
asp
ec
t
in
d
eter
m
in
in
g
tech
n
o
l
o
g
y
ad
o
p
tio
n
in
ten
tio
n
,
th
u
s
r
ec
o
m
m
en
d
in
g
th
e
co
m
m
u
n
ic
atio
n
o
f
p
er
ce
iv
e
d
b
en
ef
its
o
v
er
e
x
p
o
s
in
g
th
e
ea
s
e
o
f
u
s
e
asp
ec
t [
1
8
]
.
I
n
d
ig
ital
teac
h
in
g
an
d
lear
n
i
n
g
f
o
r
m
ats
in
to
u
n
iv
er
s
ity
tea
ch
in
g
,
n
o
t
o
n
ly
tech
n
ical,
f
in
an
cial
,
an
d
s
tr
u
ctu
r
al
p
r
er
e
q
u
is
ites
m
u
s
t
b
e
cr
e
ated
,
b
u
t
also
c
o
m
p
eten
c
e
-
r
elate
d
p
r
er
eq
u
is
ites
th
at
en
a
b
le
s
tu
d
en
ts
to
d
ea
l
with
th
e
n
ew
f
o
r
m
ats
in
co
m
p
u
ter
u
s
ag
e
am
o
n
g
n
u
r
s
es
in
r
u
r
al
h
ea
lth
ca
r
e
f
ac
ilit
ies.
A
p
r
o
n
o
u
n
ce
d
d
ig
ital
m
in
d
s
et
em
er
g
es
as
th
e
m
o
s
t
im
p
o
r
tan
t
c
o
m
p
o
n
en
t
[
3
]
.
M
o
r
eo
v
e
r
,
d
ig
ital
m
in
d
s
et
m
ay
in
cr
ea
s
e
th
e
d
ig
ital
h
ea
lth
d
ev
elo
p
m
en
t
[
1
9
]
.
A
d
ig
ital
m
in
d
s
et
also
lead
s
to
a
d
ig
ital
tr
an
s
f
o
r
m
atio
n
ef
f
ec
t
o
n
th
e
s
u
cc
ess
o
f
th
e
o
r
g
an
izatio
n
[
2
0
]
,
[
2
1
]
.
T
h
er
e
f
o
r
e,
h
o
s
p
itals
to
d
ay
r
eq
u
ir
e
n
u
r
s
es
with
a
d
ig
ital
m
in
d
s
et
wh
ich
ch
ar
ac
ter
ize
d
b
y
th
e
a
b
ilit
y
to
u
n
d
er
s
tan
d
th
e
p
o
wer
o
f
tech
n
o
lo
g
y
to
d
e
m
o
cr
atize
team
s
an
d
p
r
o
ce
s
s
es
[
2
1
]
.
T
h
e
s
tr
o
n
g
c
o
r
r
elatio
n
b
etwe
e
n
d
ig
ital
m
in
d
s
et
an
d
d
ig
ital
s
k
ills
in
n
u
r
s
in
g
s
tu
d
en
ts
u
n
d
er
lin
es
th
e
im
p
o
r
tan
ce
o
f
m
ain
tain
in
g
a
p
o
s
itiv
e
attitu
d
e
to
war
d
s
tech
n
o
lo
g
y
will
b
e
b
en
ef
icial
in
d
ev
elo
p
in
g
p
r
ac
tical
s
k
ills
.
T
h
is
f
in
d
in
g
s
u
g
g
ests
t
h
at
in
d
iv
id
u
als
with
a
p
o
s
itiv
e
m
in
d
s
et
to
war
d
s
tech
n
o
lo
g
y
ar
e
m
o
r
e
lik
ely
to
ac
q
u
ir
e
an
d
ex
ce
l
in
d
ig
ital
s
k
ills
.
T
h
is
f
in
d
in
g
also
in
d
ica
tes
th
at
n
u
r
s
in
g
s
tu
d
en
ts
with
a
p
o
s
itiv
e
a
ttit
u
d
e
to
war
d
d
ig
ital
tech
n
o
lo
g
y
ar
e
m
o
r
e
lik
ely
t
o
h
av
e
h
ig
h
er
d
i
g
ital
s
k
ills
.
A
p
o
s
itiv
e
attitu
d
e
o
n
tech
n
o
lo
g
y
ca
n
f
o
s
ter
cu
r
io
s
ity
,
o
p
e
n
n
ess
to
lear
n
in
g
,
a
n
d
ad
a
p
tab
ilit
y
,
wh
i
ch
ar
e
cr
u
cial
tr
aits
f
o
r
m
aste
r
in
g
v
ar
i
o
u
s
d
ig
ital
to
o
ls
an
d
tech
n
o
lo
g
ies.
I
n
p
r
a
ctica
l
ter
m
s
,
th
is
s
tr
o
n
g
co
r
r
el
atio
n
u
n
d
er
s
co
r
es
th
e
im
p
o
r
ta
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2
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a
c
h
e
s
[
2
8
]
.
T
h
e
r
e
f
o
r
e
,
o
f
f
e
r
i
n
g
t
a
il
o
r
e
d
d
i
g
it
a
l
s
k
il
ls
e
n
h
a
n
c
e
m
e
n
t
to
n
u
r
s
i
n
g
s
t
u
d
e
n
ts
o
n
c
a
m
p
u
s
c
an
e
m
p
o
w
e
r
t
h
e
m
t
o
r
e
s
p
o
n
s
i
b
ly
a
c
t
i
n
t
h
e
d
i
g
it
a
l
la
n
d
s
c
a
p
e
i
n
e
v
e
r
y
d
a
y
l
i
f
e
.
T
h
e
s
tr
o
n
g
c
o
r
r
elatio
n
b
etwe
e
n
d
ig
ital
liter
ac
y
a
n
d
d
ig
ital
ci
tizen
s
h
ip
u
n
d
er
s
co
r
es
th
e
co
n
n
ec
tio
n
of
u
n
d
er
s
tan
d
i
n
g
d
ig
ital
in
f
o
r
m
a
tio
n
an
d
r
esp
o
n
s
ib
le
d
ig
ital
b
eh
av
io
r
.
Dig
ital
liter
ac
y
r
ef
e
r
s
to
th
e
ab
ilit
y
to
f
in
d
,
e
v
alu
ate,
an
d
u
s
e
d
ig
it
al
in
f
o
r
m
atio
n
ef
f
ec
tiv
ely
,
w
h
ile
d
i
g
ital
citizen
s
h
ip
in
v
o
l
v
es
r
esp
o
n
s
ib
le
an
d
eth
ical
u
s
e
o
f
tech
n
o
lo
g
y
,
e
n
co
m
p
ass
in
g
ar
ea
s
s
u
c
h
as
o
n
l
in
e
etiq
u
ette,
p
r
iv
ac
y
,
a
n
d
s
ec
u
r
ity
.
T
h
is
s
tr
o
n
g
co
r
r
elatio
n
s
u
g
g
ests
th
at
d
ig
itally
liter
ate
in
d
iv
id
u
als
p
o
s
s
es
s
th
e
s
k
ill
s
to
n
av
ig
ate
an
d
cr
itically
ass
e
s
s
o
n
lin
e
in
f
o
r
m
atio
n
.
T
h
ey
a
r
e
m
o
r
e
lik
ely
to
en
g
ag
e
in
r
esp
o
n
s
ib
le
d
ig
ital
citizen
s
h
ip
.
Dig
ital
li
te
r
ac
y
is
a
n
ec
ess
i
ty
in
th
is
er
a
o
f
d
is
r
u
p
ted
s
o
ciety
to
b
ec
o
m
e
a
s
m
ar
t
an
d
g
o
o
d
d
ig
ital
citizen
[
2
9
]
.
Un
d
er
s
tan
d
in
g
h
o
w
to
v
er
if
y
th
e
cr
ed
ib
ilit
y
o
f
o
n
li
n
e
s
o
u
r
c
es,
d
is
tin
g
u
is
h
b
etwe
en
r
eliab
l
e
an
d
u
n
r
eliab
le
in
f
o
r
m
atio
n
,
an
d
u
s
e
d
ig
ital
to
o
ls
ef
f
ec
tiv
ely
ca
n
em
p
o
wer
in
d
i
v
id
u
als
to
m
ak
e
in
f
o
r
m
ed
an
d
eth
ical
d
ec
is
io
n
s
in
th
eir
o
n
lin
e
in
ter
ac
tio
n
s
.
So
m
etim
es
th
ese
ab
ilit
ies
o
f
in
f
o
r
m
atio
n
-
f
ilter
in
g
ar
e
lac
k
i
n
g
in
u
n
iv
e
r
s
ity
s
tu
d
en
ts
b
ec
au
s
e
th
ey
ar
e
f
ast
en
o
u
g
h
to
f
o
r
war
d
u
n
v
er
if
ied
in
f
o
r
m
atio
n
[
3
0
]
.
T
h
is
ac
t
m
ay
r
esu
lt
in
th
e
s
p
r
ea
d
o
f
f
al
s
e
n
ews
o
r
h
o
ax
es
r
ep
r
esen
tin
g
th
e
d
ig
ital
citizen
’
s
u
n
p
r
e
p
ar
ed
n
ess
in
f
ac
in
g
th
e
d
is
r
u
p
tiv
e
er
a
[
2
9
]
.
C
ase
s
tu
d
y
m
eth
o
d
s
an
d
p
r
o
ject
-
b
ased
lear
n
in
g
ar
e
h
i
g
h
ly
r
ec
o
m
m
e
n
d
ed
at
th
e
u
n
iv
er
s
ity
lev
el
b
ec
a
u
s
e
th
ey
ar
e
v
er
y
ef
f
ec
ti
v
e
in
h
elp
in
g
s
tu
d
en
ts
b
u
ild
a
c
r
itical
attitu
d
e,
b
e
ab
le
t
o
f
ilter
in
f
o
r
m
atio
n
b
etter
,
an
d
b
ec
o
m
e
ap
p
r
ec
iativ
e
an
d
s
u
p
p
o
r
tiv
e
i
n
r
ea
ctin
g
t
o
o
r
m
an
ag
in
g
s
o
cial
life
p
r
o
b
le
m
s
[
3
0
]
.
Ov
er
all,
r
esu
lts
s
u
g
g
est
th
at
th
er
e
ar
e
m
ea
n
in
g
f
u
l
r
elatio
n
s
h
ip
s
b
etwe
en
d
ig
ital
k
n
o
wled
g
e,
m
in
d
s
et,
s
k
ill
s
,
liter
ac
y
,
an
d
citizen
s
h
ip
am
o
n
g
n
u
r
s
in
g
s
tu
d
en
ts
.
T
h
ese
r
esu
lts
will
lead
to
th
e
d
ev
el
o
p
m
en
t
o
f
th
e
r
o
le
an
d
tr
a
n
s
f
o
r
m
atio
n
o
f
n
u
r
s
in
g
ed
u
ca
tio
n
[
2
0
]
,
[
2
1
]
.
Stre
n
g
th
en
in
g
d
ig
ital
s
k
ills
an
d
f
o
s
ter
i
n
g
a
p
o
s
itiv
e
d
ig
ital
m
in
d
s
et
m
ay
co
n
tr
ib
u
te
to
th
e
d
ev
e
lo
p
m
e
n
t o
f
r
esp
o
n
s
ib
le
d
i
g
ital c
itizen
s
h
ip
an
d
liter
ac
y
.
T
h
is
s
tu
d
y
is
n
o
t
with
o
u
t
li
m
itatio
n
s
.
L
im
itatio
n
s
o
f
th
is
s
tu
d
y
in
clu
d
e
its
s
p
ec
if
ic
f
o
cu
s
o
n
th
e
n
u
r
s
in
g
s
tu
d
en
t
p
o
p
u
latio
n
in
t
wo
p
r
iv
ate
in
s
titu
tio
n
s
in
B
an
g
k
o
k
an
d
Su
r
a
b
ay
a.
No
n
eth
el
ess
,
th
e
in
c
lu
s
io
n
o
f
a
s
u
b
s
tan
tial
n
u
m
b
er
o
f
p
ar
ti
cip
an
ts
f
r
o
m
th
ese
r
eg
io
n
s
h
a
s
p
r
o
v
id
ed
a
r
ich
d
ataset
f
o
r
co
m
p
r
eh
e
n
d
in
g
th
e
d
ig
ital
co
m
p
eten
c
y
o
f
n
u
r
s
in
g
s
tu
d
en
ts
.
F
in
d
in
g
s
h
a
v
e
r
ev
ea
led
in
tr
icate
r
elatio
n
s
h
i
p
s
b
etwe
en
v
a
r
io
u
s
asp
ec
ts
of
d
ig
ital
co
m
p
eten
c
y
,
o
f
f
e
r
i
n
g
v
alu
ab
le
in
s
ig
h
ts
in
to
th
e
d
ig
ital
lan
d
s
ca
p
e
o
f
n
u
r
s
in
g
s
tu
d
e
n
ts
.
Ho
wev
er
,
co
r
r
elatio
n
d
o
es
n
o
t
im
p
ly
ca
u
s
atio
n
,
an
d
o
th
er
f
ac
to
r
s
co
u
ld
b
e
in
f
lu
e
n
cin
g
t
h
ese
r
elatio
n
s
h
ip
s
,
s
u
ch
as
g
en
d
er
an
d
in
c
o
m
e
.
Fu
r
th
er
s
tu
d
y
m
ay
in
v
esti
g
ate
th
e
s
ig
n
if
ican
t
f
ac
to
r
s
in
f
lu
en
cin
g
th
ese
co
r
r
elatio
n
s
,
p
r
o
v
id
i
n
g
v
al
u
ab
le
in
s
ig
h
ts
f
o
r
f
u
tu
r
e
e
d
u
ca
tio
n
al
s
tr
ateg
ies
an
d
p
o
licies.
F
u
lly
u
n
d
er
s
tan
d
in
g
th
ese
co
r
r
elatio
n
s
is
cr
u
cial
f
o
r
ed
u
ca
tio
n
al
in
s
titu
tio
n
s
an
d
p
o
licy
m
ak
e
r
s
to
d
ev
elo
p
ta
r
g
eted
in
ter
v
e
n
tio
n
s
an
d
cu
r
r
ic
u
lu
m
en
h
a
n
ce
m
en
t
s
b
y
aim
in
g
at
im
p
r
o
v
in
g
d
i
g
ital
co
m
p
eten
cies
an
d
f
o
s
ter
in
g
p
o
s
itiv
e
d
ig
ital
attitu
d
es a
n
d
b
e
h
a
v
io
r
s
am
o
n
g
n
u
r
s
in
g
s
tu
d
e
n
ts
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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2
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I
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Hea
lth
Sci
,
Vo
l.
1
4
,
No
.
1
,
Ma
r
ch
20
2
5
:
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5
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4
59
458
4.
CO
NCLU
SI
O
N
T
h
is
s
tu
d
y
'
s
r
esu
lts
u
n
d
er
s
co
r
e
th
e
p
o
s
itiv
e
in
ter
p
lay
s
b
etw
ee
n
d
ig
ital
k
n
o
wled
g
e,
m
in
d
s
et,
s
k
ills
,
an
d
liter
ac
y
in
f
o
r
m
in
g
d
ig
ita
l
citizen
s
h
ip
am
o
n
g
n
u
r
s
in
g
s
tu
d
en
ts
.
Dig
ital
k
n
o
wled
g
e
is
wea
k
ly
co
r
r
elate
d
with
d
ig
ital
s
k
ills
,
liter
ac
y
,
a
n
d
citizen
s
h
ip
,
b
u
t
it
ca
n
n
o
t
d
eter
m
in
e
th
e
d
ig
ital
m
in
d
s
et
.
Dig
ital
m
in
d
s
et
is
s
tr
o
n
g
ly
c
o
r
r
elate
d
with
d
ig
ita
l
s
k
ills
,
li
t
er
ac
y
,
a
n
d
citizen
s
h
ip
.
Dig
ital
s
k
ills
ar
e
also
s
tr
o
n
g
ly
co
r
r
elate
d
with
d
ig
ital
liter
ac
y
an
d
citizen
s
h
ip
.
Fin
ally
,
d
ig
ital
liter
ac
y
is
s
tr
o
n
g
ly
c
o
r
r
elate
d
with
d
ig
ital
c
itizen
s
h
ip
.
Am
o
n
g
all,
d
ig
ital
s
k
il
ls
an
d
liter
ac
y
h
av
e
th
e
s
tr
o
n
g
est
co
r
r
elatio
n
;
b
u
t
in
f
o
r
m
in
g
d
ig
ital
citizen
s
h
ip
,
d
ig
ital
liter
ac
y
h
as
th
e
s
tr
o
n
g
est
co
r
r
elatio
n
am
o
n
g
o
th
e
r
s
.
T
h
e
s
y
n
er
g
y
o
f
d
ig
ital
m
in
d
s
et,
s
k
ills
,
an
d
liter
ac
y
is
r
ec
o
m
m
en
d
ed
to
s
u
p
p
o
r
t
d
ig
ital
citizen
s
h
ip
f
o
r
m
atio
n
.
T
h
e
co
llab
o
r
ativ
e
s
tu
d
en
t
-
ce
n
ter
e
d
lear
n
in
g
m
eth
o
d
f
ac
ilit
atin
g
th
e
in
f
o
r
m
atio
n
f
ilter
in
g
an
d
e
x
ch
an
g
in
g
b
e
h
av
io
r
s
am
o
n
g
n
u
r
s
in
g
s
tu
d
en
ts
is
en
co
u
r
a
g
ed
m
o
r
e
at
th
e
co
lleg
e
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u
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ity
lev
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ACK
NO
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DG
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M
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NT
S
T
h
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id
y
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Ma
n
d
ala
Su
r
a
b
ay
a
C
ath
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lic
Un
iv
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s
ity
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d
Sain
t
L
o
u
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C
o
lleg
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with
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eg
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ter
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r
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7
2
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2022
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1
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d
e
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r
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5
6
4
,
r
esp
ec
tiv
el
y
.
W
e
d
ee
p
ly
t
h
an
k
all
s
tu
d
y
r
esp
o
n
d
en
ts
f
o
r
th
eir
f
r
ien
d
ly
p
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ticip
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ich
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ak
es th
is
s
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o
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s
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le
.
RE
F
E
R
E
NC
E
S
[
1
]
A
.
H
a
r
e
r
i
m
a
n
a
,
S
.
E.
D
u
m
a
,
a
n
d
N
.
G
.
M
t
sh
a
l
i
,
“
F
i
r
st
-
y
e
a
r
n
u
r
si
n
g
st
u
d
e
n
t
s’
d
i
g
i
t
a
l
l
i
t
e
r
a
c
y
:
A
c
r
o
ss
-
se
c
t
i
o
n
a
l
s
t
u
d
y
,
”
J
o
u
r
n
a
l
o
f
N
u
rs
i
n
g
Ed
u
c
a
t
i
o
n
a
n
d
Pr
a
c
t
i
c
e
,
v
o
l
.
1
3
,
n
o
.
1
,
2
0
2
2
,
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o
i
:
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0
.
5
4
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/
j
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