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I
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14
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3
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20
25
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1596
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o
l
o
f
b
l
o
o
d
p
r
ess
u
r
e
b
y
th
e
u
s
e
o
f
ap
p
r
o
p
r
iate
th
er
a
p
eu
tic
m
et
h
o
d
s
an
d
t
h
e
m
o
d
if
icatio
n
o
f
an
y
life
s
ty
le
ch
o
ices
th
at
ar
e
af
f
ec
t
ed
b
y
th
e
c
o
n
d
itio
n
[
7
]
.
Ap
p
r
o
x
im
ately
f
if
ty
p
er
ce
n
t
o
f
h
y
p
er
ten
s
io
n
p
atien
ts
d
o
n
o
t
tak
e
th
eir
m
ed
icatio
n
as
d
ir
ec
ted
,
wh
ich
is
a
s
u
b
s
tan
tial c
au
s
e
o
f
tr
ea
tm
en
t
f
ailu
r
e
[
8
]
.
Po
o
r
a
d
h
er
en
ce
to
d
r
u
g
r
e
g
im
en
s
is
a
k
ey
ca
u
s
e
o
f
tr
ea
tm
en
t f
ailu
r
e.
Acc
o
r
d
in
g
to
th
e
f
in
d
in
g
s
o
f
o
u
r
in
v
esti
g
atio
n
,
a
p
r
o
m
i
n
en
t
co
n
ce
r
n
am
o
n
g
h
y
p
er
te
n
s
io
n
p
atien
ts
is
a
lack
o
f
ad
h
er
en
ce
to
th
ei
r
m
ed
icatio
n
r
eg
im
en
.
I
n
th
e
ca
s
e
o
f
h
y
p
er
t
en
s
io
n
,
f
o
r
in
s
tan
ce
,
m
o
r
e
th
a
n
h
alf
(
4
5
%)
o
f
th
e
p
o
p
u
latio
n
th
at
was
in
v
esti
g
ated
is
n
o
t
tak
i
n
g
t
h
eir
an
tih
y
p
e
r
ten
s
iv
e
m
ed
icatio
n
as
p
r
escr
i
b
ed
.
I
n
a
s
tu
d
y
th
at
lo
o
k
ed
at
th
e
ad
h
er
en
ce
o
f
p
at
ien
ts
with
r
ef
r
ac
to
r
y
h
y
p
er
ten
s
io
n
to
th
eir
an
tih
y
p
er
t
e
n
s
iv
e
m
ed
icatio
n
,
C
o
r
r
ea
et
a
l.
f
o
u
n
d
th
at
5
7
%
o
f
p
atien
t
s
wer
e
tak
in
g
th
eir
m
ed
icatio
n
as
p
r
escr
ib
ed
[
9
]
.
Patien
ts
wh
o
h
av
e
h
y
p
e
r
ten
s
io
n
an
d
d
o
n
o
t
tak
e
th
eir
p
h
a
r
m
ac
o
lo
g
ical
p
r
escr
ip
tio
n
s
as
p
r
esc
r
ib
ed
h
a
v
e
a
n
eg
ativ
e
im
p
ac
t
a
n
d
an
in
cr
ea
s
ed
r
is
k
o
f
ca
r
d
io
v
ascu
lar
ev
en
ts
an
d
s
tr
o
k
e
,
a
n
d
o
th
er
co
m
p
licatio
n
s
[
1
0
]
.
T
h
e
is
s
u
e
o
f
m
ed
icatio
n
n
o
n
a
d
h
er
e
n
ce
is
a
co
m
p
licated
o
n
e;
m
u
ltip
le
s
tu
d
ies
h
av
e
p
r
o
v
en
a
co
n
n
e
ctio
n
b
etwe
en
n
o
n
ad
h
er
e
n
ce
an
d
a
v
ar
iety
o
f
ch
ar
ac
ter
is
tics
,
in
clu
d
in
g
p
ati
en
ts
'
p
er
s
p
ec
tiv
es,
s
o
cio
ec
o
n
o
m
ic
s
tatu
s
,
h
ea
lth
liter
ac
y
,
an
d
r
ac
e/eth
n
icity
,
am
o
n
g
o
th
er
s
[
1
1
]
.
Fo
r
in
d
iv
i
d
u
als
wh
o
h
av
e
h
y
p
er
ten
s
io
n
t
o
co
n
tin
u
e
t
o
a
d
h
er
e
to
t
h
eir
tr
ea
tm
en
t
r
eg
im
e
n
,
it
is
n
ec
ess
ar
y
f
o
r
r
esear
ch
an
d
clin
ical
ex
p
er
ts
to
p
o
s
s
ess
a
v
alid
an
d
ac
cu
r
ate
i
n
s
tr
u
m
en
t
t
h
at
ca
n
q
u
a
n
tify
th
is
b
eh
av
io
r
.
I
n
2
0
1
6
,
r
esear
ch
er
s
in
th
e
Un
ited
States
d
e
v
elo
p
ed
th
e
Hill
-
B
o
n
e
h
ig
h
b
lo
o
d
p
r
ess
u
r
e
th
er
a
p
y
co
m
p
lian
ce
s
ca
le,
a
s
elf
-
ca
r
e
ass
es
s
m
en
t
to
o
l
s
p
ec
if
ically
d
esig
n
ed
f
o
r
in
d
iv
id
u
als
with
h
y
p
e
r
ten
s
io
n
an
d
tailo
r
ed
to
th
eir
co
n
d
iti
o
n
[
1
2
]
.
T
h
er
e
f
o
r
e,
th
is
s
tu
d
y
aim
s
to
ev
alu
ate
th
e
p
s
y
ch
o
m
etr
ic
ch
ar
ac
ter
is
tics
—
s
p
ec
if
ically
v
alid
ity
an
d
r
eliab
ilit
y
—
o
f
th
e
I
n
d
o
n
esian
ad
a
p
tatio
n
o
f
th
e
Hill
-
B
o
n
e
s
ca
le.
2.
M
E
T
H
O
D
2
.
1
.
Desig
n a
nd
s
a
m
ple
T
h
is
s
tu
d
y
was
a
cr
o
s
s
-
s
ec
t
io
n
al
d
escr
ip
tiv
e
in
v
est
ig
atio
n
c
ar
r
ied
o
u
t
in
W
est
J
av
a,
I
n
d
o
n
esia,
o
v
er
th
e
p
er
i
o
d
o
f
J
u
n
e
to
J
u
ly
2
0
2
1
.
A
s
tu
d
y
was
d
o
n
e
to
ass
ess
th
e
p
s
y
ch
o
m
etr
ic
f
ea
tu
r
es
o
f
an
in
v
en
to
r
y
,
in
v
o
l
v
in
g
1
4
4
p
e
r
s
o
n
s
b
etwe
en
th
e
a
g
es
o
f
3
5
a
n
d
6
5
wh
o
h
av
e
h
y
p
e
r
ten
s
io
n
.
T
h
e
s
tu
d
y
p
ar
ticip
a
n
ts
wer
e
in
d
iv
id
u
als
d
iag
n
o
s
ed
with
h
y
p
er
ten
s
io
n
wh
o
wer
e
p
r
escr
ib
ed
n
o
m
o
r
e
th
an
two
an
tih
y
p
er
ten
s
iv
e
m
ed
icatio
n
s
,
h
a
d
an
in
itial
b
lo
o
d
p
r
ess
u
r
e
r
ea
d
in
g
ab
o
v
e
1
4
0
/9
0
m
m
Hg
,
wer
e
ca
p
ab
le
o
f
m
an
ag
in
g
th
eir
b
lo
o
d
p
r
ess
u
r
e
a
n
d
ad
ju
s
tin
g
th
eir
m
ed
icatio
n
in
d
ep
en
d
e
n
tly
,
an
d
wer
e
p
r
o
f
ic
ien
t
in
B
ah
asa
I
n
d
o
n
esia.
T
h
e
s
am
p
le
s
ize
wa
s
d
eter
m
in
ed
u
s
in
g
a
1
:
5
r
atio
f
o
r
f
ac
to
r
an
aly
s
is
p
u
r
p
o
s
es [
1
3
]
.
2
.
2
.
I
ns
t
rum
ent
T
h
e
s
o
cio
d
em
o
g
r
a
p
h
ic
a
n
d
cli
n
ical
s
u
r
v
ey
in
clu
d
e
d
a
cl
o
s
ed
-
en
d
ed
q
u
esti
o
n
.
T
h
e
d
em
o
g
r
ap
h
ic
an
d
clin
ical
in
f
o
r
m
ati
o
n
,
s
u
ch
as
th
e
p
atien
t'
s
ag
e,
g
en
d
e
r
,
lev
el
o
f
ed
u
ca
tio
n
,
m
ar
ital
s
tatu
s
,
h
y
p
er
ten
s
io
n
s
tatu
s
,
an
d
n
u
m
b
er
o
f
m
e
d
icatio
n
s
.
T
h
e
n
u
m
b
e
r
o
f
m
ed
ica
tio
n
s
wa
s
co
n
f
ir
m
ed
f
r
o
m
m
ed
ical
r
ec
o
r
d
s
.
T
h
e
Hill
-
B
o
n
e
h
ig
h
b
lo
o
d
p
r
ess
u
r
e
th
er
a
p
y
co
m
p
lian
ce
m
ea
s
u
r
e
was
s
u
b
s
eq
u
en
tly
estab
lis
h
ed
u
tili
zin
g
a
L
ik
er
t
s
ca
lin
g
ap
p
r
o
ac
h
.
T
h
is
was
d
o
n
e
s
o
t
h
at
p
ar
ticip
an
ts
co
u
ld
a
n
s
wer
to
ea
ch
item
with
in
th
e
s
ca
le,
s
o
in
d
ic
atin
g
th
e
f
r
eq
u
e
n
cy
with
wh
ich
th
e
item
is
s
ig
n
if
ican
t
[
1
2
]
.
A
co
m
p
lian
ce
with
th
e
HB
P
T
h
er
ap
y
Sc
ale
th
at
is
h
ill
-
b
o
n
e.
Fo
u
r
p
o
in
ts
ar
e
awa
r
d
e
d
f
o
r
ea
ch
o
f
th
e
f
o
llo
win
g
r
esp
o
n
s
es
o
n
th
e
s
ca
le:
(
4
)
all
th
e
tim
e,
(
3
)
m
o
s
t
o
f
th
e
tim
e
,
(
2
)
s
o
m
etim
es,
an
d
(
1
)
n
ev
e
r
.
T
h
e
s
ca
le
co
n
s
is
ts
o
f
f
o
u
r
tee
n
i
tem
s
.
W
h
en
th
e
o
v
er
all
s
co
r
e
is
ad
d
ed
u
p
,
th
e
to
tal
s
co
r
e
m
ig
h
t r
an
g
e
an
y
wh
e
r
e
f
r
o
m
1
4
(
th
e
m
in
im
u
m
)
to
5
6
(
t
h
e
m
ax
im
u
m
)
wh
e
n
th
e
o
b
ject
s
ar
e
d
ee
m
ed
to
b
e
cu
m
u
lativ
e.
T
h
e
s
u
b
s
ca
le
m
a
k
in
g
ap
p
o
in
tm
e
n
ts
h
as
th
r
ee
q
u
esti
o
n
s
th
at
ev
alu
ate
ap
p
o
i
n
tm
en
ts
f
o
r
d
o
cto
r
'
s
v
is
its
an
d
p
ill r
ef
ills
,
an
d
th
e
s
u
b
s
ca
le
m
ed
icin
e
co
n
tain
s
eig
h
t item
s
th
at
m
ea
s
u
r
e
p
s
y
ch
iat
r
ic
th
er
ap
y
.
B
o
th
o
f
th
ese
s
u
b
s
ca
les
ar
e
u
s
ed
to
ev
a
lu
ate
th
e
d
ietar
y
i
n
tak
e
o
f
s
alty
f
o
o
d
s
.
T
h
e
s
o
d
iu
m
s
u
b
s
ca
le
in
clu
d
es
3
elem
en
ts
th
at
will
b
e
m
ea
s
u
r
ed
b
y
in
d
iv
id
u
als
f
r
o
m
1
4
to
5
6
.
T
h
e
s
ca
l
e
was
u
s
ed
as
a
s
elf
-
ad
m
in
is
te
r
ed
q
u
esti
o
n
n
air
e
as
well
as
an
in
ter
v
iewe
r
,
an
d
it
tak
es
ab
o
u
t
5
m
in
u
tes
to
co
m
p
lete.
An
in
cr
ea
s
e
in
th
e
C
o
m
p
lian
ce
Scale
s
co
r
e
ex
ce
ed
in
g
2
0
p
er
ce
n
t is
co
n
s
id
er
ed
ef
f
ec
tiv
e.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
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lic
Hea
lth
Sci
I
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N:
2252
-
8
8
0
6
C
r
o
s
s
-
cu
ltu
r
a
l a
d
a
p
ta
tio
n
,
va
l
id
ity,
a
n
d
r
elia
b
ilit
y
o
f th
e
I
n
d
o
n
esia
n
ve
r
s
io
n
o
f
…
(
E
l
d
a
w
a
ti E
ld
a
w
a
ti
)
1597
2
.
3
.
T
ra
ns
la
t
io
n pro
ce
s
s
A
n
u
r
s
e
s
p
ec
ialis
t
in
in
ter
n
al
i
lln
ess
es
(
Ph
.
D.
)
an
d
a
b
ilin
g
u
al
p
r
o
f
ess
io
n
al
wer
e
t
h
e
f
ir
s
t
t
o
ad
a
p
t
th
e
Hill
-
B
o
n
e
h
ig
h
b
lo
o
d
p
r
ess
u
r
e
th
er
ap
y
co
m
p
lian
ce
s
ca
le
in
to
I
n
d
o
n
esian
.
T
h
e
tr
a
n
s
latio
n
s
wer
e
ev
alu
ated
an
d
f
o
r
m
alize
d
.
W
e
d
is
co
v
e
r
ed
n
o
alter
n
ativ
e
d
ef
in
itio
n
s
.
T
h
is
tr
an
s
latio
n
was
co
m
p
leted
b
y
a
h
ea
lth
ex
p
e
r
t
an
d
lin
g
u
is
t
wh
o
s
p
ea
k
b
o
th
E
n
g
l
is
h
an
d
I
n
d
o
n
esian
.
T
h
e
s
ca
le
was
ev
alu
ated
b
y
a
n
e
x
p
er
t
in
th
e
I
n
d
o
n
esian
lan
g
u
ag
e,
a
h
ea
lth
ca
r
e
r
esear
c
h
er
,
an
d
a
n
u
r
s
in
g
s
p
ec
ialis
t in
in
ter
n
al
m
e
d
icin
e
to
ass
ess
its
s
en
ten
ce
s
tr
u
ctu
r
e
,
s
y
n
tax
,
an
d
co
n
te
x
tu
al
r
elev
a
n
ce
.
No
d
if
f
er
en
c
es
in
m
ea
n
in
g
wer
e
id
en
tifie
d
.
Af
ter
ca
r
e
f
u
l
co
n
s
id
er
atio
n
,
it
was d
ec
id
ed
th
at
n
o
ch
an
g
es we
r
e
n
ec
ess
ar
y
.
2
.
4
.
Co
nte
nt
v
a
lid
it
y
W
h
en
it
co
m
es
to
m
ea
s
u
r
in
g
an
id
ea
,
co
n
ten
t
v
alid
ity
r
ef
er
s
to
h
o
w
well
th
e
in
s
tr
u
m
en
t
f
its
th
e
b
ill.
I
n
o
r
d
er
to
i
n
cr
ea
s
e
th
e
co
n
ten
t
v
alid
ity
,
th
er
e
ar
e
two
way
s
th
at
ca
n
b
e
u
tili
ze
d
:
i)
s
u
itab
le
co
n
ce
p
tio
n
an
d
d
o
m
ai
n
ev
alu
atio
n
im
m
ed
iately
p
r
io
r
t
o
th
e
d
ev
el
o
p
m
en
t
o
f
th
e
item
s
,
an
d
ii)
ev
al
u
atio
n
o
f
th
e
n
ec
ess
ar
y
in
f
o
r
m
ati
o
n
b
y
ex
p
er
t
ev
al
u
atio
n
o
n
ce
th
e
item
s
h
av
e
b
ee
n
f
o
r
m
e
d
[
1
3
]
.
Fo
r
th
e
p
u
r
p
o
s
e
o
f
co
n
ce
p
tu
al
izin
g
d
o
m
ain
s
an
d
g
en
er
atin
g
th
i
n
g
s
,
th
e
th
eo
r
y
th
at
u
n
d
er
p
i
n
s
th
e
n
o
tio
n
w
as
u
tili
ze
d
.
A
p
an
e
l
o
f
f
iv
e
ex
p
er
ts
,
co
m
p
r
is
in
g
ca
r
d
io
v
ascu
lar
n
u
r
s
in
g
p
r
o
f
ess
io
n
als
an
d
s
cien
tific
r
esear
ch
er
s
,
was
in
v
ited
to
ass
es
s
th
e
c
o
n
ten
t
r
elev
an
ce
o
f
ea
ch
item
u
s
in
g
a
s
ca
le
f
r
o
m
o
n
e
(
i
r
r
el
eva
n
t
)
t
o
f
o
u
r
(
ve
r
y r
el
ev
ant
)
.
T
h
is
ev
alu
atio
n
was
ca
r
r
ied
o
u
t d
u
r
in
g
th
e
s
ec
o
n
d
s
tag
e
o
f
th
e
p
r
o
ce
s
s
.
Ad
d
itio
n
ally
,
it
was
r
eq
u
ested
th
at
e
x
p
er
ts
p
r
o
v
i
d
e
th
eir
f
ee
d
b
ac
k
o
n
m
atter
s
th
at
n
ee
d
r
ev
is
io
n
as
well
as
th
e
lack
o
f
in
f
o
r
m
atio
n
[
1
4
]
.
B
ef
o
r
e
we
ev
en
tu
ally
b
eg
an
c
o
n
d
u
ctin
g
p
s
y
ch
o
m
etr
ic
test
in
g
o
n
th
e
s
ca
le,
th
e
s
u
g
g
esti
o
n
s
f
o
r
m
in
o
r
ad
ju
s
tm
en
ts
th
at
wer
e
m
ad
e
b
y
th
e
ex
p
er
t
p
a
n
el
wer
e
in
co
r
p
o
r
ated
in
to
th
e
s
ca
le.
W
ith
in
th
e
r
an
g
e
o
f
0
.
8
0
to
1
.
0
0
,
th
e
co
n
ten
t
v
alid
ity
in
d
e
x
(
C
VI
)
was o
b
tain
ed
.
2
.
5
.
Co
ns
t
ruct
v
a
lid
it
y
C
o
n
f
ir
m
ato
r
y
f
ac
to
r
a
n
aly
s
is
(
C
FA)
was u
s
ed
to
ass
ess
co
n
s
tr
u
ct
v
alid
ity
,
with
ea
ch
item
e
x
p
ec
ted
t
o
h
av
e
a
f
ac
to
r
lo
ad
in
g
ab
o
v
e
0
.
4
0
.
T
h
e
C
FA w
as e
v
alu
ated
u
s
in
g
v
a
r
io
u
s
g
o
o
d
n
ess
-
of
-
f
it in
d
ices,
in
clu
d
in
g
th
e
C
hi
-
s
q
u
ar
e
test
(
X²/d
f
)
,
g
o
o
d
n
ess
-
of
-
f
it
in
d
ex
(
GFI
)
,
n
o
n
-
n
o
r
m
ed
f
it
in
d
ex
(
NNFI
)
,
s
tan
d
ar
d
ized
r
o
o
t
m
ea
n
s
q
u
ar
e
r
esid
u
al
(
SR
MR),
an
d
co
m
p
ar
ativ
e
f
it
in
d
e
x
(
C
FI)
.
Mo
d
el
f
it
was
co
n
s
id
er
ed
ac
c
ep
tab
le
if
th
e
v
alu
es
m
et
th
e
f
o
llo
win
g
cr
iter
ia:
X²/d
f
≤
2
.
0
,
GFI
≥
0
.
9
0
,
NNFI
≥
0
.
9
0
,
C
FI
≥
0
.
9
0
,
SR
MR
<
0
.
1
0
,
an
d
R
MSE
A
≤
0
.
0
8
.
I
n
ter
n
al
co
n
s
is
ten
cy
o
f
th
e
test
was m
ea
s
u
r
ed
u
s
in
g
C
r
o
n
b
ac
h
'
s
alp
h
a
co
ef
f
icien
t [
1
5
]
.
2
.
6
.
Da
t
a
c
o
llect
io
n pro
ce
du
re
B
o
th
th
e
p
atien
ts
an
d
t
h
e
eth
ic
s
co
m
m
ittee
(
0
1
1
9
/KE
PK/S
T
I
KE
P/P
PNI
/
J
A
B
AR
/VI
I
I
/2
0
2
1
)
p
r
o
v
id
ed
th
eir
wr
itten
co
n
s
en
t
f
o
r
th
e
s
tu
d
y
to
p
r
o
ce
e
d
.
A
co
n
s
id
er
atio
n
o
f
th
e
Helsin
k
i
De
clar
atio
n
was
tak
en
in
to
ac
co
u
n
t
wh
e
n
co
n
d
u
ctin
g
th
is
r
esear
ch
.
Patien
ts
u
s
ed
a
web
-
b
ased
s
u
r
v
ey
p
latf
o
r
m
ca
lled
Go
o
g
le
Fo
r
m
t
o
f
ill
o
u
t th
e
q
u
esti
o
n
n
air
es d
u
r
in
g
t
h
eir
r
o
u
tin
e
v
is
its
to
o
u
t
p
atien
t
clin
ics an
d
p
u
b
lic
h
ea
lth
ce
n
t
er
s
.
T
h
e
f
ir
s
t g
r
o
u
p
o
f
q
u
es
tio
n
s
co
m
p
r
is
ed
th
e
q
u
esti
o
n
n
air
e,
as
well
as
clin
ical
an
d
d
e
m
o
g
r
ap
h
ic
ch
ar
ac
ter
is
tics
.
th
e
q
u
esti
o
n
n
air
e
was a
ls
o
in
clu
d
ed
.
2
.
7
.
Resul
t
I
n
th
is
p
a
r
ticu
lar
s
tu
d
y
,
th
e
r
e
wer
e
a
to
tal
o
f
1
4
4
in
d
iv
id
u
als
th
at
to
o
k
p
ar
t
in
th
e
r
esear
ch
.
T
h
e
av
er
a
g
e
ag
e
o
f
th
e
p
atien
ts
was 5
5
.
6
7
y
ea
r
s
at
a
s
tan
d
ar
d
d
ev
iatio
n
o
f
1
0
.
6
5
y
ea
r
s
,
5
9
.
7
% o
f
th
e
m
wer
e
f
em
ale,
7
7
.
8
%
wer
e
m
ar
r
ied
,
an
d
4
8
.
6
%
h
ad
co
m
p
leted
s
ec
o
n
d
ar
y
e
d
u
ca
tio
n
.
T
h
er
e
was
a
m
ea
n
len
g
th
o
f
7
.
3
8
y
ea
r
s
,
with
a
s
tan
d
ar
d
d
ev
iatio
n
o
f
3
.
5
5
y
e
ar
s
.
T
h
e
n
u
m
b
er
o
f
a
n
tih
y
p
er
ten
s
iv
e
d
r
u
g
s
th
at
p
atien
ts
to
o
k
o
n
av
er
ag
e
was
3
.
1
1
1
.
5
4
,
as sh
o
wn
in
T
a
b
le
1
.
T
h
e
Kaiser
–
Me
y
er
–
Olk
in
(
K
MO
)
v
alu
e
was
0
.
9
4
5
,
wh
ic
h
in
d
icate
s
th
at
th
e
s
am
p
le
th
at
was
r
ep
r
esen
tativ
e
o
f
th
e
p
o
p
u
latio
n
was
s
u
itab
le
f
o
r
th
e
r
esear
ch
ex
p
er
im
en
t.
Giv
e
n
t
h
at
th
e
B
ar
tlett
test
p
r
o
d
u
ce
d
a
s
tatis
t
ically
s
ig
n
if
ican
t
r
esu
lt
(
X2
=
1
3
2
.
4
1
;
p
<
0
.
0
0
1
)
,
it
is
ev
id
en
t
th
at
f
ac
to
r
an
aly
s
is
wa
s
o
f
u
tm
o
s
t
im
p
o
r
tan
ce
.
Usi
n
g
f
ac
to
r
an
al
y
s
is
,
it
wa
s
d
is
co
v
er
ed
th
at
th
e
Hill
-
B
o
n
e
h
ig
h
b
lo
o
d
p
r
ess
u
r
e
th
er
ap
y
c
o
m
p
lian
ce
s
ca
le
h
ad
a
s
in
g
le
c
o
m
p
o
n
en
t
with
an
eig
en
v
alu
e
g
r
ea
ter
th
a
n
o
n
e
,
wh
ich
ex
p
lain
e
d
4
2
.
1
3
p
er
ce
n
t
o
f
th
e
to
tal
v
ar
ian
ce
as sh
o
wn
in
T
ab
le
2
.
I
n
lig
h
t
o
f
th
e
f
ac
t
th
at
th
e
v
al
u
e
o
f
KM
O
was
0
.
9
4
4
,
th
e
f
in
d
in
g
s
o
f
th
e
f
ac
to
r
an
aly
s
is
s
u
g
g
ested
th
at
th
e
s
am
p
le
s
ize
w
as
ap
p
r
o
p
r
iate
f
o
r
f
ac
to
r
an
aly
s
is
p
r
o
ce
d
u
r
e
s
.
T
h
e
r
esu
lts
o
f
th
e
B
ar
tlett te
s
t,
wh
ich
in
d
icate
d
a
s
tatis
tical
ly
s
ig
n
if
ican
t
r
esu
l
t
(
X2
=
1
2
3
9
0
.
1
2
,
p
<0
.
0
0
1
)
,
p
r
o
v
id
e
s
u
p
p
o
r
t
f
o
r
th
e
n
ec
es
s
ity
o
f
d
o
i
n
g
f
ac
to
r
an
aly
s
is
.
W
h
en
p
r
im
ar
y
co
m
p
o
n
en
t
an
aly
s
es
wer
e
p
er
f
o
r
m
e
d
,
it
was
d
is
co
v
er
ed
th
at
a
s
in
g
le
f
ac
to
r
with
its
o
wn
v
alu
e
g
r
ea
te
r
th
a
n
o
n
e
w
as
ex
tr
ac
ted
.
T
h
is
f
ac
to
r
ex
p
l
ain
ed
4
9
.
1
3
%
o
f
t
h
e
to
tal
v
ar
ian
ce
.
A
C
r
o
n
b
ac
h
alp
h
a
co
ef
f
icien
t
o
f
0
.
9
0
1
w
as
f
o
u
n
d
to
b
e
ass
o
ciate
d
w
ith
th
e
Hill
-
B
o
n
e
h
i
g
h
b
lo
o
d
p
r
ess
u
r
e
t
h
er
ap
y
co
m
p
lian
ce
s
ca
le,
as lis
ted
in
T
ab
le
3
.
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.
14
,
No
.
3
,
Sep
tem
b
er
20
25
:
1
5
9
5
-
1
6
0
0
1598
T
ab
le
1
.
So
cio
d
em
o
g
r
ap
h
ic
c
h
ar
ac
ter
is
tics
o
f
th
e
s
am
p
le
(
N
=
1
4
4
)
V
a
r
i
a
b
l
e
s
n
(
%)
A
g
e
,
y
e
a
r
s,
me
a
n
SD
5
5
.
6
7
±
1
0
.
6
5
F
e
mal
e
8
8
(
5
9
.
7
%)
M
a
l
e
5
6
(
4
0
.
3
)
M
a
r
r
i
e
d
1
1
2
(
7
7
.
8
%)
U
n
marr
i
e
d
3
2
(
2
2
.
2
%)
Ed
u
c
a
t
i
o
n
a
t
t
a
i
n
me
n
t
P
r
i
mary
sc
h
o
o
l
4
6
(
3
1
.
9
%)
S
e
c
o
n
d
a
r
y
sc
h
o
o
l
7
0
(
4
8
.
6
%)
H
i
g
h
e
r
t
h
a
n
se
c
o
n
d
a
r
y
sc
h
o
o
l
2
8
(
1
9
.
4
%)
D
u
r
a
t
i
o
n
o
f
h
y
p
e
r
t
e
n
si
o
n
,
y
e
a
r
s,
m
e
a
n
SD
7
.
3
8
±
3
.
5
5
A
n
t
i
h
y
p
e
r
t
e
n
s
i
v
e
m
e
d
i
c
a
t
i
o
n
,
m
e
a
n
SD
3
.
1
1
±
1
.
5
4
T
ab
le
2
.
C
o
n
f
i
r
m
ato
r
y
f
ac
to
r
s
an
aly
s
is
o
f
Hill
-
B
o
n
e
h
ig
h
b
lo
o
d
p
r
ess
u
r
e
th
e
r
ap
y
co
m
p
lian
c
e
s
ca
le
(
N
=
1
4
4
)
S
c
a
l
e
X
2
X
2
/
d
f
R
M
S
EA
S
R
M
R
C
F
I
N
N
F
I
G
F
I
A
d
h
e
r
e
n
c
e
3
8
.
8
6
5
1
.
9
7
4
0
.
0
7
2
0
.
0
6
5
0
.
9
2
1
0
.
9
2
5
0
.
9
2
6
T
ab
le
3
.
R
eliab
ilit
y
o
f
Hill
-
B
o
n
e
h
ig
h
b
lo
o
d
p
r
ess
u
r
e
th
e
r
ap
y
co
m
p
lian
ce
s
ca
le
S
c
a
l
e
C
r
o
n
b
a
c
h
’
s I
t
e
m
-
t
o
t
a
l
c
o
r
r
e
l
a
t
i
o
n
(
n
=
1
4
4
)
I
t
e
m
-
t
o
t
a
l
c
o
r
r
e
l
a
t
i
o
n
(
r
a
n
g
e
)
(
n
=
1
4
4
)
A
d
h
e
r
e
n
c
e
0
.
9
0
1
0
.
5
2
1
-
0
.
7
2
3
3.
DIS
CU
SS
I
O
N
T
h
e
f
in
d
in
g
s
o
f
th
is
s
tu
d
y
s
h
o
w
th
at
th
e
I
n
d
o
n
esian
v
er
s
io
n
o
f
th
e
Hill
-
B
o
n
e
h
ig
h
b
lo
o
d
p
r
ess
u
r
e
th
er
ap
y
co
m
p
lian
ce
s
ca
le
is
a
r
eliab
le
an
d
v
alid
in
s
tr
u
m
en
t
f
o
r
ass
ess
in
g
s
e
lf
-
m
an
ag
em
en
t in
in
d
iv
id
u
als
with
h
y
p
er
ten
s
io
n
.
T
h
e
s
tu
d
y
r
ev
ea
led
s
tr
o
n
g
in
ter
n
al
co
n
s
is
ten
cy
ac
r
o
s
s
its
th
r
ee
co
m
p
o
n
en
ts
,
in
d
icatin
g
th
at
th
e
I
n
d
o
n
e
s
ian
Hill
-
B
o
n
e
s
ca
le
[
1
6
]
,
[
1
7
]
is
a
tr
u
s
two
r
th
y
to
o
l
s
u
itab
le
f
o
r
u
s
e
in
b
o
th
clin
ical
p
r
ac
tice
an
d
r
esear
c
h
s
ettin
g
s
.
Ass
e
s
s
in
g
s
elf
-
ca
r
e
b
eh
av
io
r
in
clin
ical
p
r
ac
tice
is
ess
en
tial.
Nev
er
th
eles
s
,
th
e
s
itu
atio
n
ap
p
ea
r
s
in
tr
icate
b
ec
au
s
e
p
atien
ts
'
ac
co
u
n
ts
o
f
s
elf
-
ca
r
e
b
e
h
av
io
r
s
er
v
e
as th
e
s
o
le
m
et
h
o
d
f
o
r
ac
q
u
ir
in
g
in
f
o
r
m
atio
n
in
r
eg
u
lar
ly
s
ch
ed
u
led
clin
ical
p
r
ac
tice
[
1
8
]
,
[
1
9
]
.
Ho
wev
er
,
th
er
e
is
co
n
tr
o
v
er
s
y
a
r
o
u
n
d
th
e
ac
cu
r
ac
y
a
n
d
co
n
s
is
ten
cy
o
f
p
r
ec
is
io
n
an
d
ag
r
ee
m
en
t
with
o
th
er
s
o
u
r
ce
s
o
f
in
f
o
r
m
atio
n
,
n
ec
ess
itatin
g
f
u
r
th
er
e
x
am
in
atio
n
in
to
th
eir
v
e
r
ac
ity
.
T
h
e
p
r
elim
in
ar
y
v
alid
atio
n
o
f
th
e
Hill
-
B
o
n
e
h
y
p
er
ten
s
io
n
th
er
ap
y
ad
h
e
r
en
ce
m
ea
s
u
r
e
was p
er
f
o
r
m
ed
b
y
[
1
2
]
.
Acc
o
r
d
in
g
to
th
e
p
ap
er
,
th
e
m
ea
s
u
r
e
m
en
t
was
d
ee
m
ed
cr
ed
i
b
le
an
d
s
h
o
wed
a
c
o
r
r
elatio
n
with
b
lo
o
d
p
r
ess
u
r
e
m
an
ag
em
en
t
in
lo
w
-
in
co
m
e
in
d
iv
id
u
als
with
h
y
p
er
ten
s
io
n
.
Nev
e
r
th
eless
,
th
e
ec
o
n
o
m
ically
d
is
ad
v
an
tag
ed
p
atien
ts
in
clu
d
ed
in
o
u
r
s
tu
d
y
c
o
n
s
titu
te
a
s
u
b
s
tan
tial
p
r
o
p
o
r
tio
n
o
f
o
u
r
h
y
p
er
ten
s
io
n
p
atien
t
co
h
o
r
t.
Alth
o
u
g
h
th
ei
r
r
esp
o
n
s
es
ca
n
n
o
t
b
e
attr
ib
u
t
ed
to
a
lack
o
f
u
n
d
er
s
tan
d
in
g
ca
u
s
ed
b
y
r
etest
r
eliab
ilit
y
,
th
ey
ar
e
lik
el
y
ac
cu
r
ate.
I
d
e
n
t
if
y
in
g
in
d
iv
id
u
als
with
lo
w
a
d
h
er
en
ce
m
ay
b
e
m
o
r
e
ad
v
an
tag
eo
u
s
f
o
r
clin
ical
o
b
jectiv
es
th
an
f
o
c
u
s
in
g
o
n
th
o
s
e
with
well
-
m
an
ag
ed
b
lo
o
d
p
r
ess
u
r
e
[
18
]
,
[
2
0
]
.
Fu
r
th
er
m
o
r
e,
d
u
e
to
th
e
p
o
ten
tial
f
o
r
a
s
ig
n
if
ican
t
n
u
m
b
er
o
f
f
alsely
lo
w
ad
h
er
en
ce
r
ates
ca
u
s
ed
b
y
lim
ited
s
p
ec
if
icity
,
ef
f
o
r
ts
to
im
p
r
o
v
e
a
d
h
er
e
n
ce
ar
e
u
s
u
ally
n
o
t a
cc
o
m
p
an
ied
b
y
e
x
p
en
s
iv
e
o
r
r
is
k
y
ac
tio
n
s
.
T
o
en
h
an
ce
a
d
h
er
en
ce
,
r
ed
u
ce
co
s
ts
,
o
p
tim
ize
p
h
ar
m
ac
o
lo
g
i
ca
l
th
er
ap
y
,
an
d
ac
h
iev
e
ef
f
ec
tiv
e
b
lo
o
d
p
r
ess
u
r
e
m
an
ag
em
en
t,
it
is
cr
u
cial
to
r
ec
o
g
n
ize
p
atien
ts
'
d
if
f
i
cu
lties
at
an
ea
r
ly
s
tag
e
an
d
co
m
m
u
n
icate
th
em
t
o
h
ea
lth
ca
r
e
p
er
s
o
n
n
el
[
2
1
]
.
Nev
er
th
eless
,
ce
r
tain
ap
p
r
o
ac
h
es
h
av
e
u
n
d
er
g
o
n
e
th
o
r
o
u
g
h
test
in
g
to
im
p
r
o
v
e
co
m
p
lian
ce
.
I
t
is
im
p
o
r
tan
t
to
h
ig
h
lig
h
t
th
at
th
ese
in
ter
v
en
t
io
n
s
h
av
e
o
n
l
y
b
ee
n
a
p
p
lied
t
o
th
e
ad
h
e
r
en
ce
o
f
p
r
escr
ib
ed
m
ed
icatio
n
s
f
o
r
b
l
o
o
d
p
r
ess
u
r
e
m
a
n
ag
em
en
t
[
2
2
]
,
[
2
3
]
.
Su
b
s
eq
u
en
t
s
tu
d
ies
s
h
o
u
ld
in
v
esti
g
ate
th
e
p
o
s
s
ib
le
ad
v
an
ta
g
es
o
f
tailo
r
in
g
in
ter
v
en
tio
n
s
to
s
p
ec
if
ic
p
atien
ts
,
th
e
co
r
r
elatio
n
b
et
wee
n
ad
h
e
r
en
ce
to
im
p
lem
en
tatio
n
a
n
d
l
o
n
g
-
te
r
m
o
u
tco
m
es,
an
d
p
atien
t p
r
ef
er
e
n
ce
s
f
o
r
h
o
w
i
n
ter
v
en
tio
n
s
ar
e
d
eliv
er
ed
(
s
u
ch
as
in
-
p
er
s
o
n
v
e
r
s
u
s
tech
n
o
lo
g
y
-
m
ed
iated
)
.
T
h
e
in
ter
v
en
tio
n
s
wer
e
s
u
b
s
tan
ti
ated
b
y
W
ad
e
[
24
]
.
T
h
e
lack
o
f
ad
h
er
en
ce
to
m
ed
ical
tr
ea
tm
en
ts
h
as su
b
s
tan
tial
ec
o
n
o
m
ic
im
p
licatio
n
s
.
I
t
d
im
in
is
h
es
th
e
co
s
t
-
ef
f
ec
tiv
en
ess
o
f
th
er
ap
ies,
lead
in
g
to
less
-
th
an
-
o
p
tim
al
clin
ical
r
esu
lts
an
d
h
ig
h
er
p
u
b
lic
h
ea
lth
ex
p
en
d
itu
r
es.
R
eg
r
ettab
ly
,
clin
i
cian
s
o
f
ten
f
ail
to
g
iv
e
s
u
f
f
icien
t
atten
tio
n
to
a
n
d
u
n
d
er
esti
m
ate
th
e
is
s
u
e
o
f
p
o
o
r
ad
h
er
en
ce
,
as
it
is
ch
allen
g
in
g
t
o
o
b
jectiv
ely
d
e
m
o
n
s
tr
ate
o
r
e
x
clu
d
e.
T
h
is
s
tu
d
y
h
ad
s
ev
er
al
c
o
n
s
tr
ain
ts
.
I
n
itially
,
ce
r
tain
p
s
y
c
h
o
m
etr
ic
f
ea
tu
r
es,
s
u
c
h
as
d
i
s
cr
im
in
an
t
v
alid
ity
,
wer
e
n
o
t
ex
a
m
in
ed
.
Fu
r
th
er
m
o
r
e
,
th
e
r
estricte
d
g
e
n
er
aliza
b
ilit
y
o
f
o
u
r
f
in
d
in
g
s
m
ay
b
e
attr
i
b
u
ted
t
o
th
e
f
ac
t
th
at
th
e
s
am
p
le
was
tak
en
o
n
l
y
f
r
o
m
a
s
in
g
le
in
s
titu
tio
n
.
Fu
r
th
e
r
m
o
r
e,
t
h
e
m
ajo
r
ity
o
f
p
atien
ts
h
ad
a
lim
ited
ed
u
ca
tio
n
al
b
ac
k
g
r
o
u
n
d
.
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
C
r
o
s
s
-
cu
ltu
r
a
l a
d
a
p
ta
tio
n
,
va
l
id
ity,
a
n
d
r
elia
b
ilit
y
o
f th
e
I
n
d
o
n
esia
n
ve
r
s
io
n
o
f
…
(
E
l
d
a
w
a
ti E
ld
a
w
a
ti
)
1599
4.
CO
NCLU
SI
O
N
T
h
e
Hill
-
B
o
n
e
h
i
g
h
b
lo
o
d
p
r
ess
u
r
e
th
er
ap
y
co
m
p
lian
ce
s
c
ale
h
as
b
ee
n
ef
f
ec
tiv
ely
tr
a
n
s
lated
an
d
cu
s
to
m
ized
to
m
ee
t
th
e
n
ee
d
s
o
f
th
e
I
n
d
o
n
esian
p
o
p
u
latio
n
i
n
ter
m
s
o
f
cr
o
s
s
-
cu
ltu
r
al
ad
ap
t
atio
n
.
I
t
is
p
o
s
s
ib
le
th
at
th
e
Hill
-
B
o
n
e
h
ig
h
b
lo
o
d
p
r
ess
u
r
e
th
er
ap
y
c
o
m
p
lian
ce
s
ca
le
co
u
ld
b
e
o
f
ass
is
tan
ce
in
g
iv
in
g
an
ac
c
u
r
ate
f
o
r
ec
ast
r
eg
ar
d
in
g
th
e
in
f
lu
en
c
e
th
at
th
is
in
ter
v
en
tio
n
wo
u
ld
h
av
e
o
n
th
e
p
atien
ts
'
ad
h
er
en
c
e
to
th
eir
tr
ea
tm
en
t.
Fo
r
th
e
p
u
r
p
o
s
e
o
f
d
eter
m
i
n
in
g
wh
eth
er
o
r
n
o
t
p
atien
ts
f
o
llo
w
to
th
eir
tr
ea
tm
en
t
r
e
g
im
en
s
,
th
e
Hill
-
B
o
n
e
h
i
g
h
b
lo
o
d
p
r
ess
u
r
e
th
er
ap
y
c
o
m
p
l
ian
ce
s
ca
le
ca
n
b
e
ad
m
in
is
ter
ed
in
I
n
d
o
n
esian
b
y
m
ed
ical
p
r
o
f
ess
io
n
als.
T
h
is
s
ca
le
ca
n
b
e
u
tili
ze
d
in
a
r
an
g
e
o
f
s
ettin
g
s
,
s
u
ch
as
h
o
s
p
it
als,
n
u
r
s
in
g
h
o
m
es,
h
o
m
e
ca
r
e,
an
d
p
u
b
lic
h
ea
lth
cen
ter
s
.
Fu
r
th
er
s
tu
d
ies
ar
e
r
ec
o
m
m
en
d
e
d
to
ev
alu
ate
th
e
H
ill
-
B
o
n
e
h
ig
h
b
lo
o
d
p
r
ess
u
r
e
th
er
ap
y
co
m
p
lian
ce
s
ca
le
am
o
n
g
h
y
p
er
ten
s
iv
e
p
a
tien
t
g
r
o
u
p
s
f
r
o
m
d
iv
er
s
e
eth
n
ic
b
ac
k
g
r
o
u
n
d
s
an
d
with
d
i
f
f
er
en
t
ed
u
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tio
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al
lev
els.
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n
ad
d
itio
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,
f
u
t
u
r
e
r
ese
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ch
s
h
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co
n
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ass
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in
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th
e
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.
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DG
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th
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d
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an
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UNDING
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was su
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s
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.
RE
F
E
R
E
NC
E
S
[
1
]
D
.
La
c
k
l
a
n
d
,
“
N
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f
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p
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,
p
p
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1
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0
1
9
.
[
2
]
S
.
O
p
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t
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l
.
,
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H
y
p
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,
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a
t
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re
Re
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0
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4
.
[
3
]
T.
U
n
g
e
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t
a
l
.
,
“
2
0
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0
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n
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y
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1
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1
5
0
2
6
.
[
4
]
B
.
R
i
e
g
e
l
,
V
.
V
.
D
i
c
k
s
o
n
,
a
n
d
K
.
M
.
F
a
u
l
k
n
e
r
,
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h
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-
sp
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p
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t
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,
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o
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.
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4
4
.
[
5
]
K
.
S
.
D
o
r
a
n
s,
K
.
T.
M
i
l
l
s,
Y
.
Li
u
,
a
n
d
J.
H
e
,
“
Tr
e
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d
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p
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mer
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mer
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a
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a
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sso
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i
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t
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n
(
A
C
C
/
A
H
A
)
gu
i
d
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l
i
n
e
,
”
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o
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a
l
o
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Am
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/
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H
A
.
1
1
8
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0
0
8
8
8
8
.
[
6
]
K
.
P
e
l
t
z
e
r
a
n
d
S
.
P
e
n
g
p
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d
,
“
T
h
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p
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v
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e
n
c
e
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s
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si
o
n
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mo
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A
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0
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1
1
5
5
/
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0
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8
/
5
6
1
0
7
2
5
.
[
7
]
T.
M
.
A
b
e
g
a
z
,
A
.
S
h
e
h
a
b
,
E
.
A
.
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e
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A
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d
A
.
A
.
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n
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r
,
“
N
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Me
d
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,
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,
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.
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5
6
4
1
.
[
8
]
S
.
M
a
h
m
o
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d
,
Z
.
J
a
l
a
l
,
M
.
A
.
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,
T.
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.
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,
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.
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h
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h
,
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A
si
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:
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me
t
a
-
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n
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l
y
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s,
”
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n
t
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t
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o
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[
9
]
N
.
B
.
C
o
r
r
ê
a
e
t
a
l
.
,
“
A
p
r
a
c
t
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c
a
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a
p
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c
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f
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su
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a
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t
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a
d
h
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n
c
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n
p
a
t
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n
t
s
w
i
t
h
r
e
s
i
st
a
n
t
h
y
p
e
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t
e
n
si
o
n
,
”
J
o
u
rn
a
l
o
f
t
h
e
Am
e
ri
c
a
n
S
o
c
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y
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,
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.
j
a
sh
.
2
0
1
6
.
0
3
.
1
9
4
.
[
1
0
]
J.
W
a
r
r
e
n
‐
F
i
n
d
l
o
w
,
D
.
W
.
B
a
sal
i
k
,
M
.
D
u
l
i
n
,
H
.
T
a
p
p
,
a
n
d
L
.
K
u
h
n
,
“
P
r
e
l
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mi
n
a
r
y
v
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l
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a
t
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o
n
o
f
t
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y
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si
o
n
sel
f
‐
c
a
r
e
a
c
t
i
v
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t
y
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v
e
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e
f
f
e
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t
s
(
H
‐
S
C
A
LE)
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n
d
c
l
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p
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t
s
w
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si
o
n
,
”
T
h
e
J
o
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n
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l
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f
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n
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c
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l
H
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,
v
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1
5
,
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o
.
9
,
p
p
.
6
3
7
–
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3
,
S
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p
.
2
0
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,
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:
1
0
.
1
1
1
1
/
j
c
h
.
1
2
1
5
7
.
[
1
1
]
T.
S
p
i
k
e
s,
M
.
H
i
g
g
i
n
s,
A
.
Q
u
y
y
u
mi
,
C
.
R
e
i
l
l
y
,
P
.
P
e
mu
,
a
n
d
S
.
D
u
n
b
a
r
,
“
T
h
e
r
e
l
a
t
i
o
n
s
h
i
p
a
m
o
n
g
h
e
a
l
t
h
b
e
l
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e
f
s
,
d
e
p
r
e
ssi
v
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sy
m
p
t
o
ms,
m
e
d
i
c
a
t
i
o
n
a
d
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e
n
c
e
,
a
n
d
so
c
i
a
l
s
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p
p
o
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t
i
n
A
f
r
i
c
a
n
A
mer
i
c
a
n
s
w
i
t
h
h
y
p
e
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t
e
n
s
i
o
n
,
”
J
o
u
rn
a
l
o
f
C
a
rd
i
o
v
a
s
c
u
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r
N
u
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n
g
,
v
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.
3
4
,
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o
.
1
,
p
p
.
4
4
–
5
1
,
Ja
n
.
2
0
1
9
,
d
o
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:
1
0
.
1
0
9
7
/
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N
.
0
0
0
0
0
0
0
0
0
0
0
0
0
5
1
9
.
[
1
2
]
Y
.
C
o
mm
o
d
o
r
e
-
M
e
n
sa
h
e
t
a
l
.
,
“
A
s
y
st
e
ma
t
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v
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e
w
o
f
t
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e
H
i
l
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-
B
o
n
e
c
o
mp
l
i
a
n
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e
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o
b
l
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o
d
p
r
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ss
u
r
e
t
h
e
r
a
p
y
sca
l
e
,
”
P
a
t
i
e
n
t
Pre
f
e
re
n
c
e
a
n
d
A
d
h
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n
c
e
,
v
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l
.
V
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l
u
me
1
7
,
p
p
.
2
4
0
1
–
2
4
2
0
,
S
e
p
.
2
0
2
3
,
d
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:
1
0
.
2
1
4
7
/
P
P
A
.
S
4
1
2
1
9
8
.
[
1
3
]
J.
W
.
O
sb
o
r
n
e
a
n
d
A
.
B
.
C
o
st
e
l
l
o
,
“
S
a
mp
l
e
s
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z
e
a
n
d
s
u
b
j
e
c
t
t
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m rat
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p
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l
c
o
m
p
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n
e
n
t
s a
n
a
l
y
s
i
s,
”
Pr
a
c
t
i
c
a
l
Assessm
e
n
t
,
Re
se
a
rc
h
a
n
d
Ev
a
l
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ld
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s
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e
c
a
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b
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c
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tac
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:
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ri
d
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h
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m
s
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e
d
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.
m
y
.
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y
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a
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m
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p
ro
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ss
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a
l
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c
a
re
re
p
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n
tativ
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;
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h
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st
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tr
it
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c
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ti
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y
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sta
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.
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u
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tl
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se
rv
e
a
s
fa
c
u
lt
y
m
e
m
b
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rs
a
t
Li
n
c
o
ln
Un
i
v
e
rsity
Co
ll
e
g
e
,
M
a
lay
sia
.
Sh
e
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
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:
sy
a
z
a
n
a
@lin
c
o
ln
.
e
d
u
.
m
y
.
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