I
nte
rna
t
io
na
l J
o
urna
l o
f
P
u
bli
c
H
ea
lt
h Science
(
I
J
P
H
S)
Vo
l.
15
,
No
.
3
,
Sep
tem
b
er
20
26
,
p
p
.
8
3
1
~
8
3
8
I
SS
N:
2
2
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.
v
15
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J
o
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:
h
ttp
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//
ijp
h
s
.
ia
esco
r
e.
co
m
Ca
mpus
lif
e
ada
ptatio
n and
die
tary
patter
ns a
mo
ng
f
irst
-
y
ea
r
hea
lth
scien
ce st
u
dents in
Indo
nesi
a
:
a
cros
s
-
section
a
l study
Ruk
m
o
y
o
E
nd
ra
wa
n,
Da
nin
g
Widi
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s
t
ia
nti
N
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D
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p
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e
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d
o
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Art
icle
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nfo
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RAC
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ticle
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to
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Ad
a
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o
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a
c
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g
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n
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ts
a
n
d
m
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y
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flu
e
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c
e
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e
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lt
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re
late
d
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e
h
a
v
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rs,
i
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lu
d
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p
a
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tern
s.
A
p
re
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a
ry
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y
in
v
o
l
v
in
g
fi
v
e
first
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y
e
a
r
stu
d
e
n
ts
s
h
o
we
d
th
a
t
th
e
y
e
x
p
e
rien
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e
d
d
iff
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lt
ies
m
a
n
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g
in
g
th
e
ir
d
ieta
ry
p
a
tt
e
rn
s
d
u
ri
n
g
t
h
e
ir
first
se
m
e
ste
r.
Ho
we
v
e
r,
e
v
id
e
n
c
e
re
g
a
rd
in
g
th
e
re
lati
o
n
s
h
ip
b
e
twe
e
n
a
d
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p
tatio
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to
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a
m
p
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p
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tt
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a
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o
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g
first
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y
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r
h
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lt
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d
e
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ts
i
n
In
d
o
n
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sia
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m
a
in
s li
m
it
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d
.
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is stu
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y
e
m
p
lo
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l
d
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d
3
6
re
sp
o
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e
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ts.
Da
ta
we
re
c
o
ll
e
c
ted
u
si
n
g
t
h
e
S
t
u
d
e
n
t
Ad
a
p
tatio
n
t
o
Co
ll
e
g
e
Qu
e
sti
o
n
n
a
ire
(S
AC
Q)
a
n
d
th
e
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o
les
c
e
n
t
F
o
o
d
Ha
b
it
s
Ch
e
c
k
li
st
(AFHC)
a
n
d
we
re
a
n
a
ly
z
e
d
u
sin
g
S
p
e
a
rm
a
n
’s
rh
o
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o
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lati
o
n
tes
t.
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re
sp
o
n
d
e
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ts
we
re
fe
m
a
le
(8
1
%
),
a
n
d
6
9
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re
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t
h
e
a
d
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les
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e
n
t
a
g
e
g
ro
u
p
.
T
h
e
m
a
jo
rit
y
o
f
re
sp
o
n
d
e
n
ts
d
e
m
o
n
stra
ted
a
m
o
d
e
ra
te
lev
e
l
o
f
a
d
a
p
tati
o
n
to
c
a
m
p
u
s
li
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(
9
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%
)
a
n
d
re
p
o
rted
h
e
a
lt
h
y
d
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ry
p
a
tt
e
rn
s
(9
2
%
).
A
sig
n
ifi
c
a
n
t
p
o
si
ti
v
e
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o
rre
latio
n
wa
s fo
u
n
d
b
e
twe
e
n
a
d
a
p
tatio
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to
c
a
m
p
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s li
fe
a
n
d
d
ieta
ry
p
a
t
tern
s (p
<
0
.
0
0
1
,
r
=
0
.
7
3
4
),
in
d
ica
ti
n
g
th
a
t
st
u
d
e
n
t
s
with
h
i
g
h
e
r
lev
e
ls
o
f
a
d
a
p
tatio
n
ten
d
e
d
t
o
h
a
v
e
h
e
a
lt
h
ier
d
ieta
ry
p
a
tt
e
rn
s.
Th
e
se
fin
d
i
n
g
s
su
g
g
e
st
th
a
t
i
n
stit
u
t
io
n
s
sh
o
u
l
d
p
ro
v
i
d
e
c
a
m
p
u
s
-
b
a
se
d
h
e
a
lt
h
p
r
o
m
o
ti
o
n
p
r
o
g
ra
m
s,
i
n
c
lu
d
i
n
g
st
u
d
e
n
t
se
rv
ice
s,
c
o
u
n
se
li
n
g
,
stre
ss
m
a
n
a
g
e
m
e
n
t
p
ro
g
ra
m
s,
a
n
d
d
ieta
ry
e
d
u
c
a
ti
o
n
.
K
ey
w
o
r
d
s
:
Ad
ap
tatio
n
ab
ilit
y
Dietar
y
p
atter
n
Gastritis
Hab
it
Nu
r
s
in
g
s
tu
d
en
t
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
:
Dan
in
g
W
id
i I
s
tian
ti
Nu
r
s
in
g
Dep
ar
tm
en
t,
B
eth
esd
a
Yak
k
u
m
Nu
r
s
in
g
Hea
lth
Scien
ce
Yo
g
y
ak
ar
ta,
I
n
d
o
n
esia
E
m
ail:
d
an
in
g
@
s
tik
esb
eth
esd
a.
ac
.
id
1.
I
NT
RO
D
UCT
I
O
N
Ad
ap
tin
g
to
ca
m
p
u
s
life
is
a
n
im
p
o
r
tan
t
p
r
o
ce
s
s
th
at
ev
er
y
in
d
iv
id
u
al
u
n
d
e
r
g
o
es
wh
e
n
en
ter
in
g
h
ig
h
er
ed
u
ca
tio
n
.
Sev
er
al
r
e
ce
n
t
s
tu
d
ies
h
av
e
s
h
o
wn
th
at
th
e
tr
an
s
itio
n
f
r
o
m
th
e
s
ch
o
o
l
en
v
ir
o
n
m
en
t
to
u
n
iv
er
s
ity
r
eq
u
ir
es
s
tu
d
en
ts
to
ad
ap
t
to
a
d
if
f
e
r
en
t
lear
n
i
n
g
s
y
s
tem
,
a
b
u
s
ier
s
ch
ed
u
le,
an
d
m
o
r
e
c
o
m
p
lex
ac
ad
em
ic
d
em
a
n
d
s
,
lead
in
g
to
in
cr
ea
s
ed
s
tr
ess
,
p
h
y
s
ical
f
ati
g
u
e,
an
d
d
i
f
f
icu
lty
m
a
n
ag
in
g
s
tu
d
y
tim
e
[
1
]
,
[
2
]
,
[
3
]
.
T
h
is
p
h
ase
is
an
im
p
o
r
tan
t
m
iles
to
n
e
f
o
r
n
ew
s
tu
d
en
ts
.
T
h
is
p
er
io
d
o
f
ch
a
n
g
e
ca
n
b
e
q
u
ite
ch
al
len
g
in
g
f
o
r
s
tu
d
en
ts
,
as
en
ter
in
g
h
ig
h
e
r
ed
u
ca
tio
n
is
n
o
t
o
n
l
y
ab
o
u
t
g
ai
n
in
g
k
n
o
wled
g
e
an
d
o
b
tain
i
n
g
a
d
eg
r
ee
.
Aca
d
em
i
c
an
d
p
er
s
o
n
al
life
n
ee
d
to
b
e
m
an
ag
ed
in
a
b
alan
ce
d
m
an
n
er
.
I
n
ter
ac
tio
n
with
p
ee
r
s
an
d
lectu
r
er
s
o
n
ca
m
p
u
s
is
also
an
im
p
o
r
tan
t
asp
ec
t
th
at
c
an
h
elp
s
tu
d
e
n
ts
ad
ju
s
t
s
o
cially
an
d
ac
ad
em
ically
[
4
]
,
[
5
]
.
So
cial
in
ter
ac
tio
n
s
at
u
n
iv
er
s
ity
ar
e
also
m
o
r
e
d
i
v
er
s
e
th
an
th
o
s
e
i
n
h
i
g
h
s
ch
o
o
l.
Mig
r
an
t
s
tu
d
en
ts
wh
o
liv
e
f
ar
f
r
o
m
th
eir
p
ar
en
ts
also
n
ee
d
to
ad
ap
t
t
o
th
e
l
o
c
al
cu
ltu
r
e
an
d
s
o
cial
en
v
ir
o
n
m
e
n
t
[
6
]
.
A
g
o
o
d
ad
ap
tatio
n
p
r
o
ce
s
s
ca
n
s
u
p
p
o
r
t
s
tu
d
en
ts
'
p
s
y
ch
o
lo
g
ical
well
-
b
ein
g
an
d
en
h
a
n
ce
th
eir
ac
a
d
e
m
ic
ac
h
iev
em
en
t
[
7
]
,
[
8
]
.
T
h
e
ab
ilit
y
to
ad
a
p
t
to
ca
m
p
u
s
life
p
lay
s
an
in
d
ir
ec
t
b
u
t
s
ig
n
if
ican
t
r
o
le
in
life
s
ty
le
ch
an
g
es.
T
h
e
p
r
esen
ce
o
f
class
s
ch
ed
u
l
es,
d
em
an
d
in
g
ac
ad
em
ic
wo
r
k
lo
ad
s
,
an
d
in
v
o
lv
em
en
t
in
o
r
g
a
n
iz
atio
n
s
o
f
ten
ca
u
s
e
s
tu
d
en
ts
to
s
k
ip
b
r
ea
k
f
ast
a
n
d
/o
r
o
th
e
r
m
ea
ls
a
n
d
ch
o
o
s
e
co
n
v
e
n
ien
ce
f
o
o
d
s
with
o
u
t
co
n
s
id
er
in
g
th
e
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.
15
,
No
.
3
,
Sep
tem
b
er
20
26
:
8
3
1
-
838
832
n
u
tr
itio
n
al
r
eq
u
ir
e
m
en
ts
ap
p
r
o
p
r
iate
f
o
r
th
eir
ag
e
[
9
]
.
Pre
v
io
u
s
r
esear
ch
h
as
s
u
g
g
ested
t
h
at
th
e
lim
ited
tim
e
av
ailab
le
to
m
ee
t
ac
ad
em
ic
r
eq
u
ir
em
en
ts
d
u
r
i
n
g
th
e
ad
ap
t
atio
n
to
ca
m
p
u
s
life
h
in
d
er
s
th
e
ad
o
p
tio
n
o
f
a
h
ea
lth
y
life
s
ty
le
[
1
0
]
.
I
f
th
ese
u
n
h
ea
lth
y
b
eh
a
v
io
r
s
p
er
s
is
t,
th
ey
m
a
y
lea
d
to
an
in
cr
ea
s
ed
r
is
k
o
f
o
b
esit
y
an
d
non
-
c
o
m
m
u
n
icab
le
d
is
ea
s
es
s
u
ch
as
h
y
p
er
te
n
s
io
n
an
d
d
iab
etes,
as
well
a
s
o
th
er
h
ea
lth
co
n
d
itio
n
s
,
in
clu
d
in
g
g
astritis
[
1
1
]
,
[
1
2
]
.
An
o
th
er
s
tu
d
y
h
as
f
o
u
n
d
ev
id
en
ce
o
f
th
e
tr
ip
le
b
u
r
d
en
o
f
m
al
n
u
tr
itio
n
,
in
cl
u
d
in
g
u
n
d
er
n
u
tr
itio
n
,
o
v
er
n
u
tr
itio
n
,
an
d
an
em
ia.
Mig
r
an
t
s
tu
d
en
ts
m
ay
also
ex
p
er
ien
ce
d
ietar
y
a
cc
u
ltu
r
atio
n
,
wh
ich
r
eq
u
ir
es
ad
ju
s
tm
en
ts
to
f
o
o
d
ch
o
ices
an
d
tast
e
p
r
ef
er
e
n
ce
s
in
th
eir
n
ew
en
v
i
r
o
n
m
e
n
t
[
1
3
]
.
T
h
e
u
n
h
ea
lth
y
ea
tin
g
p
atter
n
s
o
b
s
er
v
ed
d
u
r
i
n
g
th
is
p
er
io
d
m
ay
s
tem
f
r
o
m
d
ietar
y
h
ab
its
estab
lis
h
ed
d
u
r
in
g
c
h
ild
h
o
o
d
an
d
ea
r
ly
ad
o
lescen
ce
.
Glo
b
ally
,
ad
u
lts
ar
e
ad
v
is
ed
to
co
n
s
u
m
e
n
u
tr
ie
n
t
-
d
en
s
e
f
o
o
d
s
an
d
b
ev
er
ag
es
th
at
p
r
o
v
id
e
ess
en
tial
n
u
tr
ien
ts
,
in
clu
d
in
g
v
itam
in
s
an
d
m
in
er
als,
wh
ile
m
in
im
izi
n
g
ad
d
e
d
s
u
g
ar
s
,
s
atu
r
ated
f
at
s
,
an
d
s
o
d
iu
m
[
1
4
]
.
M
e
a
n
w
h
i
l
e
,
i
n
I
n
d
o
n
e
s
i
a
,
d
i
et
ar
y
p
r
a
c
t
i
c
e
s
a
r
e
g
u
i
d
e
d
b
y
t
h
e
B
a
l
a
n
ce
d
N
u
t
r
i
ti
o
n
G
u
i
d
e
li
n
e
s
,
w
h
i
c
h
r
e
c
o
m
m
e
n
d
c
o
n
s
u
m
i
n
g
a
v
a
r
i
e
t
y
o
f
f
o
o
d
s
i
n
b
a
l
a
n
c
e
d
p
o
r
t
i
o
n
s
,
i
n
a
d
e
q
u
a
t
e
a
m
o
u
n
t
s
,
a
n
d
o
n
a
r
e
g
u
l
a
r
b
a
s
is
[
1
5
]
.
Un
m
et
n
u
tr
itio
n
al
n
ee
d
s
ca
n
im
p
air
a
d
o
lescen
t
g
r
o
wth
an
d
d
ev
elo
p
m
en
t.
T
h
e
p
r
ev
alen
ce
o
f
g
astr
itis
am
o
n
g
n
u
r
s
in
g
s
tu
d
en
ts
was
n
o
tab
ly
h
ig
h
an
d
was
p
r
im
ar
ily
ass
o
ciate
d
with
s
tr
ess
an
d
d
ietar
y
b
e
h
av
io
r
s
[
1
6
]
.
Acc
o
r
d
in
g
to
th
e
2
0
1
8
B
asic
Hea
lth
R
esear
ch
d
ata
f
o
r
th
e
Sp
ec
ial
R
eg
io
n
o
f
Yo
g
y
ak
ar
ta,
9
.
0
7
%
o
f
in
d
i
v
id
u
als
ag
ed
1
5
–
1
9
y
ea
r
s
an
d
5
.
6
1
%
o
f
th
o
s
e
ag
e
d
2
0
–
2
4
y
ea
r
s
r
ep
o
r
ted
n
o
t
c
o
n
s
u
m
in
g
v
eg
etab
les
o
n
a
d
aily
b
asis
d
u
r
in
g
a
o
n
e
-
wee
k
p
er
io
d
[
1
7
]
.
T
h
ese
f
ig
u
r
es
in
d
icate
a
n
in
c
r
ea
s
e
in
u
n
h
ea
lt
h
y
d
ietar
y
p
atter
n
s
o
f
n
o
t
co
n
s
u
m
in
g
v
eg
etab
les
am
o
n
g
th
e
1
5
-
1
9
a
n
d
2
0
-
2
4
ag
e
g
r
o
u
p
s
.
T
h
is
ag
e
g
r
o
u
p
f
alls
in
to
th
e
ca
teg
o
r
y
o
f
late
ad
o
lescen
ce
an
d
ea
r
ly
ad
u
lth
o
o
d
,
wh
ich
in
clu
d
es
u
n
iv
er
s
ity
s
tu
d
e
n
ts
,
p
ar
ticu
lar
ly
f
ir
s
t
-
y
ea
r
s
tu
d
en
ts
,
w
h
o
ar
e
th
e
f
o
cu
s
o
f
th
is
s
tu
d
y
.
T
h
es
e
f
i
n
d
in
g
s
s
u
g
g
est
th
at
u
n
i
v
er
s
ity
s
tu
d
en
ts
m
ay
also
b
e
at
r
is
k
o
f
u
n
h
ea
l
th
y
ea
tin
g
p
atter
n
s
,
in
clu
d
in
g
lo
w
v
eg
etab
le
co
n
s
u
m
p
tio
n
.
T
h
e
r
ef
o
r
e,
it
is
im
p
o
r
tan
t
to
ex
am
in
e
th
e
d
ietar
y
p
atter
n
s
o
f
s
tu
d
en
ts
,
p
ar
ticu
lar
ly
th
o
s
e
at
B
eth
esd
a
Yak
k
u
m
Sch
o
o
l o
f
Hea
lt
h
Scien
ce
s
.
W
e
co
n
d
u
cted
in
ter
v
iews
wi
th
f
iv
e
f
ir
s
t
-
y
ea
r
s
tu
d
en
ts
s
tu
d
y
in
g
at
B
eth
esd
a
Yak
k
u
m
Sch
o
o
l
o
f
Hea
lth
Scien
ce
s
to
id
en
tify
th
e
ch
allen
g
es
th
ey
f
ac
ed
d
u
r
in
g
th
eir
tr
an
s
itio
n
t
o
u
n
i
v
er
s
ity
life
.
T
h
e
in
ter
v
iew
r
esu
lts
in
d
icate
d
th
at
all
r
es
p
o
n
d
e
n
ts
e
x
p
e
r
ien
ce
d
d
if
f
ic
u
lties
ad
ap
tin
g
at
th
e
b
eg
in
n
i
n
g
o
f
t
h
eir
s
tu
d
ies,
p
ar
ticu
lar
ly
in
m
an
a
g
in
g
th
eir
d
ietar
y
h
ab
its
.
T
h
eir
ea
tin
g
p
atter
n
s
b
ec
am
e
ir
r
eg
u
lar
d
u
e
to
ac
ad
em
ic
d
em
an
d
s
an
d
ass
ig
n
m
en
ts
,
ca
u
s
in
g
t
h
eir
m
ea
l
f
r
eq
u
en
cy
to
d
ec
r
e
ase
f
r
o
m
th
r
ee
m
ea
ls
p
er
d
a
y
to
o
n
e
to
th
r
ee
m
ea
ls
p
e
r
d
ay
.
T
im
e
c
o
n
s
tr
ain
ts
an
d
th
e
n
ee
d
to
p
r
e
p
ar
e
m
ea
ls
in
d
e
p
e
n
d
en
tly
led
s
tu
d
en
ts
to
ch
o
o
s
e
co
n
v
en
ien
t
f
o
o
d
s
.
T
h
ey
also
r
ep
o
r
ted
in
c
r
ea
s
ed
s
tr
ess
lev
els d
u
e
to
a
h
ea
v
y
ac
a
d
em
ic
wo
r
k
lo
a
d
.
B
ased
o
n
th
e
s
e
f
in
d
in
g
s
,
f
u
r
th
e
r
r
esear
ch
is
n
ee
d
ed
to
ex
am
in
e
th
e
r
elatio
n
s
h
ip
b
etwe
en
ad
ap
tatio
n
to
ca
m
p
u
s
life
an
d
th
e
ea
tin
g
p
atter
n
s
o
f
f
ir
s
t
-
y
ea
r
s
tu
d
en
ts
at
B
eth
esd
a
Yak
k
u
m
Sch
o
o
l o
f
Hea
lth
Scien
ce
s
.
2.
M
E
T
H
O
D
2
.
1
.
Study
des
ig
n
T
h
is
s
tu
d
y
em
p
lo
y
ed
a
q
u
an
t
itativ
e
co
r
r
elatio
n
al
d
esig
n
an
d
u
s
ed
a
cr
o
s
s
-
s
ec
tio
n
al
ap
p
r
o
ac
h
.
T
h
e
o
b
jectiv
e
o
f
t
h
is
s
tu
d
y
was
to
d
eter
m
in
e
th
e
r
elatio
n
s
h
ip
b
e
twee
n
ad
ap
tatio
n
to
ca
m
p
u
s
l
if
e
an
d
th
e
d
ietar
y
p
atter
n
s
o
f
f
ir
s
t
-
y
ea
r
s
tu
d
e
n
ts
at
B
eth
esd
a
Yak
k
u
m
Sch
o
o
l
o
f
Hea
lth
Scien
ce
s
.
T
h
e
in
s
tr
u
m
en
ts
u
s
ed
in
th
is
s
tu
d
y
wer
e
th
e
Stu
d
en
t
Ad
ap
tatio
n
to
C
o
lleg
e
Qu
esti
o
n
n
air
e
(
SAC
Q)
an
d
th
e
Ad
o
le
s
ce
n
t
Fo
o
d
Hab
its
C
h
ec
k
lis
t (
AFH
C
)
.
2
.
2
.
Study
po
pu
la
t
io
n a
nd
s
a
m
pli
ng
pro
ce
du
re
T
h
e
s
tu
d
y
p
o
p
u
latio
n
c
o
n
s
is
ted
o
f
1
2
0
f
ir
s
t
-
y
ea
r
s
tu
d
e
n
ts
en
r
o
lled
in
th
e
B
ac
h
elo
r
o
f
Nu
r
s
in
g
(
R
eg
u
l
ar
)
,
Dip
lo
m
a
i
n
Nu
r
s
i
n
g
,
an
d
B
ac
h
elo
r
o
f
Ph
y
s
io
th
er
ap
y
p
r
o
g
r
am
s
at
B
eth
esd
a
Yak
k
u
m
Sch
o
o
l
o
f
Hea
lth
Scien
ce
s
.
T
h
is
s
tu
d
y
u
s
ed
p
u
r
p
o
s
iv
e
s
am
p
lin
g
b
ased
o
n
p
r
ed
ef
i
n
ed
in
clu
s
io
n
an
d
ex
clu
s
io
n
cr
iter
ia.
T
h
e
in
clu
s
io
n
cr
iter
ia
wer
e:
i
)
ac
tiv
ely
en
r
o
lled
s
tu
d
en
t
s
;
ii
)
f
ir
s
t
-
y
ea
r
s
tu
d
en
ts
in
th
e
B
ac
h
elo
r
o
f
Nu
r
s
in
g
(
R
eg
u
lar
)
,
Dip
lo
m
a
in
Nu
r
s
in
g
,
o
r
B
ac
h
elo
r
o
f
Ph
y
s
io
th
er
a
p
y
p
r
o
g
r
a
m
s
;
iii
)
willin
g
n
ess
to
p
ar
ticip
ate
in
th
e
s
tu
d
y
;
an
d
iv
)
r
esid
en
ce
awa
y
f
r
o
m
th
eir
h
o
m
eto
w
n
s
.
T
h
e
ex
clu
s
io
n
cr
iter
ia
wer
e
s
tu
d
en
ts
wh
o
d
ec
lin
ed
to
p
ar
ticip
ate
an
d
th
o
s
e
wh
o
h
a
d
b
ee
n
h
eld
b
ac
k
to
a
lo
wer
ac
ad
em
ic
lev
el.
T
h
is
s
tu
d
y
u
s
ed
th
e
Ar
ik
u
n
to
f
o
r
m
u
la
to
d
eter
m
in
e
th
e
s
am
p
le
s
ize
b
ec
a
u
s
e
th
e
p
o
p
u
latio
n
s
ize
was
alr
ea
d
y
k
n
o
wn
.
Ac
co
r
d
in
g
to
Ar
ik
u
n
to
,
if
a
s
tu
d
y
p
o
p
u
latio
n
c
o
n
s
is
ts
o
f
f
e
wer
th
a
n
1
0
0
in
d
iv
i
d
u
al
s
,
th
e
en
tire
p
o
p
u
latio
n
m
a
y
b
e
in
clu
d
ed
as
th
e
s
am
p
le
[
1
8
]
.
Ho
wev
e
r
,
if
th
e
p
o
p
u
latio
n
ex
ce
e
d
s
1
0
0
in
d
i
v
id
u
als,
1
0
–
1
5
%
o
r
2
5
–
3
0
%
o
f
th
e
p
o
p
u
latio
n
m
ay
b
e
s
elec
ted
as
th
e
s
am
p
le
[
1
8
]
.
T
h
e
s
am
p
le
s
ize
was
ca
lcu
lat
ed
as
3
0
%
o
f
th
e
to
ta
l
p
o
p
u
lat
io
n
,
r
esu
ltin
g
in
3
6
r
esp
o
n
d
en
ts
f
r
o
m
t
h
e
th
r
ee
s
tu
d
y
p
r
o
g
r
am
s
.
T
h
e
s
am
p
le
co
n
s
is
ted
o
f
2
3
s
tu
d
en
ts
f
r
o
m
th
e
B
ac
h
elo
r
o
f
Nu
r
s
in
g
(
R
eg
u
lar
)
p
r
o
g
r
am
,
1
0
s
tu
d
en
ts
f
r
o
m
th
e
Dip
lo
m
a
in
Nu
r
s
in
g
p
r
o
g
r
a
m
,
an
d
3
s
tu
d
en
ts
f
r
o
m
th
e
B
ac
h
elo
r
o
f
Ph
y
s
io
th
e
r
ap
y
p
r
o
g
r
am
.
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
a
mp
u
s
life a
d
a
p
ta
tio
n
a
n
d
d
i
eta
r
y
p
a
tter
n
s
a
mo
n
g
fir
s
t
-
ye
a
r
h
ea
lth
s
cien
ce
…
(
R
u
kmo
y
o
E
n
d
r
a
w
a
n
)
833
2
.
3
.
Da
t
a
c
o
llect
io
n a
nd
a
na
ly
s
is
T
h
e
s
tu
d
y
was
co
n
d
u
cted
f
r
o
m
J
u
ly
1
7
to
Sep
tem
b
er
1
8
,
2
0
2
4
,
at
B
eth
esd
a
Yak
k
u
m
Sch
o
o
l
o
f
Hea
lth
Scien
ce
s
,
Yo
g
y
ak
ar
ta,
I
n
d
o
n
esia.
T
h
er
e
was
n
o
r
ese
ar
ch
ass
is
tan
ts
in
v
o
lv
ed
in
th
i
s
s
tu
d
y
.
Data
wer
e
co
llected
th
r
o
u
g
h
a
W
h
atsAp
p
g
r
o
u
p
.
First,
p
o
p
u
latio
n
d
at
a
wer
e
o
b
tain
ed
f
r
o
m
th
e
s
tu
d
y
p
r
o
g
r
am
s
.
Nex
t,
ea
ch
class
r
ep
r
esen
tativ
e
was
co
n
tacte
d
to
id
en
tify
s
tu
d
en
ts
wh
o
m
et
th
e
in
clu
s
io
n
c
r
iter
ia.
A
f
ter
id
en
tif
y
in
g
elig
ib
le
r
esp
o
n
d
e
n
ts
,
th
e
r
esear
ch
er
cr
ea
ted
a
W
h
atsAp
p
g
r
o
u
p
,
s
h
a
r
ed
th
e
in
v
itatio
n
lin
k
,
an
d
ar
r
an
g
ed
a
m
ee
tin
g
s
ch
ed
u
le
to
e
x
p
lain
t
h
e
q
u
esti
o
n
n
air
e
co
m
p
letio
n
p
r
o
ce
d
u
r
es.
On
ce
th
e
g
r
o
u
p
was
estab
lis
h
ed
,
th
e
r
esear
ch
er
in
tr
o
d
u
ce
d
th
e
s
t
u
d
y
a
n
d
e
x
p
lain
ed
its
o
b
jec
tiv
es,
th
e
ac
tiv
ity
s
ch
ed
u
le,
th
e
q
u
esti
o
n
n
air
e
co
m
p
letio
n
p
r
o
ce
d
u
r
es,
an
d
th
e
tim
e
allo
ca
ted
f
o
r
p
ar
ticip
ati
o
n
.
Su
b
s
eq
u
e
n
tly
,
a
lin
k
to
th
e
q
u
esti
o
n
n
air
e
was
s
en
t to
r
esp
o
n
d
e
n
ts
wh
o
ag
r
ee
d
to
p
ar
ticip
ate.
R
esp
o
n
d
en
t
ch
ar
ac
ter
is
t
ics
wer
e
an
aly
ze
d
u
s
in
g
f
r
eq
u
en
c
ies
an
d
p
er
ce
n
tag
es.
T
h
e
r
e
latio
n
s
h
ip
b
etwe
en
th
e
v
ar
iab
les
was
a
n
aly
ze
d
u
s
in
g
Sp
ea
r
m
a
n
’
s
r
h
o
co
r
r
elatio
n
test
.
T
h
e
s
ig
n
if
ica
n
ce
lev
el
was
s
et
at
0
.
0
5
.
A
p
-
v
alu
e
o
f
0
.
0
5
was
co
n
s
id
er
ed
in
d
icativ
e
o
f
a
s
ig
n
if
ican
t
r
elatio
n
s
h
ip
b
e
twee
n
ad
ap
tatio
n
to
ca
m
p
u
s
life
an
d
d
ietar
y
p
atter
n
s
.
Var
iab
les
s
h
o
win
g
a
s
t
atis
tically
s
ig
n
if
ican
t
r
elatio
n
s
h
ip
wer
e
f
u
r
th
er
in
ter
p
r
eted
b
ased
o
n
t
h
e
co
r
r
elatio
n
r
esu
lts
.
2
.
4
.
I
ns
t
rum
ent
T
h
is
r
esear
ch
u
s
ed
two
in
s
tr
u
m
en
ts
to
m
ea
s
u
r
e
ca
m
p
u
s
life
ad
ap
tatio
n
ab
ilit
y
a
n
d
d
ietar
y
p
atter
n
s
.
2
.
4
.
1
.
Ca
m
pu
s
life
a
da
pta
t
io
n a
bil
it
y
T
h
e
in
s
tr
u
m
en
t
u
s
ed
to
m
ea
s
u
r
e
ad
ap
tatio
n
to
ca
m
p
u
s
life
was
th
e
Stu
d
en
t
Ad
ap
tatio
n
to
C
o
lleg
e
Qu
esti
o
n
n
air
e
(
SAC
Q)
,
d
e
v
el
o
p
ed
b
y
[
1
9
]
an
d
p
r
e
v
io
u
s
ly
u
s
ed
in
a
s
tu
d
y
b
y
[
2
0
]
.
T
h
is
i
n
s
tr
u
m
en
t
co
n
s
is
ts
o
f
f
o
u
r
d
im
en
s
io
n
s
o
f
co
lleg
e
ad
ju
s
tm
en
t:
ac
ad
em
ic
ad
ju
s
tm
en
t,
s
o
cial
ad
ju
s
tm
en
t,
p
er
s
o
n
al
-
em
o
tio
n
al
ad
ju
s
tm
en
t,
an
d
g
o
al
co
m
m
itm
en
t/in
s
titu
tio
n
al
attac
h
m
en
t.
T
h
e
i
n
s
tr
u
m
en
t
c
o
n
tain
s
6
7
i
tem
s
,
in
clu
d
in
g
2
4
item
s
m
ea
s
u
r
in
g
ac
ad
e
m
ic
a
d
ju
s
tm
en
t,
2
0
m
ea
s
u
r
in
g
s
o
cial
ad
ju
s
tm
en
t,
1
5
m
ea
s
u
r
in
g
p
er
s
o
n
al
-
em
o
tio
n
al
ad
ju
s
tm
en
t,
an
d
8
m
ea
s
u
r
in
g
g
o
al
c
o
m
m
itm
en
t/in
s
titu
tio
n
al
attac
h
m
en
t.
T
h
e
s
co
r
es
we
r
e
ca
teg
o
r
ize
d
in
to
th
r
ee
lev
els:
lo
w,
m
o
d
er
ate,
a
n
d
h
ig
h
a
d
ap
tatio
n
.
I
n
t
h
is
s
tu
d
y
,
C
r
o
n
b
ac
h
’
s
alp
h
a
r
an
g
e
d
f
r
o
m
0
.
9
2
to
0
.
9
5
,
wh
ile
item
v
alid
ity
co
ef
f
icien
t
s
(
r
)
r
an
g
ed
f
r
o
m
0
.
4
4
2
to
0
.
5
1
9
.
2
.
4
.
2
.
Diet
a
ry
p
a
t
t
er
ns
Dietar
y
p
atter
n
s
wer
e
m
ea
s
u
r
ed
u
s
in
g
th
e
Ad
o
lescen
t
Fo
o
d
Hab
its
C
h
ec
k
lis
t
(
AFHC
)
,
d
ev
elo
p
ed
b
y
[
2
1
]
,
[
2
2
]
an
d
p
r
ev
io
u
s
ly
u
s
ed
in
Z
ein
’
s
s
tu
d
y
[
2
2
]
.
T
h
e
AFHC
co
n
s
is
ts
o
f
f
o
u
r
in
d
ica
to
r
s
:
f
at
an
d
d
ietar
y
f
ib
er
in
tak
e
(
7
item
s
;
I
tem
s
1
–
7
)
,
f
r
u
it
an
d
v
eg
etab
le
i
n
tak
e
(
5
item
s
;
I
tem
s
8
–
1
2
)
,
d
ietar
y
r
estrictio
n
(
4
item
s
;
I
tem
s
1
3
–
1
6
)
,
an
d
n
u
tr
itio
n
k
n
o
wled
g
e
(
7
item
s
;
I
tem
s
1
7
–
2
3
)
.
AFHC
s
co
r
es
wer
e
class
if
ied
b
y
co
m
p
ar
in
g
in
d
iv
id
u
al
s
co
r
es
with
th
e
m
e
an
to
tal
s
co
r
e
o
f
all
r
esp
o
n
d
en
ts
.
T
h
e
Sh
ap
ir
o
–
W
ilk
test
was
u
s
ed
to
ass
ess
d
ata
n
o
r
m
ality
p
r
io
r
to
an
aly
s
is
.
AFHC
s
co
r
es
g
r
ea
ter
th
an
4
2
4
wer
e
class
if
ied
as
in
d
icatin
g
h
ea
lth
y
d
ietar
y
p
atter
n
s
,
wh
er
ea
s
s
co
r
es
o
f
2
4
6
o
r
b
elo
w
wer
e
class
if
ied
as
in
d
icatin
g
u
n
h
ea
lth
y
d
ieta
r
y
p
atter
n
s
.
I
n
th
is
s
tu
d
y
,
C
r
o
n
b
ac
h
’
s
alp
h
a
was
0
.
9
0
,
an
d
th
e
v
alid
ity
co
ef
f
icien
t (
r
)
was 0
.
8
3
.
3.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
A
to
tal
o
f
3
6
r
esp
o
n
d
en
ts
wer
e
ex
am
in
ed
,
an
d
t
h
e
r
esu
lts
wer
e
an
aly
ze
d
.
3
.
1
.
Resul
t
3
.
1
.
1
.
Univ
a
ria
t
e
a
na
ly
s
is
A
to
tal
o
f
3
6
r
esp
o
n
d
e
n
ts
p
a
r
ticip
ated
in
th
e
s
tu
d
y
,
an
d
t
h
e
d
ata
wer
e
a
n
aly
ze
d
.
Am
o
n
g
th
e
3
6
r
esp
o
n
d
en
ts
,
th
e
m
ajo
r
ity
wer
e
f
em
ale
(
n
=
2
9
,
8
1
%),
wh
il
e
th
e
r
em
ain
d
e
r
wer
e
m
ale
(
n
=
7
,
1
9
%).
M
o
s
t
r
esp
o
n
d
en
ts
wer
e
ag
ed
1
3
–
1
9
y
ea
r
s
(
n
=
2
5
,
6
9
%),
wh
ile
1
1
r
e
s
p
o
n
d
e
n
ts
(
3
1
%)
wer
e
2
0
y
ea
r
s
(
T
ab
le
1
)
.
Mo
s
t
r
esp
o
n
d
en
ts
d
em
o
n
s
tr
at
ed
a
m
o
d
er
ate
lev
el
o
f
ad
a
p
t
atio
n
to
ca
m
p
u
s
life
(
n
=
3
3
,
9
2
%),
wh
ile
th
e
r
em
ain
in
g
r
esp
o
n
d
en
ts
d
em
o
n
s
tr
ated
a
h
ig
h
lev
el
o
f
ad
ap
tatio
n
(
n
=
3
,
8
%)
(
T
ab
le
2
)
.
Mo
s
t
r
esp
o
n
d
en
ts
wer
e
class
if
ied
as
h
av
in
g
h
ea
lth
y
d
ietar
y
p
atter
n
s
(
n
=
3
3
,
9
2
%),
wh
er
ea
s
3
r
esp
o
n
d
en
ts
(
8
%)
wer
e
class
if
ied
as
h
av
in
g
u
n
h
ea
lth
y
d
ietar
y
p
atte
r
n
s
(
T
ab
le
3
)
.
T
ab
le
1
.
C
h
ar
ac
ter
is
tic
o
f
s
tu
d
en
ts
P
a
r
a
me
t
e
r
s
To
t
a
l
(
n
=
36)
P
e
r
c
e
n
t
a
g
e
(
%)
G
e
n
d
e
r
M
a
l
e
7
19
F
e
mal
e
9
81
A
g
e
A
d
o
l
e
s
c
e
n
t
s (
1
3
-
1
9
y
e
a
r
s)
25
69
A
d
u
l
t
(
2
0
y
e
a
r
s)
11
31
Evaluation Warning : The document was created with Spire.PDF for Python.
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SS
N
:
2
2
5
2
-
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8
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n
t J Pu
b
lic
Hea
lth
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,
Vo
l.
15
,
No
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3
,
Sep
tem
b
er
20
26
:
8
3
1
-
838
834
T
ab
le
2
.
Ad
a
p
tatio
n
ab
ilit
y
o
f
ca
m
p
u
s
life
P
a
r
a
me
t
e
r
s
To
t
a
l
(
n
=
36)
P
e
r
c
e
n
t
a
g
e
(
%)
Lo
w
0
0
M
o
d
e
r
a
t
e
33
92
H
i
g
h
e
r
3
8
T
ab
le
3
.
Dietar
y
p
atter
n
s
P
a
r
a
me
t
e
r
s
To
t
a
l
(
n
=
36)
P
e
r
c
e
n
t
a
g
e
(
%)
H
e
a
l
t
h
33
92
U
n
h
e
a
l
t
h
y
3
8
3
.
1
.
2
.
B
iv
a
ria
t
e
a
na
ly
s
is
T
h
e
co
r
r
elatio
n
b
etwe
en
ad
ap
tatio
n
to
ca
m
p
u
s
life
an
d
d
iet
ar
y
p
atter
n
s
am
o
n
g
f
ir
s
t
-
y
ea
r
s
tu
d
en
ts
is
p
r
esen
ted
in
T
a
b
le
4
.
T
h
e
m
e
an
s
co
r
e
f
o
r
ad
ap
tatio
n
to
ca
m
p
u
s
life
was
3
7
1
.
5
6
(
SD
=
3
7
.
7
4
8
)
.
T
h
e
m
ea
n
d
ietar
y
p
atter
n
s
co
r
e
was
1
5
.
4
7
,
in
d
icatin
g
r
elativ
ely
lo
w
v
a
r
iab
ilit
y
am
o
n
g
r
esp
o
n
d
en
ts
.
T
h
e
ad
ap
tatio
n
-
to
-
ca
m
p
u
s
-
life
s
co
r
es r
an
g
ed
f
r
o
m
3
1
8
t
o
4
6
0
,
wh
ile
th
e
d
ietar
y
p
atter
n
s
co
r
es r
a
n
g
ed
f
r
o
m
1
0
to
2
0
(
T
ab
le
4
)
.
B
ased
o
n
th
e
r
es
u
lts
o
f
Sp
ea
r
m
an
’
s
r
a
n
k
co
r
r
elatio
n
test
,
a
s
tatis
t
ically
s
ig
n
if
ican
t
r
elatio
n
s
h
ip
was
f
o
u
n
d
b
etwe
en
th
e
v
a
r
iab
les
(
p
<
0
.
0
0
1
)
.
T
h
er
ef
o
r
e,
t
h
e
n
u
ll
h
y
p
o
th
esis
was
r
ejec
te
d
.
T
h
e
c
o
r
r
elatio
n
co
ef
f
icien
t
was
0
.
7
3
4
,
in
d
icatin
g
a
s
tr
o
n
g
p
o
s
itiv
e
co
r
r
elatio
n
b
et
wee
n
th
e
v
ar
iab
les.
T
h
es
e
f
in
d
in
g
s
in
d
icate
th
at
h
ig
h
er
le
v
els o
f
ad
a
p
tatio
n
to
ca
m
p
u
s
life
wer
e
ass
o
ciate
d
with
h
ea
lth
ier
d
ietar
y
p
atter
n
s
am
o
n
g
s
tu
d
e
n
ts
.
T
ab
le
4
.
T
h
e
co
r
r
elatio
n
o
f
th
e
v
ar
iab
les
V
a
r
i
a
b
l
e
M
e
a
n
SD
M
i
n
M
a
x
S
i
g
n
.
2
t
a
i
l
e
d
S
p
e
a
r
ma
n
r
a
n
k
C
o
e
f
f
i
c
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n
t
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l
a
t
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o
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p
A
d
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t
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t
i
o
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a
b
i
l
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t
y
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a
mp
u
s
l
i
f
e
3
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1
.
5
6
37
.
7
4
8
3
1
8
4
6
0
0
.
0
0
0
0
.
7
3
4
D
i
e
t
p
a
t
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e
r
n
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15
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2
2
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2
3
5
9
10
20
3
.
2
.
Di
s
cus
s
io
n
T
h
e
r
esu
lts
in
d
icate
d
th
at
s
tu
d
en
ts
at
B
eth
esd
a
Yak
k
u
m
Sch
o
o
l
o
f
Hea
lth
Scie
n
ce
s
wer
e
p
r
ed
o
m
i
n
an
tly
f
em
ale.
W
o
m
e
n
ten
d
to
d
em
o
n
s
tr
ate
b
etter
s
o
cial
ad
ju
s
tm
en
t,
wh
ich
h
as
b
ee
n
ass
o
ciate
d
with
h
ig
h
er
lev
els
o
f
em
p
ath
y
an
d
s
y
m
p
ath
y
[
2
3
]
.
T
h
is
f
in
d
i
n
g
is
s
u
p
p
o
r
ted
b
y
a
liter
atu
r
e
r
ev
iew
[
2
4
]
,
wh
ich
r
ep
o
r
ted
th
at
wo
m
e
n
g
e
n
er
a
lly
ex
h
ib
it
h
ig
h
er
lev
els
o
f
em
p
ath
y
th
an
m
en
.
A
s
tu
d
y
b
y
Ad
em
i
an
d
L
o
s
h
k
o
v
s
k
a
[
2
5
]
r
ep
o
r
ted
s
ig
n
if
ican
t
d
if
f
er
e
n
ce
s
b
etwe
en
wo
m
en
an
d
m
en
in
b
o
th
ac
h
iev
em
en
t
an
d
en
g
ag
em
e
n
t.
T
h
e
au
th
o
r
s
s
u
g
g
ested
th
at
wo
m
en
ad
ap
t
m
o
r
e
ea
s
ily
to
n
ew
en
v
ir
o
n
m
en
ts
th
an
m
en
.
T
h
e
y
also
r
ep
o
r
ted
d
i
f
f
er
en
ce
s
in
ac
ad
e
m
ic
o
u
tco
m
es
b
etwe
en
wo
m
en
an
d
m
en
.
R
eg
ar
d
i
n
g
em
p
ath
y
,
an
o
th
e
r
s
tu
d
y
r
ep
o
r
ted
th
at
alth
o
u
g
h
wo
m
e
n
s
h
o
wed
h
ig
h
er
em
p
at
h
y
s
co
r
es
th
an
m
en
,
th
e
d
if
f
er
en
ce
was
n
o
t
s
tat
is
tica
lly
s
ig
n
if
ican
t
[
2
6
]
.
T
h
is
m
ay
b
e
in
f
lu
en
ce
d
b
y
I
n
d
o
n
esian
cu
ltu
r
al
f
ac
to
r
s
th
at
p
r
o
m
o
te
th
e
d
ev
elo
p
m
en
t
o
f
em
p
ath
etic
b
eh
a
v
io
r
am
o
n
g
wo
m
en
[
2
7
]
.
T
h
e
ag
e
d
is
tr
ib
u
tio
n
s
h
o
wed
th
at
m
o
s
t
r
esp
o
n
d
en
ts
wer
e
1
3
–
1
9
y
ea
r
s
o
ld
.
A
p
r
ev
io
u
s
s
tu
d
y
[1
9
]
r
ep
o
r
ted
th
at
m
o
s
t
f
ir
s
t
-
y
ea
r
u
n
iv
er
s
ity
s
tu
d
en
ts
f
all
with
in
th
e
late
ad
o
lescen
t
ag
e
ca
teg
o
r
y
.
Ad
o
lescen
ce
is
a
d
ev
elo
p
m
e
n
tal
p
er
io
d
ch
ar
ac
ter
ized
b
y
s
u
b
s
tan
tial
p
s
y
ch
o
lo
g
ical
an
d
s
o
cial
ch
an
g
es,
p
ar
ticu
lar
ly
wh
en
s
tu
d
en
ts
tr
an
s
itio
n
f
r
o
m
s
ch
o
o
l
to
u
n
i
v
e
r
s
ity
an
d
m
u
s
t
ad
a
p
t
to
a
n
ew
en
v
ir
o
n
m
en
t
[
2
8
]
.
T
h
ese
f
in
d
in
g
s
ar
e
co
n
s
is
ten
t
with
a
s
tu
d
y
co
n
d
u
cted
at
th
e
Facu
lty
o
f
Hea
lt
h
Scien
ce
s
,
R
esp
ati
Un
iv
er
s
it
y
,
Yo
g
y
a
k
ar
ta
[
2
9
]
,
wh
ich
r
ep
o
r
ted
th
at
8
8
.
2
%
o
f
r
esp
o
n
d
e
n
ts
wer
e
ag
ed
1
7
–
1
9
y
ea
r
s
,
an
ag
e
r
a
n
g
e
clas
s
if
ied
as
ad
o
lescen
ce
.
T
h
is
d
ev
elo
p
m
e
n
tal
p
h
ase
o
cc
u
p
ies a
g
r
ea
ter
p
o
r
tio
n
o
f
t
h
e
l
if
e
co
u
r
s
e
th
an
ev
er
b
ef
o
r
e
[
3
0
]
.
An
o
th
er
f
in
d
in
g
o
f
th
is
s
tu
d
y
was
th
at
m
o
s
t
r
esp
o
n
d
e
n
ts
d
em
o
n
s
tr
ated
a
m
o
d
er
at
e
lev
el
o
f
ad
ap
tatio
n
to
ca
m
p
u
s
life
.
U
p
o
n
e
n
ter
in
g
co
lleg
e,
m
an
y
s
tu
d
en
ts
f
ac
e
ch
allen
g
es
d
u
r
i
n
g
th
e
ad
ap
tatio
n
p
r
o
ce
s
s
.
A
p
r
ev
io
u
s
s
tu
d
y
[
3
1
]
f
o
u
n
d
th
at
f
ir
s
t
-
y
ea
r
s
tu
d
e
n
ts
o
f
ten
ex
p
e
r
ien
ce
d
d
if
f
icu
l
ties
u
n
d
er
s
tan
d
in
g
ac
ad
em
ic
p
r
o
ce
d
u
r
es,
p
ar
tici
p
atin
g
in
ca
s
e
-
b
ased
lear
n
in
g
,
s
p
ea
k
in
g
a
n
d
wo
r
k
in
g
ef
f
ec
tiv
ely
in
g
r
o
u
p
s
,
m
an
ag
in
g
h
ea
v
y
w
o
r
k
lo
a
d
s
,
a
n
d
tak
i
n
g
g
r
ea
ter
r
esp
o
n
s
ib
ilit
y
f
o
r
th
eir
lear
n
i
n
g
.
I
f
th
ese
d
if
f
icu
lties
ar
e
n
o
t
ad
d
r
ess
ed
ap
p
r
o
p
r
iately
,
th
ey
m
ay
co
n
tr
ib
u
te
to
p
s
y
ch
o
lo
g
ic
al
p
r
o
b
lem
s
.
A
p
r
ev
io
u
s
s
tu
d
y
[
2
4
]
r
ep
o
r
ted
th
at
ap
p
r
o
x
im
ately
o
n
e
-
th
ir
d
o
f
f
ir
s
t
-
y
ea
r
s
tu
d
en
ts
ex
p
er
ien
ce
d
c
lin
ically
s
ig
n
if
ican
t
s
y
m
p
to
m
s
o
f
d
ep
r
ess
io
n
an
d
an
x
iety
,
i
n
clu
d
in
g
s
leep
p
r
o
b
l
em
s
,
h
az
ar
d
o
u
s
s
u
b
s
tan
ce
u
s
e,
lack
o
f
r
eg
u
lar
ex
e
r
cise,
r
ed
u
ce
d
s
o
cial
s
u
p
p
o
r
t,
lo
w
s
elf
-
esteem
,
an
d
h
ig
h
p
er
ce
iv
ed
s
tr
ess
.
T
o
c
o
p
e
with
th
ese
ch
alle
n
g
es,
s
tu
d
en
ts
u
s
e
v
ar
io
u
s
c
o
p
in
g
m
ec
h
an
is
m
s
,
an
d
s
elf
-
ad
ju
s
t
m
en
t
is
in
f
lu
en
ce
d
b
y
b
o
th
ad
ap
tiv
e
an
d
m
ala
d
ap
tiv
e
co
p
in
g
s
tr
ateg
ies
[
2
5
]
.
Stu
d
en
ts
’
ad
ap
tatio
n
to
ca
m
p
u
s
life
m
ay
b
e
in
f
lu
e
n
ce
d
b
y
v
ar
io
u
s
f
ac
t
o
r
s
,
in
clu
d
i
n
g
s
o
cial
id
en
tity
,
s
elf
-
ef
f
icac
y
,
s
el
f
-
r
e
g
u
lated
lea
r
n
i
n
g
,
ac
a
d
em
ic
g
r
it,
ac
ad
em
ic
f
lo
w,
p
ee
r
s
u
p
p
o
r
t,
an
d
p
ar
e
n
t
–
ch
ild
r
elatio
n
s
h
i
p
s
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
a
mp
u
s
life a
d
a
p
ta
tio
n
a
n
d
d
i
eta
r
y
p
a
tter
n
s
a
mo
n
g
fir
s
t
-
ye
a
r
h
ea
lth
s
cien
ce
…
(
R
u
kmo
y
o
E
n
d
r
a
w
a
n
)
835
[
2
6
]
.
Fam
ily
s
u
p
p
o
r
t
also
p
la
y
s
a
k
ey
r
o
le
in
s
tu
d
en
ts
’
ab
i
lity
to
n
av
ig
ate
th
e
ch
allen
g
e
s
o
f
u
n
i
v
er
s
ity
life
.
T
h
is
is
im
p
o
r
tan
t b
ec
au
s
e
it h
e
lp
s
s
tu
d
en
ts
b
u
il
d
th
e
em
o
tio
n
al
r
esil
ien
ce
n
ee
d
ed
to
a
d
ap
t s
u
cc
ess
f
u
lly
[
3
2
]
.
R
eg
ar
d
in
g
d
ietar
y
p
atter
n
s
,
m
o
s
t
r
esp
o
n
d
e
n
ts
wer
e
class
if
ied
in
t
h
e
h
ea
lt
h
y
ca
te
g
o
r
y
.
T
h
is
p
o
s
itiv
e
tr
en
d
m
ay
r
ed
u
ce
th
e
r
is
k
o
f
g
astritis
,
in
d
icatin
g
th
at
r
esp
o
n
d
en
ts
g
en
e
r
ally
m
ain
tain
h
ea
lth
y
d
ietar
y
h
ab
its
.
Ma
in
tain
in
g
a
h
ea
lth
y
d
iet
is
c
r
u
cial
f
o
r
o
v
er
all
well
-
b
ein
g
;
f
u
r
th
er
m
o
r
e,
ad
o
p
tin
g
n
u
tr
itio
u
s
ea
tin
g
h
ab
its
h
as
b
ee
n
s
h
o
wn
to
en
h
an
ce
ac
ad
e
m
ic
p
er
f
o
r
m
an
ce
[
3
3
]
.
T
h
is
f
in
d
in
g
alig
n
s
with
p
r
e
v
io
u
s
r
es
ea
r
ch
r
ep
o
r
tin
g
th
at
a
h
ea
lth
y
life
s
ty
le
is
a
s
ig
n
if
ic
an
t p
r
ed
icto
r
o
f
ac
a
d
em
ic
s
u
cc
ess
[
3
4
]
.
Ad
ap
tatio
n
to
ca
m
p
u
s
life
r
ef
er
s
to
an
in
d
iv
id
u
al'
s
ab
ilit
y
t
o
ad
ju
s
t
to
th
e
u
n
iv
er
s
ity
en
v
ir
o
n
m
en
t,
in
clu
d
in
g
its
ac
ad
em
ic,
s
o
cial,
p
er
s
o
n
al,
em
o
ti
o
n
al,
a
n
d
in
s
titu
tio
n
al
d
em
a
n
d
s
.
A
n
i
m
p
o
r
tan
t
asp
ec
t
o
f
ad
ap
tatio
n
is
p
er
s
o
n
al
ad
ju
s
t
m
en
t,
wh
ich
e
n
ab
les
in
d
iv
id
u
als
to
co
p
e
with
in
te
r
n
al
c
h
an
g
es,
in
clu
d
in
g
ch
an
g
es
in
ea
tin
g
p
atter
n
s
[
3
5
]
.
First
-
y
ea
r
s
tu
d
e
n
ts
ar
e
lik
el
y
to
e
x
p
er
ie
n
ce
cu
ltu
r
e
s
h
o
c
k
;
h
o
wev
e
r
,
a
d
ap
tin
g
to
a
n
ew
en
v
ir
o
n
m
en
t
m
ay
p
r
o
d
u
ce
p
o
s
itiv
e
p
s
y
ch
o
lo
g
ical
ef
f
ec
ts
an
d
co
n
tr
ib
u
te
to
p
er
s
o
n
al
d
ev
elo
p
m
e
n
t
an
d
r
esil
ien
ce
[
3
6
]
.
T
h
e
s
tu
d
y
co
n
clu
d
ed
th
at
s
tu
d
en
ts
with
h
ig
h
er
p
s
y
ch
o
lo
g
ical
well
-
b
ein
g
wer
e
b
etter
ab
l
e
to
o
v
er
c
o
m
e
cu
ltu
r
e
s
h
o
ck
a
n
d
v
iewe
d
it
as
a
lear
n
in
g
o
p
p
o
r
tu
n
ity
th
at
c
o
n
tr
ib
u
te
d
t
o
th
eir
g
r
o
wth
an
d
d
ev
elo
p
m
e
n
t.
Fu
r
th
er
m
o
r
e,
ef
f
ec
tiv
e
ad
ap
tatio
n
to
cu
ltu
r
al
ch
an
g
es
m
ay
en
h
an
ce
p
s
y
ch
o
lo
g
ical
well
-
b
ein
g
an
d
im
p
r
o
v
e
ac
ad
em
ic
p
er
f
o
r
m
an
ce
.
Alth
o
u
g
h
m
o
s
t
r
esp
o
n
d
en
ts
m
ain
tain
ed
h
ea
lth
y
d
ietar
y
p
atter
n
s
,
8
%
s
till
ex
h
ib
ited
u
n
h
ea
lt
h
y
d
ietar
y
b
e
h
av
io
r
s
.
Po
o
r
n
u
tr
itio
n
al
in
tak
e
ca
n
lead
t
o
r
e
d
u
ce
d
co
n
ce
n
t
r
atio
n
a
n
d
p
h
y
s
ical
wea
k
n
ess
,
as
we
ll
as
h
ea
lt
h
p
r
o
b
lem
s
s
u
ch
as
g
astriti
s
an
d
lo
n
g
-
ter
m
co
n
d
itio
n
s
in
clu
d
in
g
o
b
esit
y
,
h
y
p
er
ten
s
io
n
,
d
iab
etes
m
ellit
u
s
,
an
d
ca
r
d
io
v
ascu
lar
d
is
ea
s
e
[
3
7
]
,
[
3
8
]
.
Sev
er
al
s
tu
d
ies
h
av
e
s
h
o
wn
t
h
at
g
astritis
i
s
a
co
m
m
o
n
h
ea
lth
p
r
o
b
lem
am
o
n
g
y
o
u
n
g
p
eo
p
le,
p
ar
ticu
lar
ly
s
tu
d
en
ts
,
an
d
is
o
f
ten
ex
ac
er
b
ated
b
y
ex
ce
s
s
iv
e
s
tr
ess
.
Sy
m
p
to
m
s
in
clu
d
e
h
ea
r
tb
u
r
n
,
n
au
s
ea
,
v
o
m
i
tin
g
,
an
d
in
s
o
m
n
ia
[
3
9
]
,
[
4
0
]
.
T
h
e
s
tr
o
n
g
c
o
r
r
elatio
n
s
u
g
g
es
t
s
th
at
s
tu
d
en
ts
wh
o
ad
ap
t
b
e
tter
to
th
eir
n
ew
en
v
ir
o
n
m
en
t
ar
e
m
o
r
e
lik
ely
to
m
ain
tain
h
ea
lth
ier
d
i
etar
y
p
atter
n
s
.
C
o
n
v
er
s
ely
,
th
e
less
ad
ap
tiv
e
s
tu
d
en
ts
ar
e
,
th
e
h
ig
h
e
r
t
h
eir
s
tr
ess
lev
el.
Stre
s
s
m
ay
ar
is
e
wh
en
s
tu
d
en
ts
f
ac
e
s
u
b
s
tan
tial
ac
a
d
em
ic
d
em
an
d
s
.
A
cc
o
r
d
in
g
t
o
s
tr
ess
an
d
co
p
in
g
th
eo
r
y
,
in
d
iv
i
d
u
als
en
g
ag
e
i
n
co
g
n
itiv
e
a
p
p
r
aisal
wh
e
n
f
ac
e
d
with
a
p
ar
ticu
lar
s
tr
ess
o
r
[
4
1
]
.
T
h
e
p
er
ce
iv
e
d
s
ev
er
ity
o
f
a
p
r
o
b
le
m
m
ay
in
f
lu
en
ce
th
e
ty
p
e
o
f
co
p
in
g
s
tr
ateg
y
in
d
iv
id
u
als
u
s
e,
wh
eth
er
ad
ap
tiv
e
o
r
m
alad
ap
tiv
e.
T
h
es
e
f
in
d
in
g
s
h
ig
h
lig
h
t
th
e
im
p
o
r
ta
n
ce
o
f
d
ev
el
o
p
in
g
s
tr
ateg
ies
th
at
f
ac
ilit
ate
s
tu
d
en
ts
’
in
teg
r
atio
n
in
t
o
th
e
ac
a
d
em
ic
en
v
ir
o
n
m
en
t,
t
h
er
eb
y
s
u
p
p
o
r
tin
g
lear
n
in
g
an
d
p
r
o
m
o
tin
g
m
en
tal
well
-
b
ein
g
[
4
2
]
.
T
h
e
h
ea
lth
co
n
s
eq
u
en
ce
s
o
f
ch
r
o
n
ic
s
tr
ess
d
ep
en
d
o
n
an
in
d
iv
id
u
al’
s
co
p
i
n
g
s
ty
le
a
n
d
r
esil
ien
ce
wh
en
d
ea
lin
g
with
s
tr
ess
f
u
l
s
itu
atio
n
s
[
4
3
]
.
An
o
th
er
f
in
d
in
g
s
u
g
g
ests
th
at
ef
f
ec
tiv
e
s
tr
ess
m
an
a
g
em
en
t
ca
n
r
e
d
u
ce
s
tr
ess
lev
els
[
4
4
]
.
T
h
e
e
f
f
ec
ti
v
en
ess
o
f
c
o
p
in
g
s
tr
ateg
ies
is
in
f
lu
en
ce
d
b
y
v
ar
io
u
s
f
ac
to
r
s
,
in
clu
d
in
g
s
o
c
ial
s
u
p
p
o
r
t.
Stu
d
en
ts
wh
o
r
ec
eiv
e
em
o
tio
n
al,
in
f
o
r
m
atio
n
al,
a
n
d
in
s
tr
u
m
en
tal
s
u
p
p
o
r
t
f
r
o
m
f
am
ily
m
em
b
er
s
,
p
ee
r
s
,
an
d
m
en
to
r
s
ten
d
to
f
ee
l
m
o
r
e
m
o
tiv
ated
an
d
less
is
o
lated
[
4
5
]
,
[
4
6
]
.
T
h
e
f
i
n
d
in
g
s
o
f
th
is
s
tu
d
y
s
u
g
g
est
th
at
ef
f
ec
tiv
e
co
p
in
g
m
a
y
s
u
p
p
o
r
t stu
d
en
ts
’
ab
ilit
y
t
o
ad
ap
t t
o
th
e
ca
m
p
u
s
en
v
ir
o
n
m
en
t.
T
h
is
s
tu
d
y
f
o
u
n
d
a
s
tr
o
n
g
c
o
r
r
elatio
n
b
etwe
en
a
d
ap
tatio
n
to
ca
m
p
u
s
life
a
n
d
d
ietar
y
p
atter
n
s
,
s
u
g
g
esti
n
g
th
at
s
tu
d
en
ts
wh
o
ad
ap
t
m
o
r
e
s
u
cc
ess
f
u
lly
ten
d
to
m
ain
tain
h
ea
lth
ier
ea
tin
g
p
atter
n
s
.
Ad
ap
tatio
n
m
ay
p
la
y
a
n
im
p
o
r
tan
t
r
o
le
in
s
h
ap
in
g
h
ea
lth
-
r
elate
d
b
eh
a
v
io
r
s
.
T
h
is
f
in
d
in
g
is
c
o
n
s
is
ten
t
with
th
e
th
eo
r
y
o
f
p
lan
n
ed
b
eh
av
io
r
,
wh
ich
p
r
o
p
o
s
es
th
at
b
eh
av
io
r
is
in
f
lu
en
c
ed
b
y
attitu
d
es,
s
u
b
jectiv
e
n
o
r
m
s
,
an
d
p
er
ce
i
v
ed
b
eh
av
io
r
al
co
n
tr
o
l [
4
7
]
.
As
s
tu
d
en
ts
in
h
ea
lth
-
r
elate
d
p
r
o
g
r
a
m
s
,
th
e
r
esp
o
n
d
e
n
ts
m
ay
p
o
s
s
ess
s
u
f
f
icien
t
h
ea
lth
k
n
o
wled
g
e
to
b
alan
ce
ac
ad
e
m
ic
r
esp
o
n
s
ib
ilit
ies
with
th
ei
r
p
h
y
s
ical
n
ee
d
s
,
in
clu
d
in
g
m
ain
tain
in
g
r
eg
u
lar
m
ea
ltime
s
.
Stu
d
en
ts
m
ay
r
ec
o
g
n
ize
th
e
im
p
o
r
tan
ce
o
f
h
ea
lth
y
b
eh
a
v
io
r
s
in
s
u
p
p
o
r
t
in
g
th
eir
ac
ad
em
ic
ac
tiv
ities
.
Hea
lth
y
d
ietar
y
p
atter
n
s
m
ay
also
b
e
s
u
p
p
o
r
ted
b
y
en
v
ir
o
n
m
en
tal
f
ac
to
r
s
,
s
u
ch
a
s
th
e
av
ailab
ilit
y
o
f
h
ea
lth
y
f
o
o
d
,
s
u
p
p
o
r
tiv
e
f
ac
il
ities
,
an
d
p
o
s
itiv
e
p
ee
r
in
f
lu
e
n
ce
.
T
h
is
f
in
d
i
n
g
is
co
n
s
is
ten
t
with
th
e
v
iew
t
h
at
b
eh
av
io
r
is
in
f
l
u
e
n
ce
d
b
y
in
t
er
ac
tio
n
s
am
o
n
g
p
er
s
o
n
al
f
a
cto
r
s
,
en
v
ir
o
n
m
e
n
tal
co
n
d
itio
n
s
,
an
d
b
eh
a
v
io
r
al
p
r
o
ce
s
s
es [
4
8
]
.
Hea
lth
b
eh
av
i
o
r
s
p
lay
a
v
ital r
o
le
in
b
o
th
m
e
n
tal
an
d
p
h
y
s
ical
h
ea
lth
[
4
9
]
,
[
5
0
]
.
As
a
s
o
u
r
ce
o
f
s
o
cial
s
u
p
p
o
r
t,
th
e
in
s
titu
tio
n
s
h
o
u
ld
p
r
o
v
id
e
s
tu
d
en
t
s
er
v
ices,
co
u
n
s
elin
g
,
s
tr
ess
m
an
ag
em
en
t
p
r
o
g
r
am
s
,
a
n
d
d
ietar
y
e
d
u
ca
tio
n
.
A
p
r
ev
i
o
u
s
s
tu
d
y
r
ep
o
r
te
d
th
at
h
ea
lth
ce
n
ter
s
s
u
p
p
o
r
t
g
o
v
er
n
m
en
t
ef
f
o
r
ts
b
y
im
p
l
em
en
tin
g
p
r
o
m
o
tiv
e
a
n
d
p
r
ev
en
tiv
e
m
ea
s
u
r
es
in
o
r
d
er
to
in
cr
ea
s
e
p
u
b
lic
awa
r
en
ess
an
d
en
c
o
u
r
a
g
e
in
d
iv
id
u
als
to
m
a
n
ag
e
th
ei
r
h
ea
l
th
in
d
ep
e
n
d
en
tly
[
5
1
]
,
[
5
2
]
.
I
n
th
is
co
n
te
x
t,
th
e
ca
m
p
u
s
en
v
ir
o
n
m
e
n
t
co
n
tr
i
b
u
tes
to
s
h
ap
in
g
h
ea
lth
ie
r
b
eh
a
v
io
r
s
.
I
n
a
d
d
itio
n
,
s
tr
ess
m
an
ag
em
en
t
s
er
v
ices
ca
n
b
e
s
u
p
p
o
r
ted
th
r
o
u
g
h
r
eg
u
lar
ass
es
s
m
en
ts
u
s
in
g
ap
p
r
o
p
r
ia
te
in
s
tr
u
m
en
ts
.
At
B
eth
e
s
d
a
Yak
k
u
m
Sch
o
o
l
o
f
Hea
lth
Scien
ce
s
,
s
u
ch
s
cr
ee
n
i
n
g
h
as
b
ee
n
c
o
n
d
u
cted
f
o
r
s
t
u
d
en
ts
ex
p
e
r
ien
cin
g
m
ild
,
m
o
d
er
ate,
s
ev
er
e,
an
d
v
er
y
s
ev
er
e
le
v
els o
f
s
tr
ess
.
Stu
d
en
ts
also
r
ec
eiv
e
d
ie
tar
y
ed
u
ca
tio
n
as p
ar
t
o
f
th
eir
h
ea
lth
-
r
elate
d
co
u
r
s
ewo
r
k
.
T
h
is
s
tu
d
y
was
in
itially
p
la
n
n
ed
as
an
in
-
p
er
s
o
n
s
u
r
v
ey
;
h
o
wev
er
,
b
ec
au
s
e
m
a
n
y
r
esp
o
n
d
en
ts
h
a
d
r
etu
r
n
ed
to
th
eir
h
o
m
eto
wn
s
,
d
ata
co
llectio
n
was
co
n
d
u
cte
d
u
s
in
g
an
o
n
lin
e
q
u
esti
o
n
n
ai
r
e.
As
a
r
esu
lt,
th
e
r
esear
ch
er
s
wer
e
u
n
ab
le
to
e
x
p
lo
r
e
r
esp
o
n
s
es
in
g
r
ea
te
r
d
ep
th
o
r
d
i
r
ec
tly
o
b
s
er
v
e
p
ar
ti
cip
an
ts
wh
ile
th
ey
co
m
p
leted
th
e
q
u
esti
o
n
n
air
e.
T
h
is
m
eth
o
d
o
f
d
ata
co
llecti
o
n
m
a
y
h
a
v
e
in
tr
o
d
u
ce
d
r
esp
o
n
s
e
b
ias
an
d
s
elf
-
r
ep
o
r
t
b
ias.
R
esp
o
n
d
en
ts
m
ay
h
av
e
u
n
d
e
r
r
ep
o
r
ted
o
r
o
v
er
r
ep
o
r
ted
th
eir
ad
a
p
tatio
n
ex
p
e
r
ien
ce
s
an
d
d
ietar
y
b
eh
av
io
r
s
.
T
o
m
in
im
ize
t
h
ese
b
iases
,
r
esp
o
n
d
en
ts
wer
e
ass
u
r
ed
o
f
an
o
n
y
m
ity
an
d
co
n
f
id
en
tiality
.
An
o
t
h
er
lim
itatio
n
is
th
at
th
e
s
tu
d
y
i
n
clu
d
ed
o
n
ly
h
ea
lth
y
s
tu
d
en
t
s
an
d
in
v
o
lv
ed
a
r
elativ
ely
s
m
a
ll
s
am
p
le
o
f
3
6
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.
15
,
No
.
3
,
Sep
tem
b
er
20
26
:
8
3
1
-
838
836
r
esp
o
n
d
en
ts
,
wh
ic
h
m
ay
lim
it
th
e
g
en
er
aliza
b
ilit
y
o
f
th
e
f
in
d
in
g
s
.
T
h
er
ef
o
r
e,
f
u
tu
r
e
r
esear
c
h
s
h
o
u
ld
em
p
lo
y
a
lo
n
g
itu
d
in
al
d
esig
n
a
n
d
e
x
am
in
e
s
tu
d
en
t
ad
a
p
tatio
n
f
r
o
m
a
d
d
itio
n
al
p
e
r
s
p
ec
tiv
es,
in
clu
d
in
g
en
v
i
r
o
n
m
e
n
tal
f
ac
to
r
s
,
s
o
cial
s
u
p
p
o
r
t,
an
d
th
e
r
o
le
o
f
in
s
titu
tio
n
s
in
p
r
o
m
o
tin
g
h
ea
lth
y
b
eh
a
v
io
r
s
,
in
o
r
d
er
to
g
ain
a
m
o
r
e
co
m
p
r
eh
e
n
s
iv
e
u
n
d
er
s
tan
d
in
g
o
f
th
e
ad
a
p
tatio
n
p
r
o
ce
s
s
.
3.
CO
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O
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ased
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h
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a
d
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teg
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ated
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life
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ig
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g
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ased
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ay
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ize
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ile
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t
o
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m
p
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s
life
.
F
UNDING
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NF
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M
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T
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h
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Dir
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ate
Gen
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ax
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(
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ce
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ip
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DATA AV
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837
RE
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NC
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[
1
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.
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me
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.
M
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B
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4
.
[
7
]
T.
B
.
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E.
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a
n
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[
8
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[
9
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1
1
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L.
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3]
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.
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[
1
5
]
M
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K
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[
1
6
]
P
.
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.
K
.
K
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.
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[
1
7
]
R
i
s
k
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s
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a
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Pr
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9
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[
1
8
]
N
.
C
.
S
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,
A
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s
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.
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[
1
9
]
R
.
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a
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.
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me
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o
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D
.
S
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,
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[
2
1
]
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.
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.
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B
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l
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.
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,
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3
.
[
2
3
]
N
.
R
o
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Evaluation Warning : The document was created with Spire.PDF for Python.