Parent and peer influence models in the onset of adolescent smoking / Modelos de influencia de padres y amigos en el inicio del consumo de tabaco en adolescentes

El tabaco es la segunda droga más utilizada por los adolescentes. Objetivo. Analizar la influencia de diferentes agentes de socialización: padres y compañeros, en el uso y en la intención de uso por los adolescentes. Método: Estudio transversal en ámbito escolar. N=5,828 jóvenes (50.2% chicos, 49.8% chicas) estudiantes de Centros de Educación Secundaria (media de edad=14.15). Medidas: Consumo auto-informado de cigarrillos, actitudes hacia el tabaco y uso de tabaco por el grupo de influencia. Resultados: El consumo de tabaco por los compañeros es la variable que más incrementa la probabilidad y la intención de uso. Fumar es más probable entre los sujetos cuyos amigos fuman (odds ratio 7.16, I.C. 95% 5,5-9,3), que entre aquellos cuyos amigos no son fumadores. Conclusiones: La conducta de los compañeros juega un papel predominante en el inicio y mantenimiento del hábito tabáquico. Las chicas son más vulnerables a la influencia social. En consecuencia, la probabilidad de uso o intención de uso es mayor entre las chicas que entre los chicos ante la presencia de amigo/as que fuman. AbstractTobacco is the second most commonly used drug among adolescents. Aim. The aim is to analyse the influence of different socializing agents: parents and peers, in the use and the intention of use among adolescents. Methods. Cross-sectional study in a school setting in Spain. 5,828 youngsters (50.2% males, 49.8% females) recruited in Secondary Education Centres (mean age 14.15). Main outcome measures: Self-reported tobacco use (ever and current use of cigarettes), attitudes toward tobacco and influence groups tobacco use. Findings. There is a relative importance of parent influence to adolescent smoking onset. Peer tobacco use is the variable that increases the most the probability of use. Smoking is more likely among those subjects whose friends smoke (odds ratio 7.16, 95% confidence interval 5,5 - 9,3), than among those whose friends are non-smokers. Conclusions. Peer behaviour plays a predominant role in the onset and regular use of tobacco. Girls are more vulnerable to social pressure, the use or intention to use increases more sharply among girls in the presence of friends who smoke than among boys.

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Assessment of nicotine dependence among tobacco users visiting outreach programs in Dharan, Nepal: a cross-sectional study

10.21203/rs.3.rs-33461/v1 ◽

2020 ◽

Author(s):

Krishna Subedi ◽

Ashish Shrestha ◽

Tarakant Bhagat

Keyword(s):

Nicotine Dependence ◽

Tobacco Use ◽

Smokeless Tobacco ◽

Odds Ratio ◽

Tobacco Cessation ◽

Cross Sectional Study ◽

Cross Sectional ◽

Outreach Programs ◽

Nicotine Dependency ◽

The Mean

Abstract Background Nicotine is a highly addictive substance present in tobacco. This study was conducted to assess the prevalence of tobacco use and compare the nicotine dependence among smokers and smokeless tobacco users visiting dental outreach programs of B.P. Koirala Institute of Health Sciences -Dharan, Nepal. Methods A cross sectional study was conducted from June 2018 to April 2019. A total of 726 people were selected from participants of dental outreach programs of 6 districts using convenience sampling technique. The data collection was done using semi-structured questionnaire through face to face interview by a single researcher. History of tobacco use and level of nicotine dependency was measured using Nepali translated and validated form of Fagerström Test for Nicotine Dependence for smoking and smokeless. The mean age of the tobacco users was 39.55 ± 15.57 (Range = 19–82 years). Descriptive statistics including the mean, median, percentage, standard deviations and interquartile range were computed. Chi-square test, Fisher’s exact test and odds ratio were calculated where needed. Results The overall prevalence of any tobacco use, smoking form, smokeless and both form was found to be 32.8%, 14.9%, 14.3% and 3.6% respectively. Nicotine dependence (moderate and severe) was found in 80% of smokeless tobacco users and 48% of smokers. Among the smokeless tobacco users nicotine dependency was found to be more with female gender (Odds ratio = 4.98, 95%CI = 1.41–17.69, p = 0.01), increase in duration of tobacco use with every 10 years, low socioeconomic status (Odds ratio = 2.75, 95%CI = 1.02–7.40, p = 0.04), married, not using alcohol. Among smokers nicotine dependency was found to be significantly higher with more than 30 years of duration (Odds ratio = 3.35, 95% CI = 1.42–7.92, p = 0.005). Conclusions The study concluded that prevalence of tobacco consumption and nicotine dependence was high among the people visiting dental outreach programs. This study incorporated both smoking and smokeless tobacco users. It is high time to develop a policy to control tobacco use along with creating tobacco cessation centers. Tobacco control program are basically focusing on smoking. However, it is very necessary to incorporate in policy level to control smokeless tobacco along with smoking. Tobacco cessation centers will obviously help to quit tobacco among the tobacco users.

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Is there a relationship between gestational diabetes and postpartum depression?

Current Women s Health Reviews ◽

10.2174/1573404816999200918115133 ◽

2020 ◽

Vol 16 ◽

Author(s):

Salman Khazaei ◽

Erfan Ayubi ◽

Saeid Bashirian ◽

Ronak Hamzehei ◽

Ensiyeh Jenabi

Keyword(s):

Gestational Diabetes ◽

Postpartum Depression ◽

Odds Ratio ◽

Depression Scale ◽

Binary Logistic Regression ◽

Cross Sectional Study ◽

University Education ◽

P Value ◽

Cross Sectional ◽

The Relationship

Background: The relationship between gestational diabetes and postpartum depression (PPD) is poorly understood and seldom studied. Objective: In an effort to explore this issue, the present study investigated the relationship between gestational diabetes and PPD. Methods: The present cross-sectional study was performed with 342 women who were referred to four urban health centers of Hamadan city, west of Iran. We used convenience sampling as a method to recruit women in each health center. We used a researcher-made checklist for gathering data on socio-demographic characteristics and potential risk factors of PPD. The Persian validated version of the Edinburgh Postnatal Depression Scale (EPDS) was used to assess PPD. Univariate and multivariable binary logistic regression was applied to estimate the odds ratio (OR) (95% confidence interval [CI]). Results: Gestational diabetes was identified as the most important risk factor for PPD with OR (95% CI) of 2.19 (1.11, 4.31); P-value=0.02 after adjusting for other variables. Moreover, the adjusted odds ratio showed that PPD among lesseducated women (primary school) was 3.5 times higher compared to women with a university education (OR=3.54, 95% CI: 1.27, 9.84; P-value=0.01). Conclusion: Our findings suggested that PPD is more likely among women with gestational diabetes and those who were less educated. Interventional and educational activities for reducing the risk of PPD can be targeted for use with this population.

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Epidemiology of hypertension in selected towns of Wollega zones, Western Ethiopia, 2019: A community-based cross-sectional study

SAGE Open Medicine ◽

10.1177/20503121211024519 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110245

Author(s):

Getu Mosisa ◽

Bikila Regassa ◽

Bayise Biru

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Alcohol Consumption ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Cross Sectional Study ◽

Care Providers ◽

Sectional Study ◽

Community Based ◽

Cross Sectional

Introduction: Hypertension remains an emerging public health problem globally, particularly in developing countries. Age, income level, obesity, alcohol consumption, smoking, vegetables and fruit consumption, physical activity and chat chewing were some risk factors of hypertension. However, there are limited data on the epidemiology of hypertension in Ethiopia. This study aimed to assess Epidemiology of Hypertension among the community of selected towns of Wollega zones. Methods: A community-based cross-sectional study was conducted from 1 to 30 June 2019 in selected towns of Wollega zones. A multistage sampling technique was used to select 840 study participants. Data were collected using the WHO STEP wise approach. The data were coded and entered into EpiData 3, and exported to SPSS version 20.0 for analysis. Bivariate and multivariable logistic regression analyses were conducted. Statistical significance was declared at p-value < 0.05. Results: The study included a total of 838 respondents with a response rate of 99.7%. The prevalence of hypertension was found to be 189 (22.6%) (95% confidence interval = 19.9%–25.2%). Of this, 108 (12.9%) and 81 (9.7%) of female and male were hypertensive, respectively. Age groups of 30–44 years (adjusted odds ratio = 2.65 (1.43, 4.89)), 45–59 years (adjusted odds ratio = 3.55 (1.79, 7.04)), above 60 years (adjusted odds ratio = 2.97 (1.43, 6.18)), having history of alcohol consumption (adjusted odds ratio = 4.29 (2.4, 7.66)), involving in vigorous physical activity (adjusted odds ratio = 0.096 (0.028, 0.33)), not walking to and from the work (adjusted odds ratio = 13.12 (8.34, 20.67)), being overweight (adjusted odds ratio = 1.98 (1.21, 3.25)), inadequate fruits serving per day (adjusted odds ratio = 2.93 (1.75, 4.88)) were significantly associated with hypertension. Conclusion: The prevalence of hypertension was found to be high in the study area. Older age, alcohol consumption, not engaging in vigorous activity, physical inactivity, being overweight and inadequate intake of fruits were found to be risk factors for hypertension. Therefore, health care providers should provide extensive health education and promotion on recommended lifestyle modification to tackle the burden of hypertension.

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Quality of Life and Associated Factors in Young Workers

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18042153 ◽

2021 ◽

Vol 18 (4) ◽

pp. 2153

Author(s):

José Andrade Louzado ◽

Matheus Lopes Cortes ◽

Márcio Galvão Oliveira ◽

Vanessa Moraes Bezerra ◽

Sóstenes Mistro ◽

...

Keyword(s):

Quality Of Life ◽

Odds Ratio ◽

Cross Sectional Study ◽

Young Workers ◽

Cross Sectional ◽

Physically Active ◽

Significance Level ◽

Self Rated Health ◽

Assess Quality

Background: This study aimed to identify the factors associated with the quality of life of young workers of a Social Work of Industry Unit. Methods: This was a cross-sectional study conducted on 1270 workers. Data were collected using a digital questionnaire built on the KoBoToolbox platform that included the EUROHIS-QOL eight-item index to assess quality of life. Demographic, socioeconomic, behavioral, and clinical variables were considered explanatory. The associations were analyzed using the ordinal logistic regression model at a 5% significance level. Results: Men and women had a mean quality of life of 31.1 and 29.4, respectively. Workers that rated their health as “very good” had an odds ratio of 7.4 (95% confidence interval (CI) = 5.17–10.81), and those who rated it as “good” had an odds ratio of 2.9 (95% CI = 2.31–3.77). Both these groups of workers were more likely to have higher levels of quality of life as compared to workers with “regular”, “poor”, or “very poor” self-rated health. Physically active individuals were 30% more likely to have higher levels of quality of life (odds ratio = 1.3; 95% CI = 1.08–1.65). After adjusting the model by gender, age group, marital status, socioeconomic class, self-rated health, nutritional status, and risky alcohol consumption, the odds ratio of active individuals remained stable (odds ratio = 1.3; 95% CI = 1.05–1.66). Conclusions: In the present study, self-rated health, physical activity, and gender were associated with young workers’ quality of life.

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The Associated Factors of Prolonged Screen Time and Using Electronic Devices before Sleep among Elderly People in Shaanxi Province of China: A Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18137020 ◽

2021 ◽

Vol 18 (13) ◽

pp. 7020

Author(s):

Yaxuan Zhang ◽

Jiwei Wang ◽

Xinyuan Lu ◽

Beibei Che ◽

Jinming Yu

Keyword(s):

Sleep Quality ◽

Screen Time ◽

Odds Ratio ◽

Associated Factors ◽

Electronic Devices ◽

Cross Sectional Study ◽

Shaanxi Province ◽

Sectional Study ◽

Monthly Income ◽

Cross Sectional

This study aimed to investigate prolonged screen time and using electronic devices before sleep and their associated factors in elderly people in Shaanxi province of China. We conducted a cross-sectional study among 2647 elderly participants aged 60–88 years. Data were collected through questionnaires. Demographic characteristics, screen time, using electronic devices before sleep, health status, lifestyles, sleep quality, and other associated factors were investigated. Logistic regression analysis was used to analyze the relationship between the associated factors of screen time and using electronic devices before sleep. The crude odds ratio (cOR) and adjusted odds ratio (aOR) and their 95% confidence intervals (CI) were calculated. A total of 1784 subjects completed the questionnaire. There were 6.89% participants with prolonged screen time and 13.45% using electronic devices before sleep frequently. Prolonged screen time was associated with personal monthly income (aOR = 1.205, p = 0.001), number of household residents (aOR = 0.860, p = 0.010), rural residents (aOR = 0.617, p = 0.038), and regular drinkers (aOR = 2.889, p < 0.001). Using electronic devices before sleep was associated with being female (aOR = 0.657, p = 0.007), family monthly income (aOR = 0.866, p = 0.002), being an occasional drinker (aOR = 1.891, p = 0.005), and self-reported sleep quality (aOR = 1.593, p = 0.007). In conclusion, several factors related to screen time or using electronic devices before sleep were identified. Only being a drinker was a common associated factor for both screen time and using electronic devices before sleep.

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Investigating the relationship between insulin resistance and adipose tissue in a randomized Tehrani population

Hormone Molecular Biology and Clinical Investigation ◽

10.1515/hmbci-2020-0084 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Jalaledin Mirzay Razzaz ◽

Hossein Moameri ◽

Zahra Akbarzadeh ◽

Mohammad Ariya ◽

Seyed ali Hosseini ◽

...

Keyword(s):

Insulin Resistance ◽

Adipose Tissue ◽

Body Fat ◽

Odds Ratio ◽

Cross Sectional Study ◽

Model Assessment ◽

Fasting Insulin ◽

Cross Sectional ◽

Body Fat Percent ◽

The Relationship

Abstract Objectives Insulin resistance is the most common metabolic change associated with obesity. The present study aimed to investigate the relationship between insulin resistance and body composition especially adipose tissue in a randomized Tehrani population. Methods This study used data of 2,160 individuals registered in a cross-sectional study on were randomly selected from among subjects who were referred to nutrition counseling clinic in Tehran, from April 2016 to September 2017. Insulin resistance was calculated by homeostasis model assessment formula. The odds ratio (95% CI) was calculated using logistic regression models. Results The mean age of the men was 39 (±10) and women were 41 (±11) (the age ranged from 20 to 50 years). The risk of increased HOMA-IR was 1.03 (95% CI: 1.01–1.04) for an increase in one percent of Body fat, and 1.03 (95% CI: 1.00–1.05) for an increase in one percent of Trunk fat. Moreover, the odds ratio of FBS for an increase in one unit of Body fat percent and Trunk fat percent increased by 1.05 (adjusted odds ratio [95% CI: 1.03, 1.06]) and 1.05 (95% CI: 1.02, 1.08). Also, the risk of increased Fasting Insulin was 1.05 (95% CI: 1.03–1.07) for an increase in one unit of Body fat percent, and 1.05 (95% CI: 1.02–1.08) for an increase in one unit of Trunk fat percent. Conclusions The findings of the present study showed that there was a significant relationship between HOMA-IR, Fasting blood sugar, Fasting Insulin, and 2 h Insulin with percent of Body fat, percent of Trunk fat.

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Analysis of the relationship between periodontitis and osteoporosis/fractures: a cross-sectional study

BMC Oral Health ◽

10.1186/s12903-021-01496-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Seok-Jin Hong ◽

Byoung-Eun Yang ◽

Dae-Myoung Yoo ◽

Sung-Jae Kim ◽

Hyo-Geun Choi ◽

...

Keyword(s):

Odds Ratio ◽

Bone Destruction ◽

Epidemiological Data ◽

Income Group ◽

Cross Sectional Study ◽

Inflammatory Factors ◽

Sectional Study ◽

Mineral Density ◽

Cross Sectional ◽

History Of

Abstract Background Chronic periodontitis is a multifactorial inflammatory disease resulting in patients exhibiting high levels of inflammatory factors causing systemic inflammatory bone destruction that may lead to osteoporosis development. The association between periodontitis and osteoporosis has been documented; however, the findings remain unclear. This study aimed to identify the association between periodontitis and osteoporosis using a cross-sectional study design and Korean Genome and Epidemiology Study (KoGES) health examinee data. Methods This cross-sectional study used epidemiological data from the KoGES during 2004–2016. Of 125,324 participants (age, 40–79 years), 9969 with periodontitis and 115,332 controls (without periodontitis) were selected. We analyzed the history of osteoporosis and fractures of all participants. All participants were examined according to age, sex, income group, obesity, smoking habits, alcohol consumption, and food intake. To analyze the odds ratio (OR) of periodontitis for those with osteoporosis and fractures, a logistic regression model was used. Results The adjusted odds ratio (aOR) of periodontitis for osteoporosis was 2.16 (95% confidence interval [CI], 2.01–2.31; P < 0.001). The aOR of periodontitis for any fracture was 1.54 (95% CI 1.46–1.62; P < 0.001). Conclusion Osteoporosis and fractures are associated with periodontitis. Performing regular oral hygiene and examinations of bone mineral density are recommended to prevent aggravation of osteoporosis and periodontitis.

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Nonadherence to tuberculosis treatment and associated factors among patients using directly observed treatment short-course in north-west Nigeria: A cross-sectional study

SAGE Open Medicine ◽

10.1177/2050312121989497 ◽

2021 ◽

Vol 9 ◽

pp. 205031212198949

Author(s):

Cylia Nkechi Iweama ◽

Olaoluwa Samson Agbaje ◽

Prince Christian Ifeanachor Umoke ◽

Chima Charles Igbokwe ◽

Eyuche Lawretta Ozoemena ◽

...

Keyword(s):

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Cross Sectional Study ◽

Medication Nonadherence ◽

Cross Sectional ◽

Tuberculosis Patients ◽

North West ◽

Short Course ◽

Directly Observed Treatment

Introduction: Tuberculosis is a public health problem in Nigeria. One of the most effective ways of controlling tuberculosis is the directly observed treatment short-course. However, some factors influence tuberculosis patients’ treatment nonadherence via directly observed treatment short-course. The study objective was to assess medication nonadherence and associated factors among tuberculosis patients in north-west Nigeria. Methods: A cross-sectional study enrolled tuberculosis patients using directly observed treatment short-course in public health facilities in Kano and Kaduna States from January 2015 to June 2016. The sample selection was conducted via a multistage sampling procedure. Data were collected using tuberculosis patients’ demographic and clinical characteristics forms, well-validated structured instruments, and medical records. SPSS version 20 was used for data analysis. Logistic and multivariable logistic regression analyses to determine factors of medication nonadherence ( P < 0.05) Results: Complete responses from 390 patients out of the 460 patients recruited for the study were used for data analyses. The mean age was 51.5 (standard deviation = ±13.8) years. The mean tuberculosis medication adherence questionnaire score was 4.35 ± 1.12. The prevalence of nonadherence to tuberculosis medication was 30.5%. Multivariable logistic regression analysis showed that having a monthly income between #100,000 and #199, 000 (adjusted odds ratio = 0.01; 95% confidence interval: 0.00–0.13), being widowed (adjusted odds ratio = 26.74, 95% confidence interval: 2.92–232.9), being married (adjusted odds ratio = 120.49, 95% confidence interval: 5.38–271.1), having a distance <5 km to directly observed treatment short-course center from home (adjusted odds ratio = 0.06, 95% confidence interval: 0.00–0.01), having a tuberculosis/HIV co-infection (adjusted odds ratio = 0.01, 95% confidence interval: 0.12–0.35), use of antiretroviral treatment and cotrimoxazole prophylaxis therapy medications (adjusted odds ratio = 24.9, 95% confidence interval: 19.6–304.3) were associated with tuberculosis medication nonadherence. Conclusion: Tuberculosis medication nonadherence was high among the patients. Thus, patient-specific adherence education, attenuation of potential factors for tuberculosis medication nonadherence, and continual resource support for tuberculosis patients are needed to improve treatment outcomes.

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Changes in Tobacco Use Patterns during COVID-19 and Their Correlates among Older Adults in Bangladesh

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041779 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1779

Author(s):

Sabuj Kanti Mistry ◽

Armm Mehrab Ali ◽

Md. Ashfikur Rahman ◽

Uday Narayan Yadav ◽

Bhawna Gupta ◽

...

Keyword(s):

Older Adults ◽

Tobacco Use ◽

Rural Areas ◽

Cross Sectional Study ◽

Cross Sectional ◽

Policy Makers ◽

Use Patterns ◽

Telephone Interviews ◽

Related Information ◽

Structured Questionnaire

The present study explored the changes in tobacco use patterns during the COVID-19 pandemic and their correlates among older adults in Bangladesh. This cross-sectional study was conducted among 1032 older adults aged ≥60 years in Bangladesh through telephone interviews in October 2020. Participants’ characteristics and COVID-19-related information were gathered using a pretested semi-structured questionnaire. Participants were asked if they noted any change in their tobacco use patterns (smoking or smokeless tobacco) during the COVID-19 pandemic compared to pre-pandemic (6 months prior to the survey). Nearly half of the participants (45.6%) were current tobacco users, of whom 15.9% reported increased tobacco use during the COVID-19 pandemic and all others had no change in their tobacco use patterns. Tobacco use was significantly increased among the participants from rural areas, who had reduced communications during COVID-19 compared to pre-pandemic (OR = 2.76, 95%CI:1.51–5.03). Participants who were aged ≥70 years (OR = 0.33, 95% CI: 0.14–0.77), widowed (OR = 0.36, 95% CI: 0.13–1.00), had pre-existing, non-communicable, and/or chronic conditions (OR = 0.44, 95% CI: 0.25–0.78), and felt themselves at the highest risk of COVID-19 (OR = 0.31, 95% CI: 0.15–0.62), had significantly lower odds of increased tobacco use. Policy makers and practitioners need to focus on strengthening awareness and raising initiatives to avoid tobacco use during such a crisis period.

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Factors associated with parental traditional medicine use for children in Fagita Lekoma Woreda Northwest Ethiopia: A cross-sectional study

SAGE Open Medicine ◽

10.1177/2050312120978008 ◽

2020 ◽

Vol 8 ◽

pp. 205031212097800

Author(s):

Damtew Asrat ◽

Atsede Alle ◽

Bekalu Kebede ◽

Bekalu Dessie

Keyword(s):

Confidence Interval ◽

Traditional Medicine ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Cross Sectional Study ◽

Medicine Use ◽

Community Based ◽

Cross Sectional ◽

Traditional Medicines ◽

Factors Associated

Background: Over the last 100 years, the development and mass production of chemically synthesized drugs have revolutionized health care in most parts of the world. However, large sections of the population in developing countries still depend on traditional medicines for their primary health care needs. More than 88% of Ethiopian parents use different forms of traditional medicine for their children. Therefore, this study aimed to determine factors associated with parental traditional medicine use for children in Fagita Lekoma Woreda. Method: Community-based cross-sectional study was conducted from 1 to 30 March 2019 in Fagita Lekoma Woreda. Data collection tool was a structured interviewer-administered questionnaire. Both descriptive and inferential statistics were used to present the data. Odds ratio and binary and multiple logistic regression analysis were used to measure the relationship between dependent and independent variables. Results: Among 858 participants, 71% of parents had used traditional medicine for their children within the last 12 months. Parents who cannot read and write (adjusted odds ratio = 6.42, 95% confidence interval = 2.1–19.7), parents with low monthly income (adjusted odds ratio = 4.38, 95% confidence interval = 1.58–12.1), and those who had accesses to traditional medicine (adjusted odds ratio = 2.21, 95% confidence interval = 1.23–3.98) were more likely to use traditional medicine for their children. Urban residents (adjusted odds ratio = 0.20, 95% confidence interval = 0.11–0.38) and members of community-based health insurance (adjusted odds ratio = 0.421, 95% confidence interval = 0.211–0.84) were less likely to use traditional medicine for their children. Conclusions: Our study revealed that the prevalence of traditional medicine remains high. Educational status, monthly income, residence, accessibility to traditional medicine, and being a member of community-based health insurance were predictors of potential traditional medicine use. Therefore, the integration of traditional medicine with modern medicine should be strengthened. Community education and further study on efficacy and safety of traditional medicines should be also given great attention.

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