scholarly journals Syrian mothers, why to accept or to refuse HPV vaccine for their teen girls

2018 ◽  
Vol 1 (1) ◽  
pp. 7-13
Author(s):  
Mohammed Al Saad ◽  
Saad Ahmed Ali Jadoo
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Hpv Vaccine ◽  
Multiple Logistic Regression Analysis ◽  
Univariate Analysis ◽  
Cluster Sampling ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Gynecological Examination

Background: Cervical cancer (CC) ranks the eighth most frequent cancer among Syrian women with crude incidence rates 1.4 per 100, 000 populations per year. This study aimed to test the acceptance of the human papillomavirus (HPV) vaccine among mothers of schoolgirls in sixth-grade class. Methods: A cross-sectional survey was conducted through a structured and self-administrated questionnaire. A total of 400 Syrian mothers of schoolgirls were selected randomly by the cluster sampling method in Aleppo city, Syria, in 2011. Significant variables from univariate analysis were included in an enter technique multiple logistic regression analysis. Results: The response rate was 86%. If the vaccine was free, 282 (81.7%) mothers would accept the vaccine for themselves and 236 (68.4%) for their daughters, respectively. However, the acceptance rate grossly decreased to 24.6% and 15.1%, respectively, if the vaccine was not provided free. The high cost of the HPV vaccine and lack of knowledge were the significant barriers for mothers' acceptance of the HPV vaccine. Protection of daughters and the trust with health authority were the main encouraging reasons to accept the HPV vaccine. Findings from logistic regression analysis revealed that the employed mothers (odds ratio = 2.4; 95% CI: 1.3–4.4), with a positive history of gynecological examination (OR = 2.1; 95% CI: 1.6–2.9) and having sound knowledge (OR = 2.4; 95% CI: 1.0–5.7) are independent factors related to the acceptance of the HPV vaccine for their daughters. Conclusion: The results from this study suggest that mothers from different cultural backgrounds, including Syrian mothers, are holding different beliefs on privacy and health that may affect their willingness to accept the HPV vaccine.

scholarly journals Effect of living environment on ear, nose and throat diseases: a cross sectional survey in rural areas of Rohtas district in Bihar

2018 ◽  
Vol 4 (3) ◽  
pp. 625
Author(s):  
Sujeet Kumar ◽  
Ahmad Nadeem Aslami ◽  
Tarkeshwar Rai ◽  
Bhaskar Alwa
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Rural Areas ◽  
Multiple Logistic Regression Analysis ◽  
Living Environment ◽  
Internal Environment ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Nose And Throat

<p class="abstract"><strong>Background:</strong> Ear, nose and throat (ENT) diseases are very common in general population. Internal living environment can act an important risk factor for these diseases. In rural areas, patients do not consult ENT experts. So, free health camps can bring treatment facilities at their doorsteps. The objective of this study was to determine the pattern and prevalence of ENT diseases in rural areas of Sasaram, Rohats district, Bihar and to find out the effect of living environment on these diseases.</p><p class="abstract"><strong>Methods:</strong> The study<strong> </strong>was conducted using camp approach in rural areas of Sasaram, Rohtas, Bihar. ENT and Community Medicine experts, interns along with audiologists, medico social workers, nurses and paramedical staff were voluntarily involved.<strong> </strong>The patients were screened and referred to ENT experts. A logistic regression analysis was conducted to determine the internal environment factors associated with ENT diseases.  </p><p class="abstract"><strong>Results:</strong> Out of 832 patients, 61.9% were suffering from ENT disorders. Most common age group affected was of 31-40 years. 54.8% of patients were suffering from ear diseases while nasal and throat problem was seen in 14.9% and 30.3% respectively.<strong> </strong>Multiple logistic regression analysis of living environment conditions propounds that non-availability of cross ventilation in houses and overcrowding are most important factor influencing ENT diseases.</p><p class="abstract"><strong>Conclusions:</strong> Free health camps conducted by medical experts act as an opportunity to screen people with various diseases of ENT in a community. Bad internal environment can act as a vital determinant for these diseases.</p><p class="abstract"> </p>

scholarly journals Attitudes towards the New Zealand Government’s Smokefree 2025 goal associated with smoking and vaping in university students aged 18 to 24 years: results of a 2018 national cross-sectional survey

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037362
Author(s):  
Ben Wamamili ◽  
Mark Wallace-Bell ◽  
Ann Richardson ◽  
Randolph C Grace ◽  
Pat Coope
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
New Zealand ◽  
University Students ◽  
Confidence Intervals ◽  
Logistic Regression Analysis ◽  
Smoking Prevalence ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Lower Odds

ObjectiveIn March 2011, New Zealand (NZ) launched an aspirational goal to reduce smoking prevalence to 5% or less by 2025 (Smokefree 2025 goal). Little is known about university students’ awareness of, support for and perceptions about this goal. We sought to narrow the knowledge gap.SettingUniversity students in NZ.MethodsWe analysed data from a 2018 cross-sectional survey of university students across NZ. Logistic regression analysis examined the associations between responses about the Smokefree goal with smoking and vaping, while controlling for age, sex and ethnicity. Confidence intervals (95% CI) were reported where appropriate.ParticipantsThe sample comprised 1476 students: 919 (62.3%) aged 18 to 20 and 557 (37.7%) aged 21 to 24 years; 569 (38.6%) male and 907 (61.4%) female; 117 (7.9%) Māori and 1359 (92.1%) non-Māori. Of these, 10.5% currently smoked (ie, smoked at least monthly) and 6.1% currently vaped (ie, used an e-cigarette or vaped at least once a month).ResultsOverall awareness of the Smokefree goal was 47.5% (95% CI: 44.9 to 50.1); support 96.9% (95% CI: 95.8 to 97.8); belief that it can be achieved 88.8% (95% CI: 86.8 to 90.7) and belief that e-cigarettes/vaping can help achieve it 88.1% (95% CI: 86.0 to 89.9).Dual users of tobacco cigarettes and e-cigarettes had greater odds of being aware of the Smokefree goal (OR=3.07, 95% CI: 1.19 to 7.92), current smokers had lower odds of supporting it (OR=0.13, 95% CI: 0.06 to 0.27) and of believing that it can be achieved (OR=0.15, 95% CI: 0.09 to 0.24) and current vapers had greater odds of believing that e-cigarettes/vaping can help to achieve it (OR=8.57, 95% CI: 1.18 to 62.52) compared with non-users.ConclusionsThe results suggest strong overall support for the Smokefree goal and belief that it can be achieved and that e-cigarettes/vaping can help achieve it. Smoking and vaping were associated with high awareness of the Smokefree goal, but lower support and optimism that it can be achieved.

scholarly journals Prevalence of postural deviations and associated factors in children and adolescents: a cross-sectional study

2016 ◽  
Vol 29 (4) ◽  
pp. 777-786 ◽  
Author(s):  
Mariana Vieira Batistão ◽  
Roberta de Fátima Carreira Moreira ◽  
Helenice Jane Cote Gil Coury ◽  
Luis Ernesto Bueno Salasar ◽  
Tatiana de Oliveira Sato
Keyword(s):  
Physical Activity ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Associated Factors ◽  
Multiple Logistic Regression Analysis ◽  
Extrinsic Factors ◽  
Cross Sectional ◽  
Postural Changes ◽  
Intrinsic And Extrinsic Factors

Abstract Introduction: Postural deviations are frequent in childhood and may cause pain and functional impairment. Previously, only a few studies have examined the association between body posture and intrinsic and extrinsic factors. Objective: To assess the prevalence of postural changes in school children, and to determine, using multiple logistic regression analysis, whether factors such as age, gender, BMI, handedness and physical activity might explain these deviations. Methods: The posture of 288 students was assessed by observation. Subjects were aged between 6 and 15 years, 59.4% (n = 171) of which were female. The mean age was 10.6 (± 2.4) years. Mean body weight was 38.6 (± 12.7) kg and mean height was 1.5 (± 0.1) m. A digital scale, a tapeline, a plumb line and standardized forms were used to collect data. The data were analyzed descriptively using the chi-square test and logistic regression analysis (significance level of 5%). Results: We found the following deviations to be prevalent among schoolchildren: forward head posture, 53.5%, shoulder elevation, 74.3%, asymmetry of the iliac crests, 51.7%, valgus knees, 43.1%, thoracic hyperkyphosis, 30.2%, lumbar hyperlordosis, 37.2% and winged shoulder blades, 66.3%. The associated factors were age, gender, BMI and physical activity. Discussion: There was a high prevalence of postural deviations and the intrinsic and extrinsic factors partially explain the postural deviations. Conclusion: These findings contribute to the understanding of how and why these deviations develop, and to the implementation of preventive and rehabilitation programs, given that some of the associated factors are modifiable.

Abstract TP21: Is Presence of Diabetes Mellitus a Key Prognostic Factor among Patients Receiving Endovascular Treatment for Acute Ischemic Stroke?

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Seong-Joon Lee ◽  
Yang-Ha Hwang ◽  
Ji Man Hong ◽  
Jin Wook Choi ◽  
Dong-Hun Kang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Logistic Regression Analysis ◽  
Multiple Logistic Regression Analysis ◽  
Univariate Analysis ◽  
Intravenous Thrombolysis ◽  
The Impact

Introduction: Given the recent positive endovascular therapy trials for acute ischemic stroke (AIS), this therapeutic strategy is now being increasingly incorporated into routine clinical practice. Identifying prognostic factors among AIS patients receiving endovascular revascularization treatments (ERT) in the real world could be important for clinicians and patients. While the impact of diabetes mellitus (DM) on IV thrombolytic outcomes after AIS has been extensively investigated, there is a paucity of data assessing effects of DM on ERT outcomes after AIS. We evaluated the impact of comorbid DM on ERT for AIS. Methods: From Jan 2011 to Feb 2016, patients with AIS who underwent ERT for cervicocephalic occlusions were consecutively enrolled into the Acute Stroke due to Intracranial Atherosclerotic occlusion and Neurointervention - Korean Retrospective (ASIAN KR) registry from 3 hospitals. Patients were excluded if onset to puncture time over 8 hours, in-hospital stroke, or unavailable 3-month mRS. DM was diagnosed if a patient had the history, or hemoglobin A1c on admission was over 6.5. Univariate analysis was performed to compare the characteristics between DM and non-DM population. Multiple logistic regression analysis was used to validate the effect of comorbid DM on 3 month outcomes. Results: Of 721 patients, 667 (93%) were finally included, with 233 DM patients and 434 non-DM patients. In the univariate analysis, comorbidity with hypertension (71.2% vs. 58.3%, p=0.001) and dyslipidemia (36.7% vs. 26.7%, p=0.012) were more frequent in the DM population. Periprocedural factors such as target vessels, intravenous thrombolysis, and final reperfusion grades did not differ. Good outcomes with mRS 0-2 were less frequent in the DM population (43.3% vs. 53.7%, p=0.011). In the logistic regression analysis adjusting age, male sex, initial NIHSS, premorbid mRS, hypertension history, atrial fibrillation, intravenous thrombolysis, onset to puncture time and successful reperfusion, DM was an independent predictor of poor outcomes (mRS 3-6; 1.933, 1.274-2.933, p=0.002). Conclusion: In patients receiving ERT for AIS due to cervicocephalic artery occlusions, the presence of DM as a comorbidity confers greater odds of a poor functional outcome.

Pride, shame and health among adolescents – a cross-sectional survey

2017 ◽  
Vol 30 (6) ◽  
Author(s):  
Eva Randell ◽  
Junia Joffer ◽  
Renée Flacking ◽  
Bengt Starrin ◽  
Lars Jerdén
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Identity Development ◽  
Logistic Regression Analysis ◽  
Strong Predictor ◽  
Well Being ◽  
Multivariable Logistic Regression Analysis ◽  
Protective Mechanism ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Background Pride and shame are important emotions known to influence identity development and psychological well-being in adolescence. Research evidence indicates that self-rated health (SRH) is a strong predictor of future health. This cross-sectional study, conducted during 2008–2009, aimed to investigate the associations between pride, shame and SRH among adolescent boys and girls. Methods The study sample comprised 705 adolescents in Sweden aged 17–18 years (318 boys and 387 girls) who completed a questionnaire that included items on SRH, shame and pride (participation rate 67%). Logistic regression analyses (univariable and multivariable) were used to investigate the associations between pride and shame as separate and combined constructs on SRH, adjusting for potential confounders (country of birth, parental educational level, school experience, having enough friends, mood in family and being active in associations). Results Pride and shame separately were significantly associated with SRH in both genders. Logistic regression analysis of the pride-shame model showed that the odds of having lower SRH were highest in boys and girls with lower pride-higher shame. In a multivariable logistic regression analysis of the pride-shame model the odds of having lower SRH remained significant in boys and girls with lower pride-higher shame [boys: odds ratio (OR) 3.51, confidence interval (CI) 1.40–8.81; girls: OR 2.70, CI 1.22–5.96] and in girls with lower pride-lower shame (OR 2.16, CI 1.02–4.56). Conclusion The emotions of shame and pride are associated with SRH in adolescence. Experiencing pride seems to serve as a protective mechanism in SRH in adolescents exposed to shame. We believe that this knowledge should be useful in adolescent health promotion.

scholarly journals Complications as important predictors of disability in ischemic stroke

2017 ◽  
Vol 36 (3) ◽  
pp. 197
Author(s):  
Rizaldy Taslim Pinzon ◽  
Rosa De Lima Renita Sanyasi
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Ischemic Stroke ◽  
Logistic Regression Analysis ◽  
Predictive Factors ◽  
Recurrent Stroke ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
Cross Sectional ◽  
Stroke Registry

Background<br />Stroke is the main cause of disability and death in many countries. The high incidence of disability in stroke survivors requires special attention to determine various predictive factors of disability. This study aimed to identify the various predictive factors of disability in ischemic stroke.<br /><br />Methods<br />This study was a cross sectional study on 4510 ischemic stroke patients. Each patient’s data had been recorded in the electronic stroke registry of Bethesda Hospital. Ischemic stroke diagnosis was confirmed by brain CT scan, which was interpreted by a neurologist and a radiologist. Disability was assessed using the modified Rankin scale. Predictors of disability were assessed. Multiple logistic regression analysis was used to analyse the data. <br /><br />Results<br />The subjects were predominantly males, &gt;60 years of age, and suffered stroke for the first time. The incidence of disability was 31.5% (1420/4510). Multiple logistic regression analysis showed that the presence of complications (OR: 6.43; 95% CI: 4.74-8.73; p&lt;0.001), decreased level of consciousness (OR: 4.82; 95% CI: 3.95-5.90; p &lt;0.001), onset ³3 hours (OR: 1.93; 95% CI: 1.52-2.45; p&lt;0.001), recurrent stroke (OR: 1.63; 95% CI: 1.39-1.90; p&lt;0.001), and age &gt;60 years (OR: 1.55; 95% CI: 1.35-1.79; p&lt;0.001) were independent predictive factors of disability.<br /><br />Conclusion<br />We demonstrated that a substantial proportion of patients with ischemic stroke become disabled. And the presence of complications was the most predictive factor of disability in ischemic stroke.

scholarly journals COVID-19 vaccine confidence and hesitancy among healthcare workers: a cross-sectional survey from a MERS-CoV experienced nation

2020 ◽  
Author(s):  
Mazin Barry ◽  
Mohamad-Hani Temsah ◽  
Abdullah Alhuzaimi ◽  
Nurah Alamro ◽  
Ayman Al-Eyadhy ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Healthcare Workers ◽  
Vaccine Safety ◽  
Outcome Variable ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
To Receive

AbstractObjectivesThis study aimed to identify COVID-19 vaccine perception, acceptance, confidence, hesitancy, and barriers among healthcare workers (HCW).MethodsAn online national cross-sectional pilot-validated questionnaire was self-administered by HCW in Saudi Arabia, a nation with MERS-CoV experience. The main outcome variable was HCW’s acceptance of COVID-19 vaccine candidates. The associated factors of vaccination acceptance were identified through a logistic regression analysis and the level of anxiety using generalized anxiety disorder 7.ResultOut of 1512 HCWs who completed the study questionnaire—944 (62.4%) women and 568 (37.6%) men—1058 (70%) were willing to receive COVID-19 vaccines. Logistic regression analysis revealed that male HCWs (ORa=1.551, 95% CI: 1.122–2.144), HCWs who believe in vaccine safety (ORa=2.151; 95% CI:1.708–2.708), HCWs who believe that COVID vaccines are the most likely way to stop the pandemic (ORa=1.539; 95% CI: 1.259–1.881), and HCWs who rely on Centers for Disease Control and Prevention website for COVID 19 updates (ORa=1.505, 95% CI: 1.125–2.013) were significantly associated with reporting willingness to be vaccinated. However, HCWs who believed vaccines were rushed without evidence-informed testing were found to be 60% less inclined to accept COVID-19 vaccines (ORa=0.394, 95% CI: 0.298– 0.522).ConclusionMost HCWs are willing to receive COVID-19 vaccines once available; yet, satisfactoriness of COVID-19 vaccination among HCWs is crucial because health professionals’ knowledge and confidence toward vaccines are important determining factors for their own vaccine acceptance and recommendation to their patients.

scholarly journals Factors Associated with Treatment Outcome of Patients with Pulmonary Tuberculosis in the Philippines, 2015 to 2016

2020 ◽  
Vol 54 (5) ◽  
Author(s):  
Ian Oliver D. Macatangay ◽  
Sophia Anne S.P. Liao ◽  
Joshua Jason A. Dadural ◽  
Fatima Joy S. Gagui ◽  
Angelica Joy A. Galas ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Treatment Outcome ◽  
Logistic Regression Analysis ◽  
Multiple Logistic Regression Analysis ◽  
The Philippines ◽  
Sputum Smear ◽  
Cross Sectional ◽  
Factors Associated ◽  
Unsuccessful Treatment

Objective. The study aims to determine the factors associated with unsuccessful treatment outcome amongpatients who have undergone tuberculosis treatment. Methods. An analytic cross-sectional study was employed through secondary data analysis of administrativedata collected by the National Tuberculosis Control Program from October 2015 to September 2016. Usingmultiple logistic regression analysis, factors associated with unsuccessful treatment outcome were determined. Results. Multiple logistic regression analysis revealed that belonging to age groups 25 to 34 (aOR=0.73; 95%CI0.54-0.99) or 35 to 44 (aOR=0.75; 95%CI 0.56-0.99), being male (aOR=1.30; 95%CI 1.03-1.64), doing craftsand related trades work (aOR=0.66; 95%CI 0.46-0.94), living in either a 4th class city (aOR=0.46; 95%CI0.26-0.82), 1st class municipality (aOR=0.75; 95%CI 0.57-0.98), 4th class municipality (aOR=0.59; 95%CI0.38-0.93), having a positive sputum smear result (aOR=1.60; 95%CI 1.29-2.00), having rifampicin-resistant/multidrug-resistant tuberculosis (aOR=9.32; 95%CI 7.28-11.93), being a treatment after lost to follow-up case(aOR=1.84; 95%CI 1.37-2.47) or a case with previously unknown treatment outcome (aOR=1.42; 95%CI 1.00-2.01)were significant correlates of unsuccessful treatment outcome. Conclusion. The study found that age, sex, occupation, residence, sputum smear results, drug resistance, andhistory of previous treatment were associated with unsuccessful treatment outcome.

scholarly journals Cross-sectional survey on job satisfaction and its associated factors among doctors in tertiary public hospitals in Shanghai, China

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e023823 ◽  
Author(s):  
Jiazhen Liu ◽  
Wenya Yu ◽  
Tao Ding ◽  
Meina Li ◽  
Lulu Zhang
Keyword(s):  
Job Satisfaction ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Work Stress ◽  
Logistic Regression Analysis ◽  
Univariate Analysis ◽  
Public Hospitals ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Professional Title

ObjectivesDoctors in public hospitals in China face considerable pressure and excessive workloads, which are likely to predispose them to job dissatisfaction. We explored the job satisfaction of doctors and examined the influence of diverse sociodemographic characteristics.DesignThis was a cross-sectional study.SettingEleven tertiary public hospitals in Shanghai, China.ParticipantsThe questionnaire was designed based on the fifth National Health Service General Research, which was based on the Minnesota Satisfaction Questionnaire. Questionnaires were administered to 897 doctors randomly (using random number tables) and 730 were returned completed (response rate=81.4%). Doctors who volunteered and provided informed, written consent participated.Primary outcome measuresThe dependent variable was doctors’ job satisfaction.ResultsStatistical analyses were conducted using SPSS and SAS. Overall, 64.8% of participants were dissatisfied with their jobs. Factors that were statistically significant to doctors’ job satisfaction in the univariate analysis were entered into the logistic regression analysis, including doctors’ professional title, department, work hours, work requirements (reflected as the number of patients they diagnosed and treated monthly), life and work stress, and the types of patients that doctors treated or expected to treat. The results of the logistic regression analysis suggested that doctors’ job satisfaction was related to their professional title, types of patients that doctors treated or expected to treat, as well as their work stress.ConclusionsThere is an urgent need for public hospitals in China to establish a more reasonable promotion and management system for doctors, encourage patients to accept the two-way referral, pay more attention to less-experienced staff and help doctors release their work stress.

scholarly journals Addressing future work ability of employees in GP consultations: results of a cross-sectional study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Anna T. Ehmann ◽  
Peter Martus ◽  
Achim Siegel ◽  
Monika A. Rieger
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
General Practitioner ◽  
Logistic Regression Analysis ◽  
Work Ability ◽  
Multiple Logistic Regression Analysis ◽  
Care Providers ◽  
Cross Sectional ◽  
Integrated Healthcare ◽  
Future Work

Abstract Objectives In this study we examined to what extent members of a best-practice integrated healthcare model in Germany discussed their subjective future work ability with their general practitioner (GP); furthermore, we examined independent variables which explain whether future work ability is discussed. Methods In a cross-sectional survey, 1168 (out of 3218 invited) integrated healthcare members responded to a standardized questionnaire. This study includes n = 475 employed respondents who were at most 65 years old. We determined the (relative) frequency of employed members up to 65 years who had already discussed their subjective future work ability with their GP. By means of logistic regression analysis, explanatory variables were identified which statistically explained the discussion of future work ability with their GP. Results N = 80 (16.8%) respondents stated they had discussed their future work ability with their GP. A multiple logistic regression analysis showed the following results: The odds ratio for discussing future work ability is increased the more satisfied respondents are with their general practitioner, the worse they assess their current work ability in relation to the physical demands of the job, and when respondents suffer from one or more chronic diseases (Nagelkerke’s pseudo-R2 = 0.13). Conclusions Even in this healthcare setting, employees up to the age of 65 rarely discussed their subjective future work ability with their GP. This suggests that the issue ‘future work ability’ is even less commonly discussed in other community-based care settings in Germany. It seems that health care providers involved in acute care only sporadically take this issue into consideration - despite the great importance of maintaining work ability.

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