scholarly journals The Perceived Stress Level of Nursing Students Regarding The Clinical Practices in the Covid-19 Pandemic

2021 ◽  
Vol 11 (3) ◽  
pp. 592-599
Author(s):  
ışın cantekin
Keyword(s):  
Nursing Students ◽  
Perceived Stress ◽  
Cross Sectional Study ◽  
Nursing Profession ◽  
Clinical Practices ◽  
Perceived Stress Scale ◽  
Cross Sectional ◽  
Stress Scale ◽  
Significant Difference ◽  
Stress Levels

This descriptive cross-sectional study was conducted to determine the perceived stress levels of nursing students regarding the clinical practice during the Covid-19 pandemic. The study was conducted between May 20 and June 20, 2020, with 252 students studying in all classes in the Nursing Departments of Necmettin Erbakan University. The data were collected using the Information Form and the Perceived Stress Scale for Nursing Students (PSSNS). 52.0% of the students felt uncomfortable thinking about Covid-19, and 62.2% stated that their anxiety increased when they thought they were infected with Covid-19. The study further revealed that 57.9% of the nursing students were afraid to provide care to the individuals diagnosed with Covid-19 and 82.1% stated that they did not have enough knowledge to provide care to those individuals. Our study revealed that there is a statistically significant difference between the mean scores of the Perceived Stress Scale for Nursing Students and the students’ gender (p<0.01), the status of willingly choosing the nursing profession (p<0.01), the interest in the nursing profession during the Covid-19 pandemic (p<0.01), having enough knowledge to provide care to individuals diagnosed with Covid-19 (p<0.01), being uncomfortable thinking about Covid-19 (p<0.01), being afraid to provide care to individuals diagnosed with Covid-19 (p<0.01), and the increased anxiety level thinking that they were infected with Covid-19 (p<0.01). In this study, female nurses and nurses who did not choose the nursing profession willingly, whose interests in the nursing profession were negatively affected during the pandemic period, who believe that they do not have the knowledge or who do not want to provide care to individuals diagnosed with Covid-19, who are afraid to provide care, and who are uncomfortable thinking about Covid-19 were found to have higher perceived stress levels. It is recommended to offer training and counseling to the nursing students with high perceived stress levels

scholarly journals Association between COVID-19 Pandemic Conditions and Perceived Stress Level among College Students in Saudi Arabia

2021 ◽  
pp. 429-436
Author(s):  
Shaimaa M. Ata ◽  
Manal Eltahir ◽  
Ahad Albadah ◽  
Hind Harun ◽  
Khames T. Alzahrani
Keyword(s):  
College Students ◽  
Saudi Arabia ◽  
Perceived Stress ◽  
Stress Level ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Perceived Stress Scale ◽  
Cross Sectional ◽  
Stress Scale ◽  
Stress Levels

Aims: To assess the levels of perceived stress among college students in Saudi Arabia after changing the learning protocols because of covid-19 pandemic. Study Design: This was a cross-sectional study. Place and Duration of Study: The study was conducted in Saudi Arabia, from May 2020 to October 2021. Methodology: A cross-sectional survey study that was carried out in Saudi Arabia. A self-administered, pre-designed questionnaire, including Perceived Stress Scale of 10 items was used to measure the stress levels. The participants were selected randomly from different social media users  who lived and studied in Saudi Arabian universities.  In this study, 10-item questions of the Perceived Stress Scale (PSS-10) was used based on a 5-point Likert scale to score each item (0 = Never 1 = Almost Never 2 = Sometimes 3 = Fairly Often 4 = Very Often). Results: A total of 2034 students living in Saudi Arabia participated in the study. The results showed that 76.84% of total participants had strong stress, males reported higher score as compared to their Female counterparts.  Also, students older than 28 years reported higher level of stress, the students in Qassim region showed highest scores of stress. In addition, excellent academic achievement was strongly associated with high level of stress. Conclusion: The findings suggest that significant number of students had higher stress levels using the perceived stress scale. Therefore, this cross-sectional study identified a high stress level in COVID-19 crisis among university students in Saudi Arabia.

scholarly journals HUBUNGAN TINGKAT STRES DAN BURNOUT SYNDROME DENGAN KUALITAS TIDUR PADA MAHASISWA PROFESI NERS FAKULTAS KEPERAWATAN UNIVERSITAS AIRLANGGA

2020 ◽  
Vol 2 (1) ◽  
pp. 16
Author(s):  
Qurrata A'yuni Rasyidah ◽  
Rizki Fitryasari ◽  
Andri Setiya Wahyudi
Keyword(s):  
Nursing Students ◽  
Sleep Quality ◽  
Perceived Stress ◽  
Simple Random Sampling ◽  
Burnout Syndrome ◽  
Perceived Stress Scale ◽  
Cross Sectional ◽  
Stress Scale ◽  
Clinical Nursing ◽  
Pittsburg Sleep Quality Index

Pendahuluan: Tidur merupakan suatu kebutuhan dasar yang harus dipenuhi. Kualitas tidur yang buruk salah satunya dapat disebabkan karena stres dan kondisi kelelahan. Penelitian ini bertujuan untuk menganalisis hubungan antara tingkat stres dan burnout syndrome terhadap kualitas tidur pada mahasiswa ners Fakultas Keperawatan Universitas Airlangga.Metode: Penelitian ini menggunakan desain deskriptif korelasi dengan pendekatan cross-sectional. Populasi penelitian adalah mahasiswa profesi ners Fakultas Keperawatan Unair program regular dan alih jenis. Jumlah sampel sebanyak 126 responden yang diperoleh dengan menggunakan teknik simple random sampling  dan mahasiswa profesi ners Fakultas Keperawatan Unair dari program regular maupun alih jenis sebagai kriteria inklusi. Variabel independen yaitu tingkat stress dan burnout syndrome dan variabel dependen yaitu kualitas tidur. Data dikumpulkan dengan kuesioner Perceived Stress Scale (PSS), Maslach Burnout Invetory (MBI), Pittsburg Sleep Quality Index (PSQI) dan dianalisis menggunakan uji spearmen’s rho dan uji regresi logistik.Hasil: Penelitian ini menggunakan desain deskriptif korelasi dengan pendekatan cross-sectional. Populasi penelitian adalah mahasiswa profesi ners Fakultas Keperawatan Unair program regular dan alih jenis. Jumlah sampel sebanyak 126 responden yang diperoleh dengan menggunakan teknik simple random sampling  dan mahasiswa profesi ners Fakultas Keperawatan Unair dari program regular maupun alih jenis sebagai kriteria inklusi. Variabel independen yaitu tingkat stress dan burnout syndrome dan variabel dependen yaitu kualitas tidur. Data dikumpulkan dengan kuesioner Perceived Stress Scale (PSS), Maslach Burnout Invetory (MBI), Pittsburg Sleep Quality Index (PSQI) dan dianalisis menggunakan uji spearmen’s rho dan uji regresi logistik.Kesimpulan: Tingkat stress yang dialami oleh mahasiswa profesi terutama dalam merawat pasien dan situasi kelelahan emosional pada burnout syndrome dapat mengakibatkan  kualitas tidur mahasiswa profesi. ABSTRACTIntroduction: Sleep is a basic need that must be fulfilled. Poor sleep quality can be caused by stress and fatigue. This study aims to analyze the relationship between stress levels and burnout syndrome with sleep quality on clinical nursing students of the Nursing Faculty at Universitas Airlangga.Method: This study uses a cross-sectional design. The population is clinical nursing student Faculty of Nursing Universitas Airlangga from the regular program and over the program level. The total sample was 126 respondents using a simple random sampling technique. Independent variables are stress level and burnout syndrome and the dependent variable is sleep quality. Data collected by questionnaires Perceived Stress Scale (PSS), Maslach Burnout Inventory (MBI) and Pittsburg Sleep Quality Index (PSQI) and then analyzed using spearmen's rho test and logistic regression test.Results:  The results showed that there was a relationship between stress levels and sleep quality (p = 0,000, r = 0,311), there was a relationship between burnout syndrome specifically the dimensions of emotional exhaustion with sleep quality (p = 0,025) and the results of logistic regression tests showed a correlation between stress levels (p = 0,000) and burnout syndrome dimensions of emotional exhaustion (p = 0.025) with the quality of sleep in clinical nursing students of the Faculty of Nursing Universitas Airlangga.Conclusion: The level of stress experienced by clinical nursing students, especially stress in caring for patients and burnout syndrome, especially in the dimensions of emotional exhaustion affect the quality of sleep for clinical nursing students.

scholarly journals Study on stress among software professionals in Madhapur area of Hyderabad, Telangana

2019 ◽  
Vol 6 (9) ◽  
pp. 4062
Author(s):  
Vimala Thomas ◽  
Y. Sai Krishna ◽  
K. J. Kishore Kumar
Keyword(s):  
Perceived Stress ◽  
High Stress ◽  
Working Hours ◽  
Cross Sectional Study ◽  
Perceived Stress Scale ◽  
Cross Sectional ◽  
Stress Scale ◽  
Software Professionals ◽  
Study Participants ◽  
Stress Work

Background: Stress is inescapable part of modern life, where workplace is becoming a volatile stress factory for most employees. Occupational stress/work stress/job stress can occur when there is discrepancy between the demands of the environment/workplace and an individual’s ability to carry out and complete these demands. There is paramount need to address the factors which are leading to stress at the earliest since they are increasing rapidly. The objectives of the study were to determine the levels of stress among software professionals and to determine its association with key socio-demographic variables and with working environment.Methods: A cross sectional study was conducted among software professionals working in Madhapur area of Hyderabad using self-administered, pre-designed and pre-tested questionnaire after taking informed consent. Data was analyzed using MS Excel and Epi Info software.Results: Among the study participants, 71.5% were males and 28.5% were females. Mean age of the study participants was 34.04±7.52 years. Around 45.25% were having low stress, 33.5% moderate stress and only 21.25% had high stress according to perceived stress scale. Significant association was found between stress and age, type of family, marital status, gender and working hours per day.Conclusions: In the study, most of them were having low stress according to perceived stress scale. Females were having high stress compared to males. Software professionals have to be educated on factors which are leading to stress to prevent its adverse effects. 

scholarly journals Perceived stress, life events, fatigue and temperament in patients with psoriasis

2019 ◽  
Vol 47 (9) ◽  
pp. 4284-4291 ◽  
Author(s):  
Esra Pancar Yuksel ◽  
Dilek Durmus ◽  
Gokhan Sarisoy
Keyword(s):  
Life Events ◽  
Perceived Stress ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Sectional Study ◽  
Cross Sectional ◽  
Stress Scale ◽  
Significant Difference ◽  
Healthy Control ◽  
The Relationship

Objective To evaluate the perceived stress, life events, fatigue and temperament profile in patients with psoriasis and to investigate the relationship between these factors. Methods This cross-sectional study included patients with psoriasis and healthy control subjects. The two groups were compared regarding the number of life events, Perceived Stress Scale (PSS) and Multidimensional Assessment of Fatigue scores. The Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire was used to evaluate the personality traits among the two groups. Results A total of 75 patients with psoriasis (mean ± SD age, 44.94 ± 13.62 years) and 75 healthy controls (mean ± SD age, 41.10 ± 8.89 years) were included in the study. A statistically significant difference was found between the two groups in terms of the presence of life events, PSS score, fatigue and temperament profiles. Patients with psoriasis with depressive, cyclothymic and anxious temperament profiles were found to have higher PSS scores. In the psoriasis group, the PSS scores were positively correlated with the number of life events. Conclusions Stress and life events were found to be correlated with psoriasis. In the patients with psoriasis, depressive, cyclothymic and anxious temperament profiles seemed to be associated with higher perceived stress.

scholarly journals Asupan Zat Gizi Makro, Aktivitas Fisik dan Tingkat Stress dengan Kejadian Hipertensi pada Dewasa (18-60 Tahun)

2020 ◽  
Vol 2 (2) ◽  
pp. 83-92
Author(s):  
Erlyta Windi Mulyasari ◽  
Mia Srimiati
Keyword(s):  
Physical Activity ◽  
Perceived Stress ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Perceived Stress Scale ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Stress Scale ◽  
Food Recall

Berdasarkan data Riskesdas (2013) prevalensi hipertensi di Indonesia pada umur ≥18 tahun sebesar 25,8%. Jawa Barat termasuk provinsi lima terbesar yang memiliki prevalensi hipertensi tertinggi sebesar 29,4%. Berdasarkan data dari Dinas Kesehatan Kota Depok (2016) hipertensi merupakan penyakit yang banyak dialami oleh masyarakat Kota Depok. Penelitian ini bertujuan untuk menganalisis hubungan antara asupan zat gizi makro, aktivitas fisik dan tingkat stress dengan kejadian hipertensi di Wilayah Kota Depok. Desain penelitian cross sectional study. Sampel penelitian 80 orang dengan pengambilan sampel menggunakan purposive sampling. Asupan zat gizi makro diperoleh dari wawancara food recall 1x24 jam, aktivitas fisik dari pengisian International Physical Activity Questionnare (IPAQ) dan tingkat sress dari pengisian kuesioner Perceived Stress Scale (PSS). Uji korelasi menggunakan spearman ordinal. Hasil penelitian ini menunjukkan bahwa tidak terdapat hubungan yang signifikan antara asupan karbohidrat dengan kejadian hipertensi. Terdapat hubungan yang signifikan antara asupan protein dan lemak, aktivitas fisik, tingkat stress dengan kejadian hipertensi. Semakin tua umur seseorang, maka semakin berisiko untuk menderita hipertensi.

scholarly journals Evaluation of dentists' stress and anxiety levels in the COVID-19 pandemic

2021 ◽  
Vol 11 (Suppl. 1) ◽  
pp. 259-265
Author(s):  
Fatma Uçan Yarkaç ◽  
Ümmühan Tekin Atay ◽  
Nisa Nur Dinçer ◽  
Elif Öncü
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Perceived Stress ◽  
Generalized Anxiety ◽  
Perceived Stress Scale ◽  
Stress Scale ◽  
Significant Difference ◽  
Stress Levels ◽  
Anxiety Levels ◽  
Normalization Process

Aim: Coronavirus disease 2019 (COVID-19) can cause stress, anxiety, and fear, especially in healthcare workers as it has a high risk of transmission. The aim of this study was to investigate the levels of stress and anxiety during the COVID-19 pandemic among dentists working in our country. Methodology: The study included 164 dentists. Sociodemographic data and the stress and anxiety levels of the individuals who participated in the study were recorded. The COVID-19 Stress Scale and the Perceived Stress Scale-10 were used for evaluation of the stress levels, and the Generalized Anxiety Disorder 7 was used to evaluate the anxiety levels. All data were considered statistically significant at p < 0.05. Results: Among those who participated in the study, 112 were women and 52 were men, and 50% of them were 20 to 30 years of age. Based on the information these dentists provided, 63% did not have any expertise and 66% had worked in the normalization process. Their scores in the COVID-19 Stress Scale, the Generalized Anxiety Disorder Scale 7, and Perceived Stress Scale-10 were 64.4 ± 25.2, 5.46 ± 4.8, and 18.8 ± 5.9, respectively, and there was a positive correlation between all scales. When evaluating the stress levels according to gender, it was observed that those of the female dentists were higher than those of the male dentists (p < 0.05). There was no significant difference in the anxiety levels between the male and female dentists. While there were no significant differences between the dentists who worked during the pandemic process and those who did not work (p > 0.05), the COVID-19 stress levels were found to be lower in the normalization process (p < 0.05). Conclusion: The COVID-19 pandemic has caused stress and anxiety in dentists and has affected female dentists more than male dentists. In addition, working during the pandemic process can benefit dentists by helping to reduce the stress caused by the pandemic.   How to cite this article: Öncü E, Dinçer NN, Uçan Yarkaç F, Tekin Atay Ü. Evaluation of dentists' stress and anxiety levels in the COVID-19 pandemic. Int Dent Res 2021;11(Suppl.1):259-65. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.38   Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

scholarly journals GAMBARAN STRES PADA MAHASISWA PENDIDIKAN PROFESI PROGRAM STUDI KEDOKTERAN GIGI FAKULTAS KEDOKTERAN UNIVERSITAS SAM RATULANGI YANG MEMILIKI PENGALAMAN STOMATITIS AFTOSA REKUREN

e-GIGI ◽  
2013 ◽  
Vol 1 (2) ◽  
Author(s):  
Viniriani Tangkilisan
Keyword(s):  
Perceived Stress ◽  
Professional Education ◽  
Cross Sectional Study ◽  
Medical Faculty ◽  
Education Student ◽  
Perceived Stress Scale ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Stress Scale ◽  
Immunological Deficiency

Stomatitis Aftosa Rekuren (SAR) merupakan kelainan ulkus pada mukosa mulut dengan ciri khas ulkus single atau multiple, kambuhan (berulang), kecil, bulat atau oval dengan batas jelas kemerahan dan dasar abu-abu atau kuning. Stomatitis Aftosa Rekuren dapat dipicu oleh beberapa faktor predisposisi antara lain stres, trauma, alergi, genetik, siklus menstruasi, defisiensi hematinik dan imunologi.Tujuan dalam penelitian ini ialah untuk mengetahui gambaran stress pada mahasiswa pendidikan profesi Program Studi Kedokteran Gigi Fakultas Kedokteran Universitas Sam Ratulangi yang memiliki pengalaman Stomatitis Aftosa Rekuren. Metode penelitian yang digunakan yaitu penelitian deskriptif dengan penelitian studi cross sectional. Metode pengambilan sampel yaitu purposive sampling. Sampel pada penelitian ini berjumlah 62 orang. Cara pengambilan data mengisi kuesioner SAR dan PSS (Perceived Stress Scale) dengan wawancara.Hasil penelitian menunjukan bahwa gambaran stres pada mahasiswa pendidikan profesi Program Studi Kedokteran Gigi Fakultas Kedokteran Universitas Sam Ratulangi yang memiliki pengalaman Stomatitis Aftosa Rekuren sebesar 59,7% dengan tingkat stres yang tinggi.Kata Kunci : SAR, tingkat stresAbstractRecurrent aphthous stomatitis (RAS) is an ulcer on the oral mucosal abnormalities characterized by a single or multiple ulcers, recurrent (repeated), a small, round or oval with clear boundaries and basic reddish gray or yellow. RAS can be triggered by several predisposing factors such as stress, trauma, allergies, genetic, menstrual cycle and immunological deficiency haematinics.The purpose of this study was overview the stress on professional education student of Dentistry Program Medical Faculty, University of Sam Ratulangi. The research method used is descriptive research with a cross- sectional study design. Sampling method by purposive sampling. Samples in this study amounted to 62 people. The data were collected through questionnaires SAR and PSS (Perceived Stress Scale).The results showed that the description of stress on professional education students of Dentistry Program Medical Faculty, University of Sam Ratulangi experiencing SAR by 59.7 % with high level of stress.Keywords: SAR, stress level

scholarly journals Perceived Stress, Psychological Capital, and Psychological Distress Among Chinese Nursing Students: A Cross-Sectional Study

2021 ◽  
Author(s):  
Feifei Sun ◽  
Cuiping Xu ◽  
Jiaomei Xue ◽  
Jing Su ◽  
Qinghua Lu ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Nursing Students ◽  
Perceived Stress ◽  
Psychological Capital ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mediating Role ◽  
Significant Difference ◽  
The Relationship

Abstract Background: Previous studies have investigated variables related to psychological distress among nurses; however, the relationship among psychological capital, perceived stress, and psychological stress is poorly understood. This cross-sectional study examined the relationship between psychological capital, psychological distress, and perceived stress, and examined the mediating role of psychological capital in the relationship between perceived stress and psychological distress.Methods: Responses to questionnaires to assess psychological capital, psychological distress, and perceived stress were collected from 369 nursing students in a tertiary hospital in Shandong Province, China.Results: There was a statistically significant difference in perceived stress among students, based on whether or not they liked the nursing profession (P<0.01). Relative to college students, undergraduates experienced significantly higher levels of perceived stress (P<0.01). Nevertheless, there were no significant differences in perceived stress between the variables of gender, place of residence, and being an only child. Psychological distress was positively correlated (r=0.632, p<0.001), whereas psychological capital was negatively correlated, with perceived stress (r=-0.662, p<0.001). Psychological capital played a potential mediating role in the relationship between psychological distress and perceived stress.Conclusions: This study revealed the importance of psychological capital in reducing perceived stress to decrease psychological distress among Chinese nursing students. Managers should take meaningful steps to improve nursing students’ psychological capital and thereby reduce the negative impact of psychological distress.

Cyberbullying, student nurses’ ethical awareness and the Covid-19 pandemic

2021 ◽  
pp. 096973302110102
Author(s):  
Ka Young Kim ◽  
Jeong Sil Choi
Keyword(s):  
Clinical Practice ◽  
Nursing Students ◽  
Nursing Intervention ◽  
Cross Sectional Study ◽  
Hierarchical Regression ◽  
Clinical Practices ◽  
Ethical Awareness ◽  
Cross Sectional ◽  
Cyberbullying Victimization ◽  
Cyber Ethics

Background: The global COVID-19 pandemic has increased cyber communication, causing nursing students’ clinical practice to be held in cyberspace. Thus, it is essential to ensure that nursing students develop comprehensive cyber ethics awareness. Moreover, cyberbullying is becoming more widespread and is an increasingly relevant new concept. Objectives: This study aimed to assess the experiences of cyberbullying among nursing students during clinical practice and determine the effects of cyberbullying victimization and cyber environments on their cyber ethics awareness. Research design: Data for this descriptive cross-sectional study were collected in July 2020 using a self-reported questionnaire and analyzed using hierarchical regression. Participants and research context: The study included data from 291 nursing students with more than 6 months of clinical experience who were enrolled in two nursing universities in two cities in South Korea. Ethical considerations: This study was conducted after obtaining approval from the Institutional Review Board of G University. Written, informed consent was obtained from all participants. Results: Cyberbullying victimization experiences during clinical practice were few. The most common cyberbullies of work- and person-related cyberbullying were nurses and classmates, respectively. Discussion: Cyber ethics awareness was affected by cyber anonymity and the perceived seriousness of cyberbullying; cyberbullying related to clinical practices was a new factor that significantly affected cyber ethics awareness. Conclusions: Hospitals and nursing universities should develop a multi-dimensional, comprehensive, and effective nursing intervention education program to be integrated into the nursing curriculum to enhance cyber ethics awareness and reduce cyberbullying of nursing students.

scholarly journals Perceived Stress and Increased Food Consumption during the ‘Third Wave’ of the COVID-19 Pandemic in Spain

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2380
Author(s):  
Eduardo Sánchez-Sánchez ◽  
Jara Díaz-Jimenez ◽  
Ignacio Rosety ◽  
Maria José M. Alférez ◽  
Antonio Jesús Díaz ◽  
...  
Keyword(s):  
Food Consumption ◽  
Perceived Stress ◽  
High Stress ◽  
Cross Sectional Study ◽  
Third Wave ◽  
Sectional Study ◽  
Cross Sectional ◽  
Stress Scale ◽  
The Third ◽  
Moderate Stress

The COVID-19 pandemic has impacted the mental health of people worldwide. An increase in perceived stress can lead to unhealthy behaviors such as increased food consumption. The aim of this study was to find the level of perceived stress and its relationship with increased food consumption during the “third wave” of the COVID-19 pandemic in Spain. This was a cross-sectional study that employed anonline self-reported frequency of consumption questionnaire and the Perceived Stress Scale-10. A total of 637 subjects participated and 83.6% of respondents had moderate or high stress—more prevalent in the female and young respondents. Moreover, 36.1% of respondents reported that they had increased the frequency of consumption of some foods, mainly nuts, snacks, and jellybeans, along with coffee, tea, cocoa, and soft drinks. Eating between meals was more pronounced in those with high stress (65.1%) than in those with moderate stress (40.4%) and low stress (20.2%). Furthermore, the respondents with high stress reported greater weight gain. Thus, the results show that the level of perceived stress during the ‘third wave’ of this pandemic increased food consumption.

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