• Title/Summary/Keyword: Nursing care activity

Search Result 493, Processing Time 0.022 seconds

Evaluation of Manufacturing and Biological Properties of Y Zone Care Hydrogel Solution (Y존 케어 하이드로젤솔루션의 제조 및 생물학적 특성 평가)

  • Eun-Ji Kim;In-Kyoung Kim
    • Journal of Advanced Technology Convergence
    • /
    • v.3 no.2
    • /
    • pp.25-31
    • /
    • 2024
  • In recent industrialization and development due to information and communication technology, modern women in modern society are exposed to physical and mental health due to numerous stresses. Popular inflammations are attributable to a decrease in lactic acid bacteria, frequent antibiotic use, and a decrease in immunity. It is necessary to develop products that are helpful and reflected. The inner care gel currently introduced on the market can increase beneficial bacteria and maintain a healthy y-zone. The inner gel contains a hydrogel component. 90% is made up of water, and other components act as support for supporting water and are formed through crosslinking between polymer chains. Hydroxyethyl cellulose (HEC) is a hydroxyethyl ethylenetel of cellulose. The purpose of use is to act as a binder, an emulsion stabilizer, a viscosity enhancer (water-soluble), and a film forming agent. CA (crosslinker) is a crosslinking agent and serves to bind. Hydrogel in the beauty field acts as a film forming agent that gently wraps around the skin by forming a thin film and serves as an emulsion stabilizer that helps to prevent separation of other raw materials. It also acts as a thickener by increasing viscosity in cosmetics. In addition, it is used for glucose monitoring, nursing care, cell transplantation, and wound treatment in the bio field. Currently, it is understood that no products using functional hydrogel have been released, so in this study, a Y zone care hydrogel solution was manufactured to find out the antibacterial properties of the functional hydrogel, and a new solution was developed. As a result, it was confirmed that the appropriate Ph was applied to the Y zone, and after culturing Candida albicans in PDB medium, all three products of the Y zone care hydrogel solution showed an antibacterial effect of 0.5-1.0mm

The Effects of Clinical Application of a Nursing Diagnosis Protocol (간호진단 프로토콜(Protocol)의 임상적용 효과에 관한 연구)

  • 이향련;조미영;조결자;김윤희;김귀분;김광주;문희자;박신애;강현숙
    • Journal of Korean Academy of Nursing
    • /
    • v.19 no.1
    • /
    • pp.40-62
    • /
    • 1989
  • This study was conducted to measure the effects of clinical application of a Nursing Diagnosis Protocol. The dependent variables were the degree of patient's satisfaction and the degree of nurse's satisfaction with the nursing activity. Analysis of the effect of the use of the nursing diagnosis protocol was based on the nursing record. The subjects for this study were 61 nurses(experimental group 31, control group 30) and 155 patients (experimental group 55, control group 100) on four internal medicine wards in K University Hospital in Seoul. Data collection was done from August to October 12,1988. The results obtained in this study can be summarized as follows, 1, Effect of the clinical application of the nursing diagnosis protocol. 1) The first hypothesis ; “nurses who use the nursing diagnosis protocol will have higher degrees of satisfaction than those who use traditional methods” was rejected (t=.54, df=58, p=.59). 2) The second hypothesis ; “patients nursed by nurses using the nursing diagnosis protocol will have higher degrees of satisfaction than those nursed with traditional methods” was supported(t=1.93, df=154, p=.05). 3) The third hypothisis : Major hypothesis ; “the nursing records of the experimental group, who used the nursing diagnosis protocol, will be more detailed than those of the control group” was supported (t=6.40, df=79.90, p=.000). (1) The first subhypothesis ; “The recorded data collection of the experimental group will be more detailed than that of the control group” was rejected (t=1.79, df=118, p=.07). (2) The second subhypothesis ; “The recorded patient's problem statement of the experimental group will be more detailed than that of the control group”, was supported. (3) The third subhypothesis ; “The nursing record of the experimental group will be more convenient for implementation than that of the control group” was supported. 2. Factors related to the nurse's degree of satisfaction with protocol. 1) No general characteristics(age, religion, education level, duty career, present duty career) were related to the nurse's degree of satisfaction. 2) Variables related to the nurse's degree of satisfaction were “satisfaction as a nurse” and “consider nursing as lifelong job” (t=-2.6, df=13.22, p=.02, t=2.41, df=23.85, p=.02). 3. Factors related to the patient's degree of satisfaction. 1) General characteristics related to the patient's degree of satisfaction with nurses using the protocol were age, educational level, and being married.(F=5.17, df=3/153, p=.00, t= -2.39, df=154, p=,01, f=5.91, df=2/153, p=.00) 2) The variables previous hospitalization, duration of hospitalization, the hospital unit presence of a relative, medical insurance, or medical diagnosis were not related to the patient's degree of satisfaction. 1. The experimental group's nursing record was more detailed than the control group's record with regard to the physical and psychological state of the patients. As noted above, the experimental group nurses, who use a nursing diagnosis had protocol were less satisfied than the control group who used traditional methods of the recording, but experimental group patients had a higher degree of satisfaction than the control group patients. The nursing records of experimental group, using the nursing, diagnosis protocol was more detailed than that of the control group. If the nursing diagnosis protocol is used in clinical nursing practice, the quality of nursing care may be improved.

  • PDF

Applying Extended Theory of Planned Behavior for Lung Cancer Patients Undergone Pulmonary Resection: Effects on Self-Efficacy for Exercise, Physical Activities, Physical Function, and Quality of Life (폐절제술을 받은 폐암환자에 대한 확장된 계획행동이론의 적용: 운동 자기효능감, 신체활동, 신체기능 및 삶의 질에 미치는 효과)

  • Lim, Yeonjung;Lee, Haejung;Kim, Do Hyung;Kim, Yeong Dae
    • Journal of Korean Academy of Nursing
    • /
    • v.50 no.1
    • /
    • pp.66-80
    • /
    • 2020
  • Purpose: This study aims to examine the effects of nursing interventions based on the Extended Theory of Planned Behavior (ETPB) regarding self-efficacy for exercise (SEE), physical activity (PA), physical function (PF), and quality of life (QOL) in patients with lung cancer who have undergone pulmonary resection. Methods: This quasi-experimental study was conducted between July 2015 and June 2018 in two university-affiliated hospitals. The intervention included pre-operative patient education, goal setting (action and coping planning), and feedback (behavior intention and perceived behavioral control). The intervention group (IG) (n=51) received nursing interventions from the day before surgery to 12 months after lung resection, while the comparison group (CG) (n=36) received usual care. SEE, PA, PF (dyspnea, functional status, and 6-minute walking distance [6MWD]), and QOL were measured before surgery and at one, three, six, and 12 months after surgery. Data were analyzed using the χ2 test, Fisher's exact test, Mann-Whitney U test, t-test, and generalized estimation equations (GEE). Results: There were significant differences between the two groups regarding SEE (χ2=13.53, p=.009), PA (χ2=9.51, p=.049), functional status (χ2=10.55, p=.032), and 6MWD (χ2=15.62, p=.004). Although there were no time or group effects, the QOL mental component (Z=-2.78, p=.005) of the IG was higher than that of the CG one month after surgery. Interventions did not affect dyspnea or the QOL physical component. Conclusion: The intervention of this study was effective in improving SEE, PA, functional status, and 6MWD of lung cancer patients after lung resection. Further extended investigations that utilize ETPB are warranted to confirm these results.

Weissella cibaria CMU suppresses mgl gene expression and enzyme activity associated with bad breath

  • Kim, Hyun-Jin;Yeu, Ji-Eun;Lee, Dong-Suk;Kang, Mi-Sun
    • International Journal of Oral Biology
    • /
    • v.44 no.4
    • /
    • pp.152-159
    • /
    • 2019
  • The oral care probiotic strain Weissella cibaria CMU (oraCMU) inhibits volatile sulphur compounds associated with halitosis, presumably by inhibiting the growth of associated oral pathogens. In the present study, we investigated whether oraCMU inhibits the production of these compounds by suppressing the expression of mgl. This gene encodes L-methionine-α-deamino-γ-mercaptomethane-lyase (METase) and is involved in the production of methyl mercaptan (CH3SH) by Porphyromonas gingivalis. Therefore, we specifically investigated the effects of oraCMU on the growth, CH3SH production, METase activity, and mgl expression of P. gingivalis. The minimum inhibitory concentrations of cell-free supernatant and secreted proteins from oraCMU were 125 mg/mL and 800 ㎍/mL, respectively. At sub-minimum inhibitory concentration levels, these metabolites inhibited CH3SH production, but they also reduced P. gingivalis viability. Only heat-killed oraCMU decreased CH3SH production without affecting P. gingivalis viability. Heat-killed oraCMU also inhibited METase activity toward L-methionine and mgl mRNA expression (p < 0.05). In summary, we demonstrated the inhibition of volatile sulphur compounds via the antimicrobial action of oraCMU and, for the first time, the inhibition of such compounds by heat-killed oraCMU, which occurred at the molecular level.

An Analysis of the Relationship between Climacteric Symptoms and Management of Menopause in Middle-aged Women (일 지역 중년여성의 폐경증상과 폐경관리와의 관계에 대한 연구)

  • Song, Ae-Ri
    • The Journal of Korean Academic Society of Nursing Education
    • /
    • v.7 no.2
    • /
    • pp.308-322
    • /
    • 2001
  • The purpose of this study was to investigate the relationship between climacteric symptoms and management of menopause of middle -aged women. The subjects of this study were 261 women(40 to 60 years old). Data were collected from Jun. 1 to Jul. 15, 2001 by a structured questionnaire. The instruments employed were : 1) The Climacteric Symptoms Scale developed by Aeri Song and Eun soon Chung(1998). 2) The Management of Menopause Scale developed by Aeri Song(1997). The data were analyzed by the SPSS p.c. program using t-test, ANOVA and Pearson correlation coefficient. The results of the study were as follows : 1. Mean score of climacteric symptoms was $2.18{\pm}0.39$(Maximum 4, Minimum 1). The mean scores among the categories of climacteric symptoms, in descending order, were : a) physical and physiological reactions ($2.62{\pm}0.53$), b) social and family relationships ($2.23{\pm}0.50$), c) psychiatric and psychological reactions ($2.08{\pm}0.49$), d) relationship with sexual partner($1.73{\pm}0.54$), e) genitourinary reactions ($1.72{\pm}0.55$). 2. Mean score of management of menopause was $1.79{\pm}0.45$ (Maximum 4, Minimum 1). The mean scores among the categories of management of menopause, in descending order, were : a) dietary management($2.57{\pm}0.52$), b) self control ($2.24{\pm}0.57$), c) management of exercise and physical activity($2.14{\pm}0.75$), d) management of sex life($1.71{\pm}0.47$), e) management of professional health maintenance($1.61{\pm}0.59$). 3. There were statistically significant differences in the score of middle-aged women's self reported climacteric symptoms according to : a) occupation (t=-2.79, p<0.001) b) marriage state (t=-2.29, p<0.05) c) age of menarche (F=4.66, p<0.001) d) method of Sanhujori (post natal care & treatment) (F=4.22, p<0.001) e) hormone replacement therapy (t=-3.09, p<0.05). From the above statistics, several significant findings were noted : a) There were more climacteric symptoms from those who were unemployed, those who had no partner or were divorced and those who started a menarche earlier. b) There were less climacteric symptoms reported from those on hormone replacement therapy and those who followed their parents or parents-in-law advice regarding Sanhujori (postnatal care) 4. There were statistically significant differences in the score of middle-aged women's self reported management of menopause according to : The educational background (F=7.63, p<0.001), religion (F=3.74, p<0.001), income (F=3.65, p<0.001), number of parity (F=4.87, p<0.001), method of Sanhujori(postnatal care) (F=5.73, p<0.001), period of Sanhujori (postnatal care) (F=2.81, p<0.05), hormone replacement therapy (t=3.81, p<0.001). Women with higher educational background, strong religion, higher income, large number of parity, managed their post natal care well, were on HRT, managed their menopause significantly better than the others who took part in the survey. 5. It will be noted from the above that women's degree of climacteric symptoms showed a negative correlation to the management of menopause(r=-0.2146, p<0.001). The findings shown above suggest the need to develop a variable management of menopause, in order to improve climacteric symptoms of middle-aged women. It is hoped that the above findings will stimulate more detailed research into this matter, and thereby enable guidance to be given to women going through the menopause to cope with it in a less stressful way.

  • PDF

A study on simple nursing activities for the registered nurses and nurse aides in the hospital (단순간호활동에 관한 간호사 및 간호조무사의 태도조사연구)

  • Lee Jung-Hee
    • Journal of Korean Public Health Nursing
    • /
    • v.4 no.1
    • /
    • pp.37-55
    • /
    • 1990
  • Every country in the world has been trying to expand the basic health right for the peoples as W.H.O has established the goal 'health for AU' by the year of 2000. Related to this goal, our government authority has establish the policy 'the insurance of health for all' into effect from July 198\). Recently hospitalshave been making a ceaseless effort for the plan for the rationalization of its management the academic World is making it a subject of discussion by doing the secure of manpower at a resonable level and the increase of productivity by the manpower. As a result of the efforts the study was established to secure the numbers of nursing manpower at a resonable level and use the unskilled persons at the utilizing field and seek the possible area of their activity for more efficient service through the investigation of ablity of simple nursing activities of regiestered nurses and nurse aides for rational function according to the educational levels and talents. The method of study was established by the registered nurses and nurse and nurse aides(R.N 229, N.A 226) who are working in 15 hospitals with over 200 beds. This surrey was conducted from Mar 29, 1989 to April 8, 1989. The method to test the degree of importance, difficulties, and the abillity of performance of a simple nursing activities was classified into 35 activities on the basis of references on this field. The degree of importance was composed from point l(Not so important) to 5(Very important). the degree of difficulties. was composed as follows; very easy - Point 1 very difficult and complicated - Point 5. and the ability of performance was composed from point 1 to 5. The materials gathered through the survey were analyzed with frequency, mean standard deviation, percentage. t-test, Anova, pearson's coefficient of correlation, stepwise multiple regression. factor analysis, discriminant analysis. The obtained results are summarized as follows: 1. The recognition values of the simple nursing activities of each group of registered nurse and nurse aides show; The degree of importance; 4.04 and 4.26 The degree of difficulties; 2.72 and 2.94 The ability of performance; 2.07 and 2.38 The brief summary shows there are little differences between who two groups the simple nursing activities turned out to be easy and simple work. 2. Regardless of the degree of importance, and difficulties, the ability of performance the important in fluencing of the degree of the simple nursing activities between the registered nurses and nurse aides was the order of educational level, hospital career, working career in wards and ages of the registered nurses and ages and hospital creer of nurse aides. The result was that the simple nursing activities could easily be familiar through the training of their working environment and period of experience. 3. Among the 35 simple nursing activities the items capable of resonable entrusting to the nurse aides are 5 that is helping bed-bathing, 8itz Bath, using bed pan, care while delivering patient, accompaying patient when visitor's check. There wasn't and differences between RN and nurse aides in performing the above 5 items. In anywhere. so we can say obviosuly that this nursing activities should be performed under the nursing system of which chief of nurse are supposed to supervise nurse aides as a possible function to be entrusted. In view of the above mentioned results, therefore, this partial functional job of the simple nursing activities can able be entrusted to the nurse aides through the regular training course. In case of these functional activities could be entrusted under, the responsibility of registered nurse, we can able suggest to for that there are the following advantages: 1.. In the nursing activities-affairs, the qualified guarantee of the nursing services can be kept and increased or promotoed with accommodation of the required nursing service and roles being expanded presently. 2. In the productivity of the hospital manpower, therefore, we have comt to view and consider in favourly that when an automational administration times would be come in the near future time to hospital affairs as a reality, to utilize the existing nures aides is better rather than investing so as to develop the other source manpowers or seek its for the efficient business management in the operational strategy or its policy.

  • PDF

The Study of Alienation and Physical Aging in the Old People (노인의 소외감과 신체적 노화에 관한 연구)

  • 김미옥
    • Journal of Korean Academy of Nursing
    • /
    • v.17 no.1
    • /
    • pp.64-78
    • /
    • 1987
  • This study is attempt to submit a basic material to help the efficient nursing management which supports and to understand the alienation which they percieve social-psychologically and physical aging bringing about the phf·sical powerlessness, to understand the old people in hospitals and in community and should build up their health. The data collection of the study which has been done on Sept. 7 to Sept. 20, 1986 is objected to 300 people of 65 years old of age or more of male and female who are staying at home. Analysis of the Data was done by use of percentage, t-test, ANOVA and Pearson Correlation Coefficients. The results of study are summerized as follows: 1. According to each age group of old people(p= .0008), family living together concreteness (p=.0000), the level of education (p=.0020), how much they are participating in leisure activity (p=.0001), whether they have mate or not (p=.0000), whether they have religion or not (p=.0000), the level of alienation showed difference statistically. Also, according to sex (p=.4315), whether they have income or not (p=.1197), the level of alienation did not show any difference statistically. 2. According to each age group of old people (p=.0000), family living together concreteness (p=.0060), the level of education (p=.0000), sex (p=.0000), whether they have mate or not (p=.0000), whether they have religion or not (p=.0067), whether they have income or not (p=.0000), the level of physical aging showed difference statistically. Also, according to how much they are participating in leisure activity, the level of physical aging did not show any difference statistically (p=4879). 3. The level of alienation and physical aging in old people had positive correlation (r=.5436, p<.001). From the above result, the level of social, psychological alienation and physical aging showed high for the old who had no mate, no religion, low in their educational level, living separately' with the family and for those who do not participate much in the leisure activities, The old people who feel the social, psychological alienation can expedite the physical aging and physical aging can be result from social psychological loneliness and alienation. Therefore, for the successful aging of the old people in the community with these weak points, we should provide them with physical and emotional, psycho-logical support and care in the basis of understanding in socialization process and the character of the physical functional change.

  • PDF

Health Complaints of Elderly Persons Using a Modified C.M.I. (C.M.I.간이법에 의한 노인들의 건강수소율)

  • 박오장
    • Journal of Korean Academy of Nursing
    • /
    • v.13 no.2
    • /
    • pp.44-57
    • /
    • 1983
  • The explosion of the aging population is changing the social environment of today's older people. Traditionally in Korea, a large percentage(over 90%) of elderly parents have lived with their married first son. But today, the number of elderly who live with their married sons has decreased(65.6%) The number of those who live in a different situation such as with their married daughter, unmarried offspring, with a spouse or alone has increased (34.4%) We can expect that the number of the elderly who have to live in institution will increase. The objective of this investigation was to determine differences in the number of health Complaints of older people according to their living situation with a view to planning more effective health care. The sample consisted of 231 persons over 65 years of age, 60 living in an Old Age Home ana 171 living in their own home in Kwangju. Data were gathered from July 9 to 26, 1983 by nursing students using a Questionnaire which was a modified form of the Cornell Medical Index. The data were categorized according to the subjects, living, sex, educational level, previous occupation, hobbies and sexual activity. The date were analyzed for statistical significant differences using F and X²tests. findings included the following: 1. There was a higher number of health complaints from persons who live in the institution than those living at home, but the difference was not significant. 2. The highest number of health Complaints were from persons who live alone, followed by those living with their daughters, and then by those living in the institution. Persons who live with their sons had the least Complaints. The difference in the number of Complaints accord-ing to with whom they were living was significant. 3. Women had signincantly more Complaints than men. Persons who were not living with their spouses had significantly more complaints than those living with their spouses.4. The higher eductional level the persons had, the less health Complaints they had. The number of Complaints accoraing to educational level was significantly different. 5. The highest number of health complaints were from persons who had involved in Commerce and industry, followed by those in Agriculture. Persons who were civil servant had the least 6. There were more complains from persons who had no hobby than those with hobbies. The complaints. The difference was significant. difference was significant. 7. Persons who said they were sexually inactive had significantly more complaints than those who said they were sexually active. As age increased, sexual activity significantly decreased. Those who lived with their spouse were significantly more sexually active. 8. The highest number of Somatic Complaints were eye fatigue, followed by nocturnal frequency, lumbago, cramps in extremities, vertigo, stiffness in Shoulder, tinnitus, common cold and constipation. The order of Psychic Complaints from higher to lower were anger. sensitivity, anxiety, depression and loneliness. 9. This group of Elderly persons said they valued Health the most, followed by Harmony, Religion, Money and Honor.

  • PDF

Active Coping Strategy Model for Chronic Arthritis : Appling Internal Model of World and Coping Resource (내적모형과 대응자원을 이용한 만성관절염 환자의 적극적 대응전략모형)

  • Mun, Mi-Sook;Lim, Nan-Young
    • Journal of muscle and joint health
    • /
    • v.6 no.1
    • /
    • pp.100-135
    • /
    • 1999
  • Typical symptoms of rheumatic disease affect overall daily living and cause severe stress. Individuals afflicted with rheumatic disease have many illness-related stresses. Pain was the predominantly perceived stress followed by limitation in mobility, difficulties in carrying out activities of daily living. helplessness, dependency on others, threat to self-esteem, interference in social activity, interference in family relationships. difficulties performing at work, and discomfort of the treatment. Patients with chronic arthritis are subjected to long periods of continuous stress, which may require the management by the health care provider. In these cases, the purpose of the nursing is helping to promote health through supporting patient's coping. Therefore, for the nursing intervention to be effective, it is critical to build a theoretical framework that describes stress-coping for chronic arthritis. Thus, the purpose of this dissertation is to present a theoretical framework which describes the stress-coping processes and to empirically test pathos of this framework for the people with chronic arthritis. The foundation upon which this framework is built in the Erickson, Tomlin, and Swain(1983) theory of Modeling and role-Modeling. The subjects were 275 patients with rheumatoid arthritis or osteoarthritis who visited the outpatient clinic. A hypothetical model of stress-coping was tested by covariance structure analysis with PC-LISREL 8.12 program. As a result, the overall fit was good(Chi-square=94.49, P=0.00, RMR=0.067, GFI=0.95, AGFI=0.91, NNFI=0.93, NFI=0.91) for the hypothetical model. The results of hypothesis testing were as follows : Basic need satisfaction had a statistically significant influence on illness-related experience, emotional stress and coping resources. Internal health locus of control had a statistically significant influence on coping resources. However, independent variables(basic need satisfaction, internal health locus of control, illness-related experience, emotional stress and coping resource) did not have significantly influence on coping. And then, the hypothetical model was modified by considering both the theoretical implication and statistical significance of the parameter estimates. The revised model had a better fit to the data(Chi-square=83.11(P=0.00), RMR=0.061, GFI=0.96, AGFI=0.92, NNFI=0.95, NFI=0.92). Hypothesis emerged from the revised model was tested. The results of hypothesis testing were as follows : Basic need satisfaction had a statistically significant influence on illness-related experience, emotional stress and coping resources. Internal health locus of control had a statistically significant influence on illness-related experience and coping resources. Internal health locus of control, illness-related experience, emotional stress and coping resources had a significantly influence on coping. According to the results of this dissertation, basic need satisfaction and internal health locus of control play a central role in appraisal of illness-related experience and coping resources. And illness related-experience, emotional stress, and coping resources affect on coping activities. In summary, nursing interventions to enhance basic need satisfaction and internal health locus of control will decrease illness related experience and emotional stress and increase coping resources. Increased coping resources will prompt coping activities.

  • PDF

The Importance and Performance of Hospice Volunteer's Activities Perceived by Hospice Volunteers (호스피스자원봉사자가 지각한 호스피스자원봉사자 활동의 중요도 및 수행도)

  • Jeon, Myung-Hwa;Lee, Byoung-Sook
    • Journal of Hospice and Palliative Care
    • /
    • v.12 no.3
    • /
    • pp.122-131
    • /
    • 2009
  • This study was performed to identify the importance and performance of hospice volunteer's activities perceived by hospice volunteers. Methods: The subjects were 259 hospice volunteers from six hospitals in Daegu and Gyeongsangbukdo areas. A list of hospice volunteer's activities was developed by authors, based on literature, and interviews with the hospice volunteers were used to measure the perception on the importance and performance of their activities. Data were analyzed by using Descriptive statistics, t-test, One-way ANOVA with Scheffe test, and Pearson's product-moment correlation in SPSS Win 12.0. Results: The average of the importance of hospice volunteer's activities was 3.09 and the performance was 2.31, which was lower than the importance. There was a significant correlation between the importance and the performance (r=.487, P=.000). There were significant differences in total score of the importance, depending on religion, education, and period of hospice volunteer activity of subjects. There were significant differences in total score of the performance, depending on age, religion, and period of hospice volunteer activity of subjects. Conclusion: The importance of hospice volunteer's activities, perceived by hospice volunteers, was relatively high, however their performance didn't reach the level of the importance. Some characteristics of the volunteers influenced the perception of the importance and performance of the hospice volunteer's activities. The findings of this study are expected to provide useful information for the development of educational and management programs the hospice volunteers.

  • PDF