• Journal of Korean Medical classics
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• v.24 no.4
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• pp.157-174
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• 2011

We derived following result by organizing research about processing of medicinal of before Han(漢) dynesty. The human being intake of natural substance for the purpose of treatment was what happened later than the use of natural substance as food. According to the record of by the early years of Shang(商) dynasty, we can assume that we cooked food with water and fire. The reason why there is no appearance of common production that can be included under the name of 'Tang Ye(湯液)' in the medical record discovered from Ma Wang Dui(馬王堆) is because 'Tang Ye' was yet developed. However, as the presentation of format of medicine process, there was gradual formation of medicinal fluid concept. There are quite of records on major details of cloth manufacture like washing and selection, grinding, processing of medicine from the recordings of "Wu Shi Er Bing Fang(五十二病方)", "Yang Sheng Fang(養生方)", "Za Liao Fang(雜療方)" discovered at Ma Wang Dui. It used words like 'Ze(擇)', 'Qu(去)' for the selection and 'Jiu(酒)', 'Zhuo(濯)' for the wash as a process method before cloth manufacture. When filter the processed medicine, it used words like 'Zhuo(捉)', 'Suo(索)', 'Jun(浚)' and used 'Yin Gan(陰乾)', 'Bao(暴)', 'Yang(暘)' for dry. The 'cutting(切削)' that crushes the medicine used different names based on the properties of medicines. The most frequent crush is 'Ye(冶)' and it means the powered medicine after dry. There was thermal process of mild fire(微火) and heating of 'Wen(溫)'. There are many states of medicine seen from the medical record discovered at Ma Wang Dui so they can be said as original medicine. 藥末劑 is relatively commercialized type then. Here, it includes later 湯劑 but there was no name such as 'decoction(湯)' or 'decoction of medical ingredients(湯液)'. Also, 'Fu Ju(㕮咀)' is the transformation of what was 'Fu Qie(父且)' at "Ja Liao Fang" of medical books of Ma Wang Dui with time flow. The original meaning of 'Fu Qie(父且)' is 'Fu Zu(斧俎)' and it means the crushing medicine with axe. The most important thing among the medical books of Han dynasty is "Shen Nong Ben Cao Jing(神農本草經)" and "Shang Han Za Bing Lun(傷寒雜病論)" of Zhang Zhong Jing(張仲景). "Shen Nong Ben Cao Jing" mentioned the dry method of medicine, collection and process production time, cooked and uncooked use of medicine and there are several types of medicine. Other than those, it mentioned 'Seven methods of combining herbs(七情合和)' to address cautions for combining medicines. Therefore, the 'processing of medicinal' in east Han dynasty period entered the theoretical step. However, there is only little recording on cloth manufacture of detailed medicine. From the "Shang Han Za Bing Lun" of Zhang Zhong Jing, the development in the way of 'processing of medicinal' reveled the cloth manufacture for each medicine. This tradition is continued until today and so it presents the development of purpose of 'processing of medicinal' is to greatly present the effect of medicine and to reduce the side-effect.

• Korean Journal of Veterinary Research
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• v.15 no.1
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• pp.57-67
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• 1975

The poxvirus group is considered to be a typical cytoplasmic inclusion forming virus. Every poxvirus has been reported to produce only one kind of inclusion in the infected tissues. A vague concept that inclusions of poxviruses are eosinophilic or acidophilic has prevailed. Although many papers and theories about the nature of the inclusion have been presented, most of them are not quite convincing on the point of the relations with virus multiplication, and an analysis of papers published showed that there seem to be many discrepancies in the descriptions of the nature of the poxvirus inclusions. Comparative studies on host-virus interaction with cowpox, orf, swinepox and fowlpox viruses which selected from each Group (I-IV) of poxviruses were performed from the morphological and virological standpoints. At first, in cowpox virus-FL cell system, as a comparative model, cytoplasmic inclusion, nucleic acid metabolism by autoradiography and detection of viral antigen by immunofluorescence were studied and obtained the results as follows: 1. The focus-like cytopathic effect (CPE) at early stage developed to entire culture at terminal stage of infection, and also the developing status of CPE was correlated to viral doses for inoculation. Two kinds of cytoplasmic inclusions which named A and B type were easily observed by Giemsa, hematoxylin-eosin (H & E) and May-Greenwald Giemsa (MGG) stainings in the infected cells. The B type inclusions were formed at early stage of infection and the A type inclusions were produced subsequently the B type formation. The B type which common type inclusion in poxviruses was a small compact or aggregate at early stage and developed to a large diffuse body at terminal stage of infection. On the other hand, the A type inclusion which depend upon the kind of virus was appeared as round and discrete shape, and its size and number was increased gradually during the culture period. It was characteristic to form distinct halos around the both types of inclusions in acid fixed, H & E stained preparations of infected cultures. The B type inclusion was always positive in Feulgen reaction and showed as DNA containing body but the A type inclusion was not. 2. In the relationship between inclusion and DNA metabolism of infected cells by the qualitative autoradiography using 3H-thymidine, the appearance of silver grains was coincided with B type inclusion but not with A type inclusion. This showed that the DNA synthesis was proceeded in all B type inclusions except those in the terminal stage with a diffuse form. This suggested that the B type inclusions are only sites of DNA synthesis and this was proceeded after the cell infection independently. The activity of DNA synthesis of the inclusions was nearly the same as that of the nucleic of normal cells and non-inclusion bearing cells. and non-inclusion bearing cells. Regardless of the size of the degree of DNA synthesis of the B type inclusion, inclusion bearing cells all showed remarkable suppression of nuclear DNA synthesis. 3. By the direct fluorescent antibody technique viral antigen in infected cells was detected. The B type inclusions have been proved to contain a great deal of viral antigen, whereas the basic substance of A type inclusion did not show antigenicity except the round edge. It was suggested that the round edge fluorescence might be caused by the glare of cytoplasmic viral antigen which pushed out and concentrated by the A type inclusion development. 4. Hemorrhagic red pock formations on chorioallantoic membrane of embryonated chicken egg had proved the characteristic of used viral strain. 5. By the above studies on the nature of two types of inclusions and the role they play in virus multiplication, it was concluded that the B type inclusion must be the site of the synthesis of viral DNA and protein as well as the site of the virus.

• Asia pacific journal of information systems
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• v.18 no.1
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• pp.53-77
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• 2008

In recent years, although numbers of corporations are bringing in PMO, they seem to be indifferent to PMO performance measurement. This demonstrates that there are also other reasons beside performance measurement of information systems (IS) project being ambiguous by introducing PMO; the lack of acknowledging the concrete function of PMO, and the scarcity of empirical study about the effect of PMO on the project members and project performance. In this sense, this study is aimed at proposing a new research model in which project success factors (i.e., standardization, management advocacy, and staff expertise) affect PMO capability (i.e., knowledge management, resources management, and problem solving competency) positively, leading to project performance (i.e., task outcomes, psychological outcomes, and organizational outcomes) eventually. To empirically test the research model, data are surveyed from PMO department and IS department. To prove the validity of the proposed research model, PLS analysis is applied with valid 132 questionnaires. By employing PLS technique, the measurement reliability and validity of research variables are tested and the path analysis is conducted to do the hypothesis testing. The path analysis results can be organized into 7 ways in large scale. First, standardization of project success factors has a positive association with knowledge management, resources management, and problem solving competency of PMO capabilities. The findings of this result indicate that the multiple or single project management should satisfy standardization in order to operate an effective PMO. Second, management advocacy of project success factors has a positive association with knowledge management, resources management, and problem solving competency. Management advocacy refers to the willingness of management to provide the required resources and authority for project success. There is agreement among researchers regarding the importance of management advocacy for favorable PMO capability. Third, staff expertise of project success factors has a positive association with knowledge management, resources management, and problem solving competency. The findings of this result indicate that the formation of an exceptional consultant or members with a proficient knowledge for staff expertise of project member is the key factor to elevate the PMO capability. Past research suggests that experience and knowledge and the resultant familiarity with the problem faced can be an important determinant of PMO capability. A capable project with appropriate staff expertise means that it enjoys a diversity of abilities and experiences. Fourth, knowledge management competency of PMO capabilities has a positive impact on psychological outcomes but has no direct effect on task outcomes and organizational outcomes. In domestic case of S. Korea, PMO was finally introduced to many other corporations in 2005 though it started bringing in 2000. Therefore, it had neither a significant impact on the task outcomes nor organizational outcomes by lacking the contents and the infrastructure of the knowledge management because the knowledge consolidation and management period of PMO is comparatively shorter by terms than other foreign nations. Fifth, resources management competency of PMO capabilities has a positive association with task outcomes, psychological outcomes, and organizational outcomes. In addition, problem solving competency of PMO capabilities has a positive association with task outcomes, psychological outcomes, and organizational outcomes. Therefore, the findings of this results stress that PMO capabilities has a positive impact on project performance. Sixth, according to the path analysis of the hypothesis, which suggested in this research, problem solving competency is the PMO capability which is the key success factor for task, psychological, and organizational outcomes as an integrated performance model. Further, the analysis reveals that problem solving competency is an important factor for integrated performance model. The finding is in line with past IS research, which affirms that the work of IS projects is essentially a problem solving endeavor. Seventh, in the path analysis of the hypothesis in this research, the path of the management advocacy $\rightarrow$ problem solving competency $\rightarrow$ organizational outcomes appears to be the most important and strongest path. In brief, the finding of this study suggests that project success factors influence PMO capability positively, and project performance as well. From the results, it can be concluded that PMO helped great improve the project success rate and project performance. This study advances research on PMO capability in three important aspects. First, the findings of our study have implications for IS theory and future research. Our study contributes to IS theory by synthesizing concepts from PMO research and project management research with those in IS research. We proposed and tested PMO capability of IS projects and the findings of our investigation provided some preliminary answers to some of the questions raised. Secondly, this thesis does not only help depicting the concept of IT governance but also approaches empirically. It makes a gradual approach to the main content, step by step, in contrary of simple standard, scholastic way of thinking. Finally, we argued that this task-oriented(technical) view is not sufficient to adequately conceptualize IS project performance. Hence, we applied that the research on organization teams, which provides a flip viewpoint to that of project management research in that it gives more weight for psychological outcomes of organizational work groups, can be very helpful in reconceptualizing the IS project performance construct. The limitations of this study are also discussed to provide research directions for future research.

• Management & Information Systems Review
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• v.30 no.4
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• pp.293-314
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• 2011

The current study investigated the position of future strategy analyzed from the perspective of design management in relation to 10 strategic industries implemented through 3 steps based on promising growth and advancement of Busan industries and evidence provided from a study on the development program of design industry in Busan. It elucidated the role of design industry as a key role from the perspective of design management in an age of creative revolution of futures values. It analyzed the associations between composition of future strategy and design industry in 10 strategic industries of Busan, and explained the relationships with the strategic industries. The perspective of design management involves that design as a ground of values is an industry of the future values, which performs a key strategic function and role, and a theoretical investigation examined the relationships between main functions of design management and business management. Chapter 3 organized items proposed in the design development program in Busan and examined goals and systems which become basic formation of establishment of design strategy in Busan and conditions for design industry in the associations with strategic industry. Chapter 4 described priorities of practicability by step through analyzing and grouping top 30 projects in Busan industry including meanings as key strategy, position relations, and policy priorities by analyzing elements of design management of strategic industry and describing and analyzing the concept of promoting Busan design. The theme of the present study is to change perception of design management as a key value and a condition to decide creativity industry into future industry and to evaluate vision of Busan design industry and meanings proposed as proceeding strategy. The early 21st century is an age when agrarian society has changed into industrial society is dominated by knowledge economy of the information revolution and one should prepare for the growth phase of creative innovation based on creative revolution of the 4th wave of creative society by design management which has become a center in 2000s on the whole. With the advent of creative paradigm and based on the function and role of the current creative economy age new innovation DNA of design management will be created. Design process has changed through information and knowledge-oriented trends of digital through convergence between industries from industrial design to convergence of industries, and it is expected that integrated design of value creation using information and technology will play a key role in Busan design industry development and top 10 strategic industries.

• Korean Journal of Heritage: History & Science
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• v.42 no.2
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• pp.86-109
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• 2009

Mireuksa Temple was founded during the reign of King Mu of Baekje(AD 600-641). The circumstance of the construction of this temple is documented in "Memorabilia of the Three Kingdoms (Samgukyusa)". The pagoda named stone pagoda at Mireuksaji temple stands outside the main sanctuary of the western area. The south and west sides of the stone pagoda have completely collapsed, leaving only the eastern facade of six of its levels intact. Through the recent discovery of sarira reliquary we can see that the erection of this pagoda was in 639. So owing to accumulation of excavation results about Baekje temple site and vigorous academic exchange, it is possible that architecture of western pagoda at Mireuksaji temple can be understood in connection with the architectural development of wooden pagoda from 6th to early 7th century in East Asia. So this study is on the consideration of building of this pagoda putting first structure of upper part and cross-shaped space in 1st floor. It was considered that the material characteristics as stone could be applied to the temple pagoda architecture of large scale. The results are as follows. First, it had been built in recognition that the outer and inner part of pagoda should be separated. As it is the expression of structural system in temple pagoda architecture of large scale at that time. In pagoda there was a self-erected structure and the members of outer part of it were constructed additionally. Second, in Mireuksaji stone pagoda there is central column with stones. With inner part of pagoda it can be regarded as mixed structural system that constitutes central contral column and inner structural part. And it could be a kind of middle step to more developed structure of whole as wooden pagodas in Japan. Third, as the sarira reliquary was in central column on the first floor, the cross-shaped space could be made. The formation of this space was so on the natural meaning of sarira that the concept as memorial service of graves could be apllied to the pagoda. The style of tomb in Baekje was expressed to the space of 1st floor in pagoda where Sarira had been mstalled. That was not only effective presentation of symbolic space but also easier method in the use of same material.

• Journal of Global Scholars of Marketing Science
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• v.18 no.2
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• pp.113-145
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• 2008

Marketing for the distribution industry is making an ongoing progress in the changes of customers, the competitive environment, and the internal marketing environment. Integrated marketing communication activities are required for the enhancement of efficiency in the market.oriented activities. In this study, IMC is defined as "a notion that a market oriented business integrated marketing communication means, conducting and evaluating marketing activities with consistent messages in order to communicate with customers based on databases." In this study, an IMC planning model for the improvement of marketing efficiency in the distribution industry was derived from a pilot study. This model may be broken down into the following phases: IMC goals setting, situational analysis (customer analysis, competition analysis and company analysis), customer data analysis, contact management, budgeting, the establishment of an IMC strategy, the IMC mix and execution, an evaluation system, and feedback. In consideration of the characteristics of the distribution industry, this study was accompanied by a vocational study on IMC means employed by, in particular, department stores and other distributors such as: advertising, sales promotion, sales promotion advertising, direct marketing, public relations, personal selling, the Internet, mobile, visual merchandising, words of mouth. In addition, this study also covered the correlation among variables such as IMC activities of distributors, the process of forming customer's brand attitudes, brand loyalty and repurchase intention. This research would enhance the utilization of IMC. The analysis on customer's brand attitudes toward the IMC activities of distributors requires the simultaneous consideration of how they are linked to purchase as well as their attitudes toward both distributors and stores. The formation of brand loyalty and repurchase intention is related to the integration of marketing communication and the maintenance of consistency in contents, which requires integrated brand communication (IBC) strategies. IBC is a concept of using IMC means to manage the brand in a continuing and consistent manner and measuring their effect, which is a process to establish enterprise.level brand identity and maximize brand loyalty and repurchase intention by integrating IMC means. For an empirical analysis in this study, an online questionnaire survey was conducted among those department store customers from 20's to 50's who reside either in the Seoul and Gyeonggi areas and have made purchase at department stores. In this study, the research model consisted of four theoretical variables: IMC activities, IMC attitudes, brand loyalty, and repurchase intention, on which variables a pilot study was conducted. A number of hypotheses were constructed on the relations between IMC activities and IMC attitudes, between IMC attitudes and repurchase intention, and between brand loyalty and repurchase intention. The test of the hypotheses may be summarized as follows: Firstly, the test of the hypothesis concerning the relation between IMC attitudes and IMC activities - advertising, sales promotion, direct marketing, public relations, personal selling, the Web, mobile, visual merchandising, and word of mouth - indicates that advertising, sales promotion, direct marketing, public relations, personal selling, mobile, visual merchandising, and word of mouth have significant impact on IMC activities. In addition to the result similar to those of previous studies that such marketing communication means as word of mouth, advertising, personal selling and sales promotion, in particular, play very important roles, a notable finding of this study is that visual merchandising performed by department stores is shown to have very significant impact on IMC activities. On a separate note, it is also noteworthy that Internet marketing activities engaged by department stores are not shown to have significant impact on IMC attitudes. Secondly, the test of the hypothesis on the relation between IMC attitudes and brand loyalty attests that IMC attitudes for the distribution industry significantly affect brand loyalty. Thirdly, the test of the hypothesis concerning the relation between IMC attitudes and repurchase intention confirms that IMC attitudes for the distribution industry significantly affect repurchase intention. Fourthly, the test of the hypothesis concerning the relation between brand loyalty and repurchase intention indicates that brand loyalty significantly affect repurchase intention. A comprehensive view of these findings points to the conclusion that the IMC activities for the distribution industry do affect IMC attitudes, brand loyalty, and repurchase intention.

• Journal of muscle and joint health
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• v.2 no.1
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• pp.17-40
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• 1995

Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

• Journal of the Korean Institute of Landscape Architecture
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• v.38 no.2
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• pp.37-52
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• 2010

The main purpose of this study is to examine how place representation is related to the formation of urban parks in Seoul, which began at the end of the 19th century. In order to grasp place representation, the hypothesis of this study is that most urban parks are undertaken with the idea of monumentality and symbolism or memories of the place itself. Diverse ways of representation through physical or non-physical aspects of symbolism, monumentality, and place memory are summarized as follows. First, in the case of the physical aspects of representation in the parks, monumentality and symbolism are expressed mostly through monuments or statues. In the case that the intention of the park is commemorative, celebrative elements are more actively utilized. In other cases, symbolic sculptures or statues, which are randomly designated by the government, are so often used regardless of the overarching concept of the urban park. In addition, in the case of place memory, monumentality or symbolism are commonly represented through bronze statues or partial remnants of the past. Recently, however, the site in itself has been constructed to coordinate the memories of a certain place into the configuration of the park. Secondly, in relation to the non-physical representation elements, many urban parks tend to reveal monumentality or symbolism through the names they are given. Recently, this tendency has significantly dropped, but some places of parksare frequently denominated in consideration of place memory. In the case of events held in parks, parks which were constructed in the beginning of the park movement, such as Tapgol Park, hold certain events to commemorate certain causes that took place in those days. On the other hand, the main purpose of recently-constructed urban parks relating to place memory is to encourage citizens to participate in events in a variety of ways.

• The Korean Journal of Archival Studies
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• no.60
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• pp.123-159
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• 2019

Given that the concept of reproducing landscape is similar to that of recording historical sights, places can become special space where memories are archived through meaningful activities. Therefore, place and landscape are the important concepts for understanding the Home of Roh Moo-hyun. This research was initiated when Roh Moo-hyun Foundation's decided to return the Home of Roh Moo-hyun to the public. A research report was published as the first result of this initiative. Then an archive book was recently published based on the first research report. The research report was about philosophical and aesthetic meanings and contents, the layers of accumulated memories, the records based on the accumulated memories, and the attributes of the place, and the possibility of archiving, whereas the purpose of the archive book is to restore and to curate the original meaning of the Home of Roh Moo hyun through cultural events. There are 'three memories' of layers in the Home of Roh Moo-hyun. The first memory is about 'life and dreams' that President Roh Moo-hyun dreamed about after his retirement to the hometown. The second memory is about 'the loss of time' for 10 years of time after the decrease of the President Roh Moo-hyun. The third memory is 'the memory of citizens', which started with the public opening of the Home of Roh Moo-hyun. 'Low Roof House of President Roh Moo-hyun' is the archive book that comprises the three memories which are accumulated in the home of Roh Moo-hyun and 'record language' full of meanings.

• Journal of the Korean Chemical Society
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• v.48 no.6
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• pp.645-653
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• 2004

The purpose of this study was to compare and analyze the cognitive levels of 11th grade students and those required in high school chemistry I textbooks standardized by the 7th national education curriculum. For this study, the cognitive development stages of 456 11th grade students were surveyed using short-version GALT (group assessment of logical thinking). Furthermore, 15 basic concepts were extracted from the contents on water and air, 2 units in chemistry I order to analyze the cognitive levels necessary for understanding high school textbooks, using CAT (curriculum analysis taxonomy). The results showed that 52.5% of the surveyed 11th grade students reached the formal operational level, 28.3% transitional levels, and 19.5% concrete operational levels. 68.9% of the academic high school students and 6.6% of the technical high school students reached the formal operational levels, and the ratio of formation was very different in each logics. As a result of the analyzing the cognitive levels needed for understanding chemistry I textbook contents, in spite of a change in national education curriculum, there were no great change in cognitive levels required by scientific concept except some inquiry activities. The cognitive levels in high school chemistry I textbooks by the 7th national education curriculum appeared higher than the cognitive levels of 11th grade student, but cognitive levels of inquiry activities were similar to the cognitive levels of the students. Chemistry teachers thought of chemistry I textbooks by the 7th national education curriculum as desirable because scientific concepts were reduced and a lot of real life materials were adapted. However, they pointed out a problem of difference in contents levels compared with chemistry I textbooks because scientific concepts were greatly reduced in chemistry I textbooks. The cognitive levels required in chemistry I textbooks still appeared higher than those of the students. Consequently, various teaching and learning methods and materials will have to be developed to be suitable for the students' cognitive levels.