• Refine Query
  • Source
  • Publication year
  • to
  • Language
  • 212
  • 72
  • 32
  • 25
  • 9
  • 7
  • 6
  • 4
  • 3
  • 3
  • 2
  • 2
  • 2
  • 1
  • 1
  • Tagged with
  • 412
  • 134
  • 128
  • 101
  • 81
  • 77
  • 62
  • 56
  • 55
  • 48
  • 40
  • 40
  • 37
  • 37
  • 36
  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
211

Sjuksköterskors möte med patienter som lider av obesitas : En allmän litteraturstudie / Nurses’ encounter with people suffering from obesity : A general literature study

Ghirmai, Tirsit, Lindgren, Amanda January 2024 (has links)
Bakgrund: Obesitas är en vanlig sjukdom som leder till allvarliga konsekvenser, både för personen och samhället. Sjukdomen kan drabba vem som helst men överrepresenteras i vissa grupper. Patienter som lider av obesitas upplever ofta bemötandet inom vården som hindrande och stigmatiserande, med brister i den personcentrerade vården. Sjuksköterskans ansvarsområde består av omvårdnad men personcentrerad vård, evidensbaserad vård, förbättringskunskap, säker vård, samverkan i team och informatik som kärnkompetenser. Syfte: Syftet med denna studie var att beskriva sjuksköterskors erfarenheter av att möta och stödja patienter som lider av obesitas. Metod: En allmän litteraturstudie med kvalitativ ansats genomfördes med Polit och Becks niostegsmodell. Denna studie använde sig utav en kvalitativ innehållsanalys av Graneheim och Lundman. Resultat: Två kategorier hittades: ett behov av fler resurser och en utmanande arbetssituation. Utifrån dessa kategorier utvecklades även fyra subkategorier: kunskapens betydelse, ett stressfullt möte, att ha blandade känslor samt en känsla av rädsla och oro. Slutsats: Att möta individer som lider av obesitas kräver ökade resurser och kunskap. Vidare forskning behövs på organisatorisknivå med fokus på hälso- och sjukvårdens ansvar och hantering av patienter med obesitas inom olika vårdinrättningar. / Background: Obesity is a common disease that leads to serious consequences, both for the individual and society. The disease can affect anyone but is overrepresented in certain groups. Patients suffering from obesity often experience the treatment in health care as hindering and stigmatizing, with shortcomings in one of the nursing areas of responsibility, person-centered care. Aim: The aim of this study was to describe nurses' experiences of meeting and supporting patients suffering from obesity. Method: A general literature review with a qualitative approach was conducted with Polit and Beck's nine-step model and a qualitative content analysis by Graneheim and Lundman. Results: Two categories were found: a need for more resources and a challenging work situation. Based on these categories, four subcategories were also developed: The importance of knowledge, a stressful meeting, having mixed feelings and a feeling of fear and anxiety. Conclusion: Meeting individuals suffering from obesity requires increased resources and knowledge. Further research is needed at the organizational level with a focus on the responsibility of health care and the management of patients with obesity in different health care facilities.
212

Sjuksköterskors erfarenheter av digital kommunikation med patienter : En allmän litteraturstudie / Nurse's experiences of digital communication with patients : A literature review

Nilsson, Erica, Rosander Davidsson, Moa January 2024 (has links)
Bakgrund: Digitala vårdmöten där sjuksköterskor och patienter kommunicerar via olika digitala system blir allt vanligare inom hälso- och sjukvården. Detta innebär nya utmaningar för sjuksköterskor då kommunikationen förändras när den sker digitalt. Genom att undersöka sjuksköterskors erfarenhet av digital kommunikation kan möjligheter samt potentiella hinder identifieras. Denna kunskap kan sedan användas för att ta till vara på de positiva aspekterna med digital kommunikation samt hitta lösningar för potentiella hinder för att skapa bättre förutsättningar för god kommunikation. Syfte: Syftet är att beskriva sjuksköterskors erfarenheter av att kommunicera med patienter via digitala system. Metod: Studien genomfördes som en allmän litteraturstudie där tolv vetenskapliga artiklar granskades och sammanställdes. Resultat: Resultatet visade på att sjuksköterskor upplevde både möjligheter samt utmaningar med digital kommunikation. Möjligheter som beskrevs var att kommunikationen blev mer lättillgänglig. Utmaningar innefattade otillräckliga kommunikationsfärdigheter, avsaknad av icke-verbal kommunikation, missförstånd samt teknologiska störningsmoment. Vidare framkom skilda upplevelser av att lyckas skapa goda relationer med patienter. Slutsats/konklusion: Digital kommunikation innebär både möjligheter men också utmaningar till följd av att kommunikationen förändras. / Background: Digital caring encounters where nurses and patients communicate via various digital systems are becoming more common in healthcare. This means new challenges for nurses as communication dynamics change in digital settings. By examining nurses' experience of digital communication, opportunities as well as potential obstacles can be identified. This knowledge can then be used to take advantage of the positive aspects of digital communication as well as find solutions for potential obstacles to create better conditions for good communication. Purpose: The purpose of this study is to describe nurses' experiences of communicating with patients via digital systems. Method: The study was conducted as a general literature study where twelve scientific articles were reviewed and compiled. Results: The results showed that nurses experienced both opportunities and challenges with digital communication. Possibilities that were described were that communication became more easily accessible. Challenges included inadequate communication skills, lack of non-verbal communication, misunderstandings and technological disruptions. Furthermore, different experiences emerged of succeeding in creating good relationships with patients. Conclusion: Digital communication presents both opportunities and challenges due to the changing nature of communication.
213

Våldsutsatta kvinnors upplevelse av bemötandet i vården : En litteraturöversikt

Gahnström, Therese, Leiderman, Emilia January 2024 (has links)
Introduktion: Våld i nära relation är ett samhällsproblem som globalt drabbar ungefär en tredjedel av världens kvinnor. Sjuksköterskor har ett ansvar att arbeta etiskt och respektera människors värde och rättigheter. Forskning visar på faktorer som gör att sjuksköterskan inte uppmärksammar att en kvinna blir utsatt för våld i nära relation och som kan skapa hinder i bemötandet. Det är därför nödvändigt att beskriva kvinnors upplevelse av bemötandet för att eventuellt kunna utveckla bemötandet inom vården. Syfte: Syftet var att beskriva kvinnors upplevelse av bemötandet i vården efter att ha blivit utsatta för våld i nära relation. Metod: Metoden var litteraturöversikt med beskrivande design. Totalt 12 kvalitativa studier i originalartiklar från databaserna PubMed respektive CINAHL inkluderades i resultatet. Artiklarna kvalitetsgranskades med SBU:s kvalitetsgranskningsmall. Resultat: Resultatet beskrivs utifrån kategorierna önskat och ej önskat bemötande med nio underkategorier. Ej önskat bemötande var upplevelsen av personalens ifrågasättande eller skuldbeläggande av kvinnorna samt att de känt sig avfärdade. Även att de inte känt sig sedda, förstådda eller tillfrågade om våldet de utsatts för. Det önskade bemötandet var tillräckligt med tid, stöd och bekräftelse samt hjälp med information. En etablerad relation med vårdpersonalen ansågs även positivt. Slutsats: Kvinnorna beskrev positiva och negativa upplevelser av bemötandet i vården och det fanns faktorer som kunde påverka mötet till det bättre eller det sämre. Resultatet visar inverkan vårdpersonalen kan ha på den våldsutsatta kvinnans upplevelse av bemötandet. Sjuksköterskans bemötande kan antingen göra kvinnan bekväm att tala om våldet eller tvärtom och då riskerar kvinnan att inte få den vård hon behöver. / Introduction: Intimate partner violence is a societal issue that globally affects about a third of the female population. Nurses have a responsibility to work ethically and to respect human values and rights. However, research shows that there are factors that prevent nurses from recognizing when a woman is being subjected to interpersonal violence, factors that can create obstacles in encountering the women. It’s therefore important to describe women's experiences to be able to possibly develop the patient encounter in health care. Aim: The aim was to describe women's experiences of their encounter with healthcare providers after they had been exposed to intimate partner violence. Method: The method used for this work was literature review with a descriptive design. A total of 12 studies in original qualitative articles from the databases PubMed and CINAHL were included in the results. The articles were quality reviewed using SBU's quality review template. Results: The results were divided into desired and undesired encounters with nine subcategories. Undesired encounter was the experience of staff questioning or blaming the women and that they felt dismissed. They also felt that they had not been seen, understood, or asked about the violence they had experienced. The desired encounter was sufficient time, support, acknowledgement and help with information as well as an established relationship with healthcare professionals. Conclusion: The women described positive and negative experiences of encounters in health care and there were factors that could influence the encounter for better or worse. The result shows the influence health care staff can have on the battered woman's experience of encounters. The way nurses' encounter these women can make them feel either comfortable talking about the violence or vice versa and that could lead to her not getting the care she needs.
214

Analysis of Potential Wake Turbulence Encounters in Current and NextGen Flight Operations

Schroeder, Nataliya 01 March 2011 (has links)
Wake vortices pose a threat to a following aircraft, because they can induce a roll and compromise the safety of everyone on board. Caused by a difference in pressure between the upper and the lower part of the wings, these invisible flows of air are a major hazard and have to be avoided by separating the aircraft at considerable distances. One of the known constraints in airport capacity for both departure and arrival operations is the large headway resulting from the wake spacing separation criteria. Reducing wake vortex separations to a safe level between successive aircraft can increase capacity in the National Airspace System (NAS) with corresponding savings in delay times. One of the main goals of the Wake Encounter Model (WEM) described in this thesis is to assess the outcome from future reduced separation criteria in the NAS. The model has been used to test probable encounters in today's operations, and can also be used to test NextGen scenarios, such as Close Parallel Approaches and reduced in-trail separation flights. This thesis presents model enhancements to account for aircraft turning maneuvers, giving the wake a more realistic shape. Three major airspaces, New York, Southern California and Atlanta, were analyzed using the original and the enhanced WEM to determine if the enhanced model better represents the conditions in today's operations. Additionally, some analysis on the wake lateral travel for closely spaced runways is presented in this thesis. Finally, some extension tools for post -analysis, such as animation tool and various graphs depicting the interactions between wake pairs were developed. / Master of Science
215

Vårdpersonalens bemötande av patienter med övervikt: En litteraturstudie om patienters erfarenheter

Larsen, Alice, Niilekselä, Victoria January 2024 (has links)
Introduktion: Detta är ett arbete i vårdvetenskap med inriktning på omvårdnad. De fyra konsensusbegreppen för omvårdnad är samskapande omvårdnad, hälsa, människa och miljö. Samtliga konsensusbegrepp har relevans för föreliggande examensarbete. Övervikt och obesitas är ett stort folkhälsoproblem där omkring 1,9 miljarder människor uppskattas leva med tillståndet. I studier där vårdpersonal och vårdstudenter intervjuades rapporterades det om diskriminering av patienter med övervikt i vårdpersonalens bemötande. Jean Watsons teori för mänsklig omsorg – att värna om mänskligheten går ut på att främja empati och omtanke i omvårdnaden.  Syfte: Syftet var att beskriva hur vuxna patienter med övervikt erfar bemötandet av vårdpersonal vid vårdbesök.  Metod: En litteraturöversikt med deskriptiv design och kvalitativ ansats användes. Resultatet baserades på elva studier.  Resultat: I resultatet framkommer sex kategoreier som beskriver hur patienter med övervikt erfarit bemötandet av vårdpersonal. Kategorierna är: Vårdpersonal visat motvilja; Vårdpersonal uttryckt fördomar; Vårdpersonal givit sårande kommentarer; Vårdpersonal visat ovilja att diskutera övervikt; Vårdpersonal endast sett övervikten inte personen samt Vårdpersonal inspirerat livsstilsförändringar via professionell hållning. Slutsats: Patienter med övervikt har erfarit både positiva och negativa bemötanden från vårdpersonal. Personalen har tydlig påverkan på patienterna när bemötandet upplevs som negativt men även vid positiva vårdmöten. Det är viktigt att behandla alla patienter med respekt samt ha goda kunskaper om patienten. Resultatet indikerar att det behövs mer forskning av patientgruppen. / Background: This is a study in nursing science which focuses on nursing care. The four concepts of consensus are nursing, health, the individual and environment. Every concept of consensus has relevance to this present dissertation. Overweight and obesity is a substantial public health problem affecting around 1.9 billion people. Healthcare personnel and healthcare students report in interviews about discrimination against patients with overweight, when encountering healthcare personnel. Jean Watson’s theory of human caring science is about promotion of empathy and consideration in nursing care. Aim: The aim of this study was to describe how adult patients with overweight experience their encounters with healthcare personnel.  Method: A literature overview with a descriptive design and a qualitative approach was used. The result was based on 11 studies.  Result: The result consists of six categories that describe the patients encounters with health care workers. These were: Healthcare personnel showed reluctance; Healthcare personnel expressed prejudice; Healthcare personnel gave hurtful comments; Healthcare personnel showed reluctance to discuss overweight; Healthcare personnel saw the overweight not the person and Healthcare personnel inspired lifestyle changes through a professional attitude.  Conclusion: Patients with overweight have experienced both negative and positive encounters with healthcare personnel. The personnel have a clear effect on the patients when the encounter is experienced to be negative, the same with positive encounters. It is important to treat every patient with respect and to have knowledge about the patient. The result indicates that further research is necessary.
216

Personer med obesitas upplevelser av mötet med vårdpersonal : En litteraturstudie / People With Obesity´s Experiences Of the Meeting With Health Care Personnel : A literature review

Malmstedt, Caroline, Holmén, Karolina January 2024 (has links)
Bakgrund: Obesitas är en kronisk sjukdom. Ungefär 16% av världens vuxna befolkning var obesa 2022. Personer med obesitas har en ökad risk för att insjukna i olika följdsjukdomar. Syftet med behandling för obesitas är att minska ohälsa och främja livskvalitet. Behandling för obesitas i Sverige kan genomföras antingen genom kombinerad levnadsvanebehandling, läkemedels-behandling eller kirurgi. Syfte: Syftet med litteraturstudien var att belysa hur personer med obesitas upplever mötet med vårdpersonal. Metod: Studien genomfördes som en litteraturstudie med en kvalitativ ansats. Tolv kvalitativa studier som alla var publicerade i vetenskapliga tidskrifter utgjorde datamaterialet. Datan kvalitetsgranskades och analyserades. Resultat: Totalt identifierades tre huvudkategorier: Betydelsen av vårdpersonals bemötande, Behovet av anpassat stöd från vårdpersonal och Att få olika förutsättningar i vården. Konklusion: Personer med obesitas önskar en förtroendefull relation med vårdpersonal. Sjuksköterskor bör arbeta personcentrerat och genom partnerskap kan en förtroendefull relation byggas med patient. / Background: Obesity is a chronic disease. About 16% of adults worldwide were obese in 2022. Being obese causes an increased risk of getting sick in various non- communicable diseases. The aim of all obesity-treatment is to reduce illness and promote quality of life. In Sweden there are three different alternatives for obesity-treatment: combined lifestyle-change treatment, drug treatment and surgery. Aim: the aim of this literature review was to illustrate how people with obesity experience the meeting with health care personnel. Method: The study was conducted as a literature review with a qualitative approach. Twelve qualitative studies, all published in scientific magazines, was quality assessed and analysed. Results: Three themes was identified: The importance of health personnel encounter, The need of customized support from health personnel and To get unequal conditions in health care. Conclusion: People with obesity wishes to have a trusting relationship with health personnel. Nurses should work person- centered and through a partnership with the patient a trusting relationship can be built.
217

Consumer control, dependency and satisfaction with online service

Chan, Shiu Fai, Barnes, B.R., Fukukawa, Kyoko 09 1900 (has links)
Yes / Purpose The purpose of this paper is to develop and test a new conceptual model in an online service context. The model focuses on an important, yet often neglected customer-oriented construct, i.e., user “control”, which is embedded in consumer behaviour when accessing the internet. The study examines the relationship between control, online dependency, online encounter satisfaction and overall satisfaction. It explains the strategic implications surrounding customer control and online dependency as means for enhancing customer satisfaction. Design/methodology/approach A questionnaire was developed drawing on a combination of existing and new measurement items for the constructs in question. The instrument was later pilot tested on two consecutive occasions ahead of the main survey. A random sample of Hong Kong banking consumers was approached and interviews were undertaken via telephone. The data were analysed via confirmatory factor analysis and structural equation modelling was used to test the hypotheses relating to the model. Findings The findings reveal positive relationships between control and online dependency, and control and online encounter satisfaction. Meanwhile control, online dependency and online encounter satisfaction lead to overall satisfaction. Originality/value This study proposes a counterintuitive argument that while online service customers gain control of the online service process, they become more dependent on it, and their control and dependency also lead to their satisfaction, at both the online service encounter level and corporate level. Drawing on the pertinent literature, this is the first study to examine the importance of two information system constructs, i.e., control and online dependency, as predictors of consumer psychological fulfilment, i.e., satisfaction. The findings confirm that control as an initiator and driver of customer satisfaction in an online context, and online encounter satisfaction, further contributes to overall satisfaction at the corporate level.
218

SAMSAS. SHARE - NEGOTIATE - INTERACT : How to encourage social community in urban architecture: Can multi-residential buildings offer a community of social connections between neighbors?

Dahlberg, Emma January 2024 (has links)
In contemporary urban housing, the essence of social connection often struggles to thrive. Amidst the bustling city life, a profound sense of disconnection prevails, highlighting the limitations of traditional apartment living. Many individuals experience isolation and loneliness, yearning for social bonds with their neighbors. Modern apartment complexes, characterized by confined and unwelcoming shared spaces, fail to foster these crucial interactions. This thesis explores the cultural and structural factors contributing to this sense of isolation. Conventional living arrangements, with their impersonal spaces, serve as barriers rather than bridges to meaningful interaction. As fleeting encounters in blank hallways become the norm, a pervasive sense of disconnection undermines the fabric of communal well-being. Central to this study is the transformation of common spaces within apartment buildings into vibrant social hubs. By challenging conventional architectural norms, the project aims to create environments that encourage spontaneous encounters and meaningful connections among residents. Through thoughtful design interventions, such as emphasizing the idea of thresholds between private and communal spaces, the project seeks to blur the boundaries between individual living units and foster a collective sense of belonging. Emphasizing inclusivity, the project targets diverse resident groups, from families to students, to enhance community understanding and cohesion. The objective is to redefine physical spaces within apartment buildings and cultivate a sense of community that enriches residents' living experiences and overall well-being in urban environments. Through innovative design and a commitment to fostering social bonds, this project aims to create a blueprint for urban living that transcends the limitations of traditional apartment complexes. / I moderna urbana bostäder kämpar ofta essensen av social anknytning för att kunna frodas. Mitt i det händelserika stadslivet råder en djup känsla av frånkoppling, vilket framhäver begränsningarna med traditionellt lägenhetsboende. Många upplever isolering och ensamhet och längtar efter sociala band med sina grannar. Moderna lägenhetskomplex, som kännetecknas av trånga och ogästvänliga delade utrymmen, misslyckas med att främja dessa avgörande interaktioner. Detta projekt utforskar de kulturella och strukturella faktorer som bidrar till denna känsla av isolering. Konventionella boende arrangemang, med sina opersonliga utrymmen, fungerar som barriärer snarare än broar till meningsfull interaktion. När flyktiga möten i tomma korridorer blir normen skapas en genomgripande känsla av frånkoppling, strukturen av gemensamt välbefinnande. Centralt i denna studie är omvandlingen av gemensamma utrymmen i flerbostadshus till levande sociala knutpunkter. Genom att utmana konventionella arkitektoniska normer syftar projektet till att skapa miljöer som uppmuntrar spontana möten och meningsfulla kontakter mellan invånarna. Genom genomtänkta design interventioner, som att betona idén om övergångar mellan privata och gemensamma utrymmen, försöker projektet sudda ut gränserna mellan individuella boendeenheter och främja en kollektiv känsla av tillhörighet. Projektet betonar inkludering och riktar sig till olika invånargrupper, från familjer till studenter, för att öka förståelsen och sammanhållningen i samhället. Målet är att omdefiniera fysiska utrymmen i flerbostadshus och odla en gemenskapskänsla som berikar de boendes livskvalitet och övergripande välbefinnande i stadsmiljöer. Genom innovativ design och ett engagemang för att främja sociala band, syftar detta projekt till att skapa en plan för urbant boende som överskrider begränsningarna för traditionella lägenhetskomplex.
219

Barn och etik : möten och möjlighetsvillkor i två förskoleklassers vardag / Children and Ethics : Ethical Encounters and Conditions in the Everyday Life of Two Preschool Classes

Halvars-Franzén, Bodil January 2010 (has links)
The aim is to examine how children create and embody ethics by analyzing their encounters and how possibilities are conditioned by the framework surrounding them. The focus has been on the following problem areas: Conditions that enable children’s ethical encounters with regard to frameworks, rules and order Conditions that enable children’s ethical encounters related to the teachers’ approach Children’s encounters in play from an ethical perspective Children’s encounters with nature from an ethical perspective The theoretical standpoint is ”the ethics of an encounter” from Emmanuel Levinas’ idea of ethics of alterity. In ethics which precedes being itself, the ethical becoming and its relational aspects appear in the encounter with the Other. The tools of analysis are mainly drawn from previous pedagogical/didactical research in ethics which highlights the ethical conditions, such as listening, encounters with diversity and differences, and preschool/school as an ethical space. The study is based on one year of ethnographical field studies relying on participant observations, video observations, focus groups, stimulated recalls and guided tours. The empirical findings show that rules and frameworks which regulate the everyday life of the preschool classes are repeatedly negotiated. The negotiations about “what’s what?”, where both the children and the teachers are involved, take place on a verbal and a bodily level. In the pedagogues’ approach, the listening is a central and complex condition for the ethical space in the preschool classes. In the children’s encounters in play and in their encounters with nature the relational aspect becomes clear. The ethical boundaries and the fixing of those boundaries are discussed in connection with the idea of the ethics of an encounter and the vision of preschool/school as a potential ethical space.
220

Vilka erfarenheter patienter med hepatit C har av bemötandet i vården / How patients with hepatitis C experience the encounter in the health care setting

Nilsson, Sara, Persson, Johanna January 2015 (has links)
Bakgrund: Den vanligaste smittvägen för hepatit C är genom intravenöst drogmissbruk. Smittöverföring kan även ske via blodtransfusioner eller stickskador i vården. Det finns många fördomar förknippade med sjukdomen och risken är stor att dessa färgar mötet med patienter. Det är viktigt att som vårdpersonal vara medveten om hur den egna synen på sjukdomen kan påverka bemötandet. Syfte: Syftet var att belysa vilka erfarenheter patienter med hepatit C har av bemötandet i vården. Metod: Studien utformades som en allmän litteraturöversikt av tolv kvalitativa artiklar. Manifest innehållsanalys användes. Resultat: Patienter med HCV hade blandade erfarenheter av mottagandet: välkomnande, avvisande eller otryggt. Vidare ledde detta till erfarenheter av stöd eller diskriminering. Patienter kunde ha erfarenheter av professionellt stöd eller brist på professionellt stöd. Diskriminering kunde orsakas av antingen vårdpersonal eller organisation. Slutsats: På grund av stigmatisering kring sjukdomen är patienter med hepatit C en utsatt grupp i samhället. Vårdpersonalens kunskap är en viktig del i bemötandet. Det krävs utbildning för att kunna erbjuda en mer holistisk vård vid hepatit C än i dagsläget. Genom ökad kunskap kring både sjukdom och bemötande kan bemötandet påverkas positivt, det vill säga: mottagandet blir bättre, stödet ökar och diskrimineringen minskar. / Background: The most common route of transmission of hepatitis C is through intravenous drug abuse. Transmission can also occur through blood transfusion. There are many prejudices associated with hepatitis C. Chances are that this colors interactions with patients. It is important that healthcare professionals are aware of how their own perception of the disease may affect the encounter.  The Objective was to highlight the experiences patients with hepatitis C have of the encounter in the healthcare. Method: The study was designed as a general literature review of twelve qualitative articles. Manifest content analysis was used. Results: Patients with hepatitis C had mixed experiences of receipt: welcoming, rejecting or unsafe. This led to experiences of support or discrimination. Patients experienced professional support or lack of professional support. Discrimination could be caused either by healthcare professionals or the organization. Conclusion: Because of stigma surrounding the disease patients with hepatitis C are a vulnerable group in society. The knowledge of healthcare professionals is an important part of the encounter. It requires training to provide holistic care for hepatitis C. Increased knowledge about both the disease and patient-professional relation can positively affect the encounter: the reception gets better, support increases and discrimination is reduced.

Page generated in 0.1043 seconds