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  • 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.
31

Comportamiento del control de crecimiento y desarrollo en niños nacidos en un centro de salud de Chiclayo periodo 2020-2022

Enriquez Salazar, Cuiny Elizabeth January 2024 (has links)
Objetivo: Determinar el comportamiento del Control de Crecimiento y Desarrollo en niños nacidos en un centro de salud de Chiclayo periodo 2020-2022. Método: Estudio cuantitativo, diseño no experimental, descriptivo, transversal y retrospectivo, se basó en los criterios de rigor científico: validez, objetividad y los principios éticos. La población estuvo constituida por 311 historias clínicas de niños nacidos en los años 2020, 2021 y 2022 del Centro de Salud José Leonardo Ortiz, siendo la muestra final de 173 historias clínicas y se obtuvo mediante el muestreo no probabilístico por conveniencia. Se utilizó como instrumento una ficha de recolección según la Norma Técnica para el Control del Niño, que recogió ciertas características: datos generales sobre el niño, madre y padre; número de controles de crecimiento y desarrollo; condición de crecimiento y estado nutricional; y el diagnóstico del desarrollo Psicomotor. El procesamiento y análisis de la información se realizó en hojas de Excel 2016 y en el programa estadístico SPSS versión 22 a través de frecuencias absolutas y relativas. Resultados: El 58.3% de recién nacidos tuvieron 4 controles, el 37,8% de los niños tienen condición de crecimiento adecuado y el 36,9% obtuvo un desarrollo psicomotor normal. Conclusiones: La mitad de los recién nacidos, menos de la octava parte de los niños menores de 1 año y muy pocos niños de 1 año tienen los controles recomendados según edad, la cifra es preocupante porque puede repercutir en la detección temprana de alteraciones o trastornos tanto en el crecimiento como en el desarrollo. / Objective: Determine the behavior of Growth and Development Control in children born in a health center in Chiclayo period 2020-2022. Method: Quantitative study, non-experimental, descriptive, cross-sectional and retrospective design, was based on the rigor criteria scientific: validity, objectivity and ethical principles. The population was made up of 311 medical records of children born in the years 2020, 2021 and 2022 from the José Health Center Leonardo Ortiz, being the final sample of 173 medical records and was obtained through the non-probabilistic convenience sampling. A collection form was used as an instrument according to the Technical Standard for Child Control, which collected certain characteristics: general data about the child, mother and father; number of controls growth and development; growth condition and nutritional status; and the diagnosis of Psychomotor development. The processing and analysis of the information was carried out in Excel 2016 sheets and in the statistical program SPSS version 22 through absolute and relative frequencies. Results: 58.3% of newborns had 4 controls, 37.8% of children had adequate growth conditions and 36.9% obtained normal psychomotor development. Conclusions: Half of newborns, less than an eighth of children under 1 year of age and very few 1-year-old children have the recommended controls according to age, the figure is worrying because it can have an impact on the early detection of alterations or disorders both in growth and development.
32

Evolução do desenvolvimento motor e cognitivo de pré-escolares nascidos pré-termo de muito baixo peso egressos do método canguru / Very low weight preterm infants cognitive and motor development at preschool age that were former patients FROM THE KANGAROO METHOD

Gonçalves, Claudia Maria Ribeiro Martins 18 March 2014 (has links)
INTRODUÇÃO: O Método Canguru é um tipo de assistência neonatal que consiste no contato precoce pele a pele entre a mãe e o recém-nascido de baixo peso, de forma crescente e pelo tempo que ambos entenderem ser prazeroso e suficiente, permitindo dessa forma, uma maior participação dos pais no cuidado a seu recém-nascido, acompanhado de suporte assistencial, por uma equipe de saúde treinada adequadamente. Tem como premissa a interação dinâmica e continua entre fatores biomédicos e ambientais. OBJETIVO: Descrever a evolução do desenvolvimento motor e cognitivo de pré-escolares de muito baixo peso egressos do Método Canguru, que receberam leite humano durante o período de internação. MÉTODOS: Foram estudadas 54 crianças prematuras, no período de Janeiro de 2004 a Janeiro de 2011 que participaram do Método Canguru e acompanhadas no Ambulatório de Seguimento, até a idade pré-escolar. Essas crianças foram submetidas ao teste Denver II, com um ano e novamente na idade préescolar quando foi aplicada a Escala de Maturidade Mental Colúmbia. METODOLOGIA ESTATÍSTICA: As variáveis contínuas serão descritas através de suas médias e desvios-padrão. Aquelas com comportamento não paramétrico, serão descritas através da mediana e do intervalo inter-quartil. As variáveis categóricas serão descritas através de suas proporções e intervalos de confiança de 95%. Para descartar a hipótese de nulidade será utilizado o nível de corte de 5%. RESULTADOS: Na amostra houve predominância do sexo feminino de 65%, e cerca de 30% dos RNPT foram PIG. As medianas do peso de nascimento e idade gestacional foram 1316g e 32 semanas, respectivamente. A mediana da idade materna foi de 28 anos, ensino fundamental completo com nove anos de estudo e a renda per capita de R$150,00. Entre as 54 crianças do estudo, 15% tiveram Hemorragia Perintraventricular grau I, 19% desenvolveram displasia broncopulmonar e nenhuma apresentou retinopatia da prematuridade. No teste Denver II de 54 crianças na idade de um ano corrigida, constatamos um risco no desempenho do desenvolvimento motor grosso de 31%, na linguagem 7%, psicossocial 6% e motor adaptativo 2%. Na idade pré-escolar observamos uma diminuição significativa do risco no desempenho do desenvolvimento para 4% em linguagem, 3% em motor grosso e 0% em psicossocial e motor adaptativo. Na idade pré-escolar o desempenho cognitivo se assemelhou a normalidade, quando comparado com a população brasileira, de acordo com a padronização da Escala Colúmbia. Os fatores de risco para o desempenho no desenvolvimento neuropsicomotor das crianças com um ano de idade corrigida estão associados ao tempo de internação e inicio da posição Canguru e foram estatisticamente significantes (p=0,009), (p=0,013), mesmo depois de ajustar à análise para as variáveis da idade gestacional, peso de nascimento, idade materna e sexo. Embora não tenha havido significância estatística, as crianças que foram amamentadas por mais tempo (meses) tiveram percentualmente menor risco para o desempenho neuropsicomotor. Nesta amostra constatamos em relação ao aleitamento materno total a mediana de sete meses e para o aleitamento exclusivo a mediana de três meses. CONCLUSÃO: A análise da evolução do desenvolvimento motor e cognitivo de pré-escolares nascidos pré-termo de muito baixo peso e egressos do Método Canguru, mostrou que, as crianças com um ano de idade corrigida, apresentaram 38% de risco no desempenho neuropsicomotor e ao atingirem a idade pré-escolar, apenas 5% demonstraram este risco. No que diz respeito ao desenvolvimento cognitivo, os valores obtidos foram percentualmente acima da média da população brasileira. Estes achados sugerem que as crianças que foram RNPT MBP alimentadas com leite humano durante sua internação e egressas do Método Canguru podem apresentar um desempenho no desenvolvimento tanto motor como cognitivo semelhante ao padrão de normalidade / INTRODUCTION: The Kangaroo Method is a perinatal care concerning skin contact between the mother and the low birth weight (LBW) newborn as long as both consider it pleasant and necessary. It allows greater parental participation in the care of their low birth weight newborn closely followed by properly trained healthcare professionals. The dynamic and continuous interaction between biomedical and environmental factors is its premise. OBJECTIVE: To describe the cognitive and motor development of children at preschool age that were born with very low birth weight (VLBW), former patients of the Kangaroo Method that were breastfed during hospital stay. METHOD: Fifty four preterm infants were studied between January 2004 and January 2011. The infants participated in the Kangaroo Method and they were followed up to preschool age by trained professionals in a followup ambulatory. These children were submitted to Denver II test by the time they were one year old and again at preschool age. Columbia Mental Maturity scale was applied to the children at preschool age. STATISTICAL ANALYSIS: The continual variables will be described by their averages and standard deviations. The nonparametric variables will be described by the medians and the interquartile interval. The categorical variables will be described by their proportions and the confidence interval of 95%. A 5% cutoff point will be applied to discard the null hypothesis. RESULTS: In the sample 65% were female, approximately 30% of the preterm newborn were small for the gestational age. Birth weight and gestational age medians were respectively 1316g and 32 weeks. Maternal age median was 28 years old. The mothers completed elementary school in nine years and their per capita income was R$ 150,00. The fifty four children involved in the study 15% had peri-intraventricular hemorrhage level 1, 19% had bronchopulmonary dysplasia and none had retinopathy of prematurity. The fifty four children were assessed at one year old, corrected age, to Denver II test and the following development risks were detected, 31% gross motor, 7% language, 6% psychosocial and 2% adaptive motor. At preschool age there was a considerable decrease in those parameters, 4% for language and 3% for gross motor 0% for psychosocial and adaptive motor. According to the Columbia scale standardization cognitive performance at preschool age resembled normality when compared with Brazilian population. Our study identified that the children involved had a higher performance than the population of reference (Brazilian population). Hospitalization period and the beginning of the Kangaroo position determined the risks factors for psychomotor development at one year old, corrected age, even after the adjustments in the analysis for gestational age, birth weight, mother\'s age and gender (p=0,009), (p=0,013) had been made. Although there was no statistical significance children breastfed for longer period had a lower psychomotor development risk. For the sample enrolled the median for total breastfeeding was 7 months and the exclusive breastfeeding 3 months. CONCLUSION: The Kangaroo Method had an impact on motor and cognitive developmental performance of the preschool age children born preterm with very low birth weight. At one year old, corrected age, the children concerned presented a 38% risk in psychomotor performance, however at preschool age the percentage dropped to 5%. The measured values for cognitive development were above the average for the Brazilian population. These findings suggest that very low birth weight preterm newborn that were breastfed during hospital stay and submitted to Kangaroo Method may present motor as well as cognitive developmental performances similar to normal standard
33

Evolução do desenvolvimento motor e cognitivo de pré-escolares nascidos pré-termo de muito baixo peso egressos do método canguru / Very low weight preterm infants cognitive and motor development at preschool age that were former patients FROM THE KANGAROO METHOD

Claudia Maria Ribeiro Martins Gonçalves 18 March 2014 (has links)
INTRODUÇÃO: O Método Canguru é um tipo de assistência neonatal que consiste no contato precoce pele a pele entre a mãe e o recém-nascido de baixo peso, de forma crescente e pelo tempo que ambos entenderem ser prazeroso e suficiente, permitindo dessa forma, uma maior participação dos pais no cuidado a seu recém-nascido, acompanhado de suporte assistencial, por uma equipe de saúde treinada adequadamente. Tem como premissa a interação dinâmica e continua entre fatores biomédicos e ambientais. OBJETIVO: Descrever a evolução do desenvolvimento motor e cognitivo de pré-escolares de muito baixo peso egressos do Método Canguru, que receberam leite humano durante o período de internação. MÉTODOS: Foram estudadas 54 crianças prematuras, no período de Janeiro de 2004 a Janeiro de 2011 que participaram do Método Canguru e acompanhadas no Ambulatório de Seguimento, até a idade pré-escolar. Essas crianças foram submetidas ao teste Denver II, com um ano e novamente na idade préescolar quando foi aplicada a Escala de Maturidade Mental Colúmbia. METODOLOGIA ESTATÍSTICA: As variáveis contínuas serão descritas através de suas médias e desvios-padrão. Aquelas com comportamento não paramétrico, serão descritas através da mediana e do intervalo inter-quartil. As variáveis categóricas serão descritas através de suas proporções e intervalos de confiança de 95%. Para descartar a hipótese de nulidade será utilizado o nível de corte de 5%. RESULTADOS: Na amostra houve predominância do sexo feminino de 65%, e cerca de 30% dos RNPT foram PIG. As medianas do peso de nascimento e idade gestacional foram 1316g e 32 semanas, respectivamente. A mediana da idade materna foi de 28 anos, ensino fundamental completo com nove anos de estudo e a renda per capita de R$150,00. Entre as 54 crianças do estudo, 15% tiveram Hemorragia Perintraventricular grau I, 19% desenvolveram displasia broncopulmonar e nenhuma apresentou retinopatia da prematuridade. No teste Denver II de 54 crianças na idade de um ano corrigida, constatamos um risco no desempenho do desenvolvimento motor grosso de 31%, na linguagem 7%, psicossocial 6% e motor adaptativo 2%. Na idade pré-escolar observamos uma diminuição significativa do risco no desempenho do desenvolvimento para 4% em linguagem, 3% em motor grosso e 0% em psicossocial e motor adaptativo. Na idade pré-escolar o desempenho cognitivo se assemelhou a normalidade, quando comparado com a população brasileira, de acordo com a padronização da Escala Colúmbia. Os fatores de risco para o desempenho no desenvolvimento neuropsicomotor das crianças com um ano de idade corrigida estão associados ao tempo de internação e inicio da posição Canguru e foram estatisticamente significantes (p=0,009), (p=0,013), mesmo depois de ajustar à análise para as variáveis da idade gestacional, peso de nascimento, idade materna e sexo. Embora não tenha havido significância estatística, as crianças que foram amamentadas por mais tempo (meses) tiveram percentualmente menor risco para o desempenho neuropsicomotor. Nesta amostra constatamos em relação ao aleitamento materno total a mediana de sete meses e para o aleitamento exclusivo a mediana de três meses. CONCLUSÃO: A análise da evolução do desenvolvimento motor e cognitivo de pré-escolares nascidos pré-termo de muito baixo peso e egressos do Método Canguru, mostrou que, as crianças com um ano de idade corrigida, apresentaram 38% de risco no desempenho neuropsicomotor e ao atingirem a idade pré-escolar, apenas 5% demonstraram este risco. No que diz respeito ao desenvolvimento cognitivo, os valores obtidos foram percentualmente acima da média da população brasileira. Estes achados sugerem que as crianças que foram RNPT MBP alimentadas com leite humano durante sua internação e egressas do Método Canguru podem apresentar um desempenho no desenvolvimento tanto motor como cognitivo semelhante ao padrão de normalidade / INTRODUCTION: The Kangaroo Method is a perinatal care concerning skin contact between the mother and the low birth weight (LBW) newborn as long as both consider it pleasant and necessary. It allows greater parental participation in the care of their low birth weight newborn closely followed by properly trained healthcare professionals. The dynamic and continuous interaction between biomedical and environmental factors is its premise. OBJECTIVE: To describe the cognitive and motor development of children at preschool age that were born with very low birth weight (VLBW), former patients of the Kangaroo Method that were breastfed during hospital stay. METHOD: Fifty four preterm infants were studied between January 2004 and January 2011. The infants participated in the Kangaroo Method and they were followed up to preschool age by trained professionals in a followup ambulatory. These children were submitted to Denver II test by the time they were one year old and again at preschool age. Columbia Mental Maturity scale was applied to the children at preschool age. STATISTICAL ANALYSIS: The continual variables will be described by their averages and standard deviations. The nonparametric variables will be described by the medians and the interquartile interval. The categorical variables will be described by their proportions and the confidence interval of 95%. A 5% cutoff point will be applied to discard the null hypothesis. RESULTS: In the sample 65% were female, approximately 30% of the preterm newborn were small for the gestational age. Birth weight and gestational age medians were respectively 1316g and 32 weeks. Maternal age median was 28 years old. The mothers completed elementary school in nine years and their per capita income was R$ 150,00. The fifty four children involved in the study 15% had peri-intraventricular hemorrhage level 1, 19% had bronchopulmonary dysplasia and none had retinopathy of prematurity. The fifty four children were assessed at one year old, corrected age, to Denver II test and the following development risks were detected, 31% gross motor, 7% language, 6% psychosocial and 2% adaptive motor. At preschool age there was a considerable decrease in those parameters, 4% for language and 3% for gross motor 0% for psychosocial and adaptive motor. According to the Columbia scale standardization cognitive performance at preschool age resembled normality when compared with Brazilian population. Our study identified that the children involved had a higher performance than the population of reference (Brazilian population). Hospitalization period and the beginning of the Kangaroo position determined the risks factors for psychomotor development at one year old, corrected age, even after the adjustments in the analysis for gestational age, birth weight, mother\'s age and gender (p=0,009), (p=0,013) had been made. Although there was no statistical significance children breastfed for longer period had a lower psychomotor development risk. For the sample enrolled the median for total breastfeeding was 7 months and the exclusive breastfeeding 3 months. CONCLUSION: The Kangaroo Method had an impact on motor and cognitive developmental performance of the preschool age children born preterm with very low birth weight. At one year old, corrected age, the children concerned presented a 38% risk in psychomotor performance, however at preschool age the percentage dropped to 5%. The measured values for cognitive development were above the average for the Brazilian population. These findings suggest that very low birth weight preterm newborn that were breastfed during hospital stay and submitted to Kangaroo Method may present motor as well as cognitive developmental performances similar to normal standard
34

AVALIAÇÃO DO DESENVOLVIMENTO NEUROPSICOMOTOR EM PREMATUROS COM ALTERAÇÕES ULTRA-SONOGRÁFICAS CEREBRAIS NO PERÍODO NEONATAL / EVALUATE THE MOTOR AND COGNITIVE DEVELOPMENT OF PREMATURE BABIES WHO HAD BRAIN ULTRASOUND ALTERATIONS AT THE NEONATAL PERIODS

Cunha, Roxana Desterro e Silva da 13 December 2007 (has links)
Made available in DSpace on 2016-08-19T18:16:08Z (GMT). No. of bitstreams: 1 Roxana Desterro.pdf: 688994 bytes, checksum: ceb8107f09c4ea13f75ca8e4a721da06 (MD5) Previous issue date: 2007-12-13 / The scientific and technologic advances that occurred in the neonatal ITU over the last decades increased the survival rate of babies over and over more premature. Due to the occurency of possible sequelae inherent to this condition, it has been a bigger interest for de development of egress babies from these unites of treatment. The present study is retrospective, longitudinal, analytical of a control case, nested to a cohort. It proposes to evaluate the motor and cognitive development of premature babies who had brain ultrasound alterations at the neonatal period and the possible risk factors for its delay. It has been selected 99 premature children weighting 1800 grams or less in the birth and pregnancy age inferior to 37 weeks, submitted to a transfontanelar ultrasound in the neonatal period during their neonatal ITU (Intensive Therapy Unity) internment. The socio-economic, cultural, environmental, perinatal clinic events and mother characteristics were analysed. To evaluation of the neural, psychomotor development, the Denver II test was used. A sample made, in the majority, of corrected 12 months old children. The birth weight average was 1032 grams and the pregnancy average was 31,3 weeks. The ultrasonic alterations were present in 49, 4% of the children. In them, the periventricular leucomalacy was more frequent corrected one year old babies with alterations in the Denver II test. 34, 3% of the realized tests had unsatisfactory results. As risk factors for the development alteration, Ultrasonic alterations and low family incomes were significant for the study. . The positive predictive value of transfontanelar ultrasonic exams for the neural psychomotor development was 51,02% and the negative predictive value was 82% When the family incomes variable is added to the transfontanelar ultrasonic alterations, the positive predictive value increased to 90% and the negative predictive value decreased to 71,91%. It is believed that the variable family incomes added to the analysis is a good alternative to increase the prediction capacity development alterations of premature children with transfontanelar ultrasonic alterations. / Os avanços científicos e tecnológicos que ocorreram nas UTI neonatais nas últimas décadas, aumentaram a sobrevida de bebês cada vez mais prematuros. Devido ocorrência de possíveis seqüelas inerentes a essa condição, houve um interesse maior pelo desenvolvimento dos bebês egressos dessas unidades de tratamento. O presente estudo é retrospectivo, longitudinal, analítico do tipo caso controle, aninhado a uma coorte. Foi avaliado o desenvolvimento motor e cognitivo de prematuros que tiveram alterações ultra-sonográficas cerebrais no período neonatal e os possíveis fatores de risco para o seu atraso. Selecionou-se 99 crianças prematuras com peso de nascimento menor ou igual a 1800 gramas e idade gestacional abaixo de 37 semanas e que fizeram ultra-sonografia transfontanelar no período neonatal durante sua internação em UTI neonatal. Analisaram-se variáveis sócio-econômicas, culturais, ambientais, eventos clínicos perinatais e características maternas. Para avaliação do desenvolvimento neuropsicomotor utilizou-se o Teste de Denver II. A população foi composta de crianças com 12 meses de idade corrigida. A média de peso de nascimento foi de 1032 gramas e a média de idade gestacional foi de 31,3 semanas. As alterações ultra-sonográficas estiveram presentes em 49,4% das crianças. Destas, a leucomalácia periventricular foi a mais presente nos bebês com alteração no Teste de Denver II na idade corrigida de 1 ano. Dentre os testes realizados, 34,3% tiveram resultados desfavoráveis. Dos fatores de risco para alteração de desenvolvimento, alterações ultra-sonográficas cerebrais e renda familiar mostram-se estatisticamente significantes para o estudo. O valor preditivo positivo dos exames ultra-sonográficos transfontanelares para alterações de desenvolvimento neuropsicomotor, foi de 51,02% e valor preditivo negativo de 82%. Ao se acrescentar a variável renda familiar às alterações ultra-sonográficas transfontanelares, o valor preditivo positivo aumentou para 90% e o valor preditivo negativo reduziu-se para 71,91%. Acredita-se que o acréscimo à análise da variável renda familiar baixa é boa alternativa para aumentar a capacidade de predição de alterações do desenvolvimento de prematuros com alterações ultra-sonográficas transfontanelares.
35

Zkušenosti lektorů Feldenkraisovy metody s využitím skupinových lekcí Pohybem k sebeuvědomění u dětí / Experiences of the Feldenkrais Method Practitioners with group lessons Awareness Through Movement for Children

Nejdlová, Eliška January 2017 (has links)
Title of the Thesis: Experiences of the Feldenkrais Method Practitioners with group lessons Awareness Through Movement for Children The Aim of the Thesis: The Aim of the Thesis is finding out possible uses of Feldenkrais Method (FM) - Awareness Through Movement (ATM) in group lessons for children. We will use theoretical sources and information gained by internationally certified practitioners who use FM lessons for children groups. Method: We will use theoretical qualitative research Phenomenological conception, which has descriptive-analytical character. We chose this research because it was the most suitable one. Its main goal is description and analysis of the experience gained in the specific area. (phenomenon, action, situation or process). We cooperated with internationally certified practitioners who have used FM lessons for children groups. The research was provided by the written interview with open questions. Gained information were analyzed by topic analysis and then evaluated from the view of different topics. Results: The Thesis was dealing with the phenomenon of group lessons of Feldenkrais method (FM) - Awareness Through Movement (ATM). The results showed that this method and its principles can be used for children with or without specific needs from the age of two or three. We...
36

Speciálně pedagogická intervence u dětí s vývojovou dysfázií v mateřské škole / Special Educational Intervention in Children with Specific Language Impairment in the Kindergarten

Vávrová, Miriam January 2015 (has links)
This Masters thesis focuses on issues of Specific Language Impairment - SLI of children of pre-school age. It monitors and evaluates development of their communication and motor skills during their time in kindergarten. The theoretical part focuses on defining basic terms which relate to communication and communication disorder with the emphasis on SLI. The psychomotor and communicational development of child from birth to entering school is described too. Also how this all affected creating the Framework Educational Programme for preschool education. The aim of the empirical part was to observe four children with SLI during their attendance at a pre-school for children with specific needs. Speech and psychomotor development of these children and its changes in connection to their teachers' intervention was observed. Part of the research included interviews with children's parents and those are also evaluated. The survey was done by the qualitative method. We get four case histories. At the end was evaluated the aims of the survey and answered questions asked and summarized the results of my investigation.
37

Edukace rodičů extrémně nezralých dětí při využívání stimulačních technik pro podporu psychomotorického vývoje / Education for parents of extremely premature infants in the use of stimulation techniques for the support of psychomotor development

Mirovská, Dagmar January 2013 (has links)
Annotation: The thesis is focused on educating parents of children with perinatal risks. The work focuses on justifying the need of special educator within the multidisciplinary team of therapists and his role in the work with children with perinatal stress. Based on the questionnaire results it shows how parents are informed about the therapy options, leisure activities and other source of information. The work highlights how essential is to coordinate all offers of variety organizations and the need for long-term and systematic educational work. In the theoretical part of the thesis is the child examination and the importance of early detection of children with threats followed by clearly elaborated complex of the child psychomotor development. Further characteristics describe children with perinatal risks to define their basic diagnosis and the consequences of individual systems damages and the relevance of further development. The work shows the possibility of intervention using the latest trends in work with children at risk and the importance of early initiation and the need to combine the therapies.

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