$14 Million In Assets Over 10 Age And Vast Health Gains At Canada's Supervised Injection Absence
Entitled, "Cost-Effectiveness of the Vancouver Defended Injection Facility," the glance at is authored by Dr. Ahmed Bayoumi of St. For the study, the researchers used pc simulation to estimate the quantity of HIV and Hepatitis C cases that could be prevented the difficulty compared to sites using other intervention methods, such as needle-exchange programs, only.
Results present Insite improves health and saves the health-care course money, yet under conservative estimates of efficacy. And that's without considering the further embryonic health benefits such as decreased narcotic overdose, reduced transmission of Hepatitis B and fewer incidences of soft-tissue infections and other side-effects from unhygienic injection.
Whether the cost-effectiveness of Insite was evaluated using the corresponding standards as are commonly applied to other medical interventions, it would be considered indubitable bill effective," said Zaric, Canada Check Stool in Health Consideration State Science. When we besides excogitate the health factor of increased practice of guarded injection practices, the resources are all the more greater."
Although such findings are encouraging, Zaric cautions against extrapolating to other cities, such as Toronto and Ottawa, where collateral facilities are proposed, as the particular situations may differ. Supervised injection facilities already exist in another than two dozen cities in Europe and Australia.
Article adapted by Medical Announcement Nowadays from first-hand press release. Capital health care, however, depends on an manage discussion between patients and doctors.. Attention a Personal Medical Transcribe Medical facts is normally scattered in diverse contrastive places. To collect the culminating doable health care, humans are encouraged to collect dossier in one situate and design a personal medical record.. Landscape besides videos..
Contemporary Check Finds Anti-Same-Sex Wedding Amendments Glimmer Misery Among GLBT Adults And Families
Those living in Alabama, where an amendment passed in Jun 2006, were excluded as of the timing, as were those living in Arizona, where an amendment was defeated.) The researchers, led by Sharon Scales Rostosky, Ph.D., University of Kentucky, construct that those participants living in states that passed a degree in 2006 reported increased exposure to adverse media messages and detrimental conversations.
The results of this interpret establish that living in a native land that has dependable passed a marriage amendment is associated with higher levels of psychological stress for lesbian, alert and bisexual citizens," Rostosky said. And this stress is not due to other pre-existing conditions or factors; it is a administer consummation of the contradiction images and messages associated with the opt crusade and the words of the amendment."
The qualitative studies, while yet smaller in scope, bestow intonation to some of the humans directly affected by anti-gay marriage amendments. 2006 referendum campaign. The researchers, led by Heidi M. Levitt, Ph.D., University of Memphis, grouped the respondents' reactions into eight higher themes, or "clusters."
These included, for example: "Initiatives surpass to fixed painful reminders that I'm seen as less than human by our state and general laws," and "The irrationality of anti-GLBT initiatives and movements is baffling, painful and scary: We are not who they speak we are." Participants reported feel not condign alienated from their communities, on the contrary fearful that they would lose their children, that they would shift victims of anti-gay attack or that they would longing to act to a enhanced accepting community. Some of these anxieties were mitigated by social support.
For instance, one interviewee said he became "petrified. I care approximately vitality picked absent as a carefree guy over my mannerisms are not entirely masculine." Another said the marriage amendment supporters were using the Bible "like a brick on us. They are beating us with it." Social bedding from devout institutions, families, GLBT friends and heterosexual allies led most of the participants "to worthier feelings of safety, enchantment and strength," the researchers wrote.
And in the third study, 10 family members of GLBT dudes living in Memphis were interviewed regarding how anti-GLBT initiatives and movements had affected their family. Their responses were as well grouped into clusters of agnate themes. Some participants identified so deeply with their family member's practice that they felt equally attacked by these movements and policies," the researchers wrote.
They considered themselves members of the GLBT limited and experienced rejection by others for continuance a GLBT family member." Typically, we tend to credit of anti-GLBT policies such as marriage bans and Proposition 8 as affecting sole GLBT people. However, our analysis suggests that others in appendix to GLBT bourgeois are too impacted by this legislation and sometimes all negatively. For example, we learned that some family members experienced a contour of secondary minority stress.
Although diverse participants displayed resiliency and efficacious coping with this stress, some experienced brawny dissension consequences to their intellectual and physical health," said Jennifer Arm, M.S. Brent Mallinckrodt, Ph.D., Magazine of Counseling Psychology, said the three articles care empirical evidence of the harmful psychological and emotional thing of such measures.
This dirt is chiefly timely, as we examine the emotionally charged reactions from GLBT heads in the wake of the Proposition 8 text in California," he said. Psychologists serving GLBT clients and their families necessitate to be aware of the certain influence of these political forces on the day-to-day lives of the humanity most directly affected." Article adapted by Medical Copy Nowadays from modern press release. Article: "Marriage Amendments and Psychological Distress in Lesbian, Festive and Bisexual (LGB) Adults," Sharon Scales Rostosky, Ph.D., Ellen D.B.
Riggle, Ph.D., University of Kentucky; Sharon G. Horne, Ph.D., University of Memphis; and Angela D. Miller, Ph.D., University of Kansas; Annals of Counseling Psychology, Vol. 56, No. 1. Article: "Balancing Dangers: GLBT Intimacy in a Date of Anti-GLBT Legislation," Heidi M. Elin Ovrebo, M.S., Mollie B. Anderson-Cleveland, B.S.,
Christina Leone, M.S., Jae Y. Jeong, M.S., Jennifer R. Arm, M.S., Beth P. Bonin, B.S., John Cicala, M.B.A., Rachel Coleman, M.S., Anna Laurie, M.S., James M., Vardaman, M.B.A., Sharon G. Annual of Counseling Psychology, Vol. 1. Article: "Negotiating connexion to GLBT experience: Family members' background of anti-GLBT movements and policies," Jennifer R. Heidi M. The University of Memphis; Ledger of Counseling Psychology, Vol.
1. Plentiful matter of the articles is available from the APA Habitual Affairs Work and at: http: www.apa.org journals releases cou-jan09-Rostosky.pdf.
WHO And Health Partners Sway Massive Cholera Response In Eastern DRC
There has been a tripling of cholera cases owing to the flying start of Oct to early Nov in the Goma health zone, which includes the earth of Karisimbi. From July-August, there was a weekly incidence of less than 20 cases in Goma. Cholera is a water-borne bacterial disease characterized by acute watery diarrhea and vomiting and can rapidly prompt to cessation provided untreated. It is expressly transmitted wrapped up contaminated moisten and board and is closely linked to insufficient sanitation.
It is endemic in the eastern articulation of the territory and that has alerted the population and health providers of choloera's presence, risks and response. There is great awareness of the lethal bang that cholera, and indefinite other communicable illnesses such as malaria and measles, hog on populations in the eastern tool of the Democratic State of the Congo," Dr Laroche said.
On the other hand this fresh risk is unacceptable. Access to unharmed water, correct sanitation and health services is constitutive to prevent from spreading to those displaced on roads, residing in fleeting camps and living in established communities."
WHO is primary the coordinated health response to the emergency. All concerned health providers and agencies coordinate their efforts down a organization common as the Health Cluster. Health sector response to increasing needs WHO is buying and delivering mammoth quantities of medical supplies, including materials to treat cholera and other water-borne diseases, in the affected areas of the country.
Supplies are activity if to MSF Switzerland in the northern town of Dungu, where seperate fighting has impacted the health of the community.
The consignment includes Verbal Rehydration Salts that can treat successfully up to 80% of suspect cholera cases, as hardy as intravenous fluids and antibiotics for handling severe cases. WHO has expanded than a dozen staff in the area, including epidemiologists, who are working to strengthen the reporting manner for cholera and other potentially life-threatening diseases, including measles and malaria.
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Indian Code Criminalizing Homosexuality Remains 'Major Obstacle' In Affray Against HIV AIDS, Piot Says
Piot called the code a "violation of human rights" and said that it should enjoy been abolished a expanded day ago. The principle is activity deliberated during hearings on a request to decriminalize homosexuality. Piot said, "For India now, the bull's eye field is the MSM population. This is a problem, which is characteristic to other Asian countries also.
It has be remodelled all an epidemic among this bunch -- equal as it was in the Western countries in the 1980s." The Kaiser Diurnal Health Policy Announcement is published for kaisernetwork.org, a paper advantage of The Henry J. Kaiser Family Foundation. 2008 Advisory Board Gathering and Kaiser Family Foundation. All rights reserved. Congenial health care, however, depends on an agape review between patients and doctors..
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Nail In Infirmary Visits For Respiratory Illnesses During Southern California Wildfires
Results propose that those at risk face companion health issues during in fashion Southern California firestorm activity. The hardest hit patients were boylike children and the elderly. Teens with asthma further were affected. UC Irvine environmental epidemiologist Dr. It's valuable to grasp from this scan that large-scale wildfires can annex wide-ranging item on human health.
This info has wide policy implications, as the health energy of wildfires testament probably aggrandizement worldwide due to the part of global warming." The announce has been presented to the South Seaside Air Standard Government Regional and will check in in the online history of Occupational and Environmental Medicine.
Hospital admissions information were obtained from the California Homeland Duty of Statewide Health Planning and Development. Article adapted by Medical Data Nowadays from archetypal press release. Approximately the University of California, Irvine: The University of California, Irvine is a top-ranked university committed to research, scholarship and district service.
The third-largest director in aggressive Orange County, UCI contributes an annual economic crush of $3.6 billion. Positive health care, however, depends on an exposed review between patients and doctors.. Control a Personal Medical Draw up Medical erudition is normally scattered in alive with contrary places. To be told the crowing viable health care, humans are encouraged to capture dossier in one dwelling and discover a personal medical record..
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Blogs Message On Proposed HHS Conscience Rule, Evangelical Ease For Obama, Accoucheuse Consideration
According to Newman, while Head of the state Bush's polity "thought these proposed regulations would quietly come embedded in HHS policy, health interest advocates, health carefulness providers, women's advocates, health aggravation consumers and others took notice."
The Obamagelical Reformation, " Cristina Page, Birth Domination Stopwatch : Citing way out referendum data, Folio writes that the "new and effectual wave of support" President-elect Barack Obama received from evangelical Christians "reflects stunning changes among voters who obtain traditionally voted for the most right-wing of Republicans." She says that "Democratic strategists should hear this sign blatant and clear: divers morality voters carry party-hopped," adding that voters may be putting "reason over rhetoric" for the first off time.
The Democratic assemblage platform holds the greatest abeyant for success on the "intransigent" investigation of abortion, among others, Leaf continues. For Obamagelicals it apparently does." They may be the regular ground movement pro-choice common people enjoy stretched been praying for" (Page, Birth State Watch, 11 14).
Fresh Cochrane Notebook on Midwife-Led vs. Further "in-depth review of the methods of the virgin studies" may be required to residence concerns approximately the studies, Walden writes.
Although it is not doable to be a defining paper on midwifery affliction and election of birth providers, this Cochrane portion does propose an alluring interest -- that maternity charge regularly happens via teams of providers working together, and women may appetite to be more appropriate informed about who is primarily in charge of those teams and how that ascendancy is negotiated in practice," she concludes (Walden, Our Bodies, Our Blog, 11 17).
Announce Them and Shake Your Head: 'A Giddy Belief of Boosterism' and Obama's Vow to Pro-Lifers, '" Dave Andrusko, Civic True to High spirits blog : Andrusko in the blog entry examines a modern view plenty in which Washington Publish columnist E.J. According to Andrusko, Dionne's path includes inaccuracies that fabricate an "unpersuasive argument. Obama truly is determined about reducing the cipher of abortions."
The Diurnal Women's Health Policy Announcement is a for nothing function of the State Society for Women & Families, published by The Advisory Board Company. 2008 The Advisory Board Company. All rights reserved.
Interpret Finds Developing Children Can Evolve Full-blown OCD
There admit been extremely infrequent studies focusing on early infancy OCD, all the more though we be versed that OCD, provided left untreated, can significantly disrupt a child's expansion and evolvement and can worsen as the baby gets older," says vanguard author Abbe Garcia, PhD, employer of the Bradley Hasbro Children's Check Centre (BHCRC) Paediatric Anxiety Proof Clinic.
That's why we compulsion to deduce exceeding approximately OCD in further burgeoning children, on account of early diagnosis and intervention are critical to reducing the severity of symptoms and improving affirmation of life." OCD is an anxiety chaos characterized by recurrent, unwanted thoughts (obsessions) and or repetitive behaviors (compulsions).
Repetitive behaviors such as handwashing, counting, checking, or cleaning are repeatedly performed with the dependence of preventing besetting thoughts or production them birr away. Performing these so-called "rituals," however, provides by oneself brief relief, and not performing them plainly increases anxiety.
All children underwent a series of clinical psychological assessments. Twenty percent reported a first-degree family version of OCD.
Conventional obsessions among children in the peruse included bugbear of contamination and aggressive catastrophic fears (involving annihilation or harm to themselves or loved ones), and three-quarters reported having multiple obsessions. Almost all of the children suffered from multiple compulsive behaviors, with an criterion of four compulsions per child.
Washing, checking and repeating were the most commonly reported compulsions. A material examination revealed a numeral of parallels between fledgling children with OCD and reported samples of their older peers in terms of symptoms and severity. For example, both groups be present to acquire comparable types of obsessions and compulsions, multiple psychiatric diagnoses, and gigantic rates of OCD family history.
These similarities propose this is a recite specimen involving full-blown OCD, as opposed to children who are either in the inauguration phases of the illness or alone get a incomplete OCD diagnosis," says Garcia, who is besides an assistant professor of psychiatry (research) at The Warren Alpert Medical Institute of Brown University.
However, Garcia says they too discovered some extensive differences between younger and older children with OCD. Although anxiety disorders seem to be a general comorbid diagnosis in both groups, younger children were less potential to own depression, compared to older children.
Also, while multiplied experts hold boys are bounteous practicable to show with juvenile OCD, the findings from the ongoing announce really exhibit a lower boy to daughter ratio. Our findings essay the antecedent glimpse at the features and variables that emerge during early childhood assault OCD and testament hopefully advance to also studies focusing on assessment and treatment of this time group," Garcia says. Article adapted by Medical Disclosure Nowadays from latest press release.
The read was supported in detail by a grant from the Governmental Institutes of Intellectual Health. Co-authors were Jennifer Freeman and Henrietta Leonard from the BHCRC and Alpert Medical School; Noah Berman, Alexandra Ogata and Molly Choate-Summers from the BHCRC; Michael Himle from the University of North Dakota; and Janet Ng from the University of Oregon. Today, it remains a nationally recognized center for children's mental health care, experience and research.
Its test arm, the Bradley Hasbro Children's Analysis Center, brings calm a multidisciplinary bunch of investigators working to advance our apprehension of children's mental health ended federally funded probation projects. Bradley Infirmary very operates the Bradley School, a fully certified best education school. A private, not-for-profit hospital, Bradley Hospital is a member of the Lifespan health system.
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Description From The American Chemical Nation Nov. 12, 2008
The finding could support millions of nation avoid diarrhea, bloating, and other symptoms that eventualize when they unknowingly eat foods containing gluten. The discover is scheduled for the Dec 15 interrogation of Analytical Chemistry, a semi-monthly journal. In the latest report, Alex Fragoso, Ciara O'Sullivan and colleagues letter that patients with celiac disease can avoid symptoms by avoiding foods that subsume gluten.
Doing so can be tricky, however, now gluten may be a dark ingredient in unsuspected foods, such as soy sauce, canned soups, and liquorice candy. Some prepared foods dossier gluten content on container labels, on the contrary identifying its presence remains bothersome and time-consuming. The scientists depict evolvement of a virgin sensor that detects antibodies to the protein gliadin, a element of gluten.
Laboratory tests showed that it is superior to the so-called enzyme-linked immunosorbent assay (ELISA), directly the principles examination for gliadin. It took the dewy catechism barely 90 minutes to detect gliadin in the parts per billion range, compared to 8 hours for the ELISA test.
Although both tests were equally accurate, the cutting edge sensor would be easier to benefit at diet manufacturing plants, the researchers note. MTS ARTICLE: "Electrochemical Immunosensor for Detection of Celiac Disease Poisonous Gliadin in Foodstuff" CONTACT: Alex Fragoso, Ph.D. Ciara K. O'Sullivan, Ph.D.
Universitat Rovira I Virgli Tarragona, Spain "Powerhouses" from living cells efficacy recent explosives detector Researchers in Missouri include borrowed the technology that living cells employ to generate power to mature a tiny, self-powered sensor for lasting detection of concealed explosives. The experimental sensor, approximately the bigness of a postage stamp, represents the head of its altruistic to be powered by mitochondria, the microscopic "powerhouses" that afford pressure to living cells, the researchers say.
Their glance at is scheduled for the Nov 26 theory of the weekly Magazine of the American Chemical Society. In the advanced study, Shelley Minteer, Marguerite Germain, and Robert Arechederra location absent that today's explosives detectors are expensive, bulky, and complex. Homeland needs smaller, cheaper, simpler detection devices, based on technology that maybe could be incorporated into cell phones and portable digital air players, the researchers suggest.
The scientists construe action of an experimental sensor built from a exceptional biofuel cell, essentially a battery-like slogan consisting of a thin layer of mitochondria sandwiched between a carbon-based electrode and a gas-permeable electrode.
In laboratory studies using nitrobenzene as a check compound, the sensor showed a expressive boost in electrical capacity in the presence of the substance, demonstrating the sensor's abeyant for detecting TNT and related explosives, the researchers say. Minteer, Ph.D. Saint Louis University St. After all, "phyto" process "plant."
Immediately the basic full peruse of phytoestrogen content in foods has identified the beyond compare sources of these nutrients. The glance at is scheduled for the November 26 controversy of ACS' bi-weekly Almanac of Agricultural and Menu Chemistry. In the study, Gunter G.
On the other hand all the more of the scientific check on these compounds has focused on their occurence in plant-based foods, which has led to an underestimation of actual amounts community consume, the announce says. Isoflavones - one of the three large classes of these compounds - were substantially higher in soy-based foods.
In fact, the vastness of phytoestrogens in soy-based kid formula was extra than 300 times higher than in natural youngster formula. In animal products, phytoestrogens are low when compared to foods containing soy, the paper notes, nevertheless the scale is resembling to that of divers commonly consumed vegetables.
In the two-part C&EN embrace story, Senior Complication Editor Melody Voith paper money that while foliate building materials were once viewed as a trendy environmental statement focusing on consistent or recyclable items, these materials straightaway are emerging as practical, high-performance products that very accommodate impact efficiency. Today, a "green building" normally refers to a commercial building or household that has been certified as such by the U.S.
Flourishing Building Council (USGBC) for its advantage of environmentally-friendly materials, among other considerations. The USGBC plans to proceeds updated certification standards in 2009 that charge lower coercion end and reduced greenhouse gauze emissions, the article notes. The U.S. Branch of Energy, meanwhile, assists builders in forming homes enhanced force efficient by publishing morals specifications for insulation, windows, ductwork, appliances, and other items.
Says one producer of interpretation materials, "All of a sudden, grassy is fitting deadpan and growing up. It is a vast shift in how buildings are designed and constructed." ARTICLE: "High-Performance Buildings" ---------------------------- Article adapted by Medical Report Nowadays from first press release.
How Obama Can Denouement Health Disquiet Improve
Health step strengthening must be a top precedence for the original management provided 46 million uninsured US residents are to gain access to health care," convey the writers of the editorial.
Obama's plans to pitch a compass of expenditure choices, his commitment to establish that all children carry health insurance, and the requirement that insurance companies contain pre-existing conditions are consummate steps in relation to an inclusive health system. In addition, Medicaid and Medicare must be rebuilt, reinforced, and fully supported."
They add that, "It was encouraging to hear UK Prime Minister Gordon Brown conjecture at at the end week's international convention on the Social Determinants of Health in London that Barack Obama is dedicated to tackling trained and global inequality."
According to the editorial, Obama's pathway for global health must contemplate climate change, two in fashion wars, and commerce relations. The writers suggest six steps with which Obama can end product substantial change: "Health fairness and human security should be a stated strictly business of non-native policy."
The DHHS Employer of Global Health Affairs, Price Steiger - who has badly contused America's title in global health - should be replaced with a deeper experienced and apropos politician." Location Dybul, the belief of PEPFAR - the President's Emergency Gimmick for AIDS Relief, undoubtedly the biggest triumph of the Bush authority in spite of its controversies - testament feasible be swiftly replaced.
Able control from a respected international expert, such as Jim Kim, could balm to negate PEPFAR's dogmatic and pathetic policies - for example, its preference for abstinence-until-marriage programmes." As a term that the United states is committed to human rights, Obama could bring the USA in contour with most other UN member states by ratifying the UN Association on the Rights of the Youngster and the International Covenant on Economic, Social and Cultural Rights."
The writers and assumption that Obama will not be as antagonistic towards the UN course as the Bush state was. The election of the consequent UN Ambassador is pivotal to improving these relationships, in health as hardy as in other domains," concludes the editorial. An exaggeration in aid - including financial cooperate - for WHO would be a indication that the USA wishes to re-engage with the global health community.
President-elect Obama is a reminder approximately what is worthy about the USA and that, indeed, 'change can happen'. The fruits of that spending money will be judged by tangible improvements to the welfare and health of Americans - and those affected by American foreign policy." Obama and health: pin money can happen The Lancet (2008). 1708.
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Barrett's Oesophagus May Be Affected By DFMO
Sinicrope, M.D., Mayo Clinic, Rochester, MN. Sinicrope presented his findings here at the American Firm for Cancer Research's Seventh Annual International Convention on Frontiers in Cancer Prevention Research. The single-arm scan included 10 patients with Barrett's esophagus and low-grade dysplasia. The patients received 0.5 g m2 d of DFMO for six months. Using an endoscope, the researchers examined esophageal biopsies at enrolment and at three, six and 12 months (where available).
A gastrointestinal pathologist who was blinded to the clinical biomarker facts graded the dysplasia. Sinicrope conducted this announce while at The University of Texas M. D. Anderson Cancer Center. He collaborated with colleagues at the Federal Cancer Institute, and the Arizona Cancer Center, Tucson.
After six months of DFMO treatment, one patient's dysplasia regressed, one patient's progressed, and eight patients had steady disease. At six months, two patients in the stable troop who started with extended low-grade abnormal cells had exclusive community or focal dysplasia based on four or amassed biopsies. These improvements remained at 12 months.
DFMO lowered the alike of the polyamine putrescine, a object of the narcotic and a viable cancer risk marker. The agent works by inhibiting an enzyme in polyamine synthesis called ornithine decarboxylase (ODC). ODC hustle in Barrett's mucosa has been shown to be significantly higher in Barrett's than in natural consequent mucosa from the alike patients," Sinicrope said.
Thanks to DFMO inhibits polyamine synthesis, the truth that putrescine levels were decreased at six months and consequent returned to baseline after vitality off the drug for six months suggests that the drug is affecting its target." Interestingly, DFMO besides reduced expression of Kruppel-like ingredient 5 (KLF5) gene, an extensive marker of abnormal cell proliferation in the esophagus that may equal a story drug target.
The results are encouraging since they ascertain KLF5 as a dormant item of DFMO, which suggests a implied mechanism contributing to the chemopreventive baggage of DFMO," Sinicrope said. KLF5 has been shown to conduct proliferation, apoptosis and invasion in esophageal cancer cells." Generally, DFMO was beefy tolerated. One patient had hearing loss and balance-related problems related to treatment. DFMO warrants too check as a chemopreventive agent in patients with Barrett's esophagus and mucosal dysplasia," Sinicrope said.
Currently, the Mayo Clinic researcher and his colleagues are planning a placebo-controlled chemoprevention analysis in this patient population. Article adapted by Medical Facts Nowadays from infant press release. The assignment of the American Gathering for Cancer Trial is to prevent and cure cancer.
Founded in 1907, AACR is the world's oldest and largest ace formation committed to advancing cancer research. AACR marshals the comprehensive spectrum of expertise from the cancer district to accelerate success in the prevention, diagnosis and treatment of cancer ended high-quality scientific and educational programs. It process innovative, meritorious proof grants.
The AACR Annual Concursion attracts deeper than 17,000 participants who handwriting the original discoveries and developments in the field. Definite Conferences throughout the year even now tale counsel across a broad incongruity of topics in cancer research, treatment, and patient care. AACR publishes five elder peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; and Cancer Epidemiology, Biomarkers & Prevention.
Its most modern album and its sixth chief journal, Cancer Prevention Research, is the solitary periodical worldwide dedicated remarkably to cancer prevention, from preclinical probation to clinical trials. The AACR too publishes CR, a periodical for cancer survivors, patient advocates, their families, physicians, and scientists.
CR provides a forum for sharing essential, evidence-based hookup and perspectives on progress in cancer research, survivorship, and advocacy.

