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a
s
1
2
c
o
m
p
o
n
e
n
ts
c
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sistin
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f
:
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)
fin
a
n
c
ial
;
ii
)
c
a
re
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r
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k
n
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late
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lp
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ts
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p
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lati
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ip
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ti
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a
n
d
x
ii
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fa
c
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.
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is
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to
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b
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r
m
al
ca
r
e
g
iv
er
s
(
p
ar
en
ts
)
w
h
o
a
r
e
r
esp
o
n
s
ib
le
f
o
r
ca
r
i
n
g
f
o
r
o
r
m
an
ag
in
g
th
e
p
atien
t
[
8
]
.
C
an
ce
r
also
af
f
ec
ts
p
atien
ts
’
q
u
ality
o
f
life
,
esp
ec
ially
in
ter
m
s
o
f
co
g
n
itiv
e
f
u
n
ctio
n
[
9
]
,
d
aily
life
r
o
le
[
1
0
]
,
s
o
cial
ac
tiv
ities
[
1
1
]
,
s
elf
-
f
u
n
ctio
n
in
g
[
1
2
]
,
an
d
p
h
y
s
ical
ab
ilit
y
[
1
3
]
.
T
h
e
s
tu
d
y
o
f
Ma
r
ín
-
Ma
icas
et
a
l.
[
1
4
]
s
h
o
ws
th
at
th
e
d
is
ab
ilit
y
o
f
ca
n
ce
r
p
atien
ts
ca
u
s
e
th
em
to
d
ep
en
d
o
n
in
f
o
r
m
al
ca
r
e
g
i
v
er
s
s
u
ch
as
f
am
ily
m
em
b
er
s
to
co
p
e
with
ca
n
ce
r
,
wh
ich
th
en
af
f
ec
ts
th
eir
f
am
ily
d
y
n
am
ics
an
d
ex
p
e
r
ien
ce
s
.
C
ar
eg
iv
er
s
o
f
ten
f
ac
e
f
in
a
n
cial,
s
o
cial
[
1
5
]
,
p
h
y
s
ical,
p
s
y
ch
o
lo
g
ical,
an
d
p
er
s
o
n
al
p
r
o
b
lem
s
[
1
6
]
th
at
ca
u
s
e
th
em
to
n
eg
lect
th
eir
o
wn
p
h
y
s
ical
an
d
em
o
ti
o
n
al
n
ee
d
s
[
1
7
]
.
So
m
e
s
tu
d
ies
also
r
ep
o
r
ted
th
at
ca
r
eg
iv
er
s
o
f
ca
n
ce
r
p
atien
ts
ex
p
er
ien
ce
an
x
iety
,
s
tr
ess
,
an
d
f
ee
lin
g
b
u
r
d
en
ed
wh
en
p
r
o
v
id
in
g
h
ea
lth
ca
r
e
to
p
atien
ts
,
esp
ec
ially
at
h
o
m
e
[
1
8
]
.
T
h
is
o
v
e
r
wh
elm
in
g
ca
r
e
ex
p
er
ien
ce
af
f
ec
ts
th
e
ca
r
e
g
i
v
er
s
’
em
o
tio
n
al,
p
h
y
s
ical,
p
s
y
ch
o
lo
g
ical,
s
o
cial,
f
in
an
cial,
an
d
p
er
s
o
n
al
n
ee
d
s
,
an
d
th
eir
f
u
n
ctio
n
ality
in
life
.
E
f
f
ec
tiv
e
in
ter
v
en
tio
n
s
an
d
ap
p
r
o
p
r
iate
s
u
p
p
o
r
t
ca
n
h
elp
in
f
o
r
m
al
ca
r
eg
iv
er
s
f
ac
e
th
e
af
o
r
em
en
tio
n
ed
ch
allen
g
es
an
d
im
p
r
o
v
e
th
e
q
u
ality
o
f
ca
r
e
th
ey
p
r
o
v
id
e
to
p
atien
ts
.
I
n
th
is
co
n
tex
t,
th
e
r
o
le
o
f
a
co
u
n
s
ello
r
is
ess
en
tial
in
p
r
o
v
id
in
g
em
o
tio
n
al
an
d
p
s
y
ch
o
l
o
g
ical
s
u
p
p
o
r
t
to
in
f
o
r
m
al
ca
r
eg
iv
er
s
.
Ps
y
ch
o
lo
g
ical
s
u
p
p
o
r
t
p
r
o
v
id
e
d
b
y
co
u
n
s
ello
r
s
ca
n
h
elp
in
f
o
r
m
al
ca
r
e
g
iv
er
s
m
a
k
e
th
e
b
e
s
t
d
ec
is
io
n
s
to
tr
ea
t
th
eir
ch
ild
r
en
an
d
p
r
o
v
id
e
th
e
n
ec
ess
ar
y
s
u
p
p
o
r
t.
A
lo
t
o
f
p
r
ev
io
u
s
s
tu
d
ies
f
o
cu
s
o
n
ca
n
ce
r
p
atien
ts
b
u
t
n
o
t
o
n
th
e
in
f
o
r
m
al
ca
r
e
g
iv
er
s
o
f
c
h
i
ld
h
o
o
d
ca
n
ce
r
p
atien
ts
[
1
9
]
.
P
r
ev
io
u
s
m
o
d
els
em
p
h
asize
wellb
ein
g
b
u
t
ar
e
n
o
t
r
elate
d
to
co
u
n
s
ellin
g
,
wh
ic
h
o
v
er
lo
o
k
ed
th
e
c
o
u
n
s
ello
r
’
s
r
o
le
in
s
u
p
p
o
r
tin
g
th
e
n
ee
d
s
o
f
in
f
o
r
m
al
ca
r
e
g
iv
er
s
o
f
ch
ild
h
o
o
d
ca
n
ce
r
p
atien
ts
[
2
0
]
,
[
2
1
]
.
T
o
b
r
id
g
e
th
e
r
esear
ch
g
ap
,
th
is
o
b
jectiv
e
o
f
th
is
s
tu
d
y
is
to
d
ev
elo
p
a
co
u
n
s
ellin
g
-
b
ased
s
elf
-
wellb
e
in
g
m
o
d
el
f
o
r
in
f
o
r
m
al
ca
r
eg
iv
er
s
o
f
ch
ild
h
o
o
d
ca
n
ce
r
p
at
ien
ts
in
Ma
lay
s
ia.
T
h
e
lack
o
f
a
p
r
ee
x
is
tin
g
m
o
d
el
th
at
g
u
id
es
co
u
n
s
ello
r
s
in
th
eir
s
u
p
p
o
r
t
o
f
i
n
f
o
r
m
al
ca
r
eg
iv
er
co
p
in
g
with
ca
n
ce
r
in
ch
ild
r
en
m
ak
es
th
is
s
tu
d
y
all
th
e
m
o
r
e
u
r
g
en
t.
Fu
r
th
er
m
o
r
e,
cu
r
r
e
n
t
r
esear
ch
an
d
m
o
d
els
d
o
n
o
t
ad
eq
u
ately
a
d
d
r
ess
th
e
m
an
y
f
ac
ets o
f
in
f
o
r
m
al
ca
r
eg
iv
e
r
p
er
s
o
n
al
welln
ess
.
2.
M
E
T
H
O
D
T
h
e
d
esig
n
an
d
d
ev
elo
p
m
en
t
r
esear
ch
(
DDR)
b
ased
o
n
R
ich
ey
an
d
Klein
[
2
2
]
was
u
s
ed
i
n
th
is
s
tu
d
y
an
d
en
co
m
p
ass
es
th
r
ee
p
h
ases
.
T
h
e
f
ir
s
t
p
h
ase
was
n
ee
d
s
an
aly
s
is
,
in
wh
ich
th
e
r
esear
ch
er
s
co
n
d
u
cted
a
s
y
s
tem
atic
liter
atu
r
e
r
ev
iew
an
d
s
em
i
-
s
tr
u
ctu
r
ed
i
n
ter
v
ie
ws
to
id
en
tify
th
e
n
ee
d
s
o
f
m
o
d
el
d
ev
el
o
p
m
en
t.
A
s
em
i
-
s
tr
u
ctu
r
ed
i
n
ter
v
iew
m
eth
o
d
was
u
s
ed
to
o
b
tain
v
i
ews
f
r
o
m
i
n
f
o
r
m
al
ca
r
eg
i
v
er
s
o
f
ch
ild
h
o
o
d
ca
n
ce
r
p
atien
ts
in
Ma
lay
s
ia.
A
p
p
ly
in
g
a
p
u
r
p
o
s
iv
e
s
am
p
lin
g
tech
n
iq
u
e,
n
in
e
i
n
f
o
r
m
al
ca
r
e
g
iv
er
s
wer
e
s
elec
ted
as
r
esp
o
n
d
en
ts
.
T
h
e
d
ata
wer
e
an
aly
ze
d
u
s
in
g
th
e
th
em
atic
a
n
aly
s
is
tech
n
iq
u
e
[
2
3
]
.
T
h
em
atic
an
aly
s
is
i
s
an
ap
p
r
o
ac
h
to
an
aly
zi
n
g
q
u
alita
tiv
e
d
ata.
Fin
d
in
g
an
d
r
e
p
o
r
ti
n
g
p
atter
n
s
in
d
ata
s
ets
an
d
t
h
en
d
ed
u
cin
g
th
ei
r
m
ea
n
in
g
f
r
o
m
t
h
o
s
e
p
atter
n
s
i
s
wh
at
it e
n
tails
.
T
h
e
s
ec
o
n
d
p
h
ase
was
th
e
d
esig
n
an
d
d
e
v
elo
p
m
e
n
t
p
h
ase
o
f
th
e
m
o
d
el.
I
n
t
h
is
p
h
ase,
two
m
ai
n
m
eth
o
d
s
wer
e
u
s
ed
:
n
o
m
in
al
g
r
o
u
p
tech
n
iq
u
e
(
NGT
)
an
d
i
n
ter
p
r
etiv
e
s
tr
u
ctu
r
al
m
o
d
elin
g
(
I
SM)
.
T
h
e
NGT
f
ac
ilit
ates
ex
p
er
t
v
er
i
f
icatio
n
o
f
co
m
p
o
n
en
t
a
n
d
ele
m
en
t
d
esig
n
s
an
d
d
eter
m
in
es
elem
e
n
t
p
r
io
r
ity
f
o
r
ea
ch
s
tu
d
y
m
o
d
el
c
o
m
p
o
n
en
t.
T
h
e
NGT
was
u
s
ed
to
e
n
co
u
r
ag
e
th
e
co
n
tr
i
b
u
tio
n
o
f
id
ea
s
an
d
v
alid
ate
th
e
co
m
p
o
n
en
ts
an
d
elem
en
ts
o
f
t
h
e
p
lan
n
e
d
m
o
d
el.
T
h
e
r
o
le
o
f
th
e
ex
p
er
t
in
v
o
lv
e
d
was
to
co
n
tr
ib
u
te
id
ea
s
an
d
ev
alu
ate
th
e
im
p
o
r
tan
ce
o
f
ea
c
h
co
m
p
o
n
e
n
t
an
d
elem
e
n
t
o
f
t
h
e
m
o
d
el.
Af
ter
ex
p
er
t d
is
cu
s
s
io
n
,
NGT
was
als
o
u
s
ed
to
s
et
ea
ch
elem
en
t’
s
p
r
io
r
ity
o
r
d
er
in
t
h
e
m
o
d
el
th
r
o
u
g
h
a
v
o
tin
g
s
y
s
tem
.
Af
ter
th
e
NGT
p
r
o
ce
s
s
,
th
e
I
SM
ap
p
r
o
ac
h
was
u
s
ed
.
I
SM
h
elp
s
r
esear
ch
er
to
cr
ea
te
a
f
r
a
m
ewo
r
k
o
r
s
tr
u
ctu
r
e
to
d
escr
ib
e
ea
ch
ele
m
en
t
’
s
in
ter
ac
tio
n
b
ased
o
n
t
h
e
co
n
tex
t.
I
n
th
is
ap
p
r
o
ac
h
,
th
e
elem
en
ts
th
at
h
av
e
b
ee
n
p
r
io
r
itized
wer
e
u
s
ed
to
f
o
r
m
th
e
s
tr
u
ct
u
r
e
o
f
t
h
e
well
-
b
ein
g
m
o
d
el.
I
SM
en
ab
les
th
e
an
aly
s
is
o
f
th
e
r
elatio
n
s
h
ip
b
etwe
en
th
ese
el
em
en
ts
an
d
f
o
r
m
s
a
h
ier
a
r
ch
ical
s
tr
u
ctu
r
e
wh
ich
d
escr
ib
e
s
th
e
r
elatio
n
s
h
ip
b
etwe
en
th
em
.
T
h
is
p
r
o
ce
s
s
allo
ws
f
o
r
a
d
ee
p
u
n
d
er
s
tan
d
in
g
o
f
th
e
d
y
n
a
m
ics
an
d
in
te
r
ac
tio
n
s
o
cc
u
r
r
in
g
b
etwe
en
th
e
co
m
p
o
n
en
ts
o
f
t
h
e
well
-
b
ein
g
m
o
d
el
th
at
h
as
b
ee
n
f
o
r
m
ed
.
T
h
e
c
o
m
b
in
atio
n
o
f
NGT
an
d
I
SM
en
s
u
r
es
th
e
f
o
r
m
atio
n
o
f
a
r
elev
an
t,
co
m
p
r
eh
e
n
s
iv
e,
an
d
ef
f
ec
tiv
e
m
o
d
el
in
im
p
r
o
v
i
n
g
th
e
well
-
b
ein
g
o
f
in
f
o
r
m
al
ca
r
e
g
iv
er
s
o
f
ch
ild
h
o
o
d
ca
n
ce
r
p
atien
ts
in
Ma
lay
s
ia.
Mo
d
el
ev
al
u
atio
n
was
th
e
l
ast
p
h
ase
in
th
is
s
tu
d
y
,
in
wh
ich
,
th
e
r
esear
ch
er
s
e
v
a
lu
ated
th
e
ap
p
r
o
p
r
iaten
ess
o
f
t
h
e
m
o
d
el
th
at
h
as
b
e
en
d
ev
elo
p
e
d
.
T
h
is
p
h
ase
was
co
n
d
u
cted
to
co
llect
in
f
o
r
m
ati
o
n
r
elate
d
to
th
e
in
ter
a
ctio
n
b
etw
ee
n
th
e
p
r
o
d
u
ct
(
m
o
d
el)
an
d
t
h
e
u
s
er
,
as
well
as
th
e
co
n
tr
i
b
u
tio
n
o
f
th
e
s
p
ec
if
ic
p
r
o
p
er
ties
o
f
th
e
m
o
d
el
in
ac
h
iev
in
g
an
o
p
tim
al
lev
el
o
f
u
s
ab
ilit
y
.
I
n
th
e
ev
alu
atio
n
p
h
ase,
th
e
ev
alu
atio
n
asp
ec
ts
wer
e
d
iv
id
ed
in
to
f
o
u
r
m
ain
asp
ec
ts
:
s
u
itab
ilit
y
o
f
co
m
p
o
n
en
ts
,
s
u
itab
ilit
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o
f
ele
m
en
ts
,
s
u
itab
ilit
y
o
f
ar
r
an
g
em
e
n
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o
f
elem
e
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ts
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co
m
p
o
n
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ts
,
an
d
s
u
itab
ilit
y
o
f
th
e
m
o
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el
as
a
wh
o
le.
T
h
e
ev
alu
atio
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was
co
n
d
u
cte
d
u
s
in
g
a
q
u
esti
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n
a
ir
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-
s
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ap
ed
i
n
s
tr
u
m
en
t,
an
d
th
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esear
ch
s
am
p
le
co
n
s
is
ted
o
f
co
u
n
s
ello
r
s
wh
o
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
2
2
I
n
t
J
E
v
al
&
R
es E
d
u
c
,
Vo
l
.
14
,
No
.
5
,
Octo
b
er
20
25
:
4
2
2
2
-
4230
4224
h
ad
ex
p
er
ie
n
ce
in
co
n
d
u
ctin
g
co
u
n
s
ellin
g
s
ess
io
n
s
wi
th
in
f
o
r
m
al
ca
r
eg
iv
e
r
s
o
f
ch
ild
h
o
o
d
ca
n
ce
r
p
atien
ts
,
as
well
as
ac
ad
em
ic
lectu
r
er
s
in
th
e
f
ield
o
f
co
u
n
s
ellin
g
an
d
p
er
s
o
n
al
well
-
b
ei
n
g
.
T
h
e
q
u
e
s
tio
n
n
air
e
d
ata
was
an
aly
ze
d
u
s
in
g
th
e
Fu
zz
y
Delp
h
i
m
eth
o
d
(
FDM)
tech
n
iq
u
e
to
o
b
tain
ac
c
u
r
ate
d
ata
in
ev
al
u
atin
g
th
e
m
o
d
el’
s
u
s
ab
ilit
y
.
3.
RE
SU
L
T
S
3
.
1
.
P
ha
s
e
1
:
needs
a
na
ly
s
is
T
h
er
e
wer
e
n
i
n
e
r
esp
o
n
d
en
ts
p
ar
ticip
ated
in
th
e
f
ir
s
t
p
h
ase
(
n
ee
d
s
an
aly
s
is
)
.
T
wo
wellb
ei
n
g
m
o
d
els
n
am
ely
Hettler
’
s
s
ix
-
d
im
e
n
s
io
n
al
wellb
ein
g
m
o
d
el
[
2
0
]
an
d
R
y
f
f
’
s
p
s
y
ch
o
l
o
g
ical
wellb
ein
g
m
o
d
el
[
2
1
]
wer
e
r
ef
er
r
ed
t
o
wh
en
co
n
d
u
ctin
g
t
h
is
p
h
ase.
B
ased
o
n
th
e
f
in
d
in
g
s
f
r
o
m
th
e
liter
atu
r
e
r
ev
iew
a
n
d
s
em
i
-
s
tr
u
ctu
r
ed
in
ter
v
iews o
f
in
f
o
r
m
al
ca
r
eg
i
v
er
s
o
f
ch
ild
h
o
o
d
ca
n
ce
r
p
atie
n
ts
in
Ma
lay
s
ia,
3
0
co
m
p
o
n
en
ts
wer
e
co
d
ed
b
y
th
e
r
esear
ch
er
s
.
Fo
r
th
e
n
e
ed
f
o
r
t
h
e
m
o
d
el,
t
h
e
m
ajo
r
ity
o
f
r
esp
o
n
d
en
ts
wh
o
a
r
e
in
f
o
r
m
al
ca
r
e
g
iv
er
s
o
f
ch
ild
h
o
o
d
ca
n
ce
r
p
atien
ts
ag
r
ee
d
th
at
a
s
elf
-
welln
ess
m
o
d
el
b
ased
o
n
c
o
u
n
s
ellin
g
is
n
ee
d
ed
to
g
u
id
e
an
d
h
elp
ca
r
e
g
iv
er
s
in
m
an
ag
in
g
th
eir
wellb
ein
g
alo
n
g
th
e
p
r
o
ce
s
s
o
f
ca
r
e
a
n
d
tr
ea
tm
en
t
o
f
ch
ild
h
o
o
d
ca
n
c
er
p
atien
ts
.
T
ab
le
1
d
is
p
lay
s
th
e
ex
am
p
les
o
f
th
e
r
esear
ch
f
in
d
in
g
s
in
v
er
b
atim
f
o
r
m
.
B
ased
o
n
f
in
d
in
g
s
in
T
ab
le
1
,
it
is
clea
r
th
at
ca
r
eg
iv
er
s
o
f
ca
n
ce
r
c
h
ild
r
en
r
eq
u
ir
e
a
well
-
b
ein
g
m
o
d
el
to
a
s
s
is
t th
em
.
T
ab
le
1
.
E
x
am
p
les o
f
v
er
b
ati
m
f
o
r
m
o
d
el
d
ev
elo
p
m
en
t n
ee
d
s
R
e
s
p
o
n
d
e
n
t
N
e
e
d
s
a
n
a
l
y
s
i
s f
o
r
m
o
d
e
l
R
e
s
p
o
n
d
e
n
t
t
r
a
n
scr
i
p
t
I
n
f
o
r
mal
c
a
r
e
g
i
v
e
r
(
TF 4
)
A
g
r
e
e
“
I
t
i
s v
e
ry
n
e
c
e
ss
a
r
y
a
n
d
i
m
p
o
rt
a
n
t
.
I
st
ro
n
g
l
y
a
g
r
e
e
w
i
t
h
w
h
a
t
e
v
e
r
l
e
a
d
s
t
o
g
o
o
d
n
e
ss
,
a
n
d
i
t
i
s
v
e
r
y
n
e
c
e
ss
a
ry
a
n
d
i
m
p
o
r
t
a
n
t
.
”
I
n
f
o
r
mal
c
a
r
e
g
i
v
e
r
5
(
TF 5
)
A
g
r
e
e
“
I
t
i
s i
n
d
e
e
d
n
e
c
e
ss
a
r
y
a
n
d
i
m
p
o
rt
a
n
t
t
o
h
a
v
e
e
m
o
t
i
o
n
a
l
p
r
e
p
a
r
a
t
i
o
n
.
”
I
n
f
o
r
mal
c
a
r
e
g
i
v
e
r
6
(
TF 6
)
A
g
r
e
e
“
It
’
s
a
c
t
u
a
l
l
y
v
e
r
y
g
o
o
d
,
y
e
s
i
t
s
g
o
o
d
,
i
t
’
s r
e
a
l
l
y
v
e
ry
g
o
o
d
.
.
.
b
e
c
a
u
s
e
so
m
e
t
i
m
e
s
t
h
i
n
g
s l
i
k
e
t
h
a
t
,
w
e
l
l
,
p
e
o
p
l
e
sa
y
i
t
’
s
n
o
t
a
v
a
i
l
a
b
l
e
o
n
G
o
o
g
l
e
.
”
3
.
2
.
P
ha
s
e
2
:
des
ig
n a
nd
dev
elo
pm
ent
Fo
r
th
e
f
ir
s
t
p
ar
t
o
f
th
e
d
esi
g
n
an
d
d
ev
el
o
p
m
en
t
p
h
ase,
th
e
f
o
u
r
m
ain
co
m
p
o
n
en
ts
ad
ap
ted
f
r
o
m
Hettler
’
s
s
ix
-
d
im
en
s
io
n
al
wellb
ein
g
m
o
d
el
[
2
0
]
an
d
R
y
f
f
’
s
p
s
y
ch
o
lo
g
ical
wellb
ein
g
m
o
d
el
[
2
1
]
,
co
m
b
i
n
ed
with
eig
h
t
n
ew
m
ain
co
m
p
o
n
en
ts
co
d
ed
b
y
r
esear
ch
er
s
th
r
o
u
g
h
s
em
i
-
s
tr
u
ctu
r
ed
in
ter
v
iews
with
in
f
o
r
m
al
ca
r
eg
iv
er
s
o
f
ch
ild
h
o
o
d
ca
n
c
er
p
atien
ts
,
wer
e
u
s
ed
in
th
e
d
esig
n
an
d
d
ev
elo
p
m
en
t
o
f
th
e
m
o
d
el.
All
1
2
co
m
p
o
n
en
ts
ar
e
:
i)
f
in
an
cial
;
ii)
ca
r
e
er
;
iii)
k
n
o
wled
g
e
r
e
lated
to
m
an
ag
e
m
en
t
a
n
d
ca
r
e
o
f
ch
ild
ca
n
ce
r
p
atien
ts
;
iv
)
em
o
tio
n
al
m
an
a
g
em
en
t
an
d
ca
r
e
;
v
)
s
p
ir
itu
a
l
;
v
i)
co
g
n
itiv
e
an
d
r
atio
n
ali
za
tio
n
;
v
ii)
s
o
cial
r
elatio
n
s
h
ip
;
v
iii)
r
o
les
o
f
co
u
n
s
ello
r
in
h
elp
in
g
p
ar
en
ts
;
ix
)
s
p
o
u
s
e
an
d
f
a
m
ily
r
elatio
n
s
h
ip
;
x
)
p
h
y
s
ical
;
x
i)
co
m
m
u
n
icatio
n
;
an
d
x
ii)
f
ac
ilit
ies
.
T
h
e
s
ec
o
n
d
p
a
r
t
o
f
t
h
e
s
elf
-
wellb
ein
g
m
o
d
el
d
esig
n
an
d
d
ev
elo
p
m
en
t
p
h
ase
was
m
o
d
el
d
ev
elo
p
m
en
t
an
aly
s
is
,
in
wh
ich
th
e
I
SM
ap
p
r
o
ac
h
was
u
s
ed
as
a
to
o
l
to
d
ev
elo
p
th
e
m
o
d
el.
Fig
u
r
e
1
s
h
o
ws
th
e
s
elf
-
well
b
ein
g
m
o
d
el
d
e
v
elo
p
ed
f
o
r
in
f
o
r
m
al
ca
r
eg
i
v
er
s
o
f
ch
ild
h
o
o
d
ca
n
ce
r
p
atien
ts
b
ased
o
n
c
o
u
n
s
ellin
g
in
Ma
lay
s
ia.
Fig
u
r
e
1
.
Self
-
wellb
ein
g
m
o
d
e
l f
r
am
ewo
r
k
b
ased
o
n
co
u
n
s
ellin
g
f
o
r
in
f
o
r
m
al
ca
r
eg
i
v
er
s
o
f
ch
ild
h
o
o
d
ca
n
ce
r
p
atien
ts
in
Ma
lay
s
ia
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t
J
E
v
al
&
R
es E
d
u
c
I
SS
N:
2252
-
8
8
2
2
Dev
elo
p
men
t o
f a
co
u
n
s
ellin
g
-
b
a
s
ed
s
elf
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w
ellb
ein
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mo
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el
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4225
3
.
3
.
P
ha
s
e
3
:
ev
a
lua
t
io
n o
f
m
o
del
T
ab
le
2
s
h
o
ws
th
e
d
etails
o
f
t
h
e
Fu
zz
y
Delp
h
i
a
n
aly
s
is
o
f
t
h
e
s
u
itab
ilit
y
o
f
th
e
m
o
d
el
c
o
m
p
o
n
e
n
ts
b
ased
o
n
th
e
d
ata
p
r
o
v
i
d
ed
b
y
th
e
r
esp
o
n
d
en
ts
.
R
eq
u
ir
em
e
n
ts
f
o
r
th
e
Fu
zz
y
Delp
h
i
an
al
y
s
is
ar
e
i)
th
r
esh
o
ld
v
alu
e
(
d
)
≤
0
.
2
an
d
ii)
p
er
ce
n
ta
g
e
o
f
ex
p
er
t
ag
r
ee
m
en
t
≥
7
5
.
0
%
an
d
d
ef
u
zz
if
icatio
n
with
Fu
zz
y
s
co
r
e
(
A)
≥
α
-
c
u
t
v
alu
e=
0
.
5
.
T
ab
le
2
in
d
icate
d
th
at
th
e
s
u
itab
ilit
y
o
f
all
1
2
co
m
p
o
n
e
n
ts
r
ec
o
r
d
ed
a
v
er
y
e
n
c
o
u
r
ag
in
g
r
esu
lt.
All
ex
p
er
ts
,
u
n
an
im
o
u
s
ly
,
with
a
p
er
ce
n
ta
g
e
v
al
u
e
o
f
m
o
r
e
th
an
9
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%
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ag
r
ee
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th
at
all
co
m
p
o
n
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ts
r
ec
o
r
d
e
d
a
Fu
zz
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s
co
r
e
v
alu
e
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A)
ex
ce
e
d
in
g
t
h
e
m
i
n
im
u
m
r
eq
u
ir
em
e
n
t
o
f
0
.
6
.
Ov
er
all,
all
item
s
o
f
th
is
c
o
m
p
o
n
en
t
s
u
itab
ilit
y
s
ec
tio
n
r
ec
eiv
ed
a
s
u
itab
le
ass
e
s
s
m
en
t
s
tatu
s
.
T
a
b
le
3
d
is
p
lay
s
th
e
d
etails
o
f
t
h
e
FDM
an
aly
s
is
o
f
th
e
o
v
er
all
f
it
o
f
th
e
s
elf
-
welln
ess
m
o
d
el.
B
as
e
d
o
n
th
e
f
in
d
in
g
s
in
T
a
b
le
3
,
th
e
o
v
e
r
all
s
u
itab
ilit
y
s
tatu
s
o
f
th
is
m
o
d
el
r
ec
o
r
d
ed
a
v
er
y
en
co
u
r
a
g
in
g
r
esu
lt.
All
ex
p
e
r
ts
,
u
n
an
im
o
u
s
ly
,
with
a
p
er
ce
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tag
e
o
f
ag
r
ee
m
en
t
r
ea
c
h
in
g
1
0
0
%,
ag
r
ee
d
with
ea
ch
s
tatem
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t
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eg
ar
d
in
g
th
e
s
u
itab
ilit
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o
f
th
e
en
tire
m
o
d
el
as
p
r
esen
ted
i
n
T
a
b
l
e
3
.
A
s
f
o
r
th
e
Fu
zz
y
a
s
s
e
s
s
m
e
n
t
,
al
l
e
x
p
e
r
ts
r
e
c
o
r
d
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esu
lt
o
f
th
is
s
tu
d
y
,
th
e
o
u
tco
m
e
o
f
th
is
s
tu
d
y
was
to
d
ev
el
o
p
a
n
ew
s
o
lu
tio
n
an
d
g
u
id
an
ce
i
n
t
h
e
f
o
r
m
o
f
a
well
-
b
ein
g
m
o
d
el
b
ased
o
n
co
u
n
s
elin
g
th
at
ca
n
b
e
u
s
ed
b
y
co
u
n
s
ellin
g
p
r
ac
titi
o
n
er
s
,
esp
ec
iall
y
co
u
n
s
ello
r
s
wh
o
s
er
v
e
in
h
ea
lth
i
n
s
titu
tio
n
s
an
d
will
h
an
d
le
clien
ts
co
n
s
is
tin
g
o
f
i
n
f
o
r
m
al
ca
r
eg
iv
e
r
s
o
f
ch
ild
h
o
o
d
ca
n
ce
r
p
atien
ts
.
C
o
u
n
s
ello
r
s
ca
n
h
elp
p
ar
en
ts
o
f
ch
ild
r
en
with
ca
n
c
er
en
h
an
ce
t
h
eir
em
o
tio
n
al
well
-
b
ein
g
,
o
v
er
co
m
e
ch
allen
g
es,
an
d
b
u
ild
p
e
r
s
o
n
a
l
d
ev
elo
p
m
en
t
p
lan
s
[
3
1
]
.
Ad
d
itio
n
ally
,
p
ar
en
ts
as
in
f
o
r
m
al
ca
r
eg
iv
er
s
ca
n
u
s
e
th
is
m
o
d
el
as
a
p
r
elim
in
ar
y
s
t
ep
to
m
ain
tain
th
eir
wellb
ein
g
d
u
r
in
g
th
e
ca
r
e
an
d
tr
ea
tm
en
t
o
f
a
c
h
ild
b
attlin
g
ca
n
ce
r
.
T
h
is
n
ewly
d
e
v
elo
p
ed
m
o
d
el
f
o
cu
s
es
o
n
a
h
o
lis
tic
v
iew
o
f
th
e
ch
ild
h
o
o
d
ca
n
ce
r
c
o
m
m
u
n
ity
,
esp
ec
ially
f
o
r
t
h
e
in
f
o
r
m
al
ca
r
eg
iv
er
s
(
p
a
r
en
ts
an
d
f
am
ily
)
.
I
t
aim
s
to
s
u
p
p
o
r
t
an
d
en
h
an
ce
th
eir
wellb
ein
g
as
th
ey
n
a
v
ig
ate
t
h
e
cr
itical
c
h
a
llen
g
es
o
f
h
av
i
n
g
a
ch
ild
b
at
tlin
g
ca
n
ce
r
.
Fo
r
f
u
tu
r
e
s
tu
d
i
es,
r
esear
ch
er
s
ca
n
im
p
r
o
v
e
t
h
is
m
o
d
el
b
y
p
r
o
v
id
i
n
g
a
co
m
p
r
eh
e
n
s
iv
e
m
o
d
u
le
th
at
ca
n
b
e
ac
ce
s
s
ed
b
y
co
u
n
s
elo
r
s
an
d
ca
r
eg
i
v
er
s
th
at
ca
n
ex
p
lain
th
is
m
o
d
el
in
m
o
r
e
d
etail.
I
n
a
d
d
itio
n
,
f
u
tu
r
e
r
esear
ch
er
s
ca
n
d
e
v
elo
p
a
n
ew
h
o
lis
tic
m
o
d
el
f
o
r
well
-
b
ein
g
o
f
ca
r
e
g
iv
er
s
th
at
ca
n
f
o
cu
s
o
n
th
e
ca
r
eg
i
v
er
s
o
f
o
th
er
p
atien
ts
s
u
ch
as
ad
u
lt
ca
n
ce
r
p
atien
ts
o
r
o
th
er
cr
itical
p
atien
ts
.
5.
CO
NCLU
SI
O
N
T
h
is
s
tu
d
y
u
n
d
er
s
co
r
es
th
e
p
r
ess
in
g
n
ee
d
f
o
r
a
s
tr
u
ctu
r
e
d
s
elf
-
wellb
ein
g
m
o
d
el
to
s
u
p
p
o
r
t
in
f
o
r
m
al
ca
r
eg
iv
er
s
o
f
c
h
ild
h
o
o
d
ca
n
ce
r
p
atien
ts
in
Ma
lay
s
ia.
T
h
e
m
o
d
el
was
co
n
ce
p
tu
alize
d
,
d
esi
g
n
ed
,
an
d
ev
al
u
ated
th
r
o
u
g
h
a
r
ig
o
r
o
u
s
th
r
ee
-
p
h
a
s
e
r
esear
ch
p
r
o
ce
s
s
.
Ph
ase
1
estab
lis
h
ed
th
e
f
o
u
n
d
atio
n
b
y
i
d
en
tify
in
g
3
0
co
m
p
o
n
en
ts
f
r
o
m
liter
atu
r
e
r
e
v
iews
an
d
ca
r
eg
iv
er
in
ter
v
iew
s
,
h
ig
h
lig
h
tin
g
t
h
e
cr
itical
n
ee
d
f
o
r
a
co
u
n
s
elin
g
-
b
ased
welln
ess
f
r
am
ewo
r
k
.
Ph
ase
2
s
aw
th
e
th
o
u
g
h
tf
u
l
in
t
eg
r
atio
n
o
f
Hettler
’
s
s
ix
-
d
im
e
n
s
io
n
al
well
-
b
ein
g
m
o
d
el
an
d
R
y
f
f
’
s
p
s
y
ch
o
lo
g
ic
al
well
-
b
ein
g
m
o
d
el
with
n
ew
co
m
p
o
n
en
ts
id
en
tifie
d
d
u
r
in
g
th
e
s
tu
d
y
,
r
esu
ltin
g
in
a
co
m
p
r
eh
e
n
s
iv
e
1
2
-
c
o
m
p
o
n
en
t
m
o
d
el
ad
d
r
ess
in
g
m
u
ltifa
ce
ted
ca
r
eg
iv
er
n
ee
d
s
.
Fin
ally
,
p
h
ase
3
co
n
f
ir
m
e
d
th
e
r
o
b
u
s
tn
ess
an
d
r
elev
an
ce
o
f
th
e
m
o
d
el,
with
u
n
an
im
o
u
s
ex
p
e
r
t
ag
r
e
em
en
t
an
d
F
u
zz
y
ass
es
s
m
en
t
s
co
r
es
ex
ce
ed
in
g
th
e
m
in
im
u
m
th
r
esh
o
ld
.
T
h
es
e
r
esu
lts
af
f
ir
m
th
e
m
o
d
el
’
s
p
o
ten
tial
to
p
r
o
v
id
e
p
r
ac
tical
g
u
id
an
ce
f
o
r
in
f
o
r
m
a
l
ca
r
eg
iv
er
s
,
h
elp
in
g
th
em
m
a
n
ag
e
th
eir
well
-
b
ein
g
wh
ile
s
u
p
p
o
r
tin
g
ch
ild
h
o
o
d
ca
n
ce
r
p
atien
ts
.
T
h
is
in
n
o
v
ati
v
e
ap
p
r
o
ac
h
b
r
i
d
g
es
a
cr
u
cial
g
ap
in
ca
r
eg
iv
er
s
u
p
p
o
r
t,
o
f
f
er
in
g
a
m
ea
n
in
g
f
u
l
co
n
tr
ib
u
tio
n
to
co
u
n
s
elin
g
a
n
d
h
ea
lth
ca
r
e.
T
h
e
f
in
d
in
g
s
o
f
th
is
s
tu
d
y
h
av
e
s
ig
n
if
ican
t im
p
licatio
n
s
f
o
r
th
e
co
u
n
s
ello
r
an
d
ca
r
eg
iv
e
r
s
u
p
p
o
r
t.
T
h
e
d
ev
elo
p
m
e
n
t
an
d
v
alid
atio
n
o
f
a
s
elf
-
wellb
ein
g
m
o
d
el
s
p
ec
if
ically
tailo
r
ed
f
o
r
in
f
o
r
m
al
ca
r
eg
iv
er
s
o
f
ch
ild
h
o
o
d
ca
n
ce
r
p
atien
ts
ad
d
r
ess
a
cr
itical
g
ap
in
ex
is
tin
g
s
u
p
p
o
r
t
s
y
s
tem
s
.
B
y
in
co
r
p
o
r
atin
g
m
u
ltid
im
en
s
io
n
al
c
o
m
p
o
n
en
t
s
d
er
iv
ed
f
r
o
m
b
o
th
estab
lis
h
ed
well
-
b
ei
n
g
m
o
d
els
a
n
d
em
p
ir
ical
d
ata,
th
is
f
r
am
ewo
r
k
p
r
o
v
id
es
a
h
o
lis
tic
ap
p
r
o
ac
h
to
m
a
n
ag
in
g
ca
r
e
g
iv
er
well
-
b
ein
g
.
Fo
r
co
u
n
s
elin
g
p
r
ac
titi
o
n
e
r
s
,
th
is
m
o
d
el
s
er
v
es
as
a
s
tr
u
ctu
r
ed
to
o
l
to
g
u
id
e
i
n
ter
v
en
tio
n
s
aim
ed
at
en
h
an
cin
g
th
e
p
h
y
s
ical,
em
o
tio
n
al,
an
d
p
s
y
ch
o
lo
g
ical
r
esil
ien
ce
o
f
ca
r
eg
iv
er
s
.
C
o
u
n
s
ello
r
s
also
ca
n
ad
o
p
t
t
h
e
m
o
d
el
to
d
esig
n
s
u
p
p
o
r
t
p
r
o
g
r
am
s
th
at
co
m
p
lem
en
t
m
ed
ical
t
r
ea
tm
en
ts
,
f
o
s
ter
in
g
a
m
o
r
e
c
o
m
p
r
e
h
e
n
s
iv
e
ca
r
eg
iv
i
n
g
ec
o
s
y
s
tem
.
Mo
r
eo
v
er
,
th
e
s
tu
d
y
u
n
d
er
s
co
r
es
th
e
v
alu
e
o
f
u
s
in
g
p
ar
ticip
ato
r
y
an
d
em
p
ir
ical
ap
p
r
o
ac
h
es,
s
u
ch
as
s
em
i
-
s
tr
u
ctu
r
ed
in
ter
v
iews
an
d
I
SM
,
in
d
e
v
elo
p
in
g
p
r
ac
tical
an
d
co
n
tex
t
-
s
p
ec
if
ic
f
r
a
m
ewo
r
k
s
.
Fu
tu
r
e
r
esear
c
h
co
u
ld
ex
p
a
n
d
o
n
th
is
wo
r
k
b
y
a
d
ap
tin
g
th
e
m
o
d
el
t
o
o
th
e
r
ca
r
e
g
iv
in
g
co
n
tex
ts
o
r
ex
p
lo
r
in
g
its
lo
n
g
-
te
r
m
im
p
a
ct
o
n
ca
r
eg
iv
e
r
an
d
p
atien
t w
ell
-
b
ein
g
.
ACK
NO
WL
E
DG
E
M
E
NT
S
We
g
r
ea
tly
ap
p
r
ec
iate
all
th
e
h
elp
an
d
co
o
p
er
atio
n
f
r
o
m
t
h
e
p
ar
ticip
an
ts
wh
o
ar
e
p
ar
e
n
ts
o
f
ch
ild
r
en
with
ca
n
ce
r
,
ca
n
ce
r
ass
o
ciatio
n
s
in
v
o
lv
e
d
as
well
as
ex
p
e
r
ts
in
th
e
f
ield
o
f
co
u
n
s
elin
g
,
c
o
u
n
s
elin
g
o
f
f
icer
s
at
v
ar
io
u
s
in
s
titu
tio
n
s
s
u
ch
as
in
s
titu
tio
n
s
u
n
d
er
th
e
Min
is
tr
y
o
f
Hea
lth
Ma
lay
s
ia,
th
e
Mi
n
is
tr
y
o
f
E
d
u
ca
tio
n
Ma
lay
s
ia,
co
u
n
s
ellin
g
p
r
ac
titi
o
n
er
s
,
an
d
lectu
r
er
s
at
p
u
b
lic
u
n
iv
er
s
ities
.
F
UNDING
I
NF
O
R
M
A
T
I
O
N
T
h
is
r
esear
ch
was
s
u
p
p
o
r
te
d
b
y
th
e
Min
is
tr
y
o
f
Hig
h
er
E
d
u
ca
tio
n
Ma
lay
s
ia
(
Mo
HE
)
u
n
d
er
Fu
n
d
am
en
tal
R
esear
ch
Gr
an
t
Sch
em
e
with
Gr
an
t N
u
m
b
e
r
FR
GS/1
/2
0
2
1
/SS
0
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I
/0
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.
T
h
is
ar
ticle
also
o
n
e
o
f
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n
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i
b
u
tio
n
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f
o
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y
p
o
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td
o
cto
r
al
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ch
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n
d
e
r
m
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Po
s
t
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Do
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r
al
Stu
d
ies
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n
d
er
th
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is
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y
o
f
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h
er
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d
u
ca
tio
n
Ma
lay
s
ia
g
r
an
t w
ith
r
ef
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ce
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m
b
er
KP
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4227
AUTHO
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h
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u
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s
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th
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C
o
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u
to
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R
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al
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th
o
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DATA AV
AI
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NC
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[
1
]
J.
F
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.
,
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C
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K
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3
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A
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4
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Y
.
C
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A
.
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.
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.
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[
5
]
A
.
M
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.
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,
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6
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.
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E.
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my
r
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s
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[
7
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N
.
Li
n
d
t
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J.
v
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B
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k
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,
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d
B
.
C
.
M
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mi
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8
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E.
X
i
a
n
g
,
P
.
G
u
z
ma
n
,
M
.
M
i
ms,
a
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,
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s,
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[
9
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E.
H
e
l
e
d
,
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C
h
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o
n
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c
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l
l
n
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ss
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sa
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tal
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m
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rk
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ro
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ra
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h
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ta
c
ted
a
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u
r
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l.
a
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@fp
m
.
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p
s
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e
d
u
.
m
y
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a
p
sa
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Yuso
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is
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lec
tu
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t
h
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id
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Co
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lt
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n
Id
ris
Ed
u
c
a
ti
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Un
iv
e
rsity
,
M
a
l
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y
sia
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h
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h
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in
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fr
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m
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th
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rn
Il
li
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o
is
Un
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v
e
rsity
Ca
rb
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d
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le,
Un
it
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d
S
tate
s
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p
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se
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c
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ll
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m
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ld
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rly
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M
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S
h
e
c
a
n
b
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o
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tac
ted
a
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m
a
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:
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a
p
sa
h
@fp
m
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u
p
si.e
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u
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m
y
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y
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r
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th
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F
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f
H
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m
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n
De
v
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lo
p
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t,
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n
iv
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P
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n
d
id
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k
a
n
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u
lt
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n
Id
ris
(UP
S
I),
Ta
n
ju
n
g
M
a
li
m
,
P
e
ra
k
,
M
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lay
sia
.
S
h
e
c
o
m
p
lete
d
h
e
r
P
h
.
D.
a
n
d
M
.
Ed
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in
Ed
u
c
a
ti
o
n
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l
Tec
h
n
o
lo
g
y
fr
o
m
Un
i
v
e
rsiti
P
u
tra
M
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lay
sia
.
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h
e
is
p
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ti
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ies
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h
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tac
ted
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:
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z
a
@fp
m
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u
p
si.ed
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m
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lec
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De
p
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rtme
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f
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id
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Co
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lt
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E
d
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ti
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Un
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rs
it
y
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h
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h
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in
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se
li
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g
fro
m
Ol
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in
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Un
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No
rf
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lk
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Un
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tate
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h
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c
a
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c
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tac
ted
a
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m
a
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:
p
a
u
_
k
e
e
@fp
m
.
u
p
si.ed
u
.
m
y
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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Un
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c
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tac
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h
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m
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c
o
m
.
m
y
.
Evaluation Warning : The document was created with Spire.PDF for Python.