I
nte
rna
t
io
na
l J
o
urna
l o
f
P
u
bli
c
H
ea
lt
h Science
(
I
J
P
H
S)
Vo
l.
15
,
No
.
3
,
Sep
tem
b
er
20
26
,
p
p
.
8
8
7
~
8
9
2
I
SS
N:
2252
-
8
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DOI
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1
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ijp
h
s
.
ia
esco
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co
m
NFC
technolo
g
y
i
mpro
v
ing
depress
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ms
in
a
do
lescent
s
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d
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J
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De
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c
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d
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g
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icid
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a
r
field
c
o
m
m
u
n
ica
ti
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(
NFC
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p
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id
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s
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w
wa
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c
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ta o
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re
.
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e
o
b
jec
ti
v
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s th
is stu
d
y
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s
to
d
e
term
in
e
th
e
e
ff
e
c
ts
o
f
NFC
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n
d
e
p
re
ss
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sy
m
p
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m
s.
A
q
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x
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tal
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g
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p
p
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tes
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p
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s
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sig
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v
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ial
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ra
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ted
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c
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l
g
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p
C
ON
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NFC
g
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u
p
s.
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h
g
ro
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p
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siste
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p
a
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ip
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g
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d
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y
e
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rs
w
h
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d
d
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p
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ss
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D
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h
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NFC
g
r
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p
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d
NFC
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n
a
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led
sm
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rtp
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s
a
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d
NFC
tag
s
fo
r
fo
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r
we
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k
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first
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t
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d
d
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v
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lo
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lf
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wa
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se
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d
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l
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x
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-
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su
lt
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t
h
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t
d
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n
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ly
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m
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n
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re
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p
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m
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n
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les
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ts
with
d
e
p
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ss
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.
K
ey
w
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s
:
Ad
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lescen
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C
E
S
-
D
Dep
r
ess
iv
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s
y
m
p
to
m
s
Me
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h
ea
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Nea
r
f
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co
m
m
u
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icatio
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T
h
is i
s
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p
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n
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c
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ss
a
rticle
u
n
d
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r th
e
CC B
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SA
li
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se
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C
o
r
r
e
s
p
o
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ing
A
uth
o
r
:
Su
s
ar
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Pra
k
h
in
k
it
Facu
lty
o
f
Nu
r
s
in
g
,
Siam
Un
i
v
er
s
ity
3
8
Ph
et
Kasem
R
d
,
B
an
g
W
a,
Ph
asi
C
h
ar
o
en
,
B
an
g
k
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k
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T
h
ai
lan
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E
m
ail:
s
u
s
ar
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.
p
r
a@
s
iam
.
ed
u
1.
I
NT
RO
D
UCT
I
O
N
Dep
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a
h
i
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ly
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s
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ally
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etim
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ar
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life
-
t
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in
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d
is
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s
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[
1
]
.
T
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W
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ld
Hea
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Or
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an
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o
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ab
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wo
r
ld
wid
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[
2
]
.
Dep
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s
y
m
p
to
m
s
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cr
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ap
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2
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1
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d
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3
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%).
Ov
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th
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ce
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es
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is
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p
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s
ca
n
h
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v
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s
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b
s
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tial
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ativ
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im
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t
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s
ch
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l
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tten
d
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ce
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ac
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o
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m
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ce
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th
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m
o
r
e
,
s
o
cial
with
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r
aw
al
ass
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ciate
d
with
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ep
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m
ay
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s
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ee
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o
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d
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,
wh
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also
elev
atin
g
th
e
r
is
k
o
f
s
elf
-
h
ar
m
[3
]
-
[
7]
.
T
h
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r
e
a
r
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v
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r
i
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s
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r
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a
t
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n
d
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Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
15
,
No
.
3
,
Sep
tem
b
er
20
26
:
8
8
7
-
892
888
a
p
p
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[8
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[
11]
.
W
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l
p
-
s
e
e
k
i
n
g
b
e
h
a
v
i
o
r
a
m
o
n
g
a
d
o
l
e
s
c
e
n
ts
,
t
h
e
e
x
p
l
o
s
i
v
e
g
r
o
w
t
h
o
f
m
o
b
i
l
e
a
p
p
l
i
c
a
tio
n
s
o
v
e
r
t
h
e
l
a
s
t
t
e
n
y
e
a
r
s
h
a
s
f
u
n
d
a
m
e
n
t
al
l
y
t
r
a
n
s
f
o
r
m
e
d
d
i
g
i
t
a
l
m
e
n
t
al
h
e
a
lt
h
c
a
r
e
.
C
u
r
r
e
n
t
l
y
,
m
aj
o
r
a
p
p
p
l
a
t
f
o
r
m
s
o
f
f
e
r
u
p
w
a
r
d
s
o
f
4
0
,
0
0
0
h
e
a
l
t
h
a
n
d
m
e
d
i
c
a
l
a
p
p
l
i
c
a
ti
o
n
s
[
1
2
]
.
G
i
v
e
n
t
h
at
9
5
o
f
a
d
o
l
e
s
c
e
n
ts
n
o
w
o
w
n
o
r
u
s
e
s
m
a
r
t
p
h
o
n
e
s
,
m
o
b
i
l
e
a
p
p
s
a
r
e
u
n
i
q
u
e
l
y
p
o
s
i
t
i
o
n
e
d
to
o
f
f
e
r
h
i
g
h
l
y
a
c
c
e
s
s
i
b
l
e
,
a
p
p
ea
l
i
n
g
,
a
n
d
c
o
s
t
-
e
f
f
e
c
t
i
v
e
m
e
n
ta
l
h
e
a
l
t
h
s
u
p
p
o
r
t
t
o
y
o
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t
h
e
x
a
c
t
l
y
w
h
e
n
a
n
d
w
h
e
r
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t
h
e
y
n
e
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d
it
m
o
s
t
a
n
d
t
h
e
n
,
r
e
ce
n
t
s
y
s
t
e
m
at
i
c
r
e
v
i
e
w
s
u
g
g
es
ts
t
h
a
t
t
h
e
m
a
j
o
r
it
y
o
f
c
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r
r
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t
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g
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t
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t
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o
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t
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t
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o
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o
n
d
a
n
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i
e
t
y
a
n
d
d
e
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o
n
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v
i
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n
c
e
-
b
a
s
e
d
d
i
g
i
t
al
i
n
t
e
r
v
en
t
i
o
n
s
t
e
ll
a
d
i
f
f
e
r
e
n
t
s
t
o
r
y
.
A
m
e
t
a
-
a
n
a
l
y
s
i
s
o
f
8
0
s
t
u
d
i
es
e
v
a
l
u
a
ti
n
g
8
3
e
v
i
d
e
n
c
e
-
b
a
s
e
d
m
o
b
i
l
e
h
e
al
t
h
p
r
o
g
r
a
m
s
d
e
m
o
n
s
t
r
a
t
e
d
t
h
at
t
h
e
y
e
f
f
e
ct
iv
e
l
y
r
e
d
u
c
e
d
i
s
t
r
ess
,
e
n
h
a
n
c
e
g
e
n
e
r
a
l
w
e
ll
-
b
e
i
n
g
,
a
n
d
i
m
p
r
o
v
e
s
y
m
p
t
o
m
s
a
c
r
o
s
s
a
d
i
v
e
r
s
e
r
a
n
g
e
o
f
p
s
y
c
h
o
l
o
g
i
c
al
d
i
s
o
r
d
e
r
s
[
1
3
]
-
[
1
6
]
.
C
o
n
s
eq
u
en
tly
,
ev
i
d
en
ce
-
b
ac
k
e
d
d
ig
ital
p
latf
o
r
m
s
r
e
p
r
esen
t
a
h
ig
h
ly
p
r
o
m
is
in
g
av
e
n
u
e
f
o
r
i
m
p
r
o
v
i
n
g
ad
o
lescen
t
m
en
tal
h
ea
lth
.
Sp
ec
if
ically
,
d
ig
itally
d
eliv
er
ed
b
r
ief
co
p
in
g
s
k
ills
h
av
e
b
ee
n
s
h
o
wn
to
b
o
o
s
t
m
o
o
d
an
d
h
elp
y
o
u
n
g
p
eo
p
le
n
av
i
g
a
te
in
ten
s
e
em
o
tio
n
s
b
e
f
o
r
e
t
h
e
y
b
ec
o
m
e
u
n
m
an
ag
ea
b
le,
ac
ti
n
g
as
a
p
r
ev
en
tativ
e
m
ea
s
u
r
e
ag
ain
s
t
d
ee
p
er
m
en
ta
l
h
ea
lth
c
h
allen
g
es.
Fu
r
t
h
er
m
o
r
e,
a
p
p
-
b
ased
p
o
s
itiv
e
p
s
y
ch
o
lo
g
y
in
ter
v
e
n
tio
n
s
d
esig
n
ed
to
am
p
lify
p
o
s
itiv
e
em
o
tio
n
s
an
d
d
ec
r
ea
s
e
n
eg
ativ
e
o
n
es
h
av
e
p
r
o
v
en
ef
f
ec
tiv
e
in
s
h
ield
in
g
o
ld
er
ad
o
lescen
ts
f
r
o
m
lo
n
elin
ess
a
n
d
d
e
p
r
ess
io
n
,
en
h
an
cin
g
s
leep
q
u
ality
,
an
d
ea
s
in
g
th
e
tr
a
n
s
itio
n
in
to
co
lleg
e
[
1
7
]
,
[
1
8
]
.
Alth
o
u
g
h
s
o
m
e
d
i
g
ital
m
en
tal
h
ea
lth
to
o
ls
ac
h
iev
e
p
o
s
itiv
e
u
s
er
en
g
ag
em
en
t
an
d
ad
h
er
en
ce
u
n
d
er
s
p
ec
if
ic
co
n
d
itio
n
s
,
m
an
y
ap
p
l
icatio
n
s
f
ail
to
r
etain
u
s
er
s
p
ast th
e
in
itial r
eg
is
tr
atio
n
p
h
ase.
T
h
is
h
ig
h
d
r
o
p
-
o
f
f
r
ate
am
o
n
g
a
d
o
lescen
ts
is
p
r
i
m
ar
ily
d
r
iv
en
b
y
p
o
o
r
u
s
er
ex
p
er
ien
ce
s
an
d
n
e
g
ativ
e
p
er
ce
p
tio
n
s
r
eg
ar
d
in
g
th
e
ac
tu
al
u
s
ef
u
ln
ess
o
f
th
e
a
p
p
s
[
1
9
]
.
I
n
r
ec
e
n
t
y
ea
r
s
,
in
c
r
ea
s
in
g
e
m
p
h
asis
h
as
b
ee
n
p
lace
d
o
n
th
e
im
p
o
r
tan
ce
o
f
in
v
o
l
v
in
g
i
n
d
iv
id
u
als
with
liv
ed
ex
p
er
ien
ce
in
th
e
d
ev
elo
p
m
en
t o
f
m
en
tal
h
ea
lth
in
ter
v
en
tio
n
s
,
p
a
r
ticu
lar
ly
b
y
e
n
g
ag
in
g
ad
o
lescen
ts
in
th
e
d
esig
n
o
f
d
ig
ital
h
ea
lth
tech
n
o
lo
g
ies
in
ten
d
e
d
f
o
r
th
eir
ag
e
g
r
o
u
p
.
Nea
r
f
ield
co
m
m
u
n
icatio
n
(
NFC
)
tech
n
o
lo
g
y
was
d
ev
el
o
p
ed
to
s
u
p
p
o
r
t
a
d
o
lescen
t
m
en
tal
h
ea
lth
th
r
o
u
g
h
t
h
e
in
teg
r
ati
o
n
o
f
d
ig
ital
ed
u
ca
tio
n
al
co
n
ten
t,
in
ter
ac
tiv
e
ca
r
e
ac
t
iv
ities
,
s
k
ills
-
b
ased
co
ac
h
in
g
p
r
o
v
i
d
ed
b
y
tr
ain
e
d
p
ar
a
p
r
o
f
ess
io
n
als,
ea
r
ly
id
en
tific
atio
n
o
f
m
en
tal
h
ea
lth
n
ee
d
s
with
a
p
p
r
o
p
r
iate
r
ef
e
r
r
al
to
clin
ica
l
s
er
v
ices,
an
d
i
n
-
ap
p
cr
is
is
s
u
p
p
o
r
t
f
ea
tu
r
es
co
n
n
ec
ted
to
liv
e
c
r
is
is
as
s
is
tan
ce
wh
en
n
ec
ess
ar
y
[
2
0
]
-
[
2
3
]
.
T
h
e
co
ac
h
in
g
an
d
s
k
ills
-
tr
ain
in
g
co
m
p
o
n
en
ts
in
co
r
p
o
r
ated
in
to
th
e
NFC
in
ter
v
en
tio
n
ar
e
b
ased
o
n
well
-
estab
lis
h
ed
,
ev
id
en
ce
-
b
ased
ap
p
r
o
ac
h
es
f
o
r
ad
o
lescen
ts
,
in
clu
d
in
g
c
o
g
n
itiv
e
b
eh
a
v
io
r
al
th
er
ap
y
(
C
B
T
)
[
2
4
]
-
[
2
6
]
.
Sev
er
al
r
esear
ch
f
in
d
in
g
s
d
em
o
n
s
tr
ate
th
at
NFC
-
en
ab
led
m
o
b
ile
d
ev
ices
ca
n
s
ig
n
if
ican
tly
im
p
r
o
v
e
em
o
tio
n
s
an
d
b
eh
av
i
o
r
f
o
r
ad
o
lescen
ts
with
au
tis
m
s
p
ec
tr
u
m
d
is
o
r
d
er
[
2
7
]
-
[
3
0
]
.
Ho
wev
er
,
th
er
e
is
lim
ited
em
p
ir
ical
e
v
id
en
ce
to
s
u
p
p
o
r
t
th
e
u
s
e
o
f
NFC
a
s
a
tr
ea
t
m
e
n
t
p
r
o
g
r
a
m
f
o
r
d
e
p
r
ess
io
n
in
ad
o
lescen
ts
.
T
h
er
ef
o
r
e,
we
e
x
am
in
ed
d
ep
r
ess
iv
e
s
y
m
p
to
m
s
in
ad
o
lescen
ts
u
s
in
g
NFC
f
o
r
3
0
d
ay
s
.
2.
M
E
T
H
O
D
2
.
1
.
Su
bje
ct
s
A
to
tal
o
f
1
0
0
ad
o
lescen
ts
with
d
ep
r
ess
iv
e
s
y
m
p
to
m
s
ag
ed
1
6
-
1
8
y
ea
r
s
wer
e
r
ec
r
u
ited
f
r
o
m
th
e
two
h
ig
h
s
ch
o
o
ls
in
Sam
u
t
Pra
k
a
n
Pro
v
in
ce
,
T
h
ailan
d
.
T
h
ese
s
ch
o
o
ls
ar
e
f
u
n
d
e
d
b
y
th
e
T
h
ai
g
o
v
er
n
m
e
n
t
an
d
m
an
ag
e
r
eso
u
r
ce
s
,
d
ev
elo
p
u
p
-
to
-
d
ate
cu
r
r
icu
la,
a
n
d
en
a
ct
laws
to
co
n
tr
o
l
q
u
ality
,
a
n
d
wer
e
r
an
d
o
m
ly
allo
ca
ted
in
to
two
g
r
o
u
p
s
:
co
n
tr
o
l
g
r
o
u
p
C
ON;
n
=
5
0
an
d
ex
p
er
im
en
tal
g
r
o
u
p
NFC
;
n
=
5
0
.
T
h
e
in
clu
s
io
n
cr
iter
ia
in
clu
d
ed
m
ild
-
to
-
m
o
d
er
ate
d
ep
r
ess
io
n
as
d
ef
in
e
d
b
y
th
e
C
en
ter
f
o
r
E
p
id
e
m
io
lo
g
ical
Stu
d
ies
-
Dep
r
ess
io
n
Scale
(
C
E
S
-
D)
s
co
r
e
o
f
o
v
er
2
2
,
n
o
h
is
to
r
y
o
f
p
s
y
ch
iatr
ic
illn
ess
,
an
d
n
o
cu
r
r
en
t
p
s
y
ch
iatr
ic
m
ed
icati
o
n
s
.
On
ly
s
u
b
jects
wh
o
o
wn
ed
a
n
An
d
r
o
id
o
r
iOS
s
m
ar
tp
h
o
n
e
wer
e
ad
m
itted
to
th
e
s
tu
d
y
.
2
.
2
.
I
nte
rv
ent
io
n
2
.
2
.
1
.
O
v
er
v
iew
NFC
tech
n
o
lo
g
y
is
d
e
r
iv
ed
f
r
o
m
r
ad
i
o
f
r
eq
u
e
n
cy
id
e
n
tific
atio
n
(
R
FID
)
an
d
f
u
n
ctio
n
s
at
a
f
r
eq
u
e
n
cy
o
f
1
3
.
5
6
MH
z.
I
n
ev
er
y
d
ay
a
p
p
licatio
n
s
,
an
NFC
r
ea
d
er
c
an
in
ter
ac
t
with
an
NF
C
tag
t
o
in
s
tan
tly
id
en
tify
f
am
ily
m
em
b
er
s
th
r
o
u
g
h
a
b
ac
k
en
d
s
y
s
tem
wh
ile
en
ab
lin
g
th
e
m
o
n
ito
r
in
g
o
f
in
d
iv
id
u
al
h
ea
lth
in
f
o
r
m
atio
n
.
I
n
th
e
p
r
es
en
t
s
tu
d
y
,
th
e
NFC
s
y
s
tem
was
im
p
lem
en
ted
in
r
ea
d
er
/wr
iter
m
o
d
e,
wh
e
r
eb
y
d
at
a
wer
e
tr
an
s
m
itted
f
r
o
m
th
e
NFC
tag
to
th
e
NFC
-
en
ab
led
d
e
v
ice.
2
.
2
.
2
.
Co
nte
nt
T
h
e
in
ter
v
en
tio
n
in
s
tr
u
m
e
n
t
d
ev
elo
p
e
d
f
o
r
th
is
s
tu
d
y
in
te
g
r
ates
NFC
tech
n
o
lo
g
y
with
th
e
L
I
NE
Of
f
icia
l
Acc
o
u
n
t
(
L
I
NE
OA
)
p
latf
o
r
m
.
Gr
o
u
n
d
e
d
in
h
u
m
an
-
co
m
p
u
te
r
in
ter
ac
tio
n
(
HC
I
)
p
r
in
cip
les
to
en
s
u
r
e
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
N
F
C
tech
n
o
lo
g
y
imp
r
o
vin
g
d
e
p
r
ess
ive
s
y
mp
to
ms in
a
d
o
lescen
ts
w
ith
d
ep
r
ess
io
n
:
…
(
S
u
s
a
r
ee
P
r
a
kh
in
kit
)
889
u
s
ab
ilit
y
,
th
e
u
s
er
in
ter
f
ac
e
UI
ar
ch
itectu
r
e
co
n
s
is
ts
o
f
a
f
o
u
r
-
f
u
n
ctio
n
m
ain
m
e
n
u
s
tr
u
ctu
r
ed
ac
co
r
d
in
g
to
p
s
y
c
h
o
l
o
g
i
c
a
l
c
o
p
i
n
g
a
n
d
e
m
o
t
i
o
n
a
l
i
n
t
e
ll
i
g
e
n
c
e
f
r
a
m
e
w
o
r
k
s
.
T
h
e
f
u
n
c
t
i
o
n
a
l
s
p
e
c
i
f
ic
a
t
i
o
n
s
o
f
t
h
e
i
n
s
t
r
u
m
e
n
t
a
r
e
c
a
t
e
g
o
r
i
z
e
d
a
s
f
o
l
l
o
ws
:
i
)
F
u
n
c
t
i
o
n
1
B
u
i
l
d
i
n
g
s
e
l
f
-
aw
a
r
e
n
e
s
s
:
T
h
e
s
m
a
r
t
p
h
o
n
e
s
c
r
e
e
n
d
i
s
p
l
a
y
s
a
d
i
g
i
t
i
ze
d
v
e
r
s
i
o
n
o
f
t
h
e
C
e
n
t
e
r
f
o
r
E
p
id
e
m
i
o
l
o
g
i
c
S
t
u
d
ie
s
D
e
p
r
e
s
s
i
o
n
S
c
a
l
e
(
C
E
S
-
D
)
v
i
a
i
n
t
e
r
a
c
ti
v
e
f
l
e
x
m
e
s
s
a
g
es
,
a
l
l
o
w
i
n
g
i
m
m
e
d
i
a
t
e
,
r
e
al
-
t
i
m
e
s
c
r
e
e
n
i
n
g
o
f
d
e
p
r
e
s
s
i
v
e
s
y
m
p
t
o
m
s
;
ii
)
F
u
n
c
t
i
o
n
2
:
E
m
o
tio
n
a
l
e
x
p
r
e
s
s
i
o
n
:
a
s
e
c
u
r
e
d
i
g
it
a
l
e
n
v
i
r
o
n
m
e
n
t
o
n
th
e
d
e
v
i
c
e
f
o
r
m
o
o
d
j
o
u
r
n
a
l
i
n
g
a
n
d
c
o
n
s
t
r
u
c
t
i
v
e
a
f
f
e
c
t
i
v
e
r
e
l
e
as
e
;
i
i
i
)
F
u
n
c
t
i
o
n
3
:
C
o
p
i
n
g
s
t
r
at
e
g
i
es
:
A
n
e
v
i
d
e
n
c
e
-
b
a
s
e
d
r
e
p
o
s
it
o
r
y
a
c
c
e
s
s
i
b
l
e
v
i
a
t
h
e
s
m
a
r
t
p
h
o
n
e
,
o
f
f
e
r
i
n
g
t
a
r
g
e
t
e
d
r
e
l
a
x
a
ti
o
n
t
e
c
h
n
i
q
u
e
s
a
n
d
e
d
u
c
a
t
i
o
n
a
l
m
e
d
i
a
;
a
n
d
i
v)
F
u
n
c
ti
o
n
4
:
R
ef
l
e
c
t
i
o
n
a
n
d
c
o
u
n
s
e
l
i
n
g
:
A
n
in
t
e
r
a
c
t
i
v
e
c
h
a
n
n
e
l
c
o
n
n
e
c
t
i
n
g
t
h
e
u
s
e
r
'
s
d
e
v
i
c
e
d
i
r
e
c
t
l
y
t
o
p
r
o
f
e
s
s
i
o
n
a
l
n
u
r
s
i
n
g
a
n
d
p
s
y
c
h
o
l
o
g
i
c
a
l
s
u
p
p
o
r
t
f
o
r
r
e
al
-
t
i
m
e
c
o
u
n
s
el
i
n
g
.
2
.
2
.
3
.
Resea
rc
h
p
ro
t
o
co
l f
o
r
NF
C
G
RO
UP
T
h
e
ex
p
e
r
im
en
tal
g
r
o
u
p
r
ec
ei
v
ed
a
4
-
wee
k
NFC
in
ter
v
en
tio
n
3
d
a
y
s
p
er
wee
k
,
ex
ec
u
te
d
a
s
f
o
llo
ws:
–
NFC
a
ctiv
atio
n
:
Par
ticip
an
ts
tap
th
eir
s
m
ar
tp
h
o
n
es
ag
ain
s
t
th
e
NFC
tag
to
au
to
m
atica
lly
lau
n
ch
th
e
L
I
NE
Of
f
icial
Acc
o
u
n
t L
I
NE
OA
p
latf
o
r
m
.
–
L
I
NE
-
b
ased
co
ac
h
in
g
an
d
m
o
tiv
atio
n
:
T
h
r
o
u
g
h
o
u
t
th
e
4
-
wee
k
p
er
io
d
,
th
e
s
y
s
tem
d
eliv
er
s
s
ch
ed
u
led
,
au
to
m
ated
m
o
tiv
atio
n
al
m
ess
ag
in
g
an
d
co
ac
h
in
g
p
r
o
m
p
ts
v
ia
L
I
NE
OA.
T
h
is
s
tr
ateg
y
is
d
esig
n
ed
to
em
p
o
wer
p
ar
ticip
an
ts
,
m
ain
tain
en
g
ag
em
en
t,
an
d
en
s
u
r
e
p
r
o
g
r
am
ad
h
er
en
ce
.
–
Seq
u
en
tial
ex
ec
u
tio
n
o
f
f
u
n
ctio
n
s
:
Par
ticip
an
ts
co
m
p
lete
th
e
f
o
u
r
co
r
e
p
s
y
ch
o
lo
g
ical
f
u
n
ctio
n
s
s
eq
u
en
tially
d
u
r
in
g
ea
ch
s
ess
io
n
.
–
Fin
ally
,
u
p
o
n
co
m
p
letio
n
o
f
th
e
4
-
wee
k
in
ter
v
en
tio
n
,
all
p
ar
ticip
an
ts
in
th
e
ex
p
er
im
en
tal
g
r
o
u
p
co
m
p
lete
th
e
f
in
al
C
E
S
-
D
as a
p
o
s
t
-
test
ass
ess
m
en
t.
I
n
co
n
tr
ast,
th
e
co
n
tr
o
l
g
r
o
u
p
r
ec
eiv
ed
s
tan
d
ar
d
ca
r
e
an
d
f
o
llo
wed
th
eir
n
o
r
m
al
d
aily
r
o
u
tin
es,
with
p
r
e
-
test
an
d
p
o
s
t
-
test
ass
ess
m
en
ts
co
n
d
u
cted
at
th
e
s
am
e
in
ter
v
als as th
e
ex
p
er
im
en
tal
g
r
o
u
p
.
2
.
3
.
M
ea
s
urem
ent
s
Dep
r
ess
iv
e
s
y
m
p
to
m
s
:
C
E
S
-
D
d
ev
elo
p
ed
b
y
R
ad
lo
f
f
[
3
0
]
,
was
tr
an
s
lated
in
to
th
e
T
h
ai
l
an
g
u
ag
e
b
y
B
ai
et
a
l.
[3
1
]
.
T
h
e
s
ca
le
co
n
s
is
ts
o
f
2
0
-
item
q
u
esti
o
n
s
with
a
4
-
p
o
in
t
L
ik
er
t
s
ca
le
an
d
h
as
a
s
co
r
e
r
a
n
g
e
o
f
0
-
6
0
s
elf
-
r
ep
o
r
t
in
s
tr
u
m
en
t
d
esig
n
ed
to
m
ea
s
u
r
e
th
e
f
r
eq
u
e
n
c
y
an
d
s
ev
er
ity
o
f
d
ep
r
ess
iv
e
s
y
m
p
to
m
a
to
l
o
g
y
o
v
er
th
e
p
ast
wee
k
.
T
h
e
p
r
im
ar
y
t
o
o
l
was
th
e
T
h
ai
v
er
s
io
n
o
f
t
h
e
C
E
S
-
D,
wh
ich
co
n
tain
s
2
0
item
s
r
ated
o
n
a
4
-
p
o
in
t
L
ik
er
t
s
ca
le
1
5
.
T
h
e
to
tal
s
co
r
e
r
an
g
es
f
r
o
m
0
to
6
0
,
with
s
co
r
es
of
22
o
r
m
o
r
e
in
d
icatin
g
d
ep
r
ess
iv
e
s
y
m
p
to
m
s
.
I
n
t
h
is
s
tu
d
y
,
th
e
s
u
b
jects with
s
co
r
es
of
2
2
o
r
m
o
r
e
wer
e
r
ec
r
u
ited
.
2
.
4
.
St
a
t
is
t
ica
l a
na
ly
s
es
Descr
ip
tiv
e
s
tati
s
tics
,
in
clu
d
in
g
f
r
eq
u
e
n
cies,
p
er
ce
n
tag
es,
m
ea
n
s
,
an
d
s
tan
d
ar
d
d
ev
iatio
n
s
(
SD)
,
wer
e
u
s
ed
to
s
u
m
m
ar
ize
th
e
d
e
m
o
g
r
ap
h
ic
ch
ar
ac
ter
is
tics
o
f
th
e
p
ar
ticip
an
ts
.
T
h
e
ef
f
ec
tiv
en
ess
o
f
th
e
NFC
tech
n
o
lo
g
y
in
ter
v
e
n
tio
n
o
n
d
ep
r
ess
iv
e
s
y
m
p
to
m
s
was
f
ir
s
t
ev
alu
ated
u
s
in
g
a
p
air
ed
t
-
te
s
t
to
co
m
p
ar
e
p
r
e
-
in
ter
v
en
tio
n
a
n
d
p
o
s
t
-
in
ter
v
en
tio
n
s
co
r
es
with
in
b
o
th
th
e
in
t
er
v
en
tio
n
a
n
d
c
o
n
t
r
o
l
g
r
o
u
p
s
.
T
h
is
s
tati
s
tical
te
s
t
was
s
elec
ted
b
ec
au
s
e
it
is
ap
p
r
o
p
r
iate
f
o
r
n
o
r
m
ally
d
is
tr
ib
u
ted
d
ata
a
n
d
e
n
ab
les
th
e
ass
ess
m
en
t
o
f
ch
an
g
es
with
in
ea
ch
g
r
o
u
p
o
v
er
tim
e.
Su
b
s
eq
u
en
tly
,
a
n
aly
s
is
o
f
co
v
ar
ian
ce
(
ANCOVA)
was
p
er
f
o
r
m
ed
to
c
o
m
p
a
r
e
p
o
s
t
-
in
ter
v
e
n
tio
n
m
ea
n
s
co
r
e
s
b
etwe
en
th
e
in
ter
v
e
n
tio
n
a
n
d
co
n
tr
o
l
g
r
o
u
p
s
wh
ile
ac
co
u
n
tin
g
f
o
r
b
aselin
e
d
if
f
er
en
ce
s
.
Statis
tical
s
ig
n
if
ican
ce
was
estab
lis
h
ed
at
p
<
0
.
0
5
,
i
n
d
icatin
g
th
at
an
y
o
b
s
er
v
ed
d
if
f
er
en
ce
s
wer
e
co
n
s
id
er
ed
s
tatis
tically
s
ig
n
if
ican
t a
n
d
u
n
lik
ely
t
o
h
av
e
o
cc
u
r
r
ed
b
y
ch
a
n
ce
.
3.
RE
SU
L
T
S
AND
D
I
SCU
SS
I
O
N
3
.
1
.
Resul
t
s
3
.
1
.
1
.
Dem
o
g
ra
ph
ic
c
ha
ra
ct
e
ristics
T
ab
le
1
s
u
m
m
ar
izes
d
em
o
g
r
a
p
h
ic
ch
ar
ac
ter
is
tics
o
f
th
e
p
ar
ticip
an
ts
,
d
iv
id
ed
eq
u
ally
b
e
twee
n
th
e
NFC
g
r
o
u
p
(
n
=
5
0
)
a
n
d
th
e
c
o
n
tr
o
l g
r
o
u
p
(
n
=
5
0
)
.
R
eg
ar
d
i
n
g
ag
e
d
is
tr
ib
u
tio
n
,
th
e
m
ajo
r
i
ty
o
f
p
ar
ticip
an
ts
in
th
e
NFC
g
r
o
u
p
wer
e
1
8
y
ea
r
s
o
ld
(
5
8
.
0
0
%),
w
h
er
ea
s
a
s
u
b
s
tan
tial m
ajo
r
ity
in
th
e
c
o
n
tr
o
l
g
r
o
u
p
wer
e
1
7
y
ea
r
s
o
ld
(
7
4
.
0
0
%).
I
n
ter
m
s
o
f
g
e
n
d
er
,
b
o
th
g
r
o
u
p
s
wer
e
p
r
ed
o
m
in
an
tly
f
e
m
ale,
ac
co
u
n
tin
g
f
o
r
6
4
.
0
0
%
in
t
h
e
NFC
g
r
o
u
p
an
d
8
8
.
0
0
%
in
th
e
c
o
n
tr
o
l
g
r
o
u
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with
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co
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with
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ex
p
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im
en
tal
g
r
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u
p
f
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llo
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th
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in
ter
v
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T
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m
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d
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C
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ely
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t
Evaluation Warning : The document was created with Spire.PDF for Python.
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was
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to
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r
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ted
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f
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t d
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es b
y
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r
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p
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tr
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llin
g
f
o
r
p
r
e
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test
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S
o
u
r
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e
Ty
p
e
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I
su
m o
f
s
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df
M
e
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n
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g
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A
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4.
DIS
CU
SS
I
O
N
T
h
e
p
r
im
ar
y
o
b
jectiv
e
o
f
th
is
s
tu
d
y
was
to
ev
alu
ate
th
e
ef
f
ec
tiv
en
ess
o
f
an
NFC
tech
n
o
lo
g
y
-
b
ased
in
ter
v
en
tio
n
o
n
r
ed
u
cin
g
d
ep
r
ess
iv
e
s
y
m
p
to
m
s
am
o
n
g
ad
o
lescen
ts
.
T
h
e
with
in
-
g
r
o
u
p
an
aly
s
is
s
h
o
wed
a
h
ig
h
ly
s
ig
n
if
ican
t
r
ed
u
ctio
n
in
d
ep
r
ess
io
n
s
co
r
es
with
in
th
e
NFC
ex
p
er
im
en
tal
g
r
o
u
p
,
d
r
o
p
p
in
g
f
r
o
m
a
b
aselin
e
m
ea
n
o
f
2
7
.
0
6
±
2
.
8
0
to
1
8
.
1
8
±
4
.
8
4
af
ter
th
e
4
-
wee
k
s
tu
d
y
p
er
io
d
(
p
<
0
.
0
5
)
.
C
o
n
v
er
s
ely
,
th
e
co
n
tr
o
l
g
r
o
u
p
(
C
ON)
ex
h
ib
ited
n
o
s
ig
n
if
ican
t
im
p
r
o
v
em
en
t
(
2
6
.
6
2
±
2
.
8
2
at
p
r
e
-
test
v
s
.
2
7
.
1
2
±
6
.
4
1
at
p
o
s
t
-
test
)
.
T
h
is
is
co
n
s
is
ten
t
with
f
i
n
d
in
g
s
f
r
o
m
r
elev
an
t
liter
atu
r
e
th
at
em
p
h
asize
th
e
p
o
s
itiv
e
im
p
ac
t
o
f
NFC
tech
n
o
lo
g
y
o
n
p
o
s
itiv
e
ef
f
ec
ts
am
o
n
g
s
t
ad
o
lescen
ts
[
3
2
]
.
T
h
e
f
in
d
in
g
s
o
f
o
u
r
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u
tco
m
es
wer
e
lar
g
ely
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n
s
is
ten
t
with
p
r
ev
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u
s
s
tu
d
ies o
f
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ter
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ased
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ased
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f
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tain
ed
to
at
least 6
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8
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C
tech
n
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imp
r
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vin
g
d
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p
r
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s
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mp
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a
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w
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d
ep
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…
(
S
u
s
a
r
ee
P
r
a
kh
in
kit
)
891
T
h
e
s
u
cc
ess
o
f
th
e
NFC
in
ter
v
en
tio
n
ca
n
b
e
attr
ib
u
ted
to
its
s
tr
u
ctu
r
ed
,
m
u
lti
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p
h
ase
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s
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o
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ical
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esig
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ea
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to
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aily
h
o
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e
en
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ir
o
n
m
en
t
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ad
o
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ts
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Ov
er
th
e
4
-
wee
k
p
er
io
d
,
p
ar
ticip
an
ts
p
r
o
g
r
ess
ed
f
r
o
m
s
elf
-
awa
r
en
ess
an
d
em
o
tio
n
al
ex
p
r
ess
io
n
to
ac
q
u
ir
in
g
ac
tiv
e
co
p
in
g
s
tr
ateg
ies
an
d
en
g
ag
in
g
in
f
in
al
r
ef
lectio
n
ac
tiv
it
ies.
B
y
u
tili
zin
g
NFC
tag
s
an
d
s
m
ar
tp
h
o
n
es,
th
is
f
r
am
ewo
r
k
b
y
p
ass
ed
tr
ad
itio
n
al
b
ar
r
ier
s
to
m
en
tal
h
ea
lth
liter
ac
y
,
s
u
ch
as
s
tig
m
a
o
r
lim
ited
ac
ce
s
s
to
co
u
n
s
elin
g
,
b
y
tu
r
n
in
g
p
ass
iv
e
m
en
tal
h
ea
lth
s
u
p
p
o
r
t
in
to
an
in
ter
ac
tiv
e,
s
elf
-
p
ac
ed
d
ig
ital
ex
p
er
ien
ce
.
T
h
ese
f
in
d
in
g
s
s
tr
o
n
g
ly
alig
n
with
p
r
io
r
liter
atu
r
e
em
p
h
asizin
g
th
at
m
o
b
ile
h
ea
lth
(
m
Hea
lth
)
an
d
d
ig
ital
in
n
o
v
atio
n
s
s
ig
n
if
ican
tly
em
p
o
wer
y
o
u
n
g
er
p
o
p
u
latio
n
s
to
r
ec
o
g
n
ize
em
o
tio
n
s
an
d
p
r
ac
tice
tim
ely
s
elf
-
m
an
ag
em
en
t
[
3
2
]
.
T
h
e
s
u
b
s
tan
tial
v
ar
ian
ce
ex
p
lain
ed
b
y
th
e
m
o
d
el
(
Ad
ju
s
ted
R
2
=
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5
4
3
)
s
u
p
p
o
r
ts
th
e
co
n
s
en
s
u
s
in
d
ig
ital
h
ea
lth
r
esear
ch
th
at
s
tr
u
ctu
r
ed
,
m
icr
o
-
lear
n
in
g
m
o
d
u
les (
s
u
ch
as we
ek
ly
em
o
tio
n
al
r
ef
lectio
n
v
ia
s
m
ar
tp
h
o
n
e
in
ter
ac
tio
n
)
r
esu
lt
in
h
ig
h
er
ad
h
er
en
ce
,
g
r
ea
ter
u
s
er
en
g
ag
em
en
t,
an
d
u
ltima
t
ely
s
u
p
er
io
r
clin
ical
o
u
tco
m
es
co
m
p
ar
ed
to
s
tan
d
ar
d
,
p
ass
iv
e
ca
r
e
r
o
u
tin
es.
5.
CO
NCLU
SI
O
N
T
h
e
f
in
d
in
g
s
o
f
th
is
q
u
asi
-
ex
p
er
im
en
tal
s
tu
d
y
co
n
f
ir
m
th
at
NFC
-
b
ased
in
ter
v
en
tio
n
s
ca
n
s
ig
n
if
ican
tly
r
ed
u
ce
d
ep
r
ess
iv
e
s
y
m
p
to
m
s
am
o
n
g
ad
o
lescen
ts
,
o
f
f
er
in
g
a
p
r
ac
tical
an
d
ac
ce
s
s
ib
le
alter
n
ativ
e
to
tr
ad
itio
n
al
f
ac
e
-
to
-
f
ac
e
th
er
ap
y
.
B
y
in
teg
r
atin
g
s
elf
-
awar
en
ess
,
em
o
tio
n
al
ex
p
r
ess
io
n
,
co
p
in
g
s
tr
ateg
ies,
an
d
r
ef
lectio
n
in
to
a
s
tr
u
ctu
r
ed
d
ig
ital
f
r
am
ewo
r
k
,
NFC
tech
n
o
lo
g
y
ef
f
ec
tiv
ely
em
p
o
wer
s
ad
o
lescen
ts
to
m
an
ag
e
th
eir
m
en
tal
h
ea
lth
in
th
eir
d
aily
en
v
ir
o
n
m
en
ts
.
I
m
p
o
r
tan
tly
,
th
e
r
esu
lts
h
ig
h
lig
h
t
th
e
p
o
ten
tial
o
f
NFC
-
en
ab
led
m
o
b
ile
h
ea
lth
to
o
ls
to
o
v
er
co
m
e
b
ar
r
ier
s
s
u
ch
as
s
tig
m
a
an
d
lim
ited
ac
ce
s
s
to
co
u
n
s
elin
g
,
s
u
g
g
esti
n
g
th
at
th
is
ap
p
r
o
ac
h
co
u
ld
b
e
s
ca
led
to
b
r
o
ad
er
ad
o
lescen
t
p
o
p
u
latio
n
s
an
d
in
co
r
p
o
r
ated
in
to
s
ch
o
o
l
-
b
ased
o
r
co
m
m
u
n
ity
m
en
tal
h
ea
lth
p
r
o
g
r
am
s
.
ACK
NO
WL
E
DG
M
E
N
T
S
W
e
wis
h
to
ex
ten
d
our
s
in
ce
r
e
g
r
atitu
d
e
to
all
th
e
a
d
o
lescen
t
s
wh
o
p
ar
ticip
ated
in
t
h
is
s
tu
d
y
f
o
r
t
h
eir
tim
e,
d
ed
icatio
n
,
an
d
in
v
alu
ab
le
co
n
tr
ib
u
tio
n
s
.
W
e
also
ex
p
r
ess
o
u
r
d
ee
p
ap
p
r
ec
iat
io
n
to
t
h
e
s
ch
o
o
l
ad
m
in
is
tr
ato
r
s
,
teac
h
er
s
,
an
d
p
ar
en
ts
f
o
r
th
eir
co
o
p
er
atio
n
,
c
o
o
r
d
in
atio
n
,
an
d
s
tead
f
ast
s
u
p
p
o
r
t
th
r
o
u
g
h
o
u
t
t
h
e
d
ata
co
llectio
n
p
r
o
ce
s
s
.
F
UNDING
I
NF
O
R
M
A
T
I
O
N
T
h
is
r
esear
ch
was
m
a
d
e
p
o
s
s
ib
le
th
r
o
u
g
h
t
h
e
f
in
a
n
cial
s
u
p
p
o
r
t
o
f
Siam
Un
i
v
er
s
ity
;
t
h
e
au
th
o
r
s
g
r
atef
u
lly
ac
k
n
o
wled
g
e
th
e
r
e
s
ea
r
ch
f
u
n
d
in
g
p
r
o
v
i
d
ed
u
n
d
er
Gr
an
t N
o
.
0
0
3
/1
0
/
2
5
6
6
.
E
T
H
I
CAL AP
P
RO
V
AL
T
h
e
s
tu
d
y
was
ap
p
r
o
v
e
d
b
y
th
e
E
th
ical
R
ev
iew
C
o
m
m
ittee
f
o
r
R
esear
ch
I
n
v
o
lv
in
g
Hu
m
an
R
esear
ch
Su
b
jects a
t
th
e
Facu
lty
o
f
Nu
r
s
in
g
,
Siam
Un
iv
er
s
ity
.
RE
F
E
R
E
NC
E
S
[
1
]
B
.
A
.
H
i
c
k
e
y
e
t
a
l
.
,
“
S
m
a
r
t
d
e
v
i
c
e
s
a
n
d
w
e
a
r
a
b
l
e
t
e
c
h
n
o
l
o
g
i
e
s
t
o
d
e
t
e
c
t
a
n
d
mo
n
i
t
o
r
m
e
n
t
a
l
h
e
a
l
t
h
c
o
n
d
i
t
i
o
n
s
a
n
d
st
r
e
ss
:
a
sy
st
e
ma
t
i
c
r
e
v
i
e
w
,
”
S
e
n
s
o
rs
,
v
o
l
.
2
1
,
n
o
.
1
0
,
p
.
3
4
6
1
,
M
a
y
2
0
2
1
,
d
o
i
:
1
0
.
3
3
9
0
/
s
2
1
1
0
3
4
6
1
.
[
2
]
W
H
O
,
“
D
e
p
r
e
ssi
o
n
a
n
d
o
t
h
e
r
c
o
m
mo
n
me
n
t
a
l
d
i
s
o
r
d
e
r
s
g
l
o
b
a
l
h
e
a
l
t
h
e
s
t
i
m
a
t
e
s,”
W
o
r
l
d
H
e
a
l
t
h
O
r
g
a
n
i
z
a
t
i
o
n
.
[
O
n
l
i
n
e
]
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
:
/
/
a
p
p
s.w
h
o
.
i
n
t
/
i
r
i
s/
b
i
t
s
t
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e
a
m
/
1
0
6
6
5
/
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1
0
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W
H
O
-
M
S
D
-
M
E
R
-
2
0
1
7
.
2
-
e
n
g
.
p
d
f
?
u
a
=
1
[
3
]
K
.
M
.
K
e
y
e
s,
N
.
T.
K
r
e
s
k
i
,
a
n
d
M
.
E.
P
a
t
r
i
c
k
,
“
D
e
p
r
e
ssi
v
e
sy
m
p
t
o
ms
i
n
a
d
o
l
e
sc
e
n
c
e
a
n
d
y
o
u
n
g
a
d
u
l
t
h
o
o
d
,
”
J
AM
A
N
e
t
w
o
r
k
O
p
e
n
,
v
o
l
.
7
,
n
o
.
8
,
p
.
e
2
4
2
7
7
4
8
,
A
u
g
.
2
0
2
4
,
d
o
i
:
1
0
.
1
0
0
1
/
j
a
m
a
n
e
t
w
o
r
k
o
p
e
n
.
2
0
2
4
.
2
7
7
4
8
.
[
4
]
B
.
Lu
,
L.
L
i
n
,
a
n
d
X
.
S
u
,
“
G
l
o
b
a
l
b
u
r
d
e
n
o
f
d
e
p
r
e
ssi
o
n
o
r
d
e
p
r
e
ss
i
v
e
sy
m
p
t
o
ms
i
n
c
h
i
l
d
r
e
n
a
n
d
a
d
o
l
e
s
c
e
n
t
s
:
A
s
y
st
e
ma
t
i
c
r
e
v
i
e
w
a
n
d
m
e
t
a
-
a
n
a
l
y
si
s,”
J
o
u
r
n
a
l
o
f
A
f
f
e
c
t
i
v
e
D
i
so
r
d
e
rs
,
v
o
l
.
3
5
4
,
p
p
.
5
5
3
–
5
6
2
,
J
u
n
.
2
0
2
4
,
d
o
i
:
1
0
.
1
0
1
6
/
j
.
j
a
d
.
2
0
2
4
.
0
3
.
0
7
4
.
[
5
]
J.
Lu
e
t
a
l
.
,
“
P
r
e
v
a
l
e
n
c
e
o
f
d
e
p
r
e
ss
i
v
e
d
i
s
o
r
d
e
r
s
a
n
d
t
r
e
a
t
me
n
t
i
n
C
h
i
n
a
:
a
c
r
o
ss
-
s
e
c
t
i
o
n
a
l
e
p
i
d
e
mi
o
l
o
g
i
c
a
l
st
u
d
y
,
”
T
h
e
L
a
n
c
e
t
Psy
c
h
i
a
t
r
y
,
v
o
l
.
8
,
n
o
.
1
1
,
p
p
.
9
8
1
–
9
9
0
,
2
0
2
1
,
d
o
i
:
1
0
.
1
0
1
6
/
S
2
2
1
5
-
0
3
6
6
(
2
1
)
0
0
2
5
1
-
0.
[
6
]
C
.
Y
i
n
,
M
.
X
u
,
a
n
d
Z.
Zo
n
g
,
“
A
d
v
a
n
c
e
s
i
n
t
h
e
p
r
e
v
a
l
e
n
c
e
a
n
d
t
r
e
a
t
me
n
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.
[
2
4
]
J.
J.
P
.
C
.
R
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.
,
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En
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[
2
5
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.
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[
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6
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.
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K
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.
A
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.
[
2
9
]
J.
P
a
r
k
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t
a
l
.
,
“
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o
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t
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smar
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[
3
0
]
L.
S
.
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f
,
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T
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C
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.
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Ps
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3
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C
.
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.
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.
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.
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.
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.
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.
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.
H
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,
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d
P
.
C
u
i
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p
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s
,
“
Tr
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d
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p
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:
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,
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Me
d
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c
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e
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v
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l
.
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o
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p
p
.
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1
.
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I
O
G
RAP
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I
E
S O
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AUTH
O
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S
u
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F
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Un
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c
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.
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