PURPOSE
This study was done to develop and evaluate a smartphone application for the medication confirmation of high-alert medications.
METHODS
A nonequivalent control group non-synchronized design was used for this study. Participants in the treatment group used the application for four weeks. Data were analyzed using descriptive analysis, chi2-test, and t-test for the homogeneity of participants, and a paired t-test for effectiveness in each group with the SPSS 18.0.
RESULTS
Stability of medication administration was estimated by knowledge and certainty, ranged from a score of one to three. A correct answer with high certainty was coded as high stability, low certainty regardless of correct answer was coded as a moderate stability, and incorrect answers with high certainty were rated as low stability. There were no differences in 'knowledge of high alert medication', 'Certainty of knowledge', 'stability of medication administration', 'confidence of single checking medication', and 'medication safety activities' between the treatment group and the comparison group. The treatment group reported a greater difference between pretest and post-test in 'certainty of medication knowledge' (t=3.51, p=.001) than the comparison group.
CONCLUSION
Smartphone application for medication confirmation of high-alert medications will provide an important platform for reducing medication errors risk.

Citations

• The Development and Impact of a Respiratory Patient Care Mobile Application on Nursing Students
  Hyewon Kim
  CIN: Computers, Informatics, Nursing.2024; 42(11): 788.     CrossRef
• Development and Effectiveness of a Clinical Decision Support System for Pressure Ulcer Prevention Care Using Machine Learning
  Myoung Soo Kim, Jung Mi Ryu, Byung Kwan Choi
  CIN: Computers, Informatics, Nursing.2023; 41(4): 236.     CrossRef
• Development of a Health Promotion Application on Cancer Survivorship as an Educational Content for Nursing Students
  Yoonhee Seok, Eunyoung E. Suh
  Asian Nursing Research.2022; 16(1): 52.     CrossRef
• A model for predicting fall experience in the elderly population over 65 years old: Decision tree analysis
  Myeunghee Han
  Journal of Korean Gerontological Nursing.2022; 24(4): 366.     CrossRef
• Development and evaluation of a self‐management application for patients with gout
  Seung Gum Kang, Eun Nam Lee
  Japan Journal of Nursing Science.2020;[Epub]     CrossRef
• Effects of Smartphone-Based Mobile Learning in Nursing Education: A Systematic Review and Meta-analysis
  Ju Hee Kim, Hanjong Park
  Asian Nursing Research.2019; 13(1): 20.     CrossRef
• Development and Evaluation of “Chronic Illness Care Smartphone Apps” on Nursing Students’ Knowledge, Self-efficacy, and Learning Experience
  Jiyoung Kang, Eunyoung E. Suh
  CIN: Computers, Informatics, Nursing.2018; 36(11): 550.     CrossRef

PURPOSE
The purpose of this study was to investigate the effects of sex education for the elderly on sexual knowledge and life satisfaction.
METHODS
A quasi-experimental study used a non-equivalent control group pre-post test design. A seven week sex education program for the elderly was developed and offered to the treatment group. Subjects were drawn from three welfare centers in Seoul. Twenty six were selected for the treatment l group while 27 were assigned to a comparison group. Sexual knowledge and life satisfaction were measured.
RESULTS
The level of life satisfaction reported by the treatment group was greatly increased (t=2.14, p=.037). There were no statistically significant differences in sexual knowledge between both the two groups.
CONCLUSION
A positive influence of sex education was found to increase the level of life satisfaction. Further study on customized sex education for the elderly by individual characteristics is required.

PURPOSE
The purpose of this study was to explore the meaning and essence of good nursing from the perspective of patients undergoing hemodialysis.
METHODS
The data were collected through in-depth interviews of five hemodialysis patients who have been dialyzed for one year or longer. The data analysis was conducted using the Giorgi's phenomenological method.
RESULTS
The findings included six constituents and 13 sub-constituents. The six constituents were 'prompt and skillful response to mitigate distress', 'careful attention to provide relief', 'individualized education to promote self-management', 'an intimate relationship to regain isolated ego', 'warmhearted support to encourage strength to live in a exhausting life', and 'providing of comfortable environment to maintain stability'.
CONCLUSION
From the perspective of the hemodialysis patients, the concept of good nursing should stem from the integration of nurses' scientific knowledge, expert skills, and moral sensitivity. The finding suggests that strategies to develop nursing interventions for hemodialysis patients will be required on the basis of understanding of their sociocultural contexts and familism.

Citations

• Subjectivity study on health conservation of elderly hemodialysis patients
  Eunji Yim, Mijin Yun, Sohyune Sok
  BMC Geriatrics.2024;[Epub]     CrossRef
• Anxiety, Nursing Satisfaction Level, and Experience of Users of The General Health Checkup Center: A Mixed Methods Study
  Eun Kook Kim, Hyejin Hyun, Yeon Jeong Heo
  Journal of Korean Association for Qualitative Research.2024; 9(3): 242.     CrossRef
• The effect of using vapocoolant spray for pain reduction in arteriovenous fistula cannulation among patients undergoing hemodialysis: A randomized control trial
  Kyungmi Lee, Dohee Kim, Hyunyoung Lee, Euna Lee
  Applied Nursing Research.2023; 71: 151674.     CrossRef
• Healthy life of Korean patients with chronic kidney failure undergoing hemodialysis: A situation-specific nursing theory
  Jinhyang Yang, Myung-Ok Cho, Haeok Lee
  Applied Nursing Research.2022; 65: 151584.     CrossRef
• Effects of Thermomechanical Stimulation Intervention during Arteriovenous Fistula Puncture on Hemodialysis Patients’ Pain, Anxiety, and Stress
  Jin-Na Jang, Sunjoo Boo, Sun Hyoung Bae, Jeong-Ah Ahn
  Korean Journal of Adult Nursing.2022; 34(2): 205.     CrossRef
• Nurses' perspectives of the patient care experience assessment items using importance–performance analysis
  Hyo Jin Kang, Soyoung Yu
  Journal of Nursing Management.2022; 30(7): 3247.     CrossRef
• Patients' and Nurses' Perceptions of What Constitutes Good Nursing Care: An Integrative Review
  Kyungmi Lee, Su Hyun Kim
  Research and Theory for Nursing Practice.2020; 34(2): 144.     CrossRef
• Development of the Patient Caring Communication Scale
  Myoung Lyun Heo, Sook Bin Im
  Journal of Korean Academy of Nursing.2019; 49(1): 80.     CrossRef
• Predictors Influencing of Medication Adherence in Hemodialysis Patients
  Hana Kim, Eunha Kim
  Korean Journal of Adult Nursing.2019; 31(3): 283.     CrossRef
• Chronically Ill Patients' Perception of Hospital Nurses
  Byoung-Sook Lee, Mi-Aie Lee, Yong-Sook Eo
  Journal of Korean Academy of Nursing.2018; 48(3): 311.     CrossRef
• Influence of Experiencing Verbal Abuse, Job Stress and Burnout on Nurses' Turnover Intention in Hemodialysis Units
  Sun-ae Joung, Kyung-Yeon Park
  Journal of Korean Academy of Nursing Administration.2016; 22(2): 189.     CrossRef
• Hemodialysis Patients' Experience of Adapting to Dietary Therapy
  Eun Kyung Yang, Il-Ok Kim
  Korean Journal of Adult Nursing.2016; 28(3): 323.     CrossRef

PURPOSE
The aim of this study was to investigate the factors contributing to health-related quality of life (HRQOL) among patients with chronic hepatitis B (CHB).
METHODS
A cross-sectional, descriptive design was used. The sample included 114 patients in a gastroenterology outpatient department at one hospital located in G city. Data were collected using a structured questionnaire from June to December 2009. The collected data were analyzed using SPSS/WIN 15.0.
RESULTS
Health-related quality of life was most strongly related to age, sex, income, occupation, and the care provider. Old age, female gender, lower income, not having an occupation and having a non-medical person were associated with lower HRQOL (R2=.03~.22, p=.041~<.001).
CONCLUSION
CHB infection had a negative impact on HRQOL among the older, female gender, low socioeconomic status and not having medically knowledgeable care givers. Interventions beyond nursing care may be needed to improve the quality of health for patients with Chronic Hepatitis B.

Citations

• Factors influencing on health-related quality of life in South Korean with chronic liver disease
  Hyun Jin Kim, Hyeonsik Chu, Seonhye Lee
  Health and Quality of Life Outcomes.2018;[Epub]     CrossRef
• Quality of Life of Chronic Hepatitis C Patients and Its Associated Factors
  Hoo Jeung Cho, Euna Park
  Osong Public Health and Research Perspectives.2017; 8(2): 124.     CrossRef
• Related Factors of Quality of Life in Middle-male with Chronic Liver Disease
  Eun-Su Do, Sun-Mi Lee, Young-Sook Seo
  Journal of Digital Convergence.2015; 13(2): 267.     CrossRef

PURPOSE
This study was to develop a Health Dieting Competency (HDC) scale to assess self-rated health dieting competence of college students.
METHODS
The scale was developed as follows: items generated, and tests of validity and reliability. Items were developed through a literature review, review of instruments, and interviews. A panel of four experts reviewed the scale for content validity. Factor analysis, Pearson correlation, descriptive statistics and Cronbach's alpha were used to analyze the data (N=183).
RESULTS
In the preliminary stage, thirty-three items were generated. Final items were fourteen that were selected through exploratory factor analysis. The HDC scale was consisted with five factors and fourteen items that were Goal-Directed (5-items), Health Support (2-items), Health Self-Efficacy (3-items), Health Perception (2-items), and Escaping from Health (2-items). The internal consistency of HDC as measured by Cronbach's alpha was .78.
CONCLUSION
Content validity, construct validity, and reliability of the HDC were established. The HDC scale is a reliable and valid instrument for early adulthood youth who are willing to assess health dieting competency.

PURPOSE
The purpose of this study was to examine the relationships among perceived health, parental stress, social support, and quality of life of grandparent caregivers and to identify the factors influencing quality of their life.
METHODS
A descriptive correlational design was used. The data were collected by questionnaires from a convenience sample of 130 participants taking care of their grandchildren from ten children's daycare centers in Seoul, Korea from August to September, 2013. Data were analyzed using t-test, ANOVA, Pearson's correlation efficients, and multiple regressions.
RESULTS
Perceived health, parental stress and social support were correlated significantly with quality of life. As a result of the multiple regression analysis, education level, age of grandchildren, perceived health, parental stress and social support accounted for 48% of the variance in quality of life. Perceived health, parental stress, and social support were identified as factors influencing quality of life and the variable that most affected quality of life was perceived health.
CONCLUSION
The results of the study indicate that health of people taking care of their grandchildren must be promoted while relieving their parental stress with appropriate social support in order to improve quality of life.

Citations

• Understanding Grandparent Caregiving in Korean and U.S. Culture: An Analysis Using Role Theory
  Youjung Lee, Nancy Mendoza, Sok An
  The International Journal of Aging and Human Development.2024;[Epub]     CrossRef
• Korean Grandparents Raising Grandchildren: The Influence of Cultural Factors
  Youjung Lee, Sok An, Nancy Mendoza
  Journal of Intergenerational Relationships.2024; : 1.     CrossRef
• Intensity of Grandparent Caregiving, Health, and Well-Being in Cultural Context: A Systematic Review
  Athena C Y Chan, Sun-Kyung Lee, Jingchen Zhang, Jasmine Banegas, Scott Marsalis, Abigail H Gewirtz, Patricia C Heyn
  The Gerontologist.2023; 63(5): 851.     CrossRef
• Factors influencing quality of life in caregivers of adolescents with developmental disabilities
  Joung Woo Joung
  Osong Public Health and Research Perspectives.2022; 13(4): 298.     CrossRef
• Caregiver Stress and Related Factors in Korean Households Utilizing Childcare Support by Grandmothers
  Eun‐Jeong Kim
  Asian Social Work and Policy Review.2016; 10(1): 113.     CrossRef

PURPOSE
The purpose of this study was to analyze the effect of sexual attitude among the elderly to their sexual life while exploring the moderating effect of general characteristics in the relationship between sexual attitude and sexual life.
METHODS
A descriptive research design was used. The subjects were 322 married elderly from four silver centers in Seoul and Gangwon-do. Aging Sexuality Attitude Scale developed by White (1982) was used to examine sexual life status and general characteristics of the subjects (gender, age, academic background, religion, economic status, and residential type). For data analysis, chi2-test, t-test, and ANOVA were conducted. Since the dependent variable of sexual life is a binary variable, hierarchical logistic regression was implemented.
RESULTS
There were 180 people (55.9%) who had a sexual life. Depending on gender (chi2=35.03, p<.001), academic background (chi2=29.45, p<.001), and economic status (chi2=7.36, p=.025), the subjects showed significant difference in terms of sexual life. Regarding sexual attitude, the subjects showed significant difference depending on gender (t=-5.47, p<.001), age (t=-2.31, p=.021), academic background (t=5.16, p<.001), economic status (F=3.17, p=.043), and sexual life status (t=4.99, p<.001).
CONCLUSION
It is important to devise the sex education program in consideration of gender, age, and academic background that showed moderating effects.

Citations

• Necessity and methods of sexual education in the elderly population
  Hana Yoon
  Journal of the Korean Medical Association.2019; 62(6): 320.     CrossRef
• Effects of Expressive Sexual Coping Behavior on the Prostitution Attitude of Spouseless Men
  Byeong-Joo Jeon, Keon-Hoo Kim
  Journal of Digital Convergence.2015; 13(2): 13.     CrossRef

PURPOSE
The aim of this study was to identify the effects of auricular acupressure on nausea, vomiting and serum serotonin level in gynecological cancer patients with chemotherapy.
METHODS
The research was a randomized control group pretest-posttest design. Participants were 26 patients for the experimental group, and 26 patients for the control group. Auricular acupressure in Shen men, Occiput, Stomach and Sympathetic points was administered to those in the experimental group. Data were analyzed using chi2-test, t-test, ANCOVA, and repeated measures of ANOVA.
RESULTS
The experimental group had reported significantly lower mean nausea NRS (Number Rating Scale), INVR (Index of Nausea, Vomiting, and Retching), and serum serotonin level than those in the control group.
CONCLUSION
Results of the study show auricular acupressure is an effective nursing intervention for reducing chemotherapy-induced nausea, vomiting and serum serotonin level of gynecological cancer patients.

Citations

• The effect of ear acupressure on sexual functioning among lactating women: A randomized sham controlled trial
  Zainab Alimoardi, Sanaz Barghamadi, Terry Oleson, Mohammad Hossein Ayati, Mark D. Griffiths, Nasim Bahrami
  European Journal of Integrative Medicine.2023; 63: 102285.     CrossRef
• The Effect of Self-Acupressure on Peripheral Neuropathy, Disturbance in Daily Activity, and Quality of Life in Breast Cancer Patients undergoing Chemotherapy
  Su Young Kim, Jeong Sook Park
  Asian Oncology Nursing.2021; 21(3): 129.     CrossRef
• The effects of auricular acupressure on the sleep of the elderly using polysomnography, actigraphy and blood test: Randomized, single-blind, sham control
  Juyon Min, Bomi Kim, Hyojung Park
  Complementary Therapies in Clinical Practice.2021; 45: 101464.     CrossRef
• The effect of ear acupressure (auriculotherapy) on sexual function of lactating women: protocol of a randomized sham controlled trial
  Sanaz Barghamadi, Zainab Alimoardi, Terry Oleson, Nasim Bahrami
  Trials.2020;[Epub]     CrossRef
• Effects of Auricular Acupressure on Women With Irritable Bowel Syndrome
  Gee Youn Go, Hyojung Park
  Gastroenterology Nursing.2020; 43(2): E24.     CrossRef
• Effect of Auricular Acupressure on Nausea, Vomiting, and Retching in Patients with Colorectal Cancer Receiving Chemotherapy
  Nayeon Shin, Jummi Park
  Korean Journal of Adult Nursing.2018; 30(3): 227.     CrossRef

PURPOSE
The purpose of the study was to examine preventive effects of tailored water drinking on orthostatic hypotension and heart rate variability in the elderly.
METHODS
A non-equivalent control group pre and post time-series design was adapted. Among a total of 64 elderly people admitted to two nursing homes, 35 elderly were assigned to the experimental group and 29 were assigned to the control group. As for the elderly people in the experimental group, tailed water drink was provided according to the scheduled time for six weeks. Blood pressure and heart rate were measured twice before the intervention in both groups. The data were analyzed with SPSS program using t-test, chi2-test, and repeated measure of ANOVA.
RESULTS
There were significant differences in blood pressure and heart rate variability between the two groups.
CONCLUSION
Tailored water drinking had preventive effects on decreasing blood pressure fall as well as prevalence of orthostatic hypotension in the elderly people.

Citations

• The Effect of a Biofeedback-Based Integrated Intervention for Older Adults with Orthostatic Hypotension: A Secondary Analysis on Psychological Health Outcomes in a Non-Randomized Pilot Trial
  Nahyun Kim, Jeonghwa Han, Hyunwook Kang
  Healthcare.2024; 12(21): 2143.     CrossRef

PURPOSE
The purpose of this study was to explore the communication experience of intensive care unit (ICU) nurses in the workplace.
METHODS
The present study utilized a qualitative approach using focus group interview method. A total of three focus groups of 15 ICU nurses from two university hospitals were formed. The conversations during the focus group interviews were recorded and analyzed through Colaizzi's phenomenological method.
RESULTS
As a result of analyzing participants' conversation, Five theme clusters were elicited, namely, "one-way communication", "differences in the position of senior and junior nurses", "communication crisis", "beginning of understanding", and "movement toward change" out of 15 themes and 138 significant sentences.
CONCLUSION
ICU nurses report having experienced communication crisis because of the one-way communication of the ICU nursing environment and the hierarchical differences in junior and senior nurses' position. Systematic education and continuous training on communication skills need to be provided to improve interpersonal relationship among nurses and work environment in the ICUs.

Citations

• A Comparison of the Importance, Satisfaction, and Barrier Levels of Communication Performance between Family Members and Staff Nurses in Intensive Care Units
  Haetsal Hong, Myoungock Jang
  Journal of Korean Critical Care Nursing.2025; 18(1): 55.     CrossRef
• Experience of Clinical Adaptation among Nurses in Intensive Care Unit
  Jin Young Hong, Sue Kyung Sohn
  Journal of Korean Critical Care Nursing.2024; 17(1): 1.     CrossRef
• A Survey on Situation-related Communication Educational Needs for Novice Intensive Care Unit Nurses
  Wonjung Hwang, Jeongmin Ha, Dahye Park
  Journal of Korean Critical Care Nursing.2024; 17(1): 17.     CrossRef
• Effects of Personality Traits and Mentalization on Workplace Bullying Experiences among Intensive Care Unit Nurses
  Sun Joo Jang, Eunhye Kim, Haeyoung Lee, Amanda Jane Henderson
  Journal of Nursing Management.2023; 2023: 1.     CrossRef
• Nurses’ experiences of caring for severe COVID-19 patients
  Myoung Mi Kang, Ye Na Park, Seong Young Park, Ju Hyun Kim
  Journal of Korean Critical Care Nursing.2022; 15(2): 14.     CrossRef
• Person-Centered Care Practice, Patient Safety Competence, and Patient Safety Nursing Activities of Nurses Working in Geriatric Hospitals
  Ayoung Huh, Juh Hyun Shin
  International Journal of Environmental Research and Public Health.2021; 18(10): 5169.     CrossRef
• ICU nurses’ experiences of feeling hurt by medical personnel
  Jung-Hoon Lee, Yeoungsuk Song
  The Journal of Korean Academic Society of Nursing Education.2021; 27(4): 347.     CrossRef
• A Study the Relationships among Verbal Violence Experience, Job Stress, and Resilience and the Communication Ability of Operating Room Nurses
  Hyejung Jung, Yoonshin Lee, Sung Hee Shin
  Journal of Korean Academy of Nursing Administration.2020; 26(2): 120.     CrossRef
• The Relationship between the Work Environment and Person-centered Critical Care Nursing for Intensive Care Nurses
  Jiyeon Kang, Yun Mi Lim
  Journal of Korean Critical Care Nursing.2019; 12(2): 73.     CrossRef
• Experience of Communication for Patient Safety by Perioperative Nurses
  Shinae Ahn, Nam-Ju Lee
  Journal of Korean Academy of Nursing Administration.2019; 25(4): 329.     CrossRef
• Emergency department nurses’ experience of performing CPR in South Korea
  Mi-ran Lee, Chiyoung Cha
  International Emergency Nursing.2018; 38: 29.     CrossRef
• Reliability and Validity of the Assessment Tool for Measuring Communication Skills in Nursing Simulation Education
  Hee Mo Yang, Seon Young Hwang
  Korean Journal of Adult Nursing.2016; 28(1): 95.     CrossRef

PURPOSE
The purpose of this study was to identify Compassion Fatigue (CF), Somatization, and Silencing Response (SR) among nurses and understand intermediate effects between the variables.
METHODS
The sample of 240 nurses who were working three shifts in medical and surgical wards, and emergency room were recruited in three hospitals with over 700 beds. A structured questionnaire was used which included CF, Somatization and SR scales. The data were analyzed using descriptive statistics, ANOVA, Pearson's correlation coefficients and stepwise multiple regression.
RESULTS
There were statistically significant differences in CF, Somatization and SR depending on perceived personal health condition, experience of turnover, co-worker support. There were significant correlations between those study variables. The result also indicated that burnout (beta=.81, p<.001) which is a part of Secondary Traumatic Stress and Somatization (beta=.79, p<.001) have the role of partial mediator in the relationship between Secondary Traumatic Stress and Silencing response.
CONCLUSION
The results of study show that an intermediary role by Burnout and Somatization in Silencing response of nurses is important for effective human resource management in hospital nursing staffs. Effective human resource management which includes mentoring and social support system can enhance the professional quality of life of nurses, which will eventually contribute to the quality of care by those care providers and counselors.

Citations

• Nurse Staffing, Work Hours, Mandatory Overtime, and Turnover in Acute Care Hospitals Affect Nurse Job Satisfaction, Intent to Leave, and Burnout: A Cross-Sectional Study
  Sung-Heui Bae
  International Journal of Public Health.2024;[Epub]     CrossRef
• The relationship between psychological resilience and professional quality of life among mental health nurses: a cross-sectional study
  Ohoud Alonazi, Amira Alshowkan, Emad Shdaifat
  BMC Nursing.2023;[Epub]     CrossRef
• Factors Affecting Secondary Traumatic Stress of Nurses Caring for COVID-19 Patients in South Korea
  Mee Sun Lee, Sujin Shin, Eunmin Hong
  International Journal of Environmental Research and Public Health.2021; 18(13): 6843.     CrossRef
• Factors Influencing Depression of Nurses among Comprehensive Nursing Care Service Ward
  Eliza Lee, Sung Sook Chang
  Korean Journal of Occupational Health Nursing.2016; 25(4): 340.     CrossRef
• Effects of emotional labor, job stress and burnout on somatization in nurses : In convergence era
  Yun Jung Oh, Young Hee Choi
  Journal of Digital Convergence.2015; 13(10): 415.     CrossRef

PURPOSE
This study investigated the prevalence of hypertension, explored sleep duration, and examined the related factors to hypertension in Korean middle-aged adults.
METHODS
Using raw data from the Korean National Health and Nutritional Examination Survey (KNHANES) conducted from 2008 to 2010, a secondary analysis was performed with data from 13,230 adults aged 30~64 years. chi2-test and multiple logistic regressions was used for the data analysis.
RESULTS
The prevalence of hypertension among Korean middle-aged adults was 21.8% and 40.3% among participants reported that their average sleep duration was below six hours a night. Risk factors for hypertension include: female (the odds ratio (OR) 1.66 for male), 50~64 years age group (OR 3.66 for 30~49 years age group), education level of elementary school (OR 1.84 for university level), low household income (OR 1.27 for upper), obesity (OR 2.41), high risk drinking (OR 1.64), and sleep duration< or =6 hrs (OR 1.16 for 8 hrs of sleep).
CONCLUSION
High risk population of hypertension could be male, aged, low education, and low income. Obesity, high risk drinking, and short sleep duration should be considered as risk factors for hypertension. Interventions for obesity management, adequate alcohol drinking and sleep duration could be considered for preventing hypertension.

Citations

• Sleep Deficit as a Risk Factor for Hypertension in Korean Adults
  Mi-Joon Lee, Bum-Jeun Seo, Inmyung Song
  Sustainability.2023; 15(3): 2586.     CrossRef
• Relationship between sleep duration and prevalence of hypertension among Korean postmenopausal middle-aged women
  Eun Young Hong, Hye Ja Gu
  Korean Journal of Health Education and Promotion.2023; 40(5): 43.     CrossRef
• The Influence of Health Behaviors and Sleep related Factors on Cognitive Function in the Elderly Hypertensive Patients
  Ahrin Kim, Hae Ok Jeon
  Journal of the Korea Academia-Industrial cooperation Society.2015; 16(10): 7078.     CrossRef