Wyst¸powanie Zespoœu Stresu Pourazowego (PTSD)
Transkrypt
Wyst¸powanie Zespoœu Stresu Pourazowego (PTSD)
ʹͲͳ͵ǢͳͶȋͳȌǣͶͶǦͷʹ Wystpowanie Zespou Stresu Pourazowego (PTSD) w grupie chorych hospitalizowanych w Oddziaach Intensywnej Terapii - doniesienie wstpne Ǧ ȋȌ Ǧ ×ͳǡʹǡǡǡǡÏͳǡǡ ÏÏ ͵ǡǡ Ͷǡ ͳ ʹ¸Ï ͵ ǤǤ Ͷ Streszczenie ¸ǣ ¸¸Ă䩸ÏȋȌ Ï ǡ ¦ ͺΨ ͷͳΨǡ ×ǡä Ï Ǥ ÑǣÏ Ă¦ȋȌ × Ïä Ï Ǥ Ïǣ ¸ ¦ÏʹͶȋαͳͳǡαͳ͵Ȍ¸¦ Ïä ǤcÏ͵ǡ ȋαͻǡͲȌǡäǦͳͷǡͶȋαͳͶǡʹʹȌǡäÏä© ǦͳͶǡͷȋαͳͶǡͳȌǤ ǣ ǡ¦ ¦ä ×Ǧ Ï Ǥ ¸×æ¸ÏÑȋǦȌ ȋͳͻͻȌ¸×ȋǦͳͲȌȋͳͻͺͻȌǤ Ǧ ¸ צ¸ ȋȌǤȋͳͻͷȌǤ ǣ1. × ×ÏͷͺΨǦͳͲǡ ͷͲΨ ǦǤ 2. ¦ ¸ × ǡ Ï ¦ × Ïä ¦ Ïä ¦ Ǥ 3. ĂÏ Ăä© ×Ă Ï ǡ¸Ă ĀäǦ ä©ǡ Ïä Ăä© ×Ǥ 4. Ǧ æ¸ Ѧ ¸ ×Ǥ Sowa kluczoweǣǡǡ Abstract Ǥ ǡȋȌ ǡ ͺΨ ͷͳΨǡ Ǥ Ǥ Ǧ ȋȌ Ǥ Ǥ ʹͶȋαͳͳǡαͳ͵Ȍ Ǥ ͵ǡȋαͻǤͲȌǡͳͷǤͶȋαͳͶǤʹʹȌǡ ͳͶǤͷȋαͳͶǤͳȌǤ Ǧ ǡ Ǥ ȋǦȌȋͳͻͻȌ ȋǦͳͲȌȋͳͻͺͻȌǤ ȋȌǤȋͳͻͷȌ Ǥ ǣ1. ͷͺΨ ǦͳͲǡͷͲΨǦ Ǥ2. ǡ ̹ʹͲͳ͵ ¸ÏȋȌ Ͷͷ Ǥ3. ǡ ǡǦ Ǣ Ǥ4. Ǥ Keywordsǣ ǡ ǡ Wstp ȋȌ ¦ Ǧ ǡä¦ ¦Ǧ ä ǡ Ă ä ¦ǡ Ă Ă ä Ï × ȏͳȐǤ © ¦ ǡĂǦ ä Ǥ ¦ × Ǧ ǣ pobudzenia, unikania i intruzji ȏͳǡʹǡ͵ȐǤ Pobudzenie × ¦ Ǧ ¦ ä ¦ǡ ǡ ¦ ¦ Ā ǡ ȋ ä¸ ǡ ǡ ¦ ä ¦ȌȏͶǡͷǡȐǤ Unikanie ¦Ă ¸ ¦Ă äǡ ©×¦ ǢĂ Ǧ ä ǡ ¦ Ǥ Ï × Ă Ăä© Ă × ǡ Ā Ǧ ä ǡ Ă Ï¦Ǧ ¸ Ă© ȏͶǡͷǡȐǤ ¦intruzjǡ ĂǤ ǡ× Ǧ ǡ¦¸¸ǡ¸¦ ¦ Ă© ǡ Ă äǡ ȏͶǡ ͷǡ ȐǤ ä× ¸ Ǧ × ¦Ă¦ ¸ ¸ ÏȏȐǤ ©ÏĂæ Ǧ Ǧ Ï ǡ Ă Ă Ǥ¸ȋ͵¸ Ȍǡ Ï ȋĂ ͵ ¸ Ȍ ×Ā ¦ ȋ ¦ ¦ Ȍ ȏͳȐǤ ǡ × ¸Ñ¸ ǡ¸ × Ă Ǥ ä× Ǧ צ ¦ Ǧ Ï× ¦ ¦ ¦Ǥ ¸©¦ Ï × Ă Ǧ ¦ ¸ ©Ă×ȏͺȐǡǦ × ȏͻȐÑ Ă ×Ǧ Ï× ȏͳͲȐǤ ä Ǧ ǡ ¸ ¸ Ǧ ¸ × Ă ȏͳͳȐǤ Ï Ă Ă ×ÏǦ ¦ ø¸ǤÏ× × ¸ ǤǤǣ ¦Ǧ ¦ ä Ǧ ǡ Ăä Ǥ × Ǧ ǣä© ¦ǡ¦ ¦ǡ ǡ Ï××Ȃ Ǧ ȏͳͲȐǤ Ï ¦ ĂĂ ǡ ä Ï × ¸ Ă ȏͳʹȐǤ¸ Ǧ ȏͳ͵ǡͳͶȐǤ Celem badania Ï Ă ¦Ǧ ȋȌ × Ïä Ï Ǥ Materia ¸ ʹͶ ȋ α ͳͳ ȋͶͷǡ ͺΨȌǡ α ͳ͵ ȋͷͶǡʹΨȌǡ Ǧ ¦ ʹͲͳʹǤ ͵Ǧͳʹ ¦ Ñ Ǥ Ï Ă ä© ¦ Ǧ ȋʹͲǡͺ͵ΨȌǡ ä ×ȋʹͲǡͺ͵ΨȌǡ ȋͶͳǡΨȌǡ Ï ȋͶǡͳΨȌǡ ȋͺǡ͵͵ΨȌǡ ʹͲͳ͵ǢͳͶȋͳȌǣͶͶǦͷʹ Ͷ Ǥ×ǡǤÏǡǤÏ ǡǤ ȋͶǡͳΨȌǤ c × Ï x α͵ǡ ȋαͻǡͲȌǤ c Ï x αͳͷǡͶ ȋαͳͶǡʹʹȌ Ï ä x αͳͶǡͷȋαͳͶǡͳȌǤ Ïǣ ͳȌ Ï ǡ ʹȌ ͳͺǦͷǡ͵Ȍ ʹǡ ͶȌ Ǥ ¦ ǣͳȌÏǦ ǡ ʹȌ ¸ Ñ Ă¦ ÏǦ ȋ Ñ ¸Ǧ ǡ Ñ ¦ Ï ǡäÏȌǤ Ï ͷ Ï×Ă Ǥ ¸ ʹǦ͵ ¸ ͳ ͳ Ǧ ǤʹͲͳʹͺ ×Ǥ͵͵×Ϧ ¸ÏĂǦ ǡ ʹ × Ï ¸ Ǥ Ï ʹǤ Metoda ¸¦ ¸ ǣ ͳǤKwestionariusz wasnej konstrukcjiǦ ¦ ǡ¦Ǧ ¸ ¸Ǧ ¦ Ï ǡ×Ï © Ǥ Ǧ ǣ ͳǤ Ăä© × Ǧ ʹǤ Ăä© × ͵Ǥ Ăä© × Ă ͶǤĂ ÑͷǤĂ¸Ă ä ¸ Ǥ¦Ï Ǧ Ǥ c© × ͺǤä ͻǤ ÏǦ ͳͲǤ Ă Ǧ ͳͳǤä©ǡ Ïä ͳʹǤ×ͳ͵Ǥ Ăä ¸Ǥ ʹǤ ¸ × ¸ ǣǦǦͳͲǤ a. Zrewidowana Skala Wpywu ZdarzeȋǦȌ ͳͻͻǡ Ñ ÑǦ ȏͳ͵ȐÏĂϸʹʹÑǡ ¸¦ ǣ ¸ǡ Ǧ Ǥ×ĂĂʹͶǤǦ Ăä© Ǥ ʹͲͳ͵ǢͳͶȋͳȌǣͶͶǦͷʹ ĂĂ͵͵Ǥ©Ǧ Ǧ Ǥc × Ă ͳǡͷ ×ȏͳͷȐǤ b. Skala Symptomów Stresu Pourazowego (PTSS-10) ͳͻͺͻǡ ÏǦ Ï ȋ Ǧ × Ȍǡ ÏĂ ä ¸Ă ×ǤϸͳͲǣͳǤ ʹǤ͵ǤȀ ¸¸¸ Ȁ ¸¸ͶǤä©ȀÏ©ǡ ¸ ¸ Ï Ā¸× Ï × ͷǤ¸¸ Ă ǤĂä©ȀÏ ©ǡ Ă© Ïä © Ǥ ¸ ͺǤȀǡ ͻǤ ¸ ¸ ǡ × ¦ ͳͲǤ ¸ ¸äǤ ¦ ¦ Ͳ Ǥǡ ¦ Ǥ Ă ȏͳȐǤ Ͷ Ǥ ¸ ǡ ä ȋ× Ǥ ͵ ǤȌǡ Ă © Ǥ Ͷ Ǥ ¸ ǡ ¸ ȋ× Ǥ ͵Ͷ ǤȌǡ ¦ Ïä ȏͳȐǤ ͵Ǥ Krótk Skal Oceny Stanu Psychicznego (MMSE) × ¸ Ǥ × ȋȌ Ǥ ͳͻͷ Ñ ʹͲͳͲ ǡ Ï Ă ×Ǥ Ă © ͵Ͳ Ǥ Ă ʹ Ǥ ä Ï ¸ Ñ ¸Ǥ ¸ ¸ǡ Ï ĂʹͶǤȏͳͺȐǤ ϸ Ǧ Ϧ ȋ ǦͲʹͷͶȀͶȀʹͲͳ͵ȌǤ Wyniki × Ă ǦͳͲ ǡ Ă Ă ͷͺΨ ȋαͳͶȌ Ï ¦ ͵ͷǤǡ Ǥ c ǦͳͲ Ï ×Ï ͵ǡͺͺ Ǥ ȋαͺǡ͵ͷȌǡ ×Ă Ǧ ¸ ¦ ͵ͺǡͲͻ Ǥ ȋαͷǡͺͻȌ ¸Ă ͵ǡͻ Ǥ ȋαͳͲǡʹ͵Ȍ Ï Ǥ Ă Ǧ ¸¦ ǣ ͳǤ Ͷ ¸ÏȋȌ ǡ ʹǤ ǡ ͻǤ ¸ ¸ ǡ × ¦ Ǥ ä׸à ÏǦ ¸¦ ǣ ͳǤ ǡ Ǥ Ăä©Ȁ Ï ©ǡ Ă© Ïä ©ǡʹǤǤ ¸ ä ¦× ¸ × ǦͳͲ ǡ Ïä ¦ Ïä ¦ ǡ ¦ ¸ Ǧ ǦǤ¦ Ï Ăä ¸Ïä ¦Ǧ ¦ × ȋǤ ǦαͲǡʹȌǤ Ǧ ͳǤ ͳǤǦ Wynik cakowity ȋαͳ͵Ȍ Intruzja X SD X ʹͺǡ͵ͺ ͳͺǡʹ ͳǡͳͺ ¸Ă ĀȋαͳͳȌ ʹǡ͵ ͳʹǡͻͻ Ͳǡͺ ×ÏȋαʹͶȌ ʹǡ͵ ͳͷǡͻ ͳǡͲͻ Pobudzenie SD Unikanie X SD X SD Ͳǡͻͳ ͳǡʹ͵ ͳǡͲͻ ͳǡ͵ͺ Ͳǡ Ͳǡʹ Ͳǡͻͻ Ͳǡ ͳǡʹ Ͳǡͳ ͲǡͺͲ ͳǡͳͶ ͲǡͻͲ ͳǡ͵ͷ Ͳǡͻ × ¸Ă Ǧ ǡ× ¸ä ¸ÏÏǡǦ ǡǦǤ ĂͷͲΨ ÏǦ Ă Ă ʹͶ ǡ ǡ ä ʹͲǡͺ͵Ψ Ï Ă Ă ͵͵ ǡ © Ǥ ¦× ¸ Ă ǣ ǡ Ï©ǡ Ïä© ǡ Ïä© Ǧ ǡ ×Ï Ǧ Ǥ ¦ Ϧ Ăä© ¸ ¦ ×ǦÏä ¦Ïä ¦Ǧ Ǥ¦¸Ǧ ¦ ¸ ǦͳͲǤ ¦¸Ï Ǧ ä Ǥ Ï ǤʹǤ ʹǤ ¦ ¸ × ¦ Ǧ ¦ Wsp. korelacji r- Pearsona Wynik cakowity skali IES-R ǦͲǡͲʹ Ï©ĂÑ ǦͲǡͲͷ Ïä© Ͳǡʹ Ïä© Ͳǡʹ ¦ Ï¸Ă ¦ ¸¦Ǧ Ï ǡ×Ă © ȋÏ Ǥ͵ȌǤ ͵Ǥ ¸¦ Sytuacje traumatyczne wystpujce w OIT ͳǤĂä© × Odpowiedzi TAK ogóem 79,17% K M 76,92% ͺͳǡͺʹΨ ʹǤĂä© × ͷͶǡͳΨ ͶǡͳͷΨ ͵ǡͶΨ ͵ǤĂä© ×Ă ʹǡͷͲΨ 76,92% ͶͷǡͶͷΨ ͶǤĂ Ñ ʹͻǡͳΨ ʹ͵ǡͲͺΨ ͵ǡ͵Ψ ͷǤĂ¸Ă ä ¸ ͵ǡͷͲΨ ͵ͲǡΨ ͶͷǡͶͷΨ ʹͲͳ͵ǢͳͶȋͳȌǣͶͶǦͷʹ Ͷͺ Ǥ×ǡǤÏǡǤÏ ǡǤ Ǥ¦Ï ʹͷǡͲͲΨ ʹ͵ǡͲͺΨ ʹǡʹΨ Ǥc© × ͷͺǡ͵͵Ψ ͷ͵ǡͺͷΨ ͵ǡͶΨ ͺǤä ͷͶǡͳΨ ͷ͵ǡͺͷΨ ͷͶǡͷͷΨ ͻǤ Ï Ͳǡͺ͵Ψ 76,92% ͵ǡͶΨ ͳͲǤ Ă ʹǡͷͲΨ ͶǡͳͷΨ ͺͳǡͺʹΨ ͳͳǤä©ǡ Ïä ͻǡͳΨ ͻǡʹ͵Ψ 90,91% ͳʹǤ× ͵ǡͷͲΨ ͵ͲǡΨ ͶͷǡͶͷΨ Ͳǡͺ͵ ͻǡʹ͵Ψ ʹǡ͵Ψ ͳ͵ǤĂä ¸ Ǥ͵ Ǧ ĂÏ ǷĂǦ ä© × dzǢ ǷĂä© × ĂdzǢ Ƿ Ï dz ȋǡͻʹΨ Ă Ȍǡ ¸Ă Ā ä Ǧ Ƿä© Ïä dz ȋͻͲǡͻͳΨȌǡ ǷĂǦ ä© × dz ȋͺͳǡͺʹΨȌǤ ǣǷ¦ÏǦ dzǡ ǡǡĂ Ñdz ȋ ʹ͵ǡͲͺΨȌ Ƿ¦Ï dz ȋʹǡʹΨȌ ¸Ă Ï Ǥ ¸ ä ¦× ¸ ȋǡ Ï©Ȍ ¦ ȋÏä© ǡÏä© Ȍ ä Ǥ Ǧ ǤͶǤ ͶǤ¦¸ ä ǡǡÏ ¦ĂѦǡÏä ¦ÏǦ ä ¦ wiek pe eska dugo pobytu dugo WM Ͳǡ͵ͳ ͲǡͲ Ͳǡʹͷ Ͳǡʹ Ͳǡ͵Ͳ Ͳǡͳ ǦͲǡͲͳ ǦͲǡͲͳ ͵ǤĂä© ×Ă ǦͲǡͶʹȗ ǦͲǡ͵ʹ Ͳǡʹʹ Ͳǡʹʹ ͶǤĂ Ñ Ͳǡ͵ͷȗ Ͳǡͳͷ Ͳǡͳ͵ ͲǡͳͶ ͷǤĂ¸Ă ä ¸ Ͳǡ͵ʹ Ͳǡͳͷ Ͳǡ͵Ͳ Ͳǡʹͻ Ǥ¦Ï ͲǡͳͶ ͲǡͲͷ ͲǡͲͻ ͲǡͳͲ Ǥc© × ǦͲǡͲ ͲǡͳͲ ͲǡͲ ͲǡͲ ͺǤä ǦͲǡͳʹ ͲǡͲͳ ǦͲǡʹ ǦͲǡʹ ͻǤ Ï ǦͲǡʹͷ ǦͲǡͳͷ ǦͲǡ͵ͷȗ ǦͲǡ͵ͷȗ ͳͲǤ Ă Ͳǡͳ͵ Ͳǡ͵ȗ Ͳǡͳʹ Ͳǡͳʹ ͳͳǤä©ǡ Ïä ͲǡͲͺ Ͳǡʹ ͲǡͶͲȗ ͲǡͶͲȗ ͳʹǤ× Ͳǡͳ Ͳǡͳͷ ͲǡͲʹ ͲǡͲͳ ͳ͵ǤĂä ¸ ǦͲǡʹͳ ͲǡͲͶ ǦͲǡͳͲ ǦͲǡͲͻ Sytuacje traumatyczne ͳǤĂä© × ʹǤĂä© × ȗδͲǡͲͷ ʹͲͳ͵ǢͳͶȋͳȌǣͶͶǦͷʹ ¸ÏȋȌ Ͷͻ Ăä ǡ × ¦¸Ï ä ¸ǣ ͳȌ Ă Ă Ǣ Ă ÑǡʹȌÏ ¦ĂÑ¦Ă Ă ǡ͵ȌÏä ¦ Ïä ¦ ȋȌ Ï Ǧ ȋ Ȍǡ ͶȌ Ïä ¦ Ïä ¦ ȋȌ Ǧ ä ÏÏä Ǥ Omówienie wyników ¦¸ ǡ ǡ × Ǧ Ă × Ï× Ǧ Ǥ ¦ Ǧ × Ǧ × ȋͷͺΨ ǦͳͲǡ ͷͲΨ ǦȌ ¦ ×ǡ © Ăä©ǡøæ×Ăä© ¸ ×Ă Ǥ ¦ Ñ ȏͳͲȐ ǡ Ă ä Ǧ × ä× Ïä Ï ʹʹΨ ȋ ͺΨǦͷͳΨȌǡ ä Ǧ × ¦ © ¸ Ǧ ͳͻΨ ȋ ͳͻΨǦ͵ͻΨȌǤ Ǧ Ï © ¸ ¦Ǧ ʹͲǡͺ͵ΨǤ ĂǡĂĀ Ï × ǡ ¸ Ǧ Ǥ ¦Ă Ï Ǧ ä¸ ¸ ¦ Ă Ă Ǥ ¸ä© × ȋ Ȍ¸ Ǧ ×ǡ ¦Ă ¸ Ăä Ǥ Ǧ ¦ ¸ Ï ¦ × × Ǥ ¸ä© Ñ ¦ ¸ ¸ Ï × ȏͳͻǡʹͲǡʹͳǡʹʹǡʹ͵ǡʹͶȐǤ ¦ Ǧ ¦ ×Ă ¸Ï ¦ Ǧ × Ï Ï ä© Ǥ ǡ ¸ ¸Ă ǡĂä© Ï Ǥ Ă ¸ ¦© ¦ Ă Ï Ǧ Ï ¦ Ǥ ¸ Ï Ï ǡ ¦ ¸ Ǧ Ă Ǥ Ă Ï Ăä© Ă ǡ ¦ ǡ Ă Ï ǡ ǡ Ǥ ¸Ă ä© Ï ä© Ïä ǡ¦ ¸Ǧ Ǥ } Ă Ǧ ¸ Ă ǡ ¦¦ Ǧ ¸ Ï × Ï ǡ Ǥ Ïä ¦Ïä ¦Ǧ Ï ä Ïä ¦ ¦ Ǧ ǡ ĂÏ ¸ Ï Ǥ Ăǡ Ă ¸ ǡ Ǥ Ă Ï Ă © ϸ ÏĂ Ǥ Ï Ăä© Ă Ă Ïǡ ©ǡæà ÏǤ Ă Ï Ă¦ ¸ Ñǣ ¸ Ï ǡ ǡ ǡ ¦ ¸ Ǥ Ï ¸ Ă Ǧ ×ǡ ¦ Ǧ ǡ Ăä Ǧ ¸ ȏͳͻǡʹͲǡʹ͵ǡʹȐǤ × Ǧ Ă ¸ ¦Ǧ ¦ ȏͳͻǡʹͺȐǤ Ñ Ï ¦ Ǧ × × Ǧ Ǧ ʹͲͳ͵ǢͳͶȋͳȌǣͶͶǦͷʹ ͷͲ Ǥ×ǡǤÏǡǤÏ ǡǤ × ¦ Ǧ ȏͳȐǤ ÏÏ Ǥ ¦ ¸ ĂǦ ¦ ¸ Ǥ ¸ Ǧ ǣ ͳȌ × ¦ Ï ¦ Ǥ Ǧ ȏͳͻǡʹͳȐǡʹȌ× ¦×¦ Ǥ × ȋ ȌȏͳͲȐ͵Ȍ× ¦ Ï × Ăä© ¦Ǥ Ǥ ¦ Ǧ ¸ ¸ Ǧ × ¸ ¸ Ă Ǧ Ǥ ¸ Ȃ Ǧ Ă ¦¦ Ϧ ä© Ǧ ǡ Ă ×ĂÏ ǡ×ĂǦ © Ï Ǥ ¦ × Ï× Ï¦ Ǧ ÑǤ × ǡ ĂÏ © ¸¦ ¸ Ǧ צ ¸ ǡ¦ÏǦ ÑǤĂä©ǡ Ă Ă © ¸ ¸ ǤǦ Ïä ¸©¸Ă Ǧ ¦ ¸ ǡ Ϧ ¦ × Ǥ Ñǡ ¦ ¸ × ǡ ä© × Ǥ Wnioski ä© Ïä Ăä© ×Ǥ ͶǤ Ǧ æ¸ Ǧ Ñ ¦ ¸ Ǧ ×Ǥ References ͳǤ Ǥ Ǧ Ǥ ȋ Ͷ ǤȌǤ Ǧ ǣǤǤǢʹͲͲͲǡǦͳ͵ǣ ͻͺͲͺͻͲͶʹͲʹͷǤ ʹǤ Ǥ Ǧ Ǥ ȋͶ ǤȌǤ ǣ ǤǤǢͳͻͻͶǡǣͲǦͺͻͲͶʹͲʹͻǤ ͵Ǥ Ǥ×ÏȂǦ ǡ Ǥ ǤǡͳͻͻͷǢʹͻǣͷͳǦǤ ͶǤ Ǥ ¸Ă Ǧ Ǥ ǣ ĂÑ Ǥǡ Ǥǡ × Ǥ ȋǤȌǤ Ǧ ǤǤ ÏǣƬǢʹͲͳͳǡ ǣͻͺǦͺ͵ͲͻͳͲͺ ͷǤ Ǥǡ Ǥǡ Ǥ ×Ï Ǥ ǣ ǡ Ǥǡ Ǥǡ Ǥ ȋǤȌǤ Ǥ ȋǤȌǤ Ǥ ä Ǧ Ǥ ǦǤ ǣ Ǣ ʹͲͳͳǡ ǣ ͻͺǦͺ͵ͷ͵Ͳͻͷ Ǥ ǤǡǤ¸ǤǣǤǡ Ǥǡ Ǥ ȋǤȌǤ Ǥ Ǥ Ïǣ ƬǢʹͲͲͺǡǣͻͺǦͺ͵ͲͻͲʹͶͷ Ǥ Ǥ Ǥ Ǥ ͺǤ Ǥǡ Ǥ ×Ï Ñ Ǧ ǤǡͳͻͺǢ͵ȀͶǣͳǦͻǤ ǡ Ă×Ǥ ǡ ʹͲͲͳǢͷʹǢ͵ǢͳȄͳͺ͵Ǥ ͻǤ ÏǤǡ ǤÏ ǤǤǤǤǡʹͲͳͳǡ ǡͳͺʹǡͻǦͻͻǤ ͳͲǤ Ǥǡ Ǥǡ Ǥǡ Ǥǡ Ǧ Ǥ ͳǤ × ×ÏͷͺΨǦͳͲǡͷͲΨ ǦǤ ʹǤ ¦ ¸Ǧ × ǡ Ï ¦ × ǡÏä ¦ Ǧ Ǥ ͵Ǥ ĂÏ Ăä© × Ă Ï ǡ¸Ă Āä ǣ Ǥ Ǧ Ǥ ʹͲͲͺǢ͵ͲǣͶʹͳȂͶ͵ͶǤ ͳͳǤ ǤǡǤ ǣ ʹͲͲʹǤǤ Ǥ ʹͲͲ͵Ǣ ʹͻǣ͵ͺȂǤ ͳʹǤ Ǥǡ Ǥǡ Ǥ Ǥ Ǥ ʹͲͲͲǢ ͺǣ ͻȂ ͻͶǤ ͳ͵Ǥ ǤǡǤǡ ǤǡǤǡ Ǥǡ Ǥ Ǧ Ǧ ǣǦ ʹͲͳ͵ǢͳͶȋͳȌǣͶͶǦͷʹ ¸ÏȋȌ Ǥ Ǥ ʹͲͲǢ ͳͳǣ ʹǤ ǣ ͳͲǤͳͳͺȀ ͷͲ ͷͳ ʹʹǤ ǤǡǤǡ Ǥǡ ǤǡǤǡ Ǥǡ Ǥǡ Ǥǡ Ǥ ͳͶǤ Ǥǡ ǤǡǤǡǤ Ǧ Ǧ ǣ ǣ ǤǤʹͲͲǢ ͵͵ǣͳͷͲȂͳͺǤ ͳͷǤ ÑǤǡÑǦǤÑ Ǧ ÏÑǤ ǡʹͲͲͻǢȋͳȌǣͳͷǦʹͷǤ ͳǤ ǡ Ǥ ̵ ǣ ǡ Ǥ ǡͳͻͺͻǢͺͲȋ͵ͷͷǡȌǡ͵ǦʹǤ ǤǤʹͲͲǢͳͳǣʹͺǤ ʹ͵Ǥ Ǥǡ ǤǡǤǡǤ Ǥ Ǧ Ǥ ʹͲͲǢͳʹǣͷȂͶǤ ʹͶǤ ǤǡǤǡǤ Ǧ Ǥ Ǥ ʹͲͲͷǢ Ͳǣ ͳͲͺͷȂͻʹǤ ʹͷǤ ǤǡǤǡǤǡ ǤǡǤǡ ͳǤ Ǥǡ Ǥǡ Ǥǡ Ǥ Ǥǡ¡ǤǡǤǡ Ǥǡ ǡ Ǧ Ǥ Ǧ Ǧ Ǧ ǣ ͺǦ ǤǤͳͻͻͻǢʹǣ Ǥ ǤʹͲͳ͵ǢǢ ͳǣͻǦͺͲǤ ʹͺȂͺ͵Ǥ ʹǤ Ǥǡ Ǥǡ ǤǡǤǡ ͳͺǤ Ñ Ǥǣ Ǥ × ǡ Ǥ ǡ Ǧ Ǥ ʹͲͳͲǤ Ǥ ʹͲͲͳǢʹͻǣͷ͵ȂͺͲǤ ͳͻǤ Ǥǡ Ǥǡ Ǥ Ǧ ʹǤ Ǥǡ Ǥǡ Ǥǡ Ǥǡ Ǧ Ǥ Ǧ ǤǡǤ Ǧ ǤͳͻͻͺǢͳͶǣͳͲͺȂͳǤ Ǧ ʹͲǤ Ǥǡ Ǥǡ Ǥ Ǥ ǤʹͲͲͳǢͷͲǣͻͺȂͺͷǤ ʹͺǤ Ǥǡ Ǥǡ Ǥ ǣ ʹǦ Ǧ Ǥ ǤʹͲͲͳǢͷǣͻȂͳͶǤ Ǥ ǤʹͲͲǢͷͳǣͳȂͺǤ ʹͳǤ Ǥǡ Ǥǡ Ǥǡ Ǥ Ǧ Correspondence addres ǤǤʹͲͲͶǢ͵ͲǣͶͷͲȂ × ͷͷǤ ̷Ǥ ʹͲͳ͵ǢͳͶȋͳȌǣͶͶǦͷʹ