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DOCUMENT RESUME ED 106 728 CG 009 794 AUTHOR Frank, Harold H.; Katcher, Aaron H. TITLE The Socialization of Freshwomen Medical Students. PUB DATE [75] NOTE 40p.; Presented at the Annual Meeting of the American Educational Research Association (Washington, D.C., March 30-April 3, 1974; Figure 1 and Exhibit 1 are copy-righted and therefore not available. They are not included in the pagination EDRS PRICE MF-$0.76 HC-$1.95 PLUS POSTAGE DESCRIPTORS *Females; Group Dynamics; *Medical Students; Peer Relationship; Research Projects; *Role Perception; *Self Actualization; *Socialization; Speeches ABSTRACT The purpose of this paper was to show how women medical students are socialized into their student role. The sample group was made up of 24 groups of six medical students, up to half of whoa were women. The data were collected from responses to a questionnaire administered to the members of each group at the beginning of the semester and again at the end. The findings indicated that a solo woman poses the greatest threat to the security and stability of a formerly all-sale group, and as such is subject to intense peer pressure to assume a low profile. A group with several women poses a somewhat different situation. Two women in a group do not necessarily fora a supportive dyad, as the men in the group may succeed in dividing the women thereby minimizing the threat. Groups with three women seem to offer the greatest potential for self-actualization by women. The authors recommend that faculty responsible for forming mixed-sex groups of medical students do so, where feasible, in approximately equal numbers of men and women. (Author/PC)

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Page 1: DOCUMENT RESUME ED 106 728 CG 009 794 Frank, Harold H ... · The questionnaire was developed by Robert Freed Bales of the Department of Social Relations at Harvard University. It

DOCUMENT RESUME

ED 106 728 CG 009 794

AUTHOR Frank, Harold H.; Katcher, Aaron H.TITLE The Socialization of Freshwomen Medical Students.PUB DATE [75]NOTE 40p.; Presented at the Annual Meeting of the American

Educational Research Association (Washington, D.C.,March 30-April 3, 1974; Figure 1 and Exhibit 1 arecopy-righted and therefore not available. They arenot included in the pagination

EDRS PRICE MF-$0.76 HC-$1.95 PLUS POSTAGEDESCRIPTORS *Females; Group Dynamics; *Medical Students; Peer

Relationship; Research Projects; *Role Perception;*Self Actualization; *Socialization; Speeches

ABSTRACTThe purpose of this paper was to show how women

medical students are socialized into their student role. The samplegroup was made up of 24 groups of six medical students, up to half ofwhoa were women. The data were collected from responses to aquestionnaire administered to the members of each group at thebeginning of the semester and again at the end. The findingsindicated that a solo woman poses the greatest threat to the securityand stability of a formerly all-sale group, and as such is subject tointense peer pressure to assume a low profile. A group with severalwomen poses a somewhat different situation. Two women in a group donot necessarily fora a supportive dyad, as the men in the group maysucceed in dividing the women thereby minimizing the threat. Groupswith three women seem to offer the greatest potential forself-actualization by women. The authors recommend that facultyresponsible for forming mixed-sex groups of medical students do so,where feasible, in approximately equal numbers of men and women.(Author/PC)

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o\

0

U

U S DEPARTMENT OF HEALTH.EDUCATION & WELFARENATIONAL INSTITUTE OF

EDUCATIONTHIS DOCUMENT HAS BEEN REPRODUCED EXACTLY AS RECEIVID FROMTHE PERSON OR ORGANIZATION ORIGINA T 'NG IT PC.N TS OF VIEW OR OPINIONSSTATED DO NOT NECESSARILY REPRESENT 01,4 ICIAL N..TIONAL INSTITUTE OFEDUCATION POSITION OR POLICY

"The Socialization of Freshwomen Medical Students"

by Harold H. Frank, Ph.D. and Aaron 71. Katcher, M.D.1*

INTRODUCTION

An old riddle recently enjoying new popularity poses the following

problem: a man and his son are involved in an automobile accident. The

father is killed, and the injured son is rushed to the hospital and into

emergency surgery. The doctor called upon to operate takes one look at the

boy, and announces: "I cannot perform surgery on this patient, he's my son!"

How can this be? (See footnote 2 for the answer.)

The point of this conundrum is to present an example of conditioned

thinking regarding women in the professions, the medical profession in

particular. Traditionally considered the province of the male of the species,

(Merton, 1957) the study of medicine today is much more sexually integrated

than it was even three years ago. Still, women medical students--and

women doctors--will find themselves a conspicuous professional minority

for years to come. Women may no longer be confronted with a sexual barrier

when applying to medical school, but once admitted may become the victims

of their male counterparts' traditional and outmoded "men only" orientation.

PURPOSE AND METHOD

The purpose of this paper is to shOW how women medical students are

socialized into their student role. Considerable research has been conducted

on the problems faced by women seeking to enter the professions (Epstein

1970, Soule and Standley 1973, Theodore 1971) and on the d4fficulties they

encounter in institutions of higher learning (Lever and Schwartz 1971), but

*The authors wish to acknowledge the very considerable contribution ofpaniel Osborne, Wharton Graduate School, in the preparation and analysis

of the data presented in this par.,:r.

2

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2.

comparitively little attention has been directed toward peer perceptions,

and the means Ch_ough which they become translated into socialization

patterns. In one recent study, Wolman and Frank (1975) reported observa-

tions made of three groups of psychiatric residents and three groups of

master's candidates in business administration, each containing solo women.

They reported that those women who sought positions of influence by competing

openly with men were subjected to intense pressure and ultimate exclusion

from the mainstream of group interaction, while those who avoided direct

competition were incorporated within the group structure. To investigate

the problem more fully we studied twenty-four groups of six medical students,

one to three of whom were women, at the Medical School of the University of

Fennsylv'ania. The setting was a gross anatomy laboratory in which each

group performed various dissections on a prepared laboratory specimen

throughout the semester.

The data for our study came from the responses to a questionnaire

administered to the members of each group at the beginning of the semester,

and again shortly after its completion. Each student was asked to complete

one questionnaire for each member of the dissection team including him/her

self. Thus, a group of six students would generate thirty-six (6x6)

questionnaires on each occasion.

A Model of Group Behavior

The questionnaire was developed by Robert Freed Bales of the

Department of Social Relations at Harvard University. It came about as a

result of his pioneering work in interaction process analysis (IPA), a

method of classifying interactions between members of groups based on how

3

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they communicate with each other rather than what they communicate.3

Building on data collected through IPA, Bales constructed a model of group

behavior by placing the dimensions of dominance, friendliness and orieata-

tion toward the task in orthogonal relationship (i.e. at riet angles to

one another) to form a three-dimensional space. Each dimension or axis has

two end points and a common center. Taken one, two or three at a time, the

end points of the axes can be combined to produce twenty-seven separate

positions in-iiir:7pace. (See Figure 1 below.)Because of copyright, Figure1 has been removed from this

p********************** Document.oY

Insert Figure 1 Here************************

For ease of conceptualization, Bales named the dimensions for their

position in the space. Thus dominance is upward, submission downward;

friendliness positive and unfriendliness negative, following the convention

for the horizontal axis in mathematical graphs; and task-orientation forward,

counter or non taskorientation backward.

Aided by his student and research assistant, Arthur S. Couch, 4

a series of factor analyses were performed which resulted in separate social

psychological profiles for each of the twenty-seven positions in the space.5

These were given descriptive titles, such as "Type U: Toward Material

Success and Power, Type P: Toward Equalitarianism, Type UP: Toward Social

Success," and so on.

Questions associated with each type (with the exception of "Type

AVE," which is located at the zero point, or intersection of the three axes),

were formulated into a twenty-six Item questionnaire (see Exhibit 1 below).

f4

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*************************

.1! Insert Exhibit 1 Here***********************11

4.

Because of Copyright, Exhibit1 has been removed from thisdocument.

Hypotheses

While the principles underlying the group space are statistically

based,6

our primary concern was with the practical application of the theory

and the resultant spatial positioning of the women in the groups. Based on

a study by Wolman and Frank entitled, "The Solo Woman in a Professional

Peer Group (1975)," we hypothesized that solo women would succumb to

pressures to be friendly, task-oriented and non-assertive, behaviors associated

with long standing stereotypes for female behavior, rather than face exclusion

from the matrix of social interaction within the dissection teams if they did

not. Further, we hypothesized that women in groups containing more than one

woman would be resistent to such pressures, and would sustain a higher level

of assertive behavior than their solo counterparts.

RESULTS

We administered the Bales questionnaires (form A)7 at the start and

at the end of the semester to twenty-four six-person anatomy dissection

groups. Twelve contained only one woman eight two women, and the remaining

four three women.8

Table 1 shows the 27 Bales types and the percentages of men and

women found in each one at T1and T

2.At T1, 62% of the 104 men and 45% of

p*******************n: Insert Table I Here**********************

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the 40 women were rated UPF; 8.5% of the men and 15% of the women were

described as UP. Also at T1, 5.5% of the men and 17% of the women received

the PF rating, and 7.6% of the men and 10% of the women were seen as type

DPF. In other words, at T1

over 80% of the men apd 70% of the women were

perceived as "dominant;" 90% of the men and 100% of the women were perceived

as "friendly," and 82% of the men and 72% of the women were considered

"task-oriented." In sum the categories of UP, UPF, UPB, PF and DPF

accounted for 86% of all men and 95% of all women at T1.

At T2, 42% of the men and women were perceived as being type UPF; 13%

of the men and 5% of the women, in a little about-face, were seen as type

UP, and 13% of both the men and women were considered UPB. In the DPF

category, both men and women maintained the percentages they posted at T1;

7.6 and 10%, respectively. To summarize, at T2 77% of the men and 69% of

the women were considered "dominant," 84% of the men and 92% of the women

were perceived as "friendly," and 60% of the men and 63% of the women were

regarded as "task-oriented." Table 2 shows the aggregate percentage on these

three dimensions for men and women for each administration of the questionnaire.

p********** *********f4

* Insert Table 2 Here'i-ic*******************a

In general, the group members, who were 70% male, occupied the up-

ward, positive forward part of the space at T1 and T2. A larger proportion

of men than women were located upward in the space and there was no signifi-

cant change in these proportions across the time periods. Conversely, a

larger proportion of men than of women were perceived in the positive part of

the space, but there was a slightly significant drop in the proportions

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6.

located there for both groups at T2. A significantly smaller proportion of

women than of in were perceived as task-oriented at T1, while at T2 the

differences between mien and women in task-orientation were not significant- -

a result of a significant drop in task-orientation by the males, and a

moderately significant drop by the females.

What Table 2 does not show is the direction and magnitude of

the change in the group =embers levels of dominant (U/D), friendly (P/N)

and task oriented (F/B) behavior as a function of the number of women in a

group. To make this determination we divided the twenty-four groups into

three sections based on the number of women they contained. The twelve groups

in Section 1 each have one woman, the eight in Section 2 have two women, and

the four in Section 3 have three women. Exhibit 3 shows our findings.

**********************t

* Insert Table 3 Here :***********************

We found the men in the groups in Section 1 were generally per-

ceived as type UPF at both T1 and T2, as shown under the sub-heading

"SOLO WOMAN" under the general heading "POSITION." However, the general

movement of the men was actually in the direction of greater dominance

and less task-orientation, with no change in friendliness. The solo

women, meanwhile, were also generally perceived as type UPF at both T1 and

T2, but their movement was in the direction of less dominance and more

task orientation, again with no change in friendliness. In sum, the solo

women and the men in their groups moved in opposite directions on the IJ & F

axes but remained within the upward, positive forward part of the space.

7

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7.

In Section 2 groups, the men were again perceived as type UPF at

T1 and T2, but their movement was actually in the DNB direction; that is,

toward submissiveness, unfriendliness, and non task-orientation. The two

women in each of the eight groups in Section 2 were seen as UPF at T1, but

as UPB at T2. Their movement, like that of the men in their groups, was

regressive across all three dimensions. They became less dominant, more

unfriendly, and considerably non task-oriented.

Finally, we cume to Section 3: the men are once again perceived

as type UPF at T1, and at T2. Their general movement, however, is toward

greater dominance, ]ess friendliness, and greater task-orientation. Table

4 below summarizes these findings.

************************

-u Insert Figure 4 Heret**********************4

Solo Women

Our hypothesis that dominant behavior on the part of a woman would

lead to her isolation frcm the group is partly supported by evidence from

our study. Using the mean level of the males' dominance as a reference

point, we found that relatively more dominant behavior on the part of the

females led to exclusion from the group (i.e. deviant or isolate status),

whereas relatively less dominant behavior led to inclusion. This was

determined by counting the number of linkages to other members in the group

space. In only four of the 24 groups we studied did the llvel of male-female

interaction increase over time. These four groups (Groups 2, 5, 8, and 20,

see Appendix I) each had one woman as a member. The woman in these groups

was generally perceived at T1 as type UP and at T2 as type UPF. Her movement over

time was slightly in the direction of greater dominance and strongly toward

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8.

task- orienatior.. The men in these groups were perceived as UPF at both

T1 and T2, and their movement was toward somewhat more friendliness and

strongly away from task-orientation.

That these groups did indeed maintain and increase male-female

interaction may be explained by the fact that, on average, the men in them

were perceived as being much more dominant than their women colleagues, at

both T1 and T2. At T1, the woman wre perceived as being more friendly

and less task-oriel. d than the men; at T2, the women were perceived both

as somewhat friendlier and more task-oriented than the men. The dominance

issue, then, seems to be the key to close male-female interaction. It

appears that greater male-female interaction is possible so long as there

is a man in the group who is more dominant than the group's women. Consider

these /epresentative graphs, depicting the interaction in the groups we

have been discussing (see Appendix I, Groups 2, 5, 6, 8, 20, and 34).

Multiple Women

In those groups with multiple women, however, male-female inter-

action did not increase significantly; in fact, it lessened. Referring

again to Exhibit 4, we see that both men and women in the two-women groups

tended to become less dominant, less friendly, and less taskoriented over

time. Analysis at T1 shows that on average, the men were more dominant and

more task-oriented than the women, while the women were friendlier. At T2,

the men were still more dominant, but the women were friendlier and more task-

oriented than the men. It appears that the presence of two women in a group

makes for an unstable situation, as malt- female, male-male and female - female

interaction all broke down. (Group 3 from Section 2 is representative of

their phenomenon, see Appendix I.)

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9.

In groups with three women, both men and women became more dominant

over time. The women became less friendly aL.,1 more task-oriented, while

the men became less task-oriented. Analysis again reveals that on average,

men were perceived as being considerably more dominant and less friendly

at both TI and T2, while the women became more task-oriented at T2. Although

male-male and male-female interactions suffered net decreases, female-female

interactiens increased. It appears that the addition of a third woman to a

group provides the impetus for solidarity among the women and the basis to

function independently of the men. (Group 36--Appendix I, illustrates this

situation quite well.)

SUM NARY

To summarize our findings briefly: a solo woman poses the greatest

threat to the security and stability of a formerly all-male group, and as

such is subject to intense peer pressure to assume a low profile. If she

does this, the solo woman stands a good chance of being integrated into

the group. If she persists in showing what are perceived as assertive and

non task-oriented behaviors, she will be forced into deviant9 or isolate

status. (An example of deviancy is given in Groups 1 and 14; Groups 5, 8,

18 and 37 provide example. of isolation--Appendix I.)

A group with mul iple women poses a somewhat different situation.

Two women in a group do not necessarily form a supportive dyad resistent to

the imposition of male-determined norms. The men in the group may succeed

in dividing the women thereby minimizing the threat they pose to a caste-like

status hierarchy based on maleness.

10

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10.

Groups with three women seem to offer the greatest potential for

self-actualization by women since the formation of a sub-group relatively

resistent to male peer pressure is likely. Equal numbers of men and women

seem to force acceptance of women by the men either on an equal, or "separate

but equal" basis.

CONCLUSION

We conclude by recommending tbat faculty responsible for forming

mixed-sex groups of medical students do so in approximately equal numbers

of men and women. A solo woman too often is made the focus of male hostility

as a result of her determination to do as good a job as a man expects to do.

Her frustration is unfortunate and unnecessary. However, a change in men's

attitudes towards women competitors, and an incr3ase in the numbers of

women in medicine will both take time to come about. Until then, our

advice to wmen who find themselves in untenable positions is to decide

which is the easier pill to swallow: withholding assertive behavior to

maintain peer membership, or expressing assertiveness and facing the prospect

of a deviant or isolate membership status.

In pursuing this research we have been greatly influenced by

Margaret A. Campbell, , and her pioneering work on discrimination towards

women in medical schools aptly titled: Why Should A Girl Go Into Medicine

01973). In the foreword she states:

We all know that discrimination against women exists,

although we sometimes deny that 't.nowledge because

discrimination is painful to experience. Trying to change

the sources of discrimination is a long, hard process,

11

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11.

and in the meantime we must keep from being destroyed

or poisoned as a consequence of what some people would

have us think about ourselves. I believe the first three

lines of defense are (1) information about the specific

forms of discrimination in any situation, so we are

never taken by surprise, (2) an under,tanding of

ourselves and how we react to discriminatory attitudes

and practices, and (3) strong support of each other,

in formal or informal networks (p. 1).

We hope that this research will help women maintain and develop

their gender identity while they acquire the social and technical skills

necessary to become competent and productive physicians.

17

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FOOTNOTES

1. Dr. Frank is Assistant Professor of Management, the Wharton School and

Assistant Professor of Group Dynamics in Psychiatry, the School of

Medicine. Dr. Katcher is Associate Professor of Psychiatry, the School

of Medicine and the School of Dental Medicine, University of Pennsylvania.

2. The doctor is the boy's mother.

3. The IPA categories are: 1. Seems Freindly, 2. Dramatizes, 3. Agrees,

4. Gives Suggestions, 5. Gives Opinion, 6. Gives Information, 7. Asks

for Information, 8. Asks for Opinion, 9. Asks for Suggestion, 10.

Disagrees, 11. Shows Tension, 12. Seems Unfriendly. See pp. 96-97

of the Bales (1970) text for tables showing the relationship between

the categories and positions in the group space.

4. Bales (1970), Acknowledgements, p. x.

5. Bales (1970), Part II: Types of Group Roles and Their Value-Directions,

pp. 189-388.

6. Bales (1970), Appendix 5, p. 492.

7. Bales (1970), p. 6. Two other versions of the questionnaires are included

within the text (pp. 12-13), these can be combined or used separately to

locate persons in the space (see Chapter 3: A Spatial Model of Group

Structure, pp. 30-50).

8. We are greatly indebted to Dr. Jean Piatt, Professor of Anatomy at

the University of Pennsylvania School of Medicine for his help in

constructing the dissection teams along the gender lines we specified.

9. The term deviant .a used here to refer to a membership role that is

perceived to depart in some, but not all respects with the consensus among

the members of appropriate member behavior.

13

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13.

10. The numbers used to identify groups are those found on the

dissection tables, and should not be confused with the total nueaer

of groups studied, which was twenty-four.

14

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14.

REFERENCES

1. Bales, R. F., Personality and Interpersonal Behavior, New York: Holt,

Rinehart and Winston, 1970.

2. Campbell, M.A., Why Should A Girl Go Into Medicine, New York: Ann O'Shea,

Dept. SL, 320 West End Avenue, Apt. 6B, N.Y., N.Y. 10023 ($2.00).

3. Epstein, C.F., Woman's Place: Options and Limits in Professional Careers,

Berkeley and Los Angeles: University of California Press, 1970.

4. Lever, JI-artd Schwartz, P., Women at Yale, Indianapolis: The Bobbs-

Merrill Co., Inc., 1971.

5. Merton, R.K. et al., Thn Student-rhy0einn: introductory Studies in the

Sociology of Medical Education, Cambridge: Harvard University Press,

1957.

6. Soule, B. and Standley, K., "Perceptions of Sex Discrimination in Law,"

American Bar Association Journal, October 1973, 59, 1144-1147.

7. Theodore, A. (Ed.) The Professional Women, Cambridge: Schenkman Publishing

Co., Inc.

8. Wolman C. and Frank H., "The Solo Women in a Professional Peer Group,"

American Journal of Orthopsychiatry, January 1975, 45 (1), 164-171.

15

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UUP

UPF

OF

UNF

UN

UNB

UB

UPB

PPF

FNF

NNB

BPB

DP

DPF

DF

DNF

DN

DNB

DB

DPB

DAVE

Ml

18.5

62

31

22

2

10

17Mill

111

2

III

7.6

10

1

.

3 2Wl

15

45

13

42

12

14

1

.

13

.

12

21

III

2.8

7.6

12

W2

542

35

13

1111

85

10

5

TABLE 1:

Comparison Between Men and Women, TI and T2, Across theTwenty-Seven Positions in the Bales Space

(all figures in percent--horizontal totals

= 100%)

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DOMINANT (U/D)

1

FRIENDLY (P/N)

TASK-ORIENTED (F/B)

il

Male

Female

1

Male

Female

iMale

Female

72

100

82

70

90

ftmmoirmj

T1

80

T2

77

69

84

92

60

63

k

TABLE 2:

Aggregate Distribution of Males and Females in the Dominant, Friendly and Task-Oriented

Portion of the Group Space for T1and T2.

(all figures in percent)

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TYPE OF

GROUP

MOVEMENT (T1-91` T2)

POSITION (T1-----3'T2)

Solo Woman

Multiple Women

Solo Woman

Multile Women

FT1

T2

T1

T2

MEN

.

0-

WN

AV

NT

IO.1

1,7T

- I

TIN

IMM

IRM

NIM

MO

INIII

IIM

UPF

T11

171M

il.11

1111

.1.,

UPF

UPF

UPF

3UP?

UPF

WOMEN

-0

+-

-

UPF

UPF

UPF

UPF

-+

1

3UPF

UPF

TABLE 3:

Comparison Across the Bales Axes By Number of Women

in a Group for Men and Women

T1-2' T2.

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PERCEPTIONS OF MEN AND

DOMINANCE (U/D)

WOMEN:

1

-1-1----:,

T2

FRIENDLINESS

( ) = women

(P/N)

CONCERN FOR TASK (F/B)

(+)

12 Groups;

1 woman each

+ (-)

0 (0)

8 Groups

2 women each

(-)

(-)

.

(-)

4 Groups;

3 women each

+ (+)

0

(-)

(+)

TABLE 4:

Movement on the Bales Axes for Men and Women by Number of Women in a Group

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Appendix 1*

Graphs Showing Group Interaction TI and T?: U/D (Dominance/Submission) and

F/B (Task-Oriented/Non Task-Oriented) Axes

Group NumberPage NumberTI T2

1 1 2

2 3 4

5 5 6

6 7 8

8 9 10

141]. 12

18 13 14

20 15 16

34 17 18

37 19 20

*Page numbers refer to the pages of this appendix only.

20

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0 dVM VOA

-00'5

00'4

_ 00'£ _

00'Z

._ 00T _ _ ____

*+

+I

II

II

.1

II

II

II

iI

II

I -

I.1.

L1

11

.1

11

1I

II

1I

++

+-

++

4+

+I

II

II

I_

II

1I

I_ __ __

_I

11

I1

II

_1

11_

_1._______

1___ __

++

++

+

II

1I

1

I1

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