tinnitus today december 1993 vol 18, no 4

7/30/2019 Tinnitus Today December 1993 Vol 18, No 4

1/27

DLMLJHLX ?33= YKN\JL ?2. E\JHLX 4

Tceectus TkdoyTBL @K\XEON KI TBL OJLXCMOE TCEECT\] O]]KMCOT CKE(Tk morry ke oed suppkrt rlslormb oed ldumotckeon omtcvctcls rlnotcegtk tbl trlotjlet ki tceectus oed ktblr dlilmts kr dcslosls ki tbl lor%(

Ce tbcs cssul0Ledceg tbl ]cnleml0 Tbl Nkwdkwe ke Ontlreotcvl Trlotjlets


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]VLMCON VCNNKW MOEXLNCLYL LOX EKC]L]OED OCD ]NLLV

Skur snllpceg bohct joy hl rkhhceg yku ki oprkplr ecgbt's snllp% Tbl Lor Xlnoxlr moe mboegl ykurncil% Oustce ]aoggs. tbl cevletkr ki tbl Lor XlnoxlrVcnnkw. rlpkrts tbot ct bos blnpld bcj oed joey ktblrplkpnl wbk bovl trcld ct% Ct cs mkjikrtohnl ikr tbksl wbkwlor tblcr blorceg ocds kr josalrs tk hld% Tlstcjkeconsorl ovocnohnl ke rlqulst irkj Jr% ]aoggs%Tk krdlr. sled$?7%3< "pkstpocd# .kutscdl \%]% sled$86%3< "\%]% iueds#. ikr pkstogl pocd sbcpjlettk0LOX XLnORLXrk H K R ~ YCMCDX WY 8


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Tceectus TkdoyLdctkrcon oed odvlrtcsceg kiicmls0Ojlrcmoe Tceectus Osskmcotcke. V%K% Hkx < Vkrtnoed. KX 37867Lxlmutcvl Dcrlmtkr) Ldctkr0Gnkrco L% Xlcmb . Vb%D%Ldctkrcon Odvcskr0Trudy Drumalr% Vb%D%Odvlrtcsceg sonls0 OTO*OD. V% 6% Hkx


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Irkj tbl Ldctkrhy Gnkrco L% Xlcmb. Vb%D%.Lxlmutcvl Dcrlmtkr. OjlrcmoeTceectus Osskmcotcke

HKOXD OMTCYCTSOTO's smcletc icl odvcskry

mkjjcttll jlt ce Jceelopkncs ~ ~ * % . durceg tbl oeeuon Ojlrcmoe 1 s 8 ~ 1 ~ ~ Omodljy ki Ktknoryegknkgymkevletcke% Tbl m k ~ j ~ t t ~ l ~ ~ . 0 jljhlrs wlrl letbustostnm j ~ * * ~ * * -tblcr suppkrt ki OTO's (Jcsscke ~ * * * C C C C C C 0 0 @ C 8666( oed vknuetllrld tblcr blnp tk rlod groetprkpksons oed poplrs suhjcttld ikr tbl ?33< YtbCetlreotckeon Tceectus ]ljceor%

Dr% Gocn Ellnly strlssld tbl cjpkrtoeml kijocetoceceg strceglet rlqucrljlets hktb ikr groetprkpksons oed ikr poplrs ikr tbl ?33< jlltceg%Jkst ki tbl jljhlrs prlslet ogrlld wctb tbotvclwpkcet wctb o dcssletceg vclw ce iovkr ki jkrlnleclet rlqucrljlets ikr mncecmon studcls prkpksldhy Dr% Ohl ]bunjoe% Tblcr rlmkjjledotckes wlrlprlsletld tk tbl Lxlmutcvl Hkord ot o rlgunor jlltceg ce Ekvljhlr%TBLECDMDWbcnl ce Jceelopkncs C onsk bod tbl kppkrtuecty tk jllt wctb Dr% ]tlpble Lpstlce wbk cs tblprlslet mbocrjoe ki tbl odvcskry hkord tk tbltckeon Cestctutl ke Dloielss oed Ktblr Mkjjujmotcke Dcskrdlrs% Dr% Lpstlce lxprlssld bcswcnncegelss tk mkkplrotl wctb OTO oed lxpnoceldtbl pksctcke ki tbl ECDMD rlgordceg tceectus rlslormb% Tbly. ncal wl. bovl bod dciicmunty icedcegbcgb quoncty prk`lmts tk suppkrt% Dr% Lpstlce onskrljcedld jl tbot onn blorceg rlslormb wcnn untcjotlny hlelict tceectus suiilrlrs%

C spkal wctb ECDMD dcrlmtkr. Dr% @ojls]ekw. oed bl bos ogrlld tk wrctl oe ortcmnl ohkuttbl ECDMD oed tceectus rlslormb ikr tbl elxt cssulki Tceectus Tkdoy% Wotmb ikr ct%

Ct wos lvcdlet tk us irkj tonaceg tk tblslECDMD rlprlsletotcvls tbot tbl sjonnlr g r ~ t s ceg jodl hy OTO oed ktblr prcvotl i k u e d o t t k ~ ~ jtbl orlo ki tceectus oed blorceg rlslormb orl mettmontk joey smcletcsts% Tbl sjonn (sll;( ~ r o e t moeprkvcdl cectcon c e i k r j o t c k ~ elldld tk @\]ttiy dlvlnkpceg jo`kr rlslormb prk@lmts%V\HNCM OWOXLEL]]

Ct cs lvcdlet tk jl. irkj jy tlnlpbkel monnsoed nlttlrs tbot OTO cs ke tbl hrcea ki o jo`krhrloatbrkugb ce puhncm oworlelss% Sku joy tbceaC'j ke tbl wrkeg troma blrl oed tbot wbot wl woetcs o hrloatbrkugb ce trlotjlet% KA. C ogrll. hut wlelld hktb% Wl wke't glt tbl (murl( uetcn wl gltjkrl plkpnl tbceaceg oed dlvcsceg elw sknutckestk tbl knd prkhnljs% OTO cs wkraceg tk joaltceectus o (bkuslbknd wkrd( "ek jottlr bkw ykuprkekueml ct/#% Sku moe blnp. tkk hy ~ p r l o d c e g tblwkrd ohkut tceectus ce ykur mkjjuetty% Wl bovlmojlro*rlody mkpy ikr puhncm slrvcml ods ikr jogozcels oed elwspoplrs. oed wl bovl oudck topls i;rrodck oed vcdlk topls ikr TY% Wl bovl sploalrs jjoey ports ki tbl mkuetry wbk moe tona tk ykur m n ~ h kr huscelss ohkut tceectus% Wl moe blnp yku wttbhomagrkued ceikrjotcke ci yku woet tk sborl ykurlxplrcleml wctb tceectus ke o nkmon (tona sbkw(%Sku ?? iced tbot cevknvjlet ce OTO wcnn lvle blnpyku ikrglt ykur kwe tceectus% "Ct wkrald ikr jl/#HKKA]

(Jcssceg Wkrds0 Tbl Iojcny Boedhkka keOdunt Blorceg Nkss( hy Aotbnlle Tbkjsltt oedLvl Ecmalrske. cs o hloutciun oed pkcgeoet o ~ k u e t wrcttle hy tbcs jktblr*dougbtlr tloe0% Ce ?t ~ v l sploas moedcdny ki blr struggnl tk ~ k e t j u l n l o ~ j g o rcmb. prkdumtcvl ncil wbcnl nksjg blr b ~ o r t ~ g % Aoy odds usliun ceikrjotcke ohkut m k j j u j m ~ t j g wctb skjlkel wbk moe't blor. oed ki o juntctudlki kptckes ikr blnp tbot orl ovocnohnl% C ncald rlodceg tbcs hkka oed rlmkjjled ct bcgbny% Tbl hkkawke't tlnn yku jumb ohkut tceectus hut ct prlslets o


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Ledceg tbl ]cnleml **TBL NKWDKWE KE ONTLXEOTCYLTCEECT\] TBLXOVCL]Mkjpcnld hy Horhoro Tohombecmaoed tbl OTO stoii

Ikr 88 ylors. OTO bos hlle o sjonn hut vlryplrscstlet icsb ce oe cjjlesl kmloe ki eke*prkictblontb oglemcls. onn vyceg ikr tbl sojl pbcnoetbrkpcm oed gkvlrejleton dknnors% Tbrkugb tblslylors. tblrl bos hlle oe uewovlrceg dltlrjceotckeke tbl port ki OTO tk jocetoce mrldchcncty wctb tbllstohncsbld jldcmon mkjjuecty os o jloes ki dlvlnkpceg tbl aced ki mrldletcons tbot wkund ottromtpksctcvl ottletcke** oed @%_ns ki ct% Ct cs o plrscstlemltbot bos hlle rlwordld wctb summlss% Kur ]mcletcicm Odvcskry Hkord grlw tk mketoce skjl ki tblhlst tceectus*rlnotld jldcmon jceds ce tbcs mkuetry%Kur Hkord ki Dcrlmtkrs oed Bkekrory Dcrlmtkrs.cemnudceg omtkr Tkey Xoedonn oed \%]% ]leotkrJora Boticlnd. cs o eotckeonny rlsplmtld mknnlmtcvl%Wl hlmojl o mlrtcicld Eotckeon Yknuetory BlontbOglemy oiicncotl. oed blnpld ce tbl ikrjotcke kitblECDMD. kel ki tbl jkst lstlljld blorceg blontbcestctutls ce tbl mkuetry tkdoy%

Wctb kur mrldletcons lstohncsbld oed o mkestctulemy eujhlrceg o quortlr ki o jcnncke. wlpurpksliunny mketceuld tk scdl*stlp rlpkrtceg ohkutjoey (lxplrcjleton( tceectus trlotjlets tbot wl'dblord ohkut. os jumb tk soemtcke tbl mkdl ki rlslormbltbcms iknnkwld hy tbl \%]% jldcmon mkjjuecty. os tk ovkcd kiilrceg ionsl bkpl oed pksschnydoeglrkus oed jcsnlodceg ceikrjotcke tk dlsplrotlplkpnl% OTO cs oe onny tk hktb tbl jldcmon mkjjuecty oed tbl tceectus suiilrlr. ylt wl sllj tk hluemkjikrtohny mougbt ce tbl jcddnl oed drowcegicrl rlgordnlss ki tbl scdl ke wbcmb wl stoed% Kurpost opprlblesckes oed tbl murrlet dcsmkrd bovljodl us stkp oed toal o mnkslr nkka ot bkw wl slrvltbksl wl slrvl%

Vbyscmcoes oed ktblr blorceg blontb prkilssckeons ce tbcs mkuetry bovl nkkald tkOTO ekt keny

sckeon Xlilrron Eltwkra cs tbl homahkel ki kurpotclet slrvcmls% Hut wl sll kurslnvls os o jkrlusliun tkkn tk tbl prkilssckeon jldcmon mkjjuectyci wl kiilr o grlotlr hrlodtb ki kptckes ikr tceectussuiilrlrs%

Os o tceectus suiilrlr. ykur mkemlre ikr ykurkwe wlnnelss cs keny jotmbld hy kur dltlrjceotcketk suppkrt ykur slormb ikr oeswlrs% Tk tbot led.tbcs cssul ki Tceectus Tkdoy mketoces o sujjoryki tbl jkst murrlet tceectus rlslormb ceikrjotcke cetbl \%]% tkdoy. o rlsunt ki tbl Dltrkct rlslormbjlltceg wbcmb wos blnd ke Kmtkhlr ?9. ?33=% "]llXlslormb Vnoe ortcmnl. p% n7%# Bkwlvlr. tbksl wctbtceectus ce tbcs mkuetry woet OTO tk hl tbl mnlorcegbkusl ikr onn tceectus rlslormb wkrndwcdl. oed ciekt tbl prkpkelet ki ct. ot nlost tbl rlpkrtlr ki ct%Wctb skjl dcsmrltckeory smrlleceg oed wctbkutledkrsljlet. wl bovl dlmcdld tk rlpkrt wbot wlaekw ohkut eke*trodctckeon tceectus trlotjlets. wctbtbl bkpl tbot tblsl tblropcls ** lvle tbl eke*smcletcicmonny prkvle kels **moe blnp% Wl `ust odvcsl yku tkrlod morliunny. mkesunt ykur plrskeon pbyscmcoe krjldcmon odvcskr. oed dlmcdl ikr ykurslni%GceagkJumb bos hlle wrcttle oed trcld rlgordcegtceectus oed tbcs oemclet blrh% Gceagk cs usld tkcemrlosl hnkkd inkw oed ommlnlrotl kxygle suppnytk morry owoy tkxces% Tbl irustrotcke ikr us boshlle tbot tk dotl jkst ki tbl smcletcicm wkra ce tbcsiclnd bos hlle ce eke*Legncsb sploaceg mkuetrcls%Troesnotckes ki tblsl studcls bovl hlle irougbtwctb syetomtcm lrrkrs joaceg tbl doto bord tk uedlrstoed% Oddld mkeiuscke bos rlsuntld irkj tbliomt tbot dciilrlet troesnotckes ki tbl sojl dkmujlets mketoce skjl mketrodcmtkry doto Tbl iknnkwceg cs kur hlst murrlet cetlrprltotcke ki tbltroesnotld studcls%Gceagk*Noslr

Tbl icrst study tbot wl'vl ikued usceg tbcs


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tblcr tceectus. vlrsus ?9%7, murl wctb EMG oed?


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tblcr tceectus. vlrsus ?9%7, murl wctb EMG oed?


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Ledceg tbl ]cnleml** "mketceuld#OmupuemturlOmupuemturl tblropy cevknvls tbl suhmutoelkus ceslrtcke kivlry sjonn elldnls ot vorckus pkcetstbrkugbkut tbl hkdy% Kmmosckeonny tblsl elldnlsorl blotld kr lnlmtrcmonny stcjunotld wbcnl ce tblsace% Tbcs Mbcelsl trlotjlet ikr blonceg dotls homajkrl tboe 8666 ylors oed bos ikued rlmlet pkpunorcty wkrndwcdl%

Omupuemturl. ct bos hlle sugglstld. stcjunotls tbl prkdumtcke ki (ledkglekus kpcotls( *tblhkdy's kwe eoturon sldotcvls. sumb os ledkrpbces%Hucndceg ke tbot tblkry oed tbl tblkry tbot tceectusoed poce sborl tbl sojl potbwoy tk tbl hroce.omupuemturl os o tceectus trlotjlet wos studcld ceLegnoed ce ?32?% Ce o dkuhnl hnced. mrkss*kvlr.pnomlhk study hy Joras. Kecscpbkrke. oedTrkueml. ?4 tceectus potclets wlrl tlstld. onn kiwbkj bod mkestoet tceectus oed bod ekt rlspkedldtk oey ktblr ikrj ki tceectus trlotjlet% Icvl kut kitbl ?4 ektcmld o (suh`lmtcvl cjprkvljlet( oitlrtwk omupuemturl trlotjlets wbcnl ekel ki tbl pnomlhk potclets rlpkrtld oey cjprkvljlet% Ek elgotcvl scdl liilmts wlrl ektld%

Ce ?328. o iknnkw*up trcon ce Dlejora ke ?7tceectus potclets iknnkwld o prktkmkn vlry scjcnor tktbl Joras study hut ikued ek scgecicmoet cjprkvljlet ce lctblr tbl pnomlhk kr omupuemturl grkup%Cetlrlstcegny. oitlr tbl study mkemnudld. tbly ikuedtbot tbl study portcmcpoets bod (o drcit tk cjprkvljlet wctb tcjl wbcmb wos cedlpledlet ki trlotjlet%(Oe Oustroncoe study ce ?32= iknnkwld 86 tceectus potclets tbrkugb C6 omupuemturl trlotjlets%Tbrll kut ki tbl 86 rlpkrtld mkjpnltl dcsopploroeml ki tblcr tceectus ikr jkrl tboe = jketbs% Tbrllktblrs bod troesclet rlncli "nostceg up tk < doys#%Tbl rljoceceg ?4 bod ek mboegl ce tblcr tceectus%Ce ?323. o mketrknnld pnomlhk study wos mkedumtld ce Csroln mkjporceg tbl trlotjlets ki Mceeorczcel. hckilldhoma. oed omupuemturl ke =6

Tbl kvlronn mkemnuscke irkj tblsl studcls cstbot omupuemturl moe prkduml skjl rlncli ikr skjltceectus suiilrlrs% Tbl rlslormblrs tbljslnvls uecikrjny sugglstld tbot omupuemturl cs o rloskeohnlontlreotcvl tk try wble ktblr tblropcls ikr tceectusbovl iocnld%Ld% Ektl0 Ot prlss tcjl tblrl cs pledceg nlgcsnotcke tbot wkund rlstrcmt kr lncjceotl tbl sonl ki

jkst blrhs oed vctojce suppnljlets ce tbl \%]% oski ?+?+34% Tbl possogl ki oe ontlreotcvl hcnn. tblDcltory ]uppnljlet Blontb oed Ldumotcke Omt ki?33=. wkund rlpnoml tbcs nlgcsnotcke oed onnkw ikrmketceuld ovocnohcncty ki blrhs oed vctojces. wbcnlrlqucrceg tbl mrlotcke ki oe Kiicml ki Dcltory ]uppnljlets wctbce tbl Eotckeon Cestctutl ki Blontb tkrlslormb tbl hlelicts ki suppnljlets%

GCEAGK*NO]LX TBLXOVS MKETOMT]n#Dr \wl WcttJubcleaojp =88666 Bojhurg 96GLXJOES"646# 87? =8 6


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=#Dr Xleotl ]wkhkdoDr Onhrlmbt ]mbkttNoslr*Jldczce*Tlmbeca. Ilbr ) IcsblrJkrcalwlg 2. Vkstiomb ?84492=3 Khlrbousle. XblcebousleGLXJOES

Trcld tk dupncmotlDr Wctt's study wctbkut summlss4#Boes Aekrr. VrlscdletDlutsmbl Tceectus*NcgoLrhsmbnklrstrossl 88D*48=93 WupplrtonGLXJOESVb0 6868 84 9< 86

Bos cetlrprltld = Glrjoe Gceagk*Noslr studcls"mkeincmtceg rlsunts# oed cs sledceg survlys tk 866potclets wbk bod tbcs trlotjlet tk glt tblcr stkrcls%"]ploas Legncsb#


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Gceagk* Iomt kr Icmtcke;hy ]usoe @% ]lcdln. JO%. MMM+O. Grlotlr Hontc*jkrl Jldcmon Mletlr. Dlportjlet ki Ktknorye*gknkgy*Blod ) Elma ]urglry. Dcvcscke kiOudcknkgy

Tbl Hontcjkrl Orlo Tceectus ]lni*Blnp Grkupwkund ncal tk sborl cts lxplrclemls wctb Gceagkhcnkho%Hy ekw jkst rlodlrs bovl blord ki Gceagk

hcnkho lxtromt "LGH#% Ct mketoces purcicld stoedordczld lxtromts irkj tbl Gceagk hcnkho nloi% Tblblrhon lxtromt irkj tbcs nloi cemnudls o grkup kisuhstoemls wbcmb eutrctckeonny sllj tk mketrchutltk jleton omucty hy suppkrtceg hroce iuemtcke% Wlusl o pbytkskjl ikrj ki Gceagk hcnkho% Tbl pbytkskjl prkmlss cs socd tk cesurl tbl jkst eutrctckeonvonul irkj blrhon lxtromts hy cetlesciyceg tblpkwlr ki stoedordczld blrhs hy cjprkvceg ohskrptcke. cemrlosceg hcknkgcmon omtcvcty oed leboemcegdlncvlry ki tbl eutrclets tk tbl mlnn jljhroels% Wlbovl o rlgcstlrld pborjomcst +eutrctckecst ce kurgrkup wbk bos rlslormbld tbcs Gceagk pbytkskjlikr us oed illns tbot ct cs suplrckr ce purcty oedstrlegtb% Ct mketoces ek sugor. sont. ylost. wblot.mkj. docry prkdumts. mknkrceg. inovkrceg kr prlslrvotcvls% Gceagk pbytkskjl cs o mkjpnlx ki pbkspbotcdy #mbkncel oed stoedordczld lxtromtkiGceagkhcnkho mketoceceg 84, gceagkbltlrkscdls%

Ikr tbksl wbk moeekt khtoce tbcs portcmunorgceagk mkjpnlx. wl hlnclvl tbl jkst hlelicmconprkdumt wkund hl kel wbcmb cs onnlrgle*irll oedmketoces tbl nlost prlslrvotcvls kr hcedlrs%LHG opplors tk cjprkvl mcrmunotcke. jltohk

ncsj. hnkkd vcsmkscty oed elurktroesjcsscke ce tblogceg% Cjprkvljlets wctb LGH sllj tk mkjl irkjoe cemrlosld mlrlhron hnkkd inkw oed tblrlikrlkxygle oed gnumksl utcnczotcke% LGH onsk tleds tkcemrlosl tbl rotl ot wbcmb ceikrjotcke cs troesjcttld ot tbl elrvl mlnn nlvln% Tblrl bovl hlle khslrvohnl cjprkvljlets ce jleton plrikrjoeml.jusmunor rlbohcnctotcke. lorny slecncty. jomunor dlglelrotcke. sleskrceluron blorceg nkss. ldljo. oed

ot tbot tcjl hut skjl bod stortld toaceg tblcrGceagk hlikrl tbot% Lxmlpt ikr o sncgbt upslt stkjomb hy twk jljhlrs wble tbly icrst stortld toacegGceagk. tbl woy.]prcegvcnnl. \tob 2499=% @ u ?336%8% Gceagk hcnkho lxtromt ce Vlrsplmtcvl% ODC] Vrlss \rrctld% Oumndoed ?6. ElwPlonoed ?336%=% Blrhon Hck*Tblropy% V%6% Hkx 88=?6% Grlle Hoy. WC]MKK]ce


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Jldco Wotmb0 Tceectus ce tbl Elwshy Mncii Mknnces. Krlgke irllnoeml wrctlr% Vnloslsled mncps. ektceg skurml oed dotl. tk JldcoWotmb. VK Hkx


12/27

Dlvlnkpjlet Dcrlmtckeshy HrletXcmbordJkwlrDlvlnkpjlet DcrlmtkrKut ki scjpnl cdlos kitle mkjlgroed sknutckes% @cnn JmMkrjoma. oe

OTO jljhlr irkj Jcmbcgoe. wrktl tkjl ce Ougust wctb tbl cdlo. (Wl elldhcg jkely ikr rlslormb %%%% C i tblrl orl=6 jcnncke plkpnl wctb tceectus * osalvlrykel tk dkeotl kel dknnor. tbotwkund gcvl us =6 jcnncke dknnors//(

Jy icrst tbkugbt wos. ci ct wlrl keny tbot losy%Hut C'vl junnld ct kvlr joey tcjls kvlr tbl postjketbs oed rlmlcvld o mkescdlrohnl ojkuet kisoglwcsdkj ce jy dcsmussckes wctb lxplrts ce ktblreke*prkict krgoeczotckes. os wlnn os ikuedotcke oedhuscelss nlodlrs% Ct hkcns dkwe tk cdletciyceg ykurprcjory oudcleml oed slrvceg ct wlnn%

OTO bos `ust tbot kppkrtuecty% @cnn cs rcgbt ketorglt% Wl aekw tblrl orl jcnnckes ki Ojlrcmoeswctb tceectus% Tbot cs wlnn dkmujletld% ]kjl plkpnl orl oiilmtld tk o suhstoetcon dlgrll% Ktblrs orlohnl tk cgekrl ct% Hut onn orl oiilmtld% ]k orl tblcrircleds oed iojcny. ljpnkylrs. blontb morl prkvcdlrs. oed lvlrykel lnsl wbk pnoys o scgecicmoet rknlce tblcr ncvls%Wl moe hl oe krgoeczotcke ki jcnnckes. ekttbkusoeds% Cjogcel tbl mnkut wl wkund bovl cesmcleml. ce jldcmcel. ce gkvlrejlet% Cjogcel tbljcnnckes ki dknnors wl mkund rocsl oed usl ikrtceectus rlslormb% Dknnors untcjotlny nlodceg tklncjceotceg wbotlvlr tceectus cs tk lvlrykel * hl cto dlhcnctotceg. ncil*ontlrceg mkedctcke kr o scjpnloeekyoeml%Vuhncm oworlelss ki tceectus. wbot ct cs oedwbot ct dkls. oed puhncm oworlelss ki OTO oed ctsslrvcmls wcnn nlod us tk tbot pkcet% Tblrl orl twklquon mkjpkelets tk cemrlosceg tbot puhncm oworlelss% Icrst cs tbrkugb prkjktcke cemnudceg jldcomkvlrogl. odvlrtcsceg oed lvlets% Ce tbl vlry eloriuturl. C'nn hl prlsletceg oe kvlronn pnoe tk OTO's

Skur kwe stkrcls% Tbot cs tbl slmked mkjpkelet ki cemrlosceg puhncm oworlelss% Vuttceg obujoe ioml ke tceectus joals ct rlon ikr ktblrs%Keny yku moe dk tbot% C'j ekt sugglstceg tbot ykudldcmotl ykur woaceg bkurs tk mkjpnocecegohkut tbcs bkrrchnl mkedctcke yku bovl tk ncvlwctb. hut scjpny hlgce tk nlt ktblrs aekw ykubovl tceectus oed wbot cjpomt ct bos ke ykur ncil%Ce ykur kwe wkrds% Sku'nn hl oe cemrldchnlskurml kildumotcke oed tbl hlst puhncmcty jkelymkund elvlr huy%

Kur vkcml ellds tk hl strkeg. hut ekt mkjpnoceceg% Nkud. hut ekt khekxckus% ]cjpny tlnn ykurstkry% Lemkurogl ktblrs tk tlnn tblcrs% Wl wcnn rlombjcnnckes%

WKXAVNOML GCYCEG MOE ]\VVKXT OTOJoey ki yku onrlody mketrchutl tk OTOtbrkugb tbl Mkjhceld Ildlron "Ljpnkylls# Mojpocge kr tbrkugb tbl Eotckeon Yknuetory BlontbOglemcls mojpocges% Tbot suppkrt cs scgecicmoet tkOTO oed blnps iued joey ki kur prkgrojs oedslrvcmls% Ct cs o scjpnl woy tk hudglt ykur plrskeongcvceg oed blnps suppkrt oglemcls oed krgoeczotckes yku morl ohkut%O eujhlr ki ljpnkylrs ekw onnkw tblcr ljpnkylls tk dlscgeotl krgoeczotckes ce wkrapnomlgcvceg mojpocges tbot ljpnkylls splmcicmonny woettblcr mketrchutckes tk iued% Vnlosl mblma wctb ykurljpnkylr tk sll ci tbot kptcke lxcsts ikr yku% Ci ykubovl tbl inlxchcncty tk splmciy tbot ykur mketrchutckes gk tk OTO. pnlosl slrckusny mkescdlr tbotkptcke% Sku'nn hl blnpceg us rlomb tbl gkon kilncjceotceg tceectus os o blontb prkhnlj hy cemrlosceg tbl iceoemcon ohcnctcls kiOTO tk iued prkjcscegrlslormb oed ldumotcke%

Ci ykur ljpnkylr dkls ekt gcvl yku tbl inlxchcncty tk eojl krgoeczotckes sumb os OTO ce ykurwkrapnoml gcvceg mojpocges. stort ykur kwe mojpocge tk lemkurogl tblj tk gcvl yku tbot inlxchcncty%


13/27

pnkylls o wcdl roegl ki kptckes ikr gcvceg% Skurssbkund tkk%]kjl mkjpoecls keny portcmcpotl ce tbl\ectld Woy mojpocge% Tbot dkls ekt prlmnudl ykuirkj dlscgeotceg OT O os tbl hlelicmcory ki ykurwkrapnoml gcvceg% Onn \ectld Woy mojpocges bovlo splmcicm dlscgeotcke kptcke ovocnohnl tk yku% Skumoe dlscgeotl OTO hy rlqulstceg tbl dlscgeotckeikrj irkj ykur ljpnkylr oed ncstceg OTO os rlmcpclet ikr onn kr port ki ykur dkeotcke% Ci yku bovldciicmunty dkceg tbot. pnlosl gcvl jl o monn% C'nn hlgnod tk blnp% Sku CC hl blnpceg OTO joal iostlroed grlotlr strcdls ce tbl icgbt ogocest tceectus%EKEVXKICT ]LMTKX OMMK\ETOHCNCTS

Tblrl cs cemrlosceg jldco oed nlgcsnotcvl ottletcke tk bcgbny qulstckeohnl hlbovckr ki skjl ekeprkict krgoeczotckes oed ohkut tbl elld ikr onnekeprkicts tk prkvcdl jkrl ceikrjotcke tk tbl puhncmohkut iceoemls. gkvlreoeml oed ommkjpncsbjlets%

Ot OTO. wl nkka upke smrutcey os pksctcvl% Ctgcvls us tbl kppkrtuecty tk dljkestrotl tbot kurmousl oed omtcvctcls dlslrvl mketrchutld tcjl oedjkely wctb puhncm mkeicdleml% Wl wlnmkjl ykurqulstckes oed ykur sugglstckes% OTO cs ykur krgoeczotcke%?334 XL]LOXMB MOJVOCGEACMAKII ]KKEVnlosl rlod morliunny tbl kvlrvclw ki OTO'srlslormb jcsscke oed pnoes cemnudld ce tbcs cssul%Wl hlnclvl ct bknds prkjcsl ikr scgecicmoet odvoemls ce tbl trlotjlet ki tceectus% Sku ?? skke hlrlmlcvceg ceikrjotcke ohkut kur ?33= iuedrocsceggkons splmcicmonny torgltld ikr rlslormb% Kur gkonsorl oggrlsscvl. hut wctb ykur blnp wl wcnn rlombtblj% Vnlosl slrckusny mkescdlr kur rlqulsts ikriueds oed dke't blsctotl tk mketomt us wctb ykurcdlos kr tk lxpnkrl kur pnoes ce grlotlr dltocn% Skudk oed wcnn joal tbl dciilrleml ce hlotceg tceectus%

Elws stkrcls oed mkegrls* % % * ************%%%sckeon blorcegs lxpksl iuedrocsceg WCTB TBOEA] %%%smojs tbot rocsl jkely ikr ekelx* Joey tboeas tk Xke ]pog*cstlet rlslormb1 rlvlon rcdcmunkus VNLO]L MKJVNLTL OED eordc. Ldctkr+Vuhncsblr kiJkd*mnocjs ki sovceg ncvls kr skuns oed XLT\XE K\X JL.Jn=LX lj Drujjlr Jogozcel ikr bcsrlpkrt slmrlt mkjplesotcke or* ]OTC]IOMTCKE ]\XYLS iunn pogl OTO odvlrtcsljletroegljlets tbot orl mborctohnl CEMN\DLD CE TBC] C]]\L% wbcmb rlombld kvlr ?66.666keny tk tbl rlmcpclets% Bustnlrs oed SK\X KVCECKE] MK\ET% plkpnl ce Kmtkhlr oed tk Dovcdmbornotoes lxcst ce lvlry port ki Acrawkkd oed ]bcrnly Hynls.skmclty hut wble tbly kplrotl ce rlsplmtcvl Ldctkrs kiTbl Blor*tbl eojl ki mborcty ct cs portcmu* %%%%%[[[[[[[[[[[[ % ceg @kureon oed Tbl Mkjju*norny dcsblortleceg% Lvle tbkugb ecty Lor ikr dkeotcegsumb grkups rlprlslet o tcey iromtcke ki onn vknue* odvlrtcsceg spoml tk OTO ce rlmlet cssuls% Tblcrtory krgoeczotckes. tblcr owiunelss uedlrjcels glelrkscty jloes grkwtb ikr OTO oed cs vlrypuhncm mkeicdleml ce tbl grkups tbot plrikrj bke* opprlmcotld%lstny oed vonuohny Iceonny. tboeas tk lomb ki yku ikr ykur supplr*Vnlosl hl ossurld tbot OTO wcnn strkegny le* tcvl pbkel monns oed nlttlrs% Sku bovl jodl jl illnmkurogl oggrlsscvl prkslmutcke kiiroudunlet omtcv* vlry wlnmkjl os port ki tbl OTO iojcny durceg tblcty. suppkrt rlgunor oed iunnlr rlpkrtceg tk tbl post scx jketbs% Kur jcsscke wcnn ekt hl losy. hutpuhncm ki onn hoscm ceikrjotcke ohkut kur cestctu* os o tloj wl wcnn ommkjpncsb grlot tbcegs% Ki tbot

ki


14/27

]MCLETCICM ODYC]KXS HKOXDXkeond G% Ojldll. J% D%Elw Krnloes. NkucscoeoXkhlrt L% Hrujjltt. Vb%D%Vkrtnoed. Krlgke@oma D% Mnljns. J%D%Mbcmogk. Cnncekcs@kbe X%Ljjltt. J%D%Jljpbcs. TleelssllMbrcs H% Ikstlr. J%D%]oe Dclgk. moncikrecoHorhoro Gkndstlce. Vb%D %Elw Skra. Elw SkraXcmbord N% Gkkdl. J%D%]toeikrd. moncikrecoW% I% ]% Bkpjlclr]t% Nkucs. Jcsskurc@kbeW%Bkusl. JD%Nks Oeglnls. moncikrecoXkhlrt @kbeske. Vb%D%Vkrtnoed. KrlgkeGonlW%Jcnnlr. J%D%Mcemceeotc. Kbck@% Gonn Ellny.J%D%]t% nkucs.Jcsskurc@lrry N% Ekrtblre. Vb%D%Dlevlr. MknkrodkXkhlrt L% ]oednce. Vb%D%Ln MH`ke. moncikrecoOhroboj ]bunjoe. J%D%Hrkkanye. Elw SkraJoesiclnd ]jctb. J%D%]oe @ksl. moncikrecoBorknd G% Tohh. J%D%Elw Krnloes. NkucscoeoBKEKXOXS DCXLMTKX]Tbl Bkekrohnl Jora k% Boticlnd\ectld ]tstls ]leotlJr% Tkey XoedonnElw Skra. Elw SkraNLGON MK\E]LNBlery M% Hrlctboupt

Dlor Ircled.

OJLXCMOETCEECT\]O]]KMCOTCKE

V% 6 % HKR


15/27

OJLXCMOE TCEECT\] O]]KMCOTCKEJLJHLX]BCV ]\XYLSSK\X KVCECKE] OED CDLO] OXL CJVKXTOET TK \] OED WCNNO]]C]T \] CE VNOEECEG K\X OMTCYCTCL] OED DCXLMTCEG K\XXL]K\XML] TK JK]T OVVXKVXCOTLNS JLLT SK\X ELLD] OED DL]CXL]% VNLO]L

TOAL O JKJLET TK MKJVNLTL TBC] ]\XYLS%?% VNLO]L XOEA TBL IKNNKWCEG OTO ]LXYCML] OED OMTCYCTCL] CE TBL KXDLX KI CJVKX*TOEML SK\ ILLN C] JK]T OVVXKVXCOTL "? HLCEG JK]T CJVKXTOET. ?? HLCEG NLO]T CJ*VKXTOET#

[ [ ceoemcon suppkrt ikr tceectus rlslormb[ [ Vuhncmotcke ki Tceectus Tkdoy[[Vuhncmotcke ki tceectus ceikrjotcke hrkmburls[[]onl ki tceectus ceikrjotcke hkkas[[ rkilssckeon mncecmcoe rlilrron eltwkra[ [ stohncsbjlet oed suppkrt ki nkmon slni*blnp grkups[[Vuhncm oworlelss+ldumotcke oed prlvletcke prkgrojs[[ chnckgropby slrvcml[[ krasbkps oed sljceors ikr pbyscmcoes oed jldcmon prkvcdlrs[[ ljceors C ikrujs ikr plkpnl wctb tceectus[[ khhyceg oed odvkmomy ikr tceectus wctb Ildlron Gkvlrejlet8% BKW WLNN CEIKXJLD DK SK\ HLNCLYL SK\ OXL KE BKW SK\X OTO MKETXCH\TCKE]OXL ONNKMOTLD;

[[ lry wlnn ceikrjld [[[ otcsicld[[ lld oddctckeon ceikrjotcke=% BKW WK\ND SK\ XOTL TBL _\ONCTS KI Tceectus Tkdoy CE JLLTCEG SK\X CEIKXJO*TCKEON ELLD] OHK\T TCEECT\] OED TBL OMTCYCTCL] KI OTO;[[[[ xmlnnlet [ [ [ kkd[ [ [ ocr [[[ kkr4% VNLO]L NC]T TWK OXLO] KI Tceectus Tkdoy SK\ NCAL HL]T "C%l% _ulstckes )Oeswlrs. Jl*dco Wotmb. Xlgunor Mknujes. ltm%#


16/27

7% DCD SK\ ]LL O VBS]CMCOE KX BLONTB MOXL VXKYCDLX NC]TLD CE OTO'] VXKIL]]CKEONELTWKXA DCXLMTKXS ]LET TK SK\;[ [ [[Sls [[ [[[[[[EkCI SL]. BKW WK\ND SK\ XOTL TBL _\ONCTS KI MOXL OED OTTLETCKE SK\ XLMLCYLDIXKJ TBOT CEDCYCD\ON KX MNCECM;[[[[ xmlnnlet [ [[[Gkkd[[[ ocr [ [[Vkkr3% BOYL SK\ VOXTCMCVOTLD CE OE OTO ]VKE]KXLD ]LNI*BLNV GXK\V CE SK\X OXLO;[[[[Sls [[[[[Ek[[[[ blrl orl ek omtcvl slni*blnp grkups ce jy orlo?6% CI SL]. BKW WK\ND SK\ XOTL TBL _\ONCTS KI ]\VVKXT OED CEIKXJOTCKE SK\ XLMLCYLD IXKJ TBOT ]LNI*BLNV GXK\V;[[[[ xmlnnlet[[[[ kkd * * o c r [ [ [ %Vkkr??% CI OTO WLXL TK KXGOECPL OE OEE\ON JLLTCEG KX MKEILXLEML WCTB ]VLOALX].]LJCEOX] OED WKXA]BKV] IKX VLKVNL WCTB TCEECT\]. WK\ND SK\ MKE]CDLX OTTLEDCEG;[[[ [ Sls [[[[ k?8% CI SL]. BKW IOO WK\ND SK\ MKE]CDLX TXOYLNCEG OED \V TK WBOT OJK\ETWK\ND SK\ MKE]CDLX O XLO]KEOHNL MKEILXLEML ILL; "Trovln oed nkdgceg lxpleslsekt cemnudld#[ [Joxcjuj jcnls tk mkeilrleml[ [ cstoeml wkund ekt hl o mkescdlrotcke$ Joxcjuj rloskeohnl mkeilrleml illLEMNK]LD C] JS MKETXCH\TCKE KI$ O] O ]VLMCON GCIT TK LRVOED TBL OL]LOXMB ]\VVKXT OED ]LXYCML] KI TBL OJLXCMOE TCEECT\] O]]KMCOTCKE%

VNLO]L XLT\XE SK\X MKJVNLTLD ]\XYLS CE TBL LEYLNKVL VXKYCDLD LYLE CI SK\OXL \EOHNL TK JOAL O MKETXCH\TCKE OT TBC] TCJL% WBCNL WL WK\ND OVVXLMCOTLAEKWCEG WBK SK\ OXL. SK\ ELLD EKT MKJVNLTL SK\X EOJL OED ODDXL]] CI SK\WK\ND NCAL TK XLJOCE OEKESJK\]. H\T VNLO]L CEMN\DL SK\X PCV MKDL IKX ]TOTC]TCMON V\XVK]L]%EOJL[[[[[[[[[[[[[[[[[[[[[[[[ [ [ [[[[[[[[[[[[[[[[[[[ODDXL]] [ [ [ [ [[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[MCTS ) ]TOTL*************************** ************* **PCV


17/27

OT O Jcsscke 8666 * Xlslormb VnoeMkjpcnld hy HrletJkwlr

Tbl post dlmodl hrkugbt scgecicmoet odvoemlsce tbl study oed trlotjlet ki tceectus. hktb tbrkugbrlslormb prk`lmts splmcicmonny dlscgeld tk study tblmkedctcke. os wlnn os tbrkugb oelmdkton potcletkhslrvotckes oed ceikrjotcke gnloeld irkj ktblroudctkry kr elrvkus systlj rlslormb% Nomaceg irkjtbl prkmlss ki tbl study ki tbl mkedctcke. bkwlvlr.bos hlle oe kvlronn rlslormb pnoe kr tljpnotl tkgucdl oed prckrctczl rlslormb omtcvctcls oed tk lesurl mkkrdceotcke ojkeg rlslormblrs% Iurtblr.sporsl mkjjuecmotcke ojkeg rlslormblrs oed kmmosckeon lgk kr (turi' wors bovl mrlotld irogjletotcke ki tbl rlslormb mkjjuecty cevknvld ce tblstudy ki tceectus%Ce oe liikrt tk iomcnctotl grlotlr mkjjuecmo

tcke ojkeg rlslormblrs oed dlvlnkp o pnoe ikriuturl tceectus rlslormb omtcvctcls oed prk`lmts tbotcs wlnn mkkrdceotld. prckrctczld oed tbkrkugb. tblOjlrcmoe Tceectus Osskmcotcke blnd cts icrst rlslormb hrocestkrjceg slsscke ce Dlorhkre. Jcmbcgoe ke Kmtkhlr ?9. ?33=% Vortcmcpoets ce tbljlltceg wlrl cevctld hy OTO hosld upke tblcr postcevknvljlet ce tceectus rlslormb% Vortcmcpoets ce tbljlltceg cemnudld0Xkeond Ojldll. JD%Tunoel \ecvlrscty ]mbkkn ki JldcmcelHorhoro Gkndstlce. Vb%D% ]totl \ecvlrscty ki Elw Skn?>Voun Gutb.Vb%D% Tunoel \ecvlrscty Jldcmon MletlrJourlle Boeenly. Vb%D% Ojlrcmoe Omodljy ki KtknoryegknkgyMyetbco Caelr. D%K% Wlst Ycrgceco ]mbkkn ki Kstlkpotbcm JldcmcelGory V% @omkhske. Vb%D% Blery Ikrd BkspctonVowln @% @ostrlhkti. Vb%D% \ecvlrscty ki Jorynoed ]mbkkn ki JldcmcelXkhlrt J% @kbeske. Vb%D% Krlgke BloBb ]mclemls \ecvlrsctyVoun X% Acnley. Vb%D% \ecvlrscty ki Jcmbcgoe ]mbkkn ki JldcmcelWcnncoj Jortce. Vb%D% Tljpnl \ecvlrscty ]mbkkn ki JldcmcelJory Jlcanl. Vb%D%Krlgke Blontb ]mclemls \ecvlrsctyLdwce Jkesle%J%D% Blery Ikrd BkspctonDkugnos B% Jkrgoe. D%D%]%. Tbl TJ@ IkuedotckeXonpb Eouetke. J%D%. Eotckeon Cestctutl ke Dloielss )Mkjj%DcskrdlrsMrocgW% Elwjoe.Vb%D% Blery Ikrd BkspctonGnkrco L% Xlcmb. Vb%D%Ojlrcmoe Tceectus OsskmcotckeOhroboj ]bunjoe. J%D% ]totl \ecvlrscty ki Elw Skn?>Xkhlrt ]wlltkw. Vb%D% \ecvlrscty ki MoncikrecoXcmbord Tynlr. Vb%D% \ecvlrscty ki Ckwo ]mbkkn ki Jldcmcel

tbot wkund hl ncal mkedumtceg o study ke blodomblsce oe ottljpt tk trlot kr murl tblj ce kel joeelr%Tbl study ki tceectus just hl juntc*dcsmcpnceoryoed cetlromtcvl% Mkescdlrotcke sbkund hl gcvle tkcdletcicmotcke oed motlgkrczotcke ki typls ki tceectus rotblr tboe lxojceceg tceectus os o glelrcmletcty% Tk dk sk wcnn blnp ikmus rlslormb oed trlotjlet omtcvctcls ce o jumb jkrl liilmtcvl joeelr%

Wbcnl ekt jutuonny lxmnuscvl. tblrl orl ikurglelron orlos ki tceectus rlslormb0 Cevlstcgotcke kitbl Jlmboecsjs ki Tceectus1 Dcogekscs oed Osslssjlet ki tbl Tceectus ]yjptkj1 Trlotjlet kitbl Tceectus ]yjptkj oed1 Vrlvletcke ki Tceectus%Ontbkugb lomb orlo ki rlslormb bos cts kwe uecqulmboromtlrcstcms oed prkhnljs. ct moeekt hl strlssldlekugb tbot rlslormb ce oey ki tblsl iclnds just hlcetlromtcvl wctb rlslormb ce ktblrs% Kutmkjls justhl sborld oed grlotlr mkkrdceotcke ojkeg rlslormbprkilssckeons just hl ombclvld%Ce oddctcke tk tblsl ikur glelron orlos ki rlslormb. tbrll jkrl wbcmb cjpomt tceectus rlslormbjust hl mkescdlrld oed iurtblrld ce krdlr tkombclvl goces ce tbl kvlronC tceectus rlslormb orleo%Icrst. o mrctcmon elld ikr stoedordczotcke ce jlosurl

jlet oed rlpkrtceg lxcsts% ]lmked. iurtblrlpcdljcknkgcmon studcls oed krgoeczotcke orl elmlssory tk gotblr cjpkrtoet ceikrjotcke ohkut plkpnl wctb tceectus oed tblcr lxplrcleml wctb tblsyjptkj% Iceonny. lstohncsbjlet ki gucdlncels krstoedords ikr tbl nlvln ki quoncty ki rlslormb justhl lstohncsbld%JLMBOEC]J] \EDLXNSCEG TCEECT\]

Bcstkrcmonny. ncttnl ki tbl rlslormb mkedumtldbos ikmusld ke tbl jlmboecsjs uedlrnyceg tceectus% O hlttlr uedlrstoedceg ki hktb tbl hckmbljcstry oed lnlmtrkpbyscknkgy ki tbl mletron elrvkussystlj wcnn leboeml skjl uedlrstoedceg oedsbkund hl lemkurogld oed suppkrtld% Bkwlvlr.wbcnl studcls ki tbl hoscm oudctkry systlj oed kitbl elurknkgcmon systljs bknd prkjcsl ikr hlttlr


18/27

Xlslormb Vnoe "mketceuld#oed rliceljlet ki oe oecjon jkdln ikr tbl studyki jlmboecsjs. os wlnn os trlotjlets. cs mrctcmon%

Twlnvl orlos kistudy krmotlgkrcls wlrl cdletcicld% Tk dltlrjcel tbl ltcknkgcls ki tceectus. lombjust hl mkescdlrld oed iunny lxojceld% Lomb joypnoy o rknl cedcvcduonny kr ce mkjhceotcke wctbktblr jlmboecsjs kr ontbkugb ekt o jlmboecsj.lomb joy hl usliun ce tbl study ki sumb% Ct joy onskhl opprkprcotl tk grkup tblsl motlgkrcls cetkhrkodlr orlos dul tk tblcr cetlromtcvl eoturl% Hlmousl ct cs jkst ncalny tbot juntcpnl jlmboecsjsuedlrny tbl vorckus mousls ki tceectus. jltbkds kidciilrletcotceg tblsl jlmboecsjs just onsk hl dltlrjceld%TCEECT\] DCOGEK]C] OED O]]L]]JLET

Os ce studcls ki tbl jlmboecsjs ki tceectus.dcogekscs oed osslssjlet ki tbl mkedctcke bovlhlle pnoguld hy noma kistoedordczld tlstceg jltbkdsoed kutmkjl jlosurls% Ct cs ohsknutlny lssletcon tbotonn dcogekstcm oed osslssjlet jkdonctcls utcnczl skjltypl kistoedordczotcke% Tk ombclvl stoedordczotcke. owkra grkup kr tosa ikrml wcnn elld tk hl lstohncsbldikr tbl purpksl ki dlvlnkpjlet oed odkptcke ki tlstceg oed jlosurljlet stoedords% Lquonny cjpkrtoetwcnn hl oe liikrt tk stoedordczl onn boedcmop kr dcsohcncty smonls kr kutmkjl jlosurls ce krdlr tk odlquotlnymkjporl studcls%

O jyrcod ki potclet lvonuotcke jltbkds lxcstikr osslssjlet ki tceectus potclets% Tbly ionn cetkikur hoscm motlgkrcls0 Vbyscknkgcm. Vsymbknkgcm.Vlrmlptcvl oed Dljkgropbcm% Bkwlvlr. jkst orlmurrletny usld ce o skjlwbot bopbozord iosbcke.lsplmconny hy mncecmcoes wbk dk ekt rlgunorny sll krtrlot tceectus potclets% Tblrlikrl. dlvlnkpjlet ki ostoedordczld tlstceg hottlry wbcmb wcnn prkvcdlkh`lmtcvl jlosurljlet oed plrjct slnlmtcke ki opprkprcotl trlotjlet jkdonctcls hosld upke o dcstcemtcke ki tbl uedlrnyceg jlmboecsj cs kiporojkuet cjpkrtoeml% Oddctckeonny. ct cs cjpkrtoet tk dlvlnkp o dlsmrcptcke ki tceectus mboromtlrcstcms ce potclets wctb dciilrlet ltcknkgcls tk

mbort ikr tlstceg hosld upke potclet rlspkesls tkgucdl tbl tlstceg prktkmkn%TXLOTJLET KI TCEECT\]

Os wctb tceectus dcogeksls oed osslssjlet. oeujhlrki trlotjlet jkdonctcls bovl hlle cetrkdumldkr tlstld. skjl wctb ncjctld summlss. ktblrs wctbjcecjon kr ek summlss% Jkst studcls cevknvld ce tbltrlotjlet ki tceectus orl hosld upke oelmdkton potcletkhslrvotckes% Wbcnl tbcs typl ki trlotjlet rlslormb cscjpkrtoet. tblrl rljoces o mrctcmon elld tk tcl tblstudy ki trlotjlet jkdonctcls tk tceectus jlmboecsjs rlslormb% Iurtblr. upke khslrvotcke kio prkjcsceg trlotjlet jkdoncty. ceikrjotcke ohkut tbotkhslrvotcke sbkund hl qucmany sborld ce krdlr tbotoddctckeon khslrvotckes joy hl gotblrld eotckeonnyoed cetlreotckeonny. oed juntc*sctl cevlstcgotckes cetktbl trlotjlet moe hl uedlrtoale% Tbcs wcnn cjprkvlekt keny tbl stoedord ki sumb rlslormb. hut wcnn onskosscst ce lxpldctceg tbl dcssljceotcke ki ceikrjotckerlgordceg study kutmkjls%

Trlotjlet jkdonctcls ionn cetk ikur hoscm motlgkrcls0 Vbyscknkgcmon. Vsymbkomkustcm. Vsymbkskmconoed Vbyscmon% Oddctckeonny. joey trlotjlet pnoes ce*mnudl o mkjhceotcke ki jkdonctcls irkj twk kr jkrlki tbl motlgkrcls% Ncttnl rlslormb bos hlle mkedumtldke tbl cetlromtcke ki trlotjlets kr wctb tbl pktletconkimkjhceotckes oed sbkund hl mkescdlrld%

Hlmousl murrlet splmcicm trlotjlet jkdonctclsbovl hlle wlnn rlpkrtld. tbly wcnn ekt hl lnohkrotldupke ce tbcs pnoe% Bkwlvlr. ct cs mrctcmon tk ljpbosczl tbot o elld lxcsts ikr stoedordczld kutmkjljlosurls tk hl dlvlnkpld oed tbot mlrtoce rlslormb stoedords just hl dlvlnkpld oed jlt cetbl prkpkson ki potclet khslrvotcke oed mncecmontrcons ce krdlr tk lesurl tbot summlssiun oedliilmtcvl kutmkjls moe hl rlodcny odkptld hy tbljldcmon mkjjuecty wctbkut scgecicmoet qulstcke% Tbcs dkls ekt jloe tbot mosuon khslrvotckesorl ekt cjpkrtoet% Xotblr. tbly sbkund hl rlpkrtld.studcld lpcdljcknkgcmonny oed tlstld ce o joeelrommlptohnl tk bcgb stoedords ki tbl jldcmon oed


19/27

dctckeon study cetk tbl psymbkskmcon oed mkgectcvltblropcls ovocnohnl kr prkpksld ikr dlvlnkpjlet cselmlssory tk cjprkvl cts usl os oe liilmtcvl od`uemt trlotjlet jkdoncty pledceg tbl dlvlnkpjlet ki hlttlr pbyscmon kr pbyscknkgcmontrlotjlets%LVCDLJCKNKGCM XL]LOXMB

O scgecicmoet ojkuet ki ceikrjotcke rlgordceg tbl syjptkj ki tceectus moe hl dlvlnkpld hyoddctckeon lpcdljcknkgcm studcls cetk tbl mboromtlrcstcms ki tbl mkedctcke oed bcstkrcls oed dljkgropbcms ki tbl tceectus potclet pkpunotcke% Oeotckeon dotohosl wctb sborld ceikrjotcke irkj oslxtlescvl o pkpunotcke hosl os cs pksschnl sbkund hlmrlotld oed jocetoceld%

Tbl mknnlmtcke ki tbcs ceikrjotcke wcnn hl lxtrljlny usliun tk rlslormblrs oed mncecmcoes oncal cetblcr prk`lmt oed trlotjlet liikrts. os wlnn os cedljkestrotcke ki tbl prlvonleml oed scgecicmoemlki tbl mkedctcke ce ktblr liikrts tk ikmus ottletckeoed iuedceg tk tceectusos o eotckeon blontb prkhnlj%OTO'] XKNL CE TCEECT\] XL]LOXMB

Tbl eujhlr ki rlslormblrs cevknvld ce tblrlslormb ki tceectus bos hlle bcstkrcmonny sjonn ikrjoey rloskes% Ct rljoces oe lnuscvl oed mkjpnlxmkedctcke wbcmb joey smcletcsts oed mncecmcoes dk ekthlnclvl moe hl studcld wctb bkpl ki summlssiun kut*mkjls% Ct cs ekt o gnojkrkus mkedctcke kr o pkpunormousl% Iuedceg ikr tceectus rlslormb bos hlle jcecjonce mkjporcske tk cts prlvonleml oed scgecicmoeml ce tblpkpunotcke% Tbl nlvln ki rlslormb mkedumtld bos ektonwoys jlt tbl bcgb stoedords ki tbl smcletcicm oedjldcmon mkjjuectcls% Tblrl onsk bos hlle ek mletron(mbojpcke( kr strkeg nlodlr ki tbl rlslormb liikrtsuedlrtoale tk dotl% OTO moe oed sbkund pnoy o rknl cecjprkvljlet kilomb ki tbkslorlos. hy toaceg oe omtcvlrknl os nlodlroed hy iomcnctotceg grlotlrmkjjuecmotckeoed mkkplrotcke ce tbl jldcmon oed smcletcicm rlslormbmkjjuectcls%

OTO sbkund mketceul tk hl o prcjory skurml

splmt oed ottletcke ki mncecmcoes oed smcletcsts wbkwcnn utcnczl tbl rlsunts ce prkdumtcvl woys%OTO's rknl os oe odvkmotl ikr plkpnl wctbtceectus sbkund cemnudl nlgcsnotcvl oed nkhhyceg liikrts tk ikmus tbl ottletcke ki Mkegrlss oed opprkprcotl ildlron oglemcls ke tceectus os o scgecicmoeteotckeon blontb prkhnlj. oed tk lesurl tbot tceectusrlslormb glts oddctckeon opprkprcotl iuedceg%]uppkrtki jkrl hrocestkrjceg oed mkn nohkro*tcvl jlltcegs ojkeg tceectus rlslormblrs ke o rlgunor hoscs sbkund hl o prcjory purpksl ki tblkrgoeczotcke oed wkra grkups oed tosa ikrmls dl*vlnkpceg elldld stoedordczotcke sbkund hl krgoeczld oed suppkrtld uedlr tbl ouspcmls kiOTO% Tbcswcnn iomcnctotl o grlotlr lxmboegl ki ceikrjotcke cehktb tbl rlslormb oed mncecmon mkjjuectcls%

]\JJOXSTbksl cevknvld ce tbl study kr suppkrt kitceectus sbkund toal o jkjlet tk hosa ce procsl ikrtblcr dldcmotcke oed plrslvlroeml ce oe uepkpunoroed irustrotceg iclnd ki study% Tbl liikrts ki hktbOTO oed cedcvcduon smcletcsts oedmncecmcoes wkrndwcdl bovl hrkugbt tbl tceectus potclet pkpunotckescgecicmoet cjprkvljlets ce trlotjlet oed uedlrstoedceg ki tbl mkedctcke%Ct cs ekw tcjl tk dlvlnkp o eotckeon kr cetlreotckeon strotlgy ikr dlonceg wctb tbl mkedctcke% Oekrgoeczld. ikmusld. bcgb*quoncty rlslormb liikrt justhl uedlrtoale tk toal odvoetogl ki tbl scgecicmoetstrcdls hlceg jodl ce jldcmon oed smcletcicm rlslormbglelronny% Tbl kppkrtuecty ikr rljoraohnl odvoemlslxcsts% O elw glelrotcke ki rlslormblrs sbkund hlrlmructld oedlemkurogld hktb hy iuedceg kiomtcvctclsoed upgrodceg tbl quoncty ki rlslormb uedlrtoale%

Jkst cjpkrtoet. o mkjjuecty ki rlslormblrsjust hl mrlotld% Mkjjuecty ce tbl slesl ki mkkplrotcke. mknnohkrotcke oed mkjjuecmotcke%Oeytbceg nlsstboe tbot cs ueommlptohnl% OTO just krgoeczl. nlodoed iomcnctotl tbot mkjjuecty% Tk dk sk wcnn mrlotl oskncd ikuedotcke ikr sknutckes tk tbcs scgecicmoet eo*


20/27

dctckeon study cetk tbl psymbkskmcon oed mkgectcvltblropcls ovocnohnl kr prkpksld ikr dlvlnkpjlet cselmlssory tk cjprkvl cts usl os oe liilmtcvl od`uemt trlotjlet jkdoncty pledceg tbl dlvlnkpjlet ki hlttlr pbyscmon kr pbyscknkgcmontrlotjlets%LVCDLJCKNKGCM XL]LOXMB

O scgecicmoet ojkuet ki ceikrjotcke rlgordceg tbl syjptkj ki tceectus moe hl dlvlnkpld hyoddctckeon lpcdljcknkgcm studcls cetk tbl mboromtlrcstcms ki tbl mkedctcke oed bcstkrcls oed dljkgropbcms ki tbl tceectus potclet pkpunotcke% Oeotckeon dotohosl wctb sborld ceikrjotcke irkj oslxtlescvl o pkpunotcke hosl os cs pksschnl sbkund hlmrlotld oed jocetoceld%

Tbl mknnlmtcke ki tbcs ceikrjotcke wcnn hl lx*trljlny usliun tk rlslormblrs oed mncecmcoes oncal cetblcr prk`lmt oed trlotjlet liikrts. os wlnn os cedljkestrotcke ki tbl prlvonleml oed scgecicmoemlki tbl mkedctcke ce ktblr liikrts tk ikmus ottletckeoed iuedceg tk tceectus os o eotckeon blontb prkhnlj%OT O'] XKNL CE TCEECT\] XL]LOXMB

Tbl eujhlr ki rlslormblrs cevknvld ce tblrlslormb ki tceectus bos hlle bcstkrcmonny sjonn ikrjoey rloskes% Ct rljoces oe lnuscvl oed mkjpnlxmkedctcke wbcmb joey smcletcsts oed mncecmcoes dk ekthlnclvl moe hl studcld wctb bkpl ki summlssiun kutmkjls% Ct cs ekt o gnojkrkus mkedctcke kr o pkpunormousl% Iuedceg ikr tceectus rlslormb bos hlle jcecjonce mkjporcske tk cts prlvonleml oed scgecicmoeml ce tblpkpunotcke% Tbl nlvln ki rlslormb mkedumtld bos ektonwoys jlt tbl bcgb stoedords ki tbl smcletcicm oedjldcmon mkjjuectcls% Tblrl onsk bos hlle ek mletron(mbojpcke( kr strkeg nlodlr ki tbl rlslormb liikrtsuedlrtoale tk dotl% OTO moe oed sbkund pnoy o rknl cecjprkvljlet ki lomb ki bksl orlos. hy toaceg oe omtcvlrknl os nlodlroed hy iomcnctotceg grlotlr mkjjuecmotckeoed mkkplrotcke ce tbl jldcmon oed smcletcicm rlslormbmkjjuectcls%

OTO sbkund mketceul tk hl o prcjory skurml

splmt oed ottletcke ki mncecmcoes oed smcletcsts wbkwcnn utcnczl tbl rlsunts ce prkdumtcvl woys%OTO's rknl os oe odvkmotl ikr plkpnl wctbtceectus sbkund cemnudl nlgcsnotcvl oed nkhhyceg liikrts tk ikmus tbl ottletcke ki Mkegrlss oed opprkprcotl ildlron oglemcls ke tceectus os o scgecicmoeteotckeon blontb prkhnlj. oed tk lesurl tbot tceectusrlslormb glts oddctckeon opprkprcotl iuedceg%]uppkrt ki jkrl hrocestkrjceg oed mknnohkrotcvl jlltcegs ojkeg tceectus rlslormblrs ke o rlgunor hoscs sbkund hl o prcjory purpksl ki tblkrgoeczotcke oed wkra grkups oed tosa ikrmls dlvlnkpceg elldld stoedordczotcke sbkund hl krgoeczld oed suppkrtld uedlr tbl ouspcmls kiOTO% Tbcswcnn iomcnctotl o grlotlr lxmboegl ki ceikrjotcke cehktb tbl rlslormb oed mncecmon mkjjuectcls%

]\JJOXSTbksl cevknvld ce tbl study kr suppkrt kitceectus sbkund toal o jkjlet tk hosa ce procsl ikrtblcr dldcmotcke oed plrslvlroeml ce oe uepkpunoroed irustrotceg iclnd ki study% Tbl liikrts ki hktbOTO oed cedcvcduon smcletcsts oed mncecmcoes wkrndwcdl bovl hrkugbt tbl tceectus potclet pkpunotckescgecicmoet cjprkvljlets ce trlotjlet oed uedlrstoedceg ki tbl mkedctcke%Ct cs ekw tcjl tk dlvlnkp o eotckeon kr cetlreotckeon strotlgy ikr dlonceg wctb tbl mkedctcke% Oekrgoeczld. ikmusld. bcgb*quoncty rlslormb liikrt justhl uedlrtoale tk toal odvoetogl ki tbl scgecicmoetstrcdls hlceg jodl ce jldcmon oed smcletcicm rlslormbglelronny% Tbl kppkrtuecty ikr rljoraohnl odvoemlslxcsts% O elw glelrotcke ki rlslormblrs sbkund hlrlmructld oed lemkurogld hktb hy iuedceg kiomtcvctclsoed upgrodceg tbl quoncty ki rlslormb uedlrtoale%

Jkst cjpkrtoet. o mkjjuecty ki rlslormblrsjust hl mrlotld% Mkjjuecty ce tbl slesl kimkkplrotcke.mknnohkrotcke oed mkjjuecmotcke% Oeytbceg nlsstboe tbot cs ueommlptohnl% OTO just krgoeczl. nlodoed iomcnctotl tbot mkjjuecty% Tk dk sk wcnn mrlotl o


21/27

grlotlr tbl byplromuscs% Ikr lxojpnl kel potcletwl tlstld rlvlonld o joxcjuj tknlroeml ki ?< dH]N "slesotcke nlvln# ot ?66Bz. 2 dH ]Not ?666Bzoed = dH ]N ot ?6.666 Bz%

Tbl lor cs lqucppld wctb o slt ki oiilrletelrvl ichlrs wbcmb toal elurknkgcmon scgeons irkjtbl ceelr lor up tk tbl hroce% Ce oddctcke tblrl cs osltkiliilrlet elrvl ichlrs wbcmb trovlrsl irkj tblhroce dkweword tk tbl ceelr lor% Tbcs liilrlet tromtcs aekwe os tbl kncvkmkmbnlor huednl oed ct csmkescdlrld hy jkst tk hl rlnotld tk nkudelss mketrknki skued ontbkugb tblrl cs o poumcty ki dcrlmt lvcdleml tk suppkrt sumb o mnocj% Ct cs vlry losy tkcjogcel tbl kncvkmkmbnlor huednl os o illd*homankkp tbl purpksl ki wbcmb cs tk gkvlre tbl ceputsystlj% Oed ct cs losy tk cjogcel tbot skjltbcegbos gkel wrkeg wctb tbl kncvkmkmbnlor huednl cetbl byplromuscs potclet%_%Jr% @% irkj JE mketceuls0 ( C dke't uedlrstoed wby yku odvkmotl dlslesctczotcke ikr byplromuscs ci tbl prkhnlj cs kel ki mknnopsld tknlroemlikr nkudelss%(O % susplmt C bovl usld oe cemkrrlmt tlrj tkdlsmrchl tbl rltroceceg C rlmkjjled tk byplromuscspotclets% \eikrtueotlny ct cs ekt tbl keny tcjl C bovlsugglstld ceopprkprcotl tlrjceknkgy oed prkhohnywcnn ekt hl tbl nost tcjl lctblr% C sbkund bovl monnldct rlbohcnctotcke ki tbl lor% Os C sll ct tbl prkmlss Cmonnld (dlslesctczotcke( cs o jottlr ki rltroceceg krrlbohcnctotceg tbl lor tk vlry groduonny ommlpt cemrlosceg nkudelss ki skued stcjunc% Tbl cdlo woshkre kut ki tbl aekwnldgl ki wbot irlquletny bopples tk potclets wctb ktksmnlrkscs wbk uedlrgk osummlssiun kplrotcke "stopldlmtkjy# tk rlstkrltblcr blorceg% Tblsl potclets bovl bod suhduld; l ~ g dul tk ~ m k e d u m t c v l blorceg nkss mousld hytjpotrld iuemtcke ki tbl hkels ce tbl jcddnl lor%~ l e tbly orl kplrotld upke tbl blorceg cs lsslehonny rlstkrld% Ylry irlquletny tblcr icrst wkrds orl

omuscs potclet oed ce jy kpcecke rltroceceg ki tblbyplromuscs lor cs tbl keny woy tk trlot byplromuscs%"]ll tbl elxt qulstcke ikr o pksschnl oddctckeontrlotjlet%# Ce oddctcke tk o dlslesctczotcke lxlrmcslC tbcea ct cs mrctcmon tbot tbl byplromuscs potclet ektkvlrprktlmt tblcr lors irkj ekrjon lvlry doyskueds ikr tk dk sk wcnn prkhohny wkrsle tbl mkedctcke% Jkst byplromuscs potclets gk ohkut wlorceglor pnugs onn tbl tcjl oed C tbcea tbot omtcke wcnnjoal tbl lors lvle jkrl cetknlroet ki nkudelss%_%Jr% V% irkj WO stotls C bovl toale Gceagkhcnkho ikr tceectus oed nk oed hlbknd jy byplromuscs cjprkvld/ Tbl tceectus rljoceld uemboegldhut tbl byplromuscs gkt jumb hlttlr% Moe yku lxpnoce tbot liilmt;(O %Ek. C moeekt lxpnoce tbl liilmt yku khslrvldhut C dk soy ci ct wkras mketceul tk usl ct% Joeywkund lxpnoce tbl rlsunt yku gkt irkj Gceagkhcnkho os o mkcemcdleml hut tbot cs oe losy woy kut%Ci ct bopples tbot yku gk kiiGceagk oed tbl byplromuscs rltures tk cts usuon nlvln nlt us aekw tblliilmt ki tbl slmked Gceagk trlotjlet%

JOS C O]A TBL XLODLX]BCV CI OES KTBLXBSVLXOM\]C] VOTCLET] BOYL KHTOCELD XL*NCLI IXKJ BSVLXOM\]C] HS TOACEGGCEAGK;_% r% X% ce ES soys0 (C oj onjkst oirocd tk osajy qulstcke. oirocd yku wcnn tbcea C ' j rkued*tblhled% Elvlrtblnlss blrl ct cs0 Wble C bovl tbl inuoed rue o ilvlr jy tceectus mkjpnltlny dcsop

plors/ Os tbl ilvlr suhscdls oed tbl inu gkls owoyjy tceectus rltures% C bovl khslrvld tbcs sojlliilmt o smkrl ki tcjls kvlr tbl ylors% Ct cs vlryprldcmtohnl% Moe yku lxpnoce ct;(O %Jr% X%. C moeekt lxpnoce tbot jkst ueusuonliilmt yku dlsmrchl% C ossujl tbot tbl tceectus dklsekt dcsopplor hlmousl yku orl dcstromtld wctb ykur


22/27

_ulstckes ) Oeswlrs "mketceuld#Jr% X% gkls ke tk soy tbot ekrjonny bl dkls

ekt tknlrotl mkiill ot onn wlnn hut durceg o mknd krinu ottoma bl moe drcea mkiill wctb cjpuecty%C JOS CO]A TBL XLODLX]BCV CI OES KEL BO]KH]LXYLD TBL LIILMT DL]MXCHLD HS JX% X%;_%Jr% M irkj VO dlsmrchls oe ueusuon mymnl kitceectus0 Ikr tbl post twk ylors C bovl owoaleldlvlry slvle doys tk o bcgb*pctmbld bcssceg ce jynlit lor% Oitlr slvle doys. tbl bcssceg stkps oedscnleml rltures ikr slvle doys% Tbl trcgglr lvlet csonwoys snllp% Xlmletny oe cjjueknkgcst trcld mkrtcskel ce`lmtckes wbcmb sbkrtleld tbl bcssceg mymnlstk ikur doys% Bovl yku lemkuetlrld oey mosls ki(MSMNCMON( tceectus oed moe yku kiilr oey cescgbts cetk pksschnl mousls;(

O%Wbot o iosmceotceg stkry% C bovl ekt slle ktblr(mymncmon( mosls sumb os yku dlsmrchl. ontbkugb wlbovl slle o sjonn grkup ki potclets wbksl tceectusinumtuotls oed wble ct mboegls irkj lctblr gkkd tkhod kr irkj hod tk gkkd ct cs onwoys durceg snllpoed elvlr wble tbly orl owoal% Wble tbly orl ceo gkkd pbosl lvle o mot eop moe rlvlrsl tbcegs% C'vldcsmussld tbcs jottlr wctb tbksl wbk study snllpoed tbly iocn tk kiilr sugglstld lxpnoeotckes% Tbliomt tbot mkrtcskel sbkrtleld ykur mymnl tk ikur doyssugglsts tbot tbl prkhnlj cs ekt ce skjl mymncmomtcvcty ki ykurs hut rotblr skjltbceg wbcmb mkundhl ontlrld hy mkrtcskel% Ce os jumb os snllp opplorstk hl tbl trcgglr joy C sugglst tbot yku usl ojosaceg skued durceg snllp tk sll ci tbot aced kioudctkry stcjunotcke wcnn ceinuleml lctblr tbl mymncmeoturl ki ykur tceectus kr cts nkudelss% Onsk joy Cosa ci ykur tceectus. wble ct cs prlslet. opplors tkglt nkudlr wble yku pnug ykur lor; "C sllj tk hlosaceg rotblr tboe oeswlrceg qulstckes%#Jlltcegs \pdotlhy Votrcmco Doggltt

Tbl Cetlreotckeon Blorceg ]kmclty blnd cts

O sljceor letctnld (Joeogljlet kt tbl Tj*ectus Votclet(. gcvle hy kel ki OTO's odvcskryhkord jljhlrs. Xkhlrt ]oednce. wos wlnn ottledld%

Wont Doggltt govl OTO lxlmutcvl osscstoet.Vot Doggltt. oed dlvlnkpjlet dcrlmtkr. HrletJkwlr. o boed rlprlsletceg tbl osskmcotcke% Ceikrjotcke oed nctlroturl wos dcssljceotld tk opprkxcjotlny 866 plkpnl wbk stkppld hy tbl OTO hkktbelxt tk tbl lxbchct bonn% Irll lor pnugs wlrl ovocnohnl ot tbl hkktb ikr tbl icrst tcjl tbcs ylor ce oeliikrt tk lemkurogl blorceg mkeslrvotcke%

0'n'n%en//nt%%Hrlet. Vot oed Wont portcmcpotld ce oe lornyjkreceg Iue Xue+Wona. spkeskrld hy Tbl HlttlrBlorceg Cestctutl% Keml ogoce. tblrl wos tbl kppkrtuecty tk plrskeonny jllt oed tona wctb blorceg prkilssckeons wbk trlot tceectus potclets oed sborl cescgbts%

Tbl Mkjhceld Ildlron Mojpocge gkt kii tk orkusceg stort ce ]lptljhlr wctb cedcvcduon stotl blontbiocrs omrkss tbl \%]% Tboeas tk kur joey vknuetllrswbk rlprlsletld tbl OTO ot tblsl lvlets. wl bovl


23/27

Xkod Tk Xlmkvlryhy ]tlioe V% Aruszlwsac. J%D%. Jldcmon Dcrlmtkr.Vsymbcotry. Vkttsvcnnl Bkspcton oed Worel Mncecm.Vkttsvcnnl. VO ?736?

Ce tbl lorny oitlrekke ki Ilhruory ?8. ?323tbl rcegceg ce jy lors hlgoe% Tbkugb ct plrscsts. t b l ~ bos hlle opprlmcohnl cjprkvljlet irkj tbot doy uetcnekw% Tbcs ommkuet cs cetledld os o pksctcvl jlssoglikr ktblrs wbk lxplrcleml tbl sojl prkhnlj%Wbot oiilmts kr wkrsles jy tceectus joy ektdk sk ikr yku% Tbl sojl cs trul ki wbot joals jceldcjcecsb% Tblrl orl joey ncalny mousls% Tblrl joyhl os joey sknutckes% Hut`ustos tbl tceectus stkrclski cedcvcduon plkpnl bovl blnpld jl iced oeswlrs.C bkpl tbcs oddctckeon slni*rlpkrt joy blnp skjlkelwbk stcnn nkkas ikr rlncli%Jy tceectus cs o iojcncon mosl% \eaekwe tk jlwble tbl rcegceg hlgoe. C suhslquletny nloreld ctonsk oiilmts jy twk hcknkgcmon schncegs oed jyiotblr% Jy 49 ylor knd scstlr oed C. ogl 48. blor orlnotcvlny bcgb irlqulemy homagrkued ekcsl wbcmbv%orcls ce cetlescty% Jcel cs mkescdlrohny jkrl plrststlet% Jy 42 ylor knd hrktblrblors juscmon jlnkdcls "l%g% (Dcxcl( (Mojptkwe Xomls(# wble bl cs

(mkeglstld%( Jy iotblr. o rkhust 26. lpcskdcmonnyblors hlnns. mbcjls oed wbctl homagrkued ekcsl%Onn ki us bovl lxmlnnlet blorceg. ueocdld% Lomb kius bos hlle jldcmonny lvonuotld% Ontbkugb kurslporotl stkrcls dciilr. kur mknnlmtcvl irustrotcke boshlle mkescdlrohnl%Oitlr jy tceectus hlgoe. C sow scx HkordMlrtcicld Vbyscmcoes "o Iojcny Vromtctckelr oed icvl

Lor*Eksl*Tbrkot ]plmconcsts# ce ?2 jketbs% Tblykrdlrld hnkkd wkra cemnudceg0 MXLOT. H\E.]GKT. ]GVT. NDB. onaoncel pbkspbotosl. omcdpbkspbotosl. jogelscuj. T=. T4. T]B. urcm omcd.BCY. Blpotctcs Vrkicnl. CgL% Onn tlsts wlrl ekrjonkr elgotcvl% Ktblr lxojs wlrl dkel os wlnn% Tblrlsunts sbkwld tbl iknnkwceg0 Ekrjon LAG% \erle0toraohnl urceonyscs% Ekrjon mblst R*roy% Ekrjon

Tbl pbyscmcoe rlspkesls tk jy tceectus vorcld%Dlspctl hlceg osyjptkjotcm. jy LET lxojceotckes wlrl rljoraohny dciilrlet% Mbort ? * wcnnsummcemtny prlslet tbl splmconcsts' mkjjlets oedicedcegs% Wblrl opprkprcotl. jy rlspkesls tk tblcrsugglstckes orl oddld%Lcgbtlle jketbs ki irustrotcke/ Jy tceectuswos hoslncel owiun% C hlgoe tk nkka ikr jy kwe

oeswlrs% C rlod juntcpnl poplrs irkj tbl jldcmonnctlroturl% Jumb ki tbl mncecmon wkra wos dcsmkurogceg% C dcd ekt woet tk lxplrcjlet wctb ncdkmocelkr morhojozlpcel ekr ceekvotcvl oed ueprkvlesurgcmon tlmbecquls% C rlod tbl ceikrjotcke jocnldtk jl irkj tbl Ojlrcmoe Tceectus Osskmcotcke"OTO#% Tbcs wos o tureceg pkcet% Tblrl wos rlncliaekwceg tbot ktblrs iomld tbl sojl prkhnlj *lvleci tbl oeswlrs wlrl lnuscvl%C rltureld tk tbl LET splmconcst wbk bod hllelsplmconny ljpotbltcm% Wl hlgoe tk wkra tkgltblr%Wctb bcs blnp oed tbl OTO nctlroturl. lorny cemkescstlet cjprkvljlets snkwny govl woy tk scgecicmoetrlncli% Mborte ncsts wbot bos blnpld jy tceectus. wbotbos ekt. oed wbot opporletny joals ct wkrsl%

Ikur oed kel*boni ylors notlr. C stcnn bovl tceectus% Tbot cs tbl hod Elws% Tbl gkkd elws "ci wlmoe prkpkrtcke ct# cs tbot ?


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Xkod tk Xlmkvlry "mketceuld#jldcmon smbkkn kr tbl Ojlrcmoe Tceectus Osskmcotcke%Mbort C Vbyscmcoe Mkjjlets

?% IV*?0 (C wcsb C mkund blnp% C gulss yku orl`ust gkceg tk bovl tk joal tbl hlst ki ct%(8% LET ? 0 (Ct's mbrkecm onnlrgcls% Glt tbcsquoetctotcvl CgL nlvln. oed tble toal tblsl "oetchcktcms pnus mkrtcmkstlrkcd eoson sproy#%(

5 Outbkr's Ektl0 Tbcs mkjhceotcke govl jl dcor*rblo oed jodl jy eksl hnlld% Ct dcd ekt oiilmtjy tceectus wbotsklvlr%=% LET*80 (Skur prkhnlj cs ykur tkescns% Sku

moe't sll ct. hut tbly orl ceilmtld ce tbl homa% Skuprkhohny glt mbrkecm suhmncecmon lor ceilmtckes%Nlt's toal tblj kut%(5 Outbkr's ektl0 C bovl ekt bod tkescnnctcs. ekr oelor kr tbrkot ceilmtcke sceml jy tceectus hlgoe% Cdlmnceld tbl kiilr tk bovl jy tkescns rljkvld%

4% LET*=0 (Sku orl prkhohny gkceg tk snkwnynksl ykur blorceg% Hut. yku dke't elld o blorcegocd ylt% Wby dke't yku mkjl homa oed mblma wctbus ce scx jketbs tk o ylor oed wl'nn rllvonuotl ykurblorceg tble;(


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Tbl Hlst Jldcmcelhy Horhoro Tohombecma. Mnclet ]lrvcmlsMkkrdceotkr

Tbl keslt ki tceectus cs kitle jlt wctbpoecm iknnkwld hy jod dosbls tk joey dkmtkrsikr oeswlrs% Tbl iomt tbot tbl oeswlrs rlmlcvldhy elw tceectus suiilrlrs orl sk kitle uesotcsiomtkry rocsls cts kwe qulstckes% Cs ct hlmousltbl tceectus suiilrlr cs oexckus oed wkrrcld oedekt ohnl tk mnkslny ikmus ke tbl potclet+dkmtkrdconkgul; Cs ct hlmousl tblrl orl tkk joeyblontb prkilssckeons wbk orl stcnn ce tbl doraohkut tbl trlotjlets oed mousls ki tceectus; Kr cs ct tbottbl rcgbt qulstckes orl ekt hlceg osald;

Tceectus suiilrlrs rlonny keny bovl kel qulstcke *(Bkw dk C glt rcd ki tbcs ekcsl ce jy blod;( * o qulstckeikr wbcmb tblrlmkundhl buedrldskioeswlrs% Hut cescstcegke lxtro mkevlrsotcke wctb ykur jldcmon prkilssckeon cscemrldchny wkrtbwbcnl. hktb ce tlrjs ki mnlorny uedlrstoedceg tbl kptckes oed ce glttceg tbl rlossuroeml tbot csvcton% Xlgordnlss ki tbl keslt dotl ki ykur tceectus. c i ykuorl stcnn sllaceg jldcmon oeswlrs. tbl iknnkwceg qulstckesikr blontb morl prkilssckeons jcgbt hrceg yku tbl ceikrjotcke yku rlonny woet%Wbot trlotjlets orl ovocnohnl;Wbot trlotjlets bovl yku usld ]\>0Ml]]iunny;Orl tblrl potclets ce ykur promtcml wbk bovl tceectus wbk bovl hlle blnpld ;Wbot cs ykur trlotjlet pnoe ikrjy tceectus%Wcnn yku lxpnoce onn ki tbl rcsas+scdl liilmts ki tbl trlotjlets kr drugs;Wbot orl tbl lxomt cestrumtckes ikr ton>ceg tbcs jldcmotcke; "Ikkds. drugs tk ovkcd%#Wbot cs tbl lxomt dcogekscs; "Wrctl ct dkwe%#Wbot lxplmtotckes moe Cbovl ikr rlncli irkj tbl tceectus kro lture tk ekrjon blorceg;Wbot moe C dk tk prlvlet cts lxomlrhotcke;Bkw moe wl dlmcdl wbot mousld jy tceectus;Mkund ct hl mousld hy oTJ@ dcskrdlr; Odrug C'j toaceg;Moe wl runl kut o ujkr sk C moe stkp wkrryceg;Wbot tlsts dk yku rlqucrl kr sugglst;Wbot wcnn tbl tlst hl ncal. oed bkw jumb wcnn ct mkst;Wcnn hl uemkjikrtohnl. oed ci sk. ikr bkw nkeg;Ci C'Yl bodo lst lnslwblrl. dk C elld tk rlplot ct;Bkwjoey v c ~ dk yku tbcea Cwcnn elld;Bkw jumb ki tbcs wcnn hl mkvlrld hy jy cesuroeml;Dk yku bovl potclet ceikrjotcke ikr jl tk rlod ohkut tceectus;Wcnn glttceg o blorceg ocd "kr rlicttld ikr jy blorceg ocd# oiilmt jy tceectus;Wbot lnsl moe Cdk ke jy kwe tk blnp; "Dclt. lxlrmcsl. levcrkejlet%#

Ct cs sugglstld tbot yku hrceg tbl iknnkwceg wctbyku wble yku vcsct ykur dkmtkr kr blorceg blontbprkilssckeon0Omkjpnltl. dltocnld wrcttle ncst ki ykur syjptkjs%* Mkpcls ki onn ki ykur prlvckus tlst rlsunts oed oudckgrojs%*O wrcttle \st kiONN jldcmotckes "KTM oed prlsmrcptcke# yku orl murrletny toacegkr bovl `ust rlmletny toale%"Hl rlody tk glt oslmked kpcecke ci surglry cs tbl icrst sugglstcke%#

Ct bos nkeg hlle khslrvld tbot plkpnl wbk od`usttbl hlst orl tbl kels wbk dk os jumb ikr tbljslnvlsos pksschnl%

Ce o rlmlet nlttlr. kelkikurslni*blnp mkkrdceotkrstknd us ki blr illncegs ohkut wkraceg wctb blr grkupoed blr cevknvljlet wctb OTO% (C illn gkkd %% Ekt kenydk C blnp jyslni. hut C blnp ktblrs oed ct 's sk sotcsiyceg%C illn ncal C'j jy kwe hlst jldcmcel%( Kur ]lni*Blnpvknuetllrs gcvl tcjl tk tblcr mkjjuectcls oed blnp tkplkpnl wbk orl ce dcstrlss% Tbly dcstrchutl kur hrkmburls hy tbl tbkusoeds. ottled nkmon blontb jlltcegstk dcsmuss tbl prlvonleml ki tceectus oed puhncmczl tblslrvcmls wl kiilr% Oed tbly bovl nlt us aekw tbot lvlrsceml tbly osald ikr ceikrjotcke ohkut hlceg port ki kursuppkrt eltwkra. tblcr cevknvljlet wctb OTO bos hlmkjl tblcr tblropy ki mbkcml% Tbl opprkprcotl blontbmorl oed tbl hlst jldcmcels kitle opplor. ct slljs. wblewl osa tbl rcgbt qulstckes ** ki kur dkmtkrs oed kurslnvls%

Kur ]uppkrt Eltwkra vknuetllrs orl tbl boedsoed vkcmls ki OTO% Wl grotliunny wlnmkjl scx elwsuppkrt grkup mkkrdceotkrs oed tbrll elw tlnlpbkel mketomts tk kur grkwceg eltwkra%Grkup MkkrdceotkrsJorgorlt Turelr. W Vonj Hlomb. IN 467+73?*?849@udy Hrcvmbca. Noemostlr VO. 7?7+=3=*4873@kly Oaces. Mbottoekkgo TE+Mbcmaojougo GO.769+=7


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Trchutls. ]pkeskrs. ]plmcon DkekrsTbl OTO trchutl iued cs dlscgeotld ?66, ikr rlslormb% Tboea yku tk onn tbksl plkpnl ncstld hlnkw ikrsborceg jljkrohnl kmmosckes ce tbcs blnpiun woy% Mketrchutckes orl tox dldumtchnl oed orl prkjptny omaekwnldgld wctb oe opprkprcotl mord% Tbl gcit ojkuet cs elvlr dcsmnksld%GO] IXKJ)*?*3=*66tk ?6*=?*3=CE JLJKXS KIHlreord HrkweHltty Ohhktt HrkweJknny LdlrJorsbo ) Jkrtke HlrakwctzOrtbur Bcrsbhlrg's JktblrMnocrl ) @omquls ]cjke\emnl Tld @orvcsWcnncoj @ BosaceHlnno AoytlsVoun AoytlsBlrjoe NklhJr ) Jrs @kbe JlylrBkword Kppleblcj]oj )]ynvco LcslehlrgJorcnyee ]jctb's JktblrMkestoeml L IorrlnnMnoro ]tualyDlncnob BknnkpltlrCE BKEKX KIOdlnl H Onoj*Hcrtbdoy@kslpb Onoj+Trudy Drumalr@kslpb G Onoj*HcrtbdoyOdlnl ]Onoj@kbe ) @uncl OnojTrudy Drumalr@unls B DrumalrJkro Ljce@cj ) Xksoncl TrovlrJory ) Votrcma TunnyXkeond Hureboj*]plldy Xlmkvlry

@loe*Mnoudl Oiikntlr@unls Drumalr*Hcrtbdoy@kslpb Onoj+Trudy DrumalrJr ) Jrs Gkndjoe*


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TCEECT\]WB/B ]\BM/ C] O]\OEM?Eni'"nnn%% tn '*(*('(%. %%%%%%%%AtnniS CCAti %C@CCKCCJ% %k*% %%%% % % % % % % %%%%%%%%%%%%%%%%%%%%%%[[

tc nnl ]nw/5Vcr d[%.@#C._%@^'Cinnnnt%w5

A O % % E C ~ h # % n k K C M K

~ 4 F ? TBL ]LNI*BLNV

%%**^S@knj T*%ndly. D%D%]%

%%% %%%%%%%%%%.[%%TnnniccT\]rw ew ????? w

C4 ? ?\ C C C C n[%%%%%%%%%

Tceectus * Nlorecet0 tk Ncvl Wctb Ct]ugglstckes oed odvcml irkj outbkrs wbkkvlrmojl jumb ki tblcr jcslry%hy Nlsncl ]blppord oed Oudrly Bowarcdgl

Tceectus0 Wble ]cnleml cs o]troeglr\sliun ceikrjotcke ohkut tceectus mousls.rlnotld prkhnljs oed trlotjlet jltbkdsCemnudls dcsmusscke ki ontlreotcvl jldcmcel. josalrs. oed psymbknkgcmonny hosldtrlotjlet tlmbecquls%by Nlsncl ]blppord

TJ%C tbl ]lni*Blnp VrkgrojBkw tk rlmkgeczl o TJ@ prkhnlj. rlnclvlpoce oed rlstkrl blontb% Wble tk slla prkilssckeon blnp%hy @kbe Toddly

Tceectus0 Wbot cs tbot Ekcsl ceJy Blod;Mnlor ceikrjotcke ohkut mousls oed trlotjlets. hktb jldcmon oed eke*jldcmon% Cemnudls oe oiilmtceg plrskeon ommkuet hy tbloutbkr. wbk bos hottnld slvlrl blorceg nkssoed tceectus sceml mbcndbkkd%hy @koe ]ouedlrs

Mkjpnltl Hchnckgropby1 ncstceg kvlr 8.

tinnitus today december 1993 vol 18, no 4

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