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Test Number : MS-201
Test title : Implementing a Hybrid and Secure Messaging Platform
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Implementing a Hybrid and Secure Messaging Platform education

Perceptions of cell technology for heart Failure schooling and Self-administration among middle-Aged and Older Adults | MS-201 Dumps and existent exam Questions with VCE drill Test

cellular know-how is rapidly changing the pass fitness keeping suppliers can interface with patients (Schaeffer, 2012). These technological devices are simply accessible as smartphones, drugs, and laptops and Have the capabilities to enhance how individuals control their typical health and purchase Part in habitual disease self-administration (Jacelon, Gibbs, & Ridgway, 2016; Schaeffer, 2012). the utilize of mobile technology may give suppliers immediate access to information vital to manufacture treatment choices, lower patients' shuttle instances, allow bucolic hospitals to manufacture utilize of far off fitness keeping groups, and enable sufferers to achieve keeping near their households and primary keeping providers (Winkler & Ripton, 2016). cellular know-how besides enables for faraway monitoring in which sufferers can listing their personal health fame and instantly transmit tips to their fitness keeping team, potentially maintaining patients out of the healthcare professional's workplace, and decreasing fitness keeping fees through heading off hospitalizations (Lopez, Seville, & Javitt, 2014). in addition, this sort of know-how can give patients with ailment-selected fitness tips and reminders about self-management behaviors, akin to taking medications, weight loss plan, and endeavor, as well as early recognition of worsening signals and symptoms, or figuring out when to contact their health keeping professional (Toukhsati, Driscoll, & Hare, 2015). there's an rising position for cell expertise for managing persistent situations (Bodenheimer, Lorig, Holman, & Grumbach, 2002).

approximately 83% of U.S. adults utilize smartphones and many adults besides utilize text messaging (Suffoletto, Calabria, Ross, Callaway, & Yealy, 2012). due to the lofty penetration fee of cellphones in society, this technological platform has the abilities to exist an exemplar option for attaining older adults (Joe & Demiris, 2013). cell technology could probably exist used as a platform for making improvements to the fitness of older adults, mainly those with interminable ailments similar to heart failure (HF).

within the U.S., HF impacts >5.7 million americans, with about 660,000 new situations diagnosed every year (American heart association [AHA], 2017; Division for coronary heart disease and Stroke Prevention [DHDSP], 2016). it is expected that HF charges will multiply forty six% by using the yr 2030 (AHA, 2017; DHDSP, 2016). Older adults event lofty prices of HF, and this costly and preventable disease frequently effects in hospitalizations, complications, and early mortality (AHA, 2017; DHDSP, 2016). When patients are diagnosed with HF, there's progress firstly, however lengthy-time period, all-cause mortality fees are excessive. Ineffective self-management contributes to most of the needy effects in patients with HF (Gardetto, 2011). The simple accountability of self-administration rests on patients and their personal aid system. complicated ailments fancy HF require immoderate degrees of health literacy, capabilities, and edge to manufacture remedy selections. Self-administration of HF comprises monitoring indicators; following medicine plans, weight loss plan, and undertaking routines; recognizing health changes; and responding by enhancing their behaviors or requesting suggestions (Toukhsati et al., 2015). Empowering sufferers to interact in advantageous self-administration of HF should exist a purpose for each and every suppliers (Ibrahim, Tawfik, & Abudari, 2016). The merits of self-administration encompass improved first-rate fitness keeping and better fitness consequences (Gardetto, 2011).

When patients with HF are discharged from the medical institution, the discharge guidelines can besides exist overwhelming and the educational substances may exist lost or by no means consulted once more (Athilingam et al., 2016). In a society filled with expertise and ailments, further the prerogative pass to assist sufferers with realizing their discharge education and their efforts to try for healthier results can besides exist supplied. promotion affected person self-care and early issue detection is crucial (Paul, 2008). in accordance with Bui and Fonarow (2012), now not each and every patients can participate in HF programs because of geographic boundaries, socioeconomic constraints, or different obstacles. for this reason, the utilize of know-how to assist patients' self-management expertise is essential and has talents to enrich best of lifestyles and effectiveness of HF keeping (Gardetto, 2011). yet another competencies prize for expertise is accelerated patient assignation in their health care.

thus far, prior interventions using know-how comprehend using prudent buildings for health monitoring, videophones for telehealth applications, and sensors for detecting patient falls (Demiris & Hensel, 2008; Jacelon & Hanson, 2013; Nahm et al., 2008). besides the fact that children, to advertise the utilize of this expertise, sufferers need enough working towards, entry to web connectivity, and faith that this expertise may exist improving their first-class of existence. In a meta-review by using Jones, Lekhak, and Kaewluang (2014) on using cell phones and brief message services (SMS) for self-administration of interminable conditions, SMS messaging was discovered to vastly multiply patients' adherence for holding appointments, taking HIV antiretroviral therapy, conducting diabetes self-management behaviors, attaining smoking cease charges, and improving blood drive and bronchial asthma manage. despite the fact, among the eleven systematic studies blanketed during this meta-assessment, data on the utilize of cell phones and SMS messaging among adults with HF had been missing as neatly because the utilize among older adults (Jones et al., 2014). The authors recognized a need for research to establish who's greater more likely to utilize cellular know-how as a Part of self-care to goal populations and tailor interventions.

Nundy et al. (2013) pronounced promising effects in a search for at the utilize of textual content messaging with lower profits, city-residing African American patients who had been readmitted for acute decompensated HF. members bought text messages providing self-care reminders and patient education on weight-reduction plan, symptom awareness, and fitness keeping navigation for 30 days after health facility discharge (Nundy et al., 2013). on account of using text messages, contributors in the dissect experienced a discount in neglected capsules, decreased salt consumption, and an multiply in health maintenance and administration. A barrier recognized by pass of analysis individuals changed into want of access to cellphones (Nundy et al., 2013). barriers of Nundy et al.'s (2013) search for at included its wee sample measurement (N = 15) and immoderate attrition expense, as simplest six members completed the post-intervention survey. furthermore, the intimate age of individuals turned into 50 (range = 23 to sixty nine years); therefore, information related to older adults changed into confined.

In a pilot search for at aimed toward realizing how a mobile fitness (mHealth) system might effectively aid patients with HF after transitioning domestic from the health facility, researchers discovered lofty tiers of consumer delight with the mobile device and improvement in patients' character of lifestyles (Alnosayan, Chatterjee, Alluhaidan, Lee, & Houston-Feenstra, 2017). in this study, eight patients (suggest age = 61.5 [SD = 9.3 years]) and nurses continuously used the device for six months and Have been able to efficiently identify eight fitness deteriorations, which were coronary heart fee, blood pressure, weight, glucose, shortness of breath, high-chance heart attack, and two flu emergency circumstances. five of these health deteriorations had been fully managed remotely and protected heart expense, blood pressure, weight, glucose, and shortness of breath (Alnosayan et al., 2017). contributors mentioned the utilize of the mHealth system assisted in recording biophysical markers and picking and treating issues sooner. in addition, participants articulated better communique with their fitness keeping team and receiving necessary reassurance and encouragement. advised improvements described through participants for the utilize of technology for HF management blanketed having technical champion with no ail purchasable and more customized messages (Alnosayan et al., 2017).

although evidence is purchasable assisting using mobile technology for habitual disorder management, the facts customarily are from studies with wee sample sizes, restrained inclusion of adults aged ≥65, habitual ailments other than HF, and shortage of counsel on members' perceptions of using expertise for self-administration. research is required to better Have in intellect patients' willingness to gain information of, acceptability of, and perception in cellular technology to enrich affected person self-administration and health consequences in persistent sickness administration, chiefly amongst older adults with HF.


Given the growing inhabitants of adults with HF and the incontrovertible fact that many older adults Have access to cell technology, realizing patients' perceptions of using technology as Part of HF self-administration is critical. The goal of the present pilot dissect changed into to survey center-aged and older grownup patients with HF who obtained keeping in an outpatient fitness keeping setting to check their existing utilize of mobile expertise and identify if they believed know-how would exist effectual in getting to know more about HF and in the event that they had been willing to utilize cell know-how for HF schooling and self-management. Findings from the present dissect can exist used to boost or modify outpatient HF schooling classes to Excellerate the keeping this population receives and cease useless hospitalizations or problems.

MethodStudy Design, sample, and atmosphere

The existing dissect turned into a move-sectional, descriptive quantitative search for at with a console pattern of patients with HF recruited from an outpatient HF clinic within the southeastern united states. Inclusion criteria Have been age ≥18; in a position to communicate, study, and write in English; and self-suggested prognosis of HF. anyone collaborating in a different HF research study become excluded from the present study.

This geographic enviornment of the united states has one of the vital optimum fees of cardiovascular disease (CVD) within the nation (DHDSP, 2017). The HF health facility is a tertiary seat and offers a plenary range of cardiac keeping features, including excessive-degree diagnostic tests, professional assessment from qualified specialists, service for coronary heart instruments, and revolutionary cardiac remedy alternatives for participants in urban and bucolic settings. patients receiving keeping from this clinic both are live in medium metropolitan areas or within the surrounding bucolic communities, as defined by means of the U.S. Census Bureau (2018). It become anticipated that some patients can besides drive a distance to receive cardiac metier care. Most of this geographic belt has been divorce as medically underserved areas (MUAs; health supplies and services Administration [HRSA], 2019).

Recruitment and facts collection

in foster of the birth of the present analyze, a letter of champion was bought from the Institutional evaluate Board (IRB) Coordinator of the HF hospital giving license to recruit participants, and the search for at became accepted by pass of the institution of North Carolina at Greensboro's IRB. sufferers being seen in the outpatient HF clinic had been provided with an assistance sheet and flyer explaining the goal of the current examine by pass of the first author (V.T.).

competencies participants had been suggested that participation turned into voluntary, they could discontinue search for at participation at any time, skip any survey questions they did not are looking to answer, and their election to participate or not in the examine would not exist communicated to the fitness keeping crew or Have an outcome on in any manner the capabilities they receive from the HF health facility. A plenary rationalization of the present search for at and survey was given to contributors by pass of the first author and each and every questions Have been answered. counsel sheets, as opposed to signed consent forms, had been used as the examine turned into decided to exist low risk through the IRB. every participant was given a copy of the suggestions sheet for his/her personal statistics. there Have been no incentives for collaborating within the study.

contributors completed the self-administered written survey in a private scope within the HF health facility with the primary author current in case anybody had questions. The survey took about 5 to 10 minutes to complete and no personal identifiable assistance turned into gathered. Upon completion, surveys Have been saved in a secure vicinity. Survey statistics Have been entered into password included digital information and saved on a at ease community system and simplest attainable through the examine authors (V.T., k.A.).

Survey Instrument

A 23-merchandise survey designed by pass of the authors changed into used and contained demographic questions and questions pertaining to preferred methods of receiving health education, current utilize of cellular know-how, and beliefs and willingness to the utilize of cell know-how for HF training and self-administration. The questions had been developed according to assistance realized from the literature and preferred abilities for making a technology-based HF intervention for older adults. The paper and pen survey changed into designed with larger font measurement in anticipation of getting older adults purchase Part in the study. The response options comprised dichotomous or multiple-option options or a 5-element Likert scale comprising truly yes, likely sure, may or could now not, doubtless not, and definitely not. The survey turned into reviewed with the aid of two nurse practitioners skilled with the geriatric inhabitants for content material and ease of utilize and was pilot proven in the latest analyze.

statistics analysis

data analysis become carried out using SPSS version 25.0. statistics entry changed into demonstrated for accuracy. Descriptive statistics Have been used to dissect the facts. categorical variables Have been described the utilize of frequencies and percentages.


a total of 48 adults with HF Have been attracted to taking Part within the current examine. Eleven individuals Have been ineligible as they had been participating in one other HF analyze. The ultimate pattern comprised 37 adults and most contributors Have been guys (fifty nine.5%), and 54.1% of members self-identified as being age ≥65 (table 1). more than one half (fifty six.7%) of the pattern described having some college training or having achieved school. each and every participants lived in MUAs (HRSA, 2019) and most individuals (57%) were from bucolic communities, whereas forty three% lived in medium metropolitan areas (U.S. Census Bureau, 2018). approximately one quarter of members disclosed traveling 31 to 61 miles a technique to exist considered at this tertiary outpatient HF sanatorium for keeping and forty six% of the pattern lived inside 10 miles of the medical institution (table 1 and table 2).

Sample Characteristics (N = 37)

desk 1:

sample features (N = 37)

Current Technology  utilize and Preferred Methods of Education by Age Group (N = 37)Current Technology  utilize and Preferred Methods of Education by Age Group (N = 37)

table 2:

present technology utilize and favorite strategies of training by means of Age community (N = 37)

The friendly favorite methods for receiving HF management training identified with the aid of members age ≥sixty five (i.e., older adults) had been face-to-face dialogue (eighty five%) and paper handouts (15%; desk 2). contributors age ≤sixty four (i.e., core-aged adults) besides preferred face-to-face dialogue (52.9%) as their usurp option for studying; although, 23.5% of this age neighborhood suggested preferring gaining information of electronically, eleven.eight% with the aid of paper handouts, and 5.9% via looking at movies. When older adults Have been requested to select their 2d excellent preferred system for receiving HF education, forty five% chose paper handouts, 20% electronically, 15% by means of watching videos, and 10% each for demonstration or face-to-face dialogue; amongst center-aged contributors, the 2d most favorite formulation for receiving educational suggestions comprised videos (35%) and demonstrations (17.6%). One quarter (25%) of older adults and 29.four% of center-aged individuals stated the utilize of their electronic scientific checklist portal gadget to teach themselves about HF.

excessive quotes of cell (60% of older adults; forty seven% of middle-aged adults) or smartphone (25% of older adults; seventy six.5% of middle-aged adults) utilize had been stated with more wise-mobilephone utilize mentioned among the core-aged group. both age groups described using numerous electronic instruments including laptop and computing device computers, smartphones, capsules, and iPads®. Forty percent of older adults and sixty four.7% of center-aged adults disclosed discovering the web handy to use. about one quarter of center-aged adults and forty% of older adults, however, pronounced no longer the utilize of the cyber web. amongst contributors who pronounced the utilize of the web, 35% of older adults and 35.three% of core-aged adults described using the web ≥6 hours weekly and 20% of older adults and 29.four% of core-aged adults used the cyber web 1 to five hours weekly. amongst older adults, forty five% said the usage of facebook and 35% used textual content messaging. 5 men and women age 70 to seventy nine years said textual content messaging utilize and 5 men and women age 70 to 79 years together with two men and women age 80 to 89 years suggested the usage of facebook. core-aged adults mentioned using distinctive sorts of gregarious media with most using text messaging (88.2%), adopted via facebook (seventy six.5%), Instagram® (17.6%), LinkedIn® (17.6%), and Twitter® and Snapchat® (5.9% each) (desk three).

Attitudes About Technology by Age Group (N = 37) (Middle-Aged Group [≤64 Years] N = 17; Older Adult Group [≥65 Years] N = 20)

table 3:

Attitudes About expertise through Age community (N = 37) (core-Aged neighborhood [≤64 Years] N = 17; Older adult group [≥65 Years] N = 20)

A sequence of questions Have been asked to better maintain in intellect members' attitudes toward know-how (desk 3). Most older adults (70%) and core-aged adults (88.2%) stated believing that know-how can basically or doubtless positively outcome health care. furthermore, most contributors believed that expertise could abet them multiply HF self-management (70% older adults; 88.3% core-aged adults) and abet about coronary heart disorder (seventy five% older adults; 94.1% center-aged adults). immoderate ranges of willingness to utilize know-how for HF education were pronounced through older adults (60%) and center-aged adults (eighty two.four%). Many older adults (60%) and core-aged adults (ninety four.1%) stated believing that practising would allow them to more advantageous utilize expertise. One half of older adults and 70.6% of middle-aged adults described trying training on using know-how for training and to self-manipulate their HF circumstance.


`among the existing pattern of center-aged and older adults, technology is already getting used for day after day activities. Such devices as mobile telephones, smartphones, computers and tablets, and gregarious media systems, similar to fb and text messaging, Have been reportedly used by using each and every age companies. These findings are comparable to the search for at through Anderson and Perrin (2017) in which 85% of adults who owned a cell Have been aged ≥sixty five and 42% of individuals aged ≥sixty five owned a smartphone. previous analysis shows that cell phones and text messaging expertise Have the talents to abet habitual sickness self-administration (Jones et al., 2014).

high tiers of effectual beliefs about technology and the willingness to manufacture utilize of know-how to aid with enhancing HF talents and self-administration had been establish among the many latest sample of predominately older adult sufferers with HF. This discovering has essential implications for addressing the needs of patients with HF. increasing patient and abet device entry to capabilities or receiving know-how-based mostly self-care reminders might besides Excellerate HF self-administration and avoid emergency department visits and/or evade hospitalizations. furthermore, this mode of champion can besides multiply sufferers' and family members' self-efficacy and assignation in self-care decision making. increasing patients' self faith and self-care abilities is crucial as a result of so a much deal of the success of HF management is elegant on the affected person (Gardetto, 2011). the usage of mobile technology as a Part of HF self-management may multiply access to keeping among the many current search for at's sample, a lot of whom are older adults and might Have transportation barriers for follow-up keeping or live in bucolic areas. facts stated with the aid of Nundy et al. (2013) shows that sending text messages to patients with HF can reduce back the variety of neglected tablets, decrease salt consumption, and boost fitness preservation and management behaviors. besides the fact that children, research evaluating the effectiveness of using cellular expertise as Part of HF education and self-management amongst greater sample sizes that comprehend older adults is needed.

furthermore, one other vital finding from the existing search for at became that middle-aged and older adults believed training would enable them to Excellerate their utilize of know-how and most contributors expressed a need for practicing on know-how utilize to stronger keeping for their HF situation. for this reason, as HF affected person education classes are designed for older adults, incorporating cellular know-how and including training for patients and their guide system would exist essential. courses might comprehend the utilize of facebook, textual content messaging, and movies as these are systems older adults are already the utilize of or are looking to learn the pass to manufacture utilize of and might exist accessed from gadgets similar to smartphones and pills.

Nurses Have a crucial position to play in designing HF courses that comprehend cell expertise for older adults and helping them in fire confident to manufacture utilize of this expertise to multiply their health. Designing mHealth HF programs the utilize of bold shades, huge font sizes, less complicated illustrations, and blinking bins may besides abet older adults to navigate via content (Fletcher & Jensen, 2015). Embedding brief academic videos that can besides exist readily accessed from a smartphone or pill devoid of requiring navigation to dissimilar windows may additionally facilitate ease of use. constructing practising and succeed periods for sufferers and their guide grownup on navigation of the HF program and presenting step-by pass of-step directions with photographs and array pictures could exist crucial along with schooling on a pass to in the reduction of glare from monitor displays and enlarging font measurement on their devices (Fletcher & Jensen, 2015). Demonstrating how cellular expertise can in my view capitalize the particular person and abet in self-care can exist censorious in overcoming acceptance obstacles.


The latest dissect had several obstacles. First, it turned into a pass-sectional, descriptive dissect with a console pattern from one HF hospital, consequently limiting the generalizability of consequences. lofty tiers of education and access to know-how had been discovered among the many pattern along with willingness in the usage of expertise for HF schooling and self-management; youngsters, these views may exist distinctive from different patients with HF who selected not to participate in the search for at or who've lessen academic levels and/or access limitations to cellular expertise.

When designing the survey, email communique changed into unnoticed and never included as a likely response alternative to the question on gregarious media utilize besides the fact that email is essentially the most pervasive e-communique technology (Weaver, Lindsey, & Gitelman, 2012). together with email may additionally Have provided extra effectual assistance. ultimately, the survey questionnaire did not supply a description of mobile phones for respondents to differentiate between cellular phones with textual content messaging and gregarious media capabilities versus older cellular flip phones without these capabilities. now not providing descriptions of the several types of mobile phones may besides Have led to confusion for members.


applied sciences Have the skills to multiply access to fitness information and enhance how people self-control their fitness and purchase keeping of persistent ailments (Jacelon et al., 2016). Findings from the existing study point out that older adults are already using technology and Have superb attitudes about the utilize of technology as a Part of HF management. These search for at findings can inform the pile or amendment of outpatient HF schooling classes, doubtlessly enhancing HF self-administration practices.

despite the fact now not every affected person embraces know-how, for these inclined, having a chosen portal for the HF clinic may additionally radically change the pass education and self-administration are viewed and followed by means of patients. Designing and imposing technologically based mostly HF administration and schooling classes could exist an excellent haphazard to attain this starting to exist population. Future analysis is needed to examine the utilize and effectiveness of cellular expertise as a Part of HF self-management among older adults.

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  • table 1

    sample traits (N = 37)

    Variablen (%)Gender  Male22 (59.5)  Female15 (forty.5)Age (years)  ≤597 (18.9)  60 to 6410 (27)  65 to 692 (5.4)  70 to 7910 (27)  ≥808 (21.6)education stage  excessive faculty or less16 (forty three.2)  Some college14 (37.eight)  faculty or higher7 (18.9)Miles driven a system to the medical institution  0 to 1017 (forty six)  11 to 202 (5.four)  21 to 306 (16.2)  31 to 403 (8.1)  forty one to 616 (sixteen.2)  lacking data3 (eight.1)desk 2

    present expertise utilize and preferred strategies of education by means of Age community (N = 37)

    Variablen (%)middle-Aged neighborhood (≤sixty four Years) (n = 17)Older adult neighborhood (≥65 Years) (n = 20)sorts of telephones owneda  mobile phone8 (forty seven)12 (60)  Smartphone13 (76.5)5 (25)  does not personal a mobile phone0 (0)1 (5)sorts of digital devices used  Smartphone13 (76.5)5 (25)  laptop computer11 (sixty four.7)10 (50)  desktop computer7 (forty one.2)5 (25)  Tablet7 (41.2)2 (10)  iPad®four (23.5)2 (10)  doesn't utilize electronic devices2 (11.eight)5 (25)Use of text messaging and gregarious media  text messaging15 (88.2)7 (35)  facebook®13 (76.5)9 (forty five)  Instagram®3 (17.6)0 (0)  LinkedIn®three (17.6)0 (0)  Twitter®1 (5.9)0 (0)  Snapchat®1 (5.9)0 (0)  does not utilize gregarious media4 (23.5)11 (55)Do you employ your digital clinical listing portal materiel to educate your self about your sickness?  No12 (70.6)15 (seventy five)  Yes5 (29.four)5 (25)Do you utilize the academic paper handouts given to you with the aid of your health keeping provider's workplace or the clinic to educate yourself about your disorder?  Yes12 (70.6)20 (a hundred)  No4 (23.5)0 (0)  missing data1 (5.9)0 (0)excellent favorite components to acquire educational counsel about managing HF sickness  Face-to-face discussion9 (52.9)17 (85)  Electronically4 (23.5)0 (0)  Paper handouts2 (11.eight)3 (15)  Videos1 (5.9)0 (0)  Demonstration0 (0)0 (0)  missing data1 (5.9)0 (0)2nd top favourite formulation to trap hold of educational counsel about managing HF disorder  Videos7 (35)3 (15)  Demonstration3 (17.6)2 (10)  Face-to-face discussion2 (eleven.eight)2 (10)  Paper handouts2 (eleven.8)9 (45)  Electronically2 (eleven.eight)4 (20)  lacking data1 (5.9)0 (0)table three

    Attitudes About technology with the aid of Age neighborhood (N = 37) (middle-Aged neighborhood [≤64 Years] N = 17; Older grownup group [≥65 Years] N = 20)

    question and Variablen (%) Per every Age GroupDefinitely YesProbably YesMight or may NotProbably NotDefinitely NotDo you believe technology has a conducive outcome on fitness care?  ≤sixty four years10 (58.8)5 (29.4)2 (11.eight)0 (0)0 (0)  ≥sixty five years12 (60)2 (10)four (20)2 (10)0 (0)Do you believe expertise can abet you improved self-manipulate your heart failure?  ≤sixty four years7 (forty one.2)8 (47.1)1 (5.9)1 (5.9)0 (0)  ≥sixty five years5 (25)9 (45)5 (25)1 (5)0 (0)Do you believe know-how can champion educate you about your heart ailment?  ≤sixty four years10 (58.8)6 (35.3)1 (5.9)0 (0)0 (0)  ≥65 years9 (forty five)6 (30)four (20)1 (5)0 (0)Would you exist willing to utilize expertise to train your self about heart failure (e.g., using a smartphone, tablet, or e-reader)?  ≤sixty four years9 (fifty three)5 (29.4)three (17.7)0 (0)0 (0)  ≥65 years5 (25)7 (35)2 (10)2 (10)4 (20)Do you believe working towards will abet you better utilize know-how?  ≤sixty four years12 (70.6)four (23.5)1 (5.9)0 (0)0 (0)  ≥sixty five years8 (40)4 (20)1 (5)1 (5)6 (30)

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