Complete Autonomy Research Articles

The Rule of Law, Economic Constitutions and Institutional Balance

Economic constitutions may be ‘substantive’, seeking to implement fundamental economic policies or ‘the will of the people’ in relation to economic management, or ‘communicative’, establishing institutions for economic organisation and holding these accountable. In the context of fiscal policy there have been recent important successes for the ‘substantive’ model through the use of balanced budget rules, but a more ‘communicative’ approach can be seen in the development of fiscal councils. Similar moves to a more ‘communicative’ model can be found in monetary policy and in the regulation of public utilities, including in EU liberalization. If such a move is to be successful, the institutions involved need independence, though this should not be confused with complete autonomy of decision-making as decisions will often need to be taken within a broader framework of government policy. The ‘communicative’ model is the most appropriate one for an economic constitution in complex modern economies.

Literary Rendering of 3⋅1 Movement in Yeom Sang-seop's Mansejeon and Hyun Jin-keon’s Hometown

This study contemplates the spirit of the 3ㆍ1 Movement as a significant event of human kind in the scale of world history and its lasting legacy passed down to Korean novels of 1920s, such as Yeom Sang-seop s Mansejeon and Hyun Jin-keon’s Hometown. This investigation will be followed by a modest proposal on the direction the contemporary Korean literature is obliged to pursue. The 3ㆍ1 Movement was a series of nationwide resistance, which started in March 1919 and continued the year around to achieve independence from Japanese occupation. It was essentially a process to establish Korean nationality and identity as an imagined communities by solidarity of multiple subjects from all stages of life and social strata. It marked a watershed in the modernization process of national subjectivity, separated from the colonial civilization governed by Japanese imperialist. Yeom Sang-seop s Mansejeon delineates the absurd and deserted reality of colonized Joseon, derived from the intrinsic contradiction, and the servility that degraded the life of people into that of the living dead. This medium-length narrative conjures up an aspiration towards certain event in the literary form of novel and describe its capability to break through the reality of Joseon and what inevitably led the 3ㆍ1 Movement with the circumstances. Hyun Jin-keon’s short novel, Hometown, by the way, depicts the face of Joseon to explain how the individuals as unclad existence are expelled from their hometowns and become refugees in Joseon where the intrinsic contradiction seized the power. Then what would be the capability and responsibility of Korean literature after 100 years from the 3ㆍ1 Movement? It would be achieving complete autonomy and independence from invasive oppressions as Mansejeon exemplifies. It also would be the efforts to protect rights and interests of minority groups and enhance the life condition of those who have been the victimized others under social hierarchy and ended up being homo sacers with abject lives as displayed in Hometown. This endeavor can only be rightfully valid when it achieves the universality in the context of human history.

The Beginning of the Debate on the Codification of Polish Law after the World War I: The Issue of the Codification Commission Autonomy in the Light of Political Declarations

The purpose of this article is to analyze the ideological basis of concepts that underpinned the establishment of the Codification Commission by virtue of the Act of 3 June 1919 and to assess its position within the system of authorities of the Second Republic of Poland. The author has found that the issues around shaping the relations of the Codification Commission with the Government and the Sejm have been covered in literature of the subject in a one-sided manner. Authors who have devoted their attention to the issue of autonomy of the Codification Commission formulated their evaluations based on the interpretation of the regulations in the drafts of the Act that established the Commission, as well as on their subsequent application that enabled the restriction of this autonomy. They did not, however, sufficiently account for the ideological declarations, thus in fact rejecting the deputies’ assertions of their striving to ensure “complete autonomy and self-sufficiency” of the Codification Commission, and the Government’s affirmations that it did not aim to “subject” the Commission to its control. Meanwhile, the author’s intention is to show that there was a widespread consensus at the time, especially at the Sejm, which sovereignly decided on the wording of the Act on the Codification Commission, that deputies had adopted a law that sufficiently protected the autonomous status of the Commission and its apolitical nature.

The role of resilience in healthcare transitions among adolescent kidney transplant recipients.

AYAs with KTs experience high rates of premature allograft loss during the HCT. There is a critical need to identify protective factors associated with stable HCT. Resilience-the ability to adapt and thrive in the setting of adversity-has known positive impact on health outcomes. This study explored the novel role of resilience constructs as protective factors in securing stable HCT among AYA with KT. We conducted semi-structured interviews of adolescents and young adults who transitioned from a single pediatric transplant center to multiple adult nephrology centers between 2010 and 2017. Interviews explored the role of key resilience constructs in participants' lives around the time of HCT. Participants were stratified into stable or unstable HCT groups based on biological markers of allograft function and clinical data from chart review. Content analyses of interview transcripts were reviewed and compared among HCT groups. Thirty-two participants enrolled (17 stable; 15 unstable). Key resilience constructs more salient in the stable versus unstable HCT group were confidence in and connection to one's healthcare team. Reports of healthcare self-management competencies were similar across both HCT groups. Confidence in and connection to one's healthcare team appear to be linked with a stable HCT among AYA with KT. This suggests that interdependence, the ability to foster connections with and elicit support from healthcare providers, as opposed to complete independence or autonomy, which is often advised in the HCT process, is a critical component of resilience linked to stable HCT.

Decision-making in Pediatric Plastic Surgery: Autonomy Versus Shared Approaches

BACKGROUND: Although shared decision-making is an essential component of patient-centered healthcare, its role in pediatric patient populations is not well-defined. Particularly among children presenting to pediatric plastic surgery clinics, the extent of agreement among parents, children, and providers regarding the extent of autonomous decision-making remains unclear. The goal of the present study was to define the preferred level of autonomy in decision-making among the various stakeholders involved in cleft care. METHODS: We surveyed children presenting to plastic surgery clinics (n = 100) and their caregivers regarding their preferences on autonomy during the process of surgical decision-making. Patients and their parents independently completed surveys on their preferred method of decision-making and autonomy. Fleiss’ kappa was used to assess the extent of agreement between groups. Bivariate chi-square tests were used to assess the relationship between decision-making preferences and demographic factors such as age, gender, and socioeconomic status. Multinomial logistic regression was performed to assess the relationship between age and sex and child/parent preference. RESULTS: Of the 100 children surveyed, 64 were female; the average age was 12.5 years. Children and their caregivers disagreed upon their overall decision-making preferences (k = 0.0385). Overall, 40% of children and 67% of parents preferred the option of completely shared decision-making among the patient, parent, and provider; the minority of children (16%) preferred the doctor to be the sole decision-maker. Approximately 20% of children desired complete autonomy. Child’s preference was significantly associated with their age; the relative risk of children deferring to parents or surgeons over a shared approach was lower for adolescents compared to children under 10 years old (RR, 0.202; 95% confidence interval, 0.054–0.751; P = 0.017). Alternatively, caregiver’s preferences did not change based on the child’s age, but rather based on the child’s sex. Parents were less likely to prefer a shared approach when the child was female (odds ratio, 0.365; 95% confidence interval, 0.139–0.961; P = 0.04). CONCLUSIONS: Although most parents preferred a completely shared approach to decision-making, children desired greater autonomy, particularly with increasing age. There was limited agreement between parents and children regarding their decision-making preferences. Providers must be cognizant of differing preferences among parents and children when discussing treatment plans and surgical algorithms; to optimize patient and parent satisfaction, differing methods of discussion may be required to respect the preferences of all stakeholders involved.

P4.32: Digestive autonomy in patients with intestinal failure after small bowel transplantation

Introduction: Home parenteral nutrition (HPN) and all the complications related to it, used to be the only option in patients with intestinal failure. Nowadays small bowel transplant (SBT) is an answer to these patients. Methods: From December 2004 to January 2019 we have assessed 105 patients as potential candidates, the majority of them not eligible; and have performed 31 transplants in 29 patients (21 IT and 8 MVT). Results: Short bowel syndrome (SBS) was found in 60% (18/29) of the patients. Potential candidates for SMT were malnourished, with a mean pretransplant BMI of 22.2, average weight of 61.6kg and pre albumin values around 21.7mg/dl. 64% of the patients required total HPN before the SBT and almost 86% had several HPN-related complications due to it (6% thrombosis of major venous access, 37% catheter -related infections, 28% sepsis, refractory balance alterations. After SBT the patients in our study reached a mean BMI of 23.7,mean weight of 67.8kg and pre albumin values around 26.7mg/dl. All recipients achieved satisfactory oral nutritionat about post-transplant day 12. Almost 80% of the patients required parenteral nutrition support during the first two months post-transplantation. SBT recipients will need some form of parenteral nutrition support for an average period of 27 months including the time before and after the SBT. One year after undergoing transplantation, all recipiets will achieve a complete digestive autonomy and only 8,3% will need fluid replacement therapy. Conclusions: Small bowel transplantation is a life-saving procedure for patients with intestinal failure who develop complications related to parenteral nutrition, and it is the most effective treatment in terms of complete digestive autonomy acquisition for these patients

320.9: The Double-Barrel Enteroplasty: A Novel Intestinal Lengthening Procedure for Short Bowel Syndrome

Advances in the management of Short bowel syndrome (SBS) has resulted in children with shorter lengths of small bowel coming off TPN and achieving enteral autonomy. Although existing bowel lengthening procedures such as the Bianchi Longitudinal Intestinal Lengthening and Tailoring (LILT) procedure and Serial Transverse Enteroplasty (STEP) have enjoyed moderated degrees of success, they have not been without complications and better alternatives are still being sought after. We present our experience with a novel bowel-lengthening procedure for SBS termed the double-barrel enteroplasty (DBE) that is simpler to perform, is less disruptive to anatomy and has the potential to achieve similar to superior results to existing bowel lengthening procedures. Methods: Ten patients have undergone the DBE at the Children’s Hospital at Westmead between January 2011 and November 2018. Baseline characteristics, complications, time to TPN weaning and growth parameters were recorded prospectively. Results: The mean age at operation was 21 months (range 4–41 months). Mean pre-operative small bowel length was 74.6cm (36-167cm) with a mean length of 35.6cm (17-60cm) undergoing enteroplasty. Mortality and progression to transplantation remains zero. Six patients have achieved complete enteral autonomy within 2.8 months (0.5–5 months). The most recent patients are still weaning TPN. All patients have normalising growth parameters. One patient required an extension of the DBE for on-going proximal dilatation. Discussion: The DBE is a safe, effective and potentially superior alternative to existing bowel lengthening procedures for SBS. Advantages include its simplicity to perform, less disruption of bowel and mesentery, less anastomoses, decreased possibility of stenosed segments and maintenance of neuromuscular integrity.

Facebook: An Emerging Arena for Politics of Self-Determination in northern Cyprus?

ABSTRACTThe present article aims to expand scholarship on the political role of social media by focusing on the case of Facebook and the self-determination claims of Turkish Cypriots vis-à-vis Turkey. Drawing upon a virtual ethnography of relevant Facebook sites and groups, this article scrutinises whether social media offer an innovative public platform for the politics of self-determination or on-line claims are in reality formed and negotiated in the same manner as the offline ones. The article concludes that Turkish Cypriots’ Facebook activism may very well be for strengthening their community, shielding their distinct characteristics from mainland Turkey and raising their self-esteem, rather than indicating demands for complete autonomy in the traditional political sense of the word and/or statehood.

My Choice: Women’s Contraceptive-Use Autonomy in Bangladesh

ABSTRACTUsing a nationally representative household survey for two cohorts of married women, this study examines women’s contraceptive-use autonomy (CUA) incidence and correlates in Bangladesh, focusing on the role of education. Previous research has examined the incidence and correlates of contraceptive use and of several dimensions of female autonomy but only rarely the intersection of the two – that is, CUA. This study finds that women from the younger cohort are far more likely to have complete autonomy over contraceptive use than women from the older cohort. Detailed decompositions reveal that the improvement in education across cohorts is the main correlate of the improved generational CUA gap. Health knowledge, especially knowledge that the use of condoms can help avoid contracting HIV/AIDS, is part of the transmission mechanism between women’s education and women’s CUA but also exerts an additional influence on CUA.

Zapata's Justice: Land and Water Conflict Resolution in Revolutionary Mexico (1914–16)

AbstractThis article challenges the widely held view that, during the Mexican Revolution, the Zapatista villages governed themselves with complete autonomy from the state and according to the pueblos’ customary justice. It shows how Zapatistas in the multi-state region of south-central Mexico dealt with quarrels over small and medium-sized properties, the restitution of usurped pueblo lands and water resources, as well as village boundary disputes. They did so by blending nineteenth-century judicial procedures and civil law, limited but radical reforms to the existing judicial system and new forms of land and water management – all of which strengthened state authority.

ЗАСТОСУВАННЯ ІНФОРМАЦІЙНИХ ТЕХНОЛОГІЙ НА ЗАЛІЗНИЧНОМУ ТРАНСПОРТІ ПРИ ПЕРЕВЕЗЕННІ КОНТЕЙНЕРІВ

Optimization downloads containers to view logistics routes, online playback across the track - requires fast data processing, reliability, reliability and efficiency of logistics companies. According to the latest statistics on the transition of freight containers to the territory of the Ukrainian railroad, for the period 2013-2018. It has been established that our time for the transport of trucks by rail is not very effective. Due to the large objects of container transportation, it has recently been very relevant to finding new ways to effectively deliver containers. Typically, GPS technology is used to reduce unproductive spaces. To resolve this issue, any suggestions were made regarding the installation of GPS beacons, proposals made regarding the use of rail transport and information transport. Installing GPS trackers in containers provides the integrity of containers and trucks. This device will be broken into the container door when it is closed. It provides complete tightness and autonomy of work. A GPS tracker can transmit signals about container damage during transmission, download, and attempts to remove seals. Thanks to its innovative technology, GPS can be turned off from the container to the road, which ensures the safety of the cargo itself, reducing the loss and impossibility of transporting the container and transport. To date, a good example of using GPS trackers is road transport. The monitoring system of transport, thanks to the graphic image of vehicles and travel statistics, allows you to find out the road situation, to efficiently compare the routes of the vehicle, and react immediately to emergencies. The feasibility of introducing a GPS monitoring system is determined by the indicator of the economic effect during the calculation period. The economic efficiency of the system implementation is assessed by comparing the expected effect and the total cost of the project implementation. After conducting economic calculations, it was discovered that the GPS system would be useful for their use on the railway, which allows planning and distributing traffic in optimal mode. This will reduce the simplicity of the containers, allow them to quickly find the necessary containers, download them on specific routes and transport the goods to their destination.

Enhanced recovery after surgery (ERAS) in hip and knee replacement surgery: description of a multidisciplinary program to improve management of the patients undergoing major orthopedic surgery.

Enhanced recovery after surgery (ERAS) protocols aim to develop peri-operative multidisciplinary programs to shorten length of hospital stay (LOS) and reduce complications, readmissions and costs for patients undergoing major surgery. The aim of this study is to evaluate the effects of an ERAS pathway for total hip (THR) and knee (TKR) replacement surgery in terms of length of stay, incidence of complications and patient satisfaction. Patients scheduled for hip and knee replacement were included in the study. The main aspects of this program were preoperative education/physical therapy, rational choice of the anesthetic technique, optimization of multimodal analgesia, reduction of incidence of urinary retention and catheterization, active management of risk for blood loss and deep vein thrombosis, and early mobilization of the patients. All patients had 6 months predicted and planned follow-up appointments. Primary outcomes of the study were the mean LOS, readmission and complication rates. Secondary Outcomes were percentage of Knee Injury & Osteoarthritis Outcome Score (KOOS) and Hip disability and Osteoarthritis Outcome Score (HOOS) increase and patient's satisfaction. We consecutively enrolled 207 patients who underwent total joint arthroplasty, 78 hip and 129 knee joint replacements. The mean length of stay (LOS) for patients of the two groups was 4.3 days for ASA 3-4 patients subjected to TKR and THR, in ASA 1-2 patients 3.6 days for TKR and 3.9 days for THR respectively. Postoperative satisfaction level was higher than 7 (very satisfied) in 94.4% of the cases. All patients were discharged home: 61.8% continued physical therapy in complete autonomy, 23.7% supported by a home-physiotherapist and only 14.5% needed the attendance to a physiotherapy center on a daily basis. The overall incidence of major complications was 3.4%. The implementation of an ERAS program for hip and knee replacement surgery allows early patient's discharge and a quick return to independency in the daily activities. IV.

RELIGIOSITY IN CRIMINAL LAW: ISLAMIC PERSPECTIVE

The fundamental premises of Islamic law are that Allah has revealed His will for human-kind in the Holy Quran and the inspired example of the Prophet Muhammad (Peace be Upon Him), and that society's law must conform to Allah's revealed will. The scope of Islamic law is broader than the common law or civil law. In addition to core legal doctrines covering the family, wrongs, procedure, and commercial transactions, Islamic law also includes detailed rules regulating religious ritual and social etiquette. In Islam, religiosity is not asceticism in monasteries nor is it chattering from the pulpits. Instead, it is behaving in a manner that is requested from the Creator under all circumstances, places and times, in belief, statement and actions. Historically, law and religion have never been completely separated. They have never been so independent as to achieve complete autonomy from each other. Religion has essentially been embodied in legal systems, even in those that have aspired to privatize religion. Based on this fact, this paper discusses such fact i.e religiosity on specific theme of Islamic law that is criminal law which means the body of law dealing with wrongs that are punishable in Islamic law with the object of deterrence.

RELIGIOSITY IN CRIMINAL LAW: ISLAMIC PERSPECTIVE

The fundamental premises of Islamic law are that Allah has revealed His will for human-kind in the Holy Quran and the inspired example of the Prophet Muhammad (Peace be Upon Him), and that society's law must conform to Allah's revealed will. The scope of Islamic law is broader than the common law or civil law. In addition to core legal doctrines covering the family, wrongs, procedure, and commercial transactions, Islamic law also includes detailed rules regulating religious ritual and social etiquette. In Islam, religiosity is not asceticism in monasteries nor is it chattering from the pulpits. Instead, it is behaving in a manner that is requested from the Creator under all circumstances, places and times, in belief, statement and actions. Historically, law and religion have never been completely separated. They have never been so independent as to achieve complete autonomy from each other. Religion has essentially been embodied in legal systems, even in those that have aspired to privatize religion. Based on this fact, this paper discusses such fact i.e religiosity on specific theme of Islamic law that is criminal law which means the body of law dealing with wrongs that are punishable in Islamic law with the object of deterrence.

The Greater Good: Agency and Inoculation in the British Army, 1914-18.

As the First World War progressed, rates of typhoid diminished. This was heralded as a triumph of sanitary improvement and disease protection; yet as to how the British military achieved this remains a contentious issue. Objections arose around the danger of inoculation and the unpleasant and potentially deadly side effects. Between the unaffected and the sufferers of the vaccine's side effects are the unexplored stories of the refusers. Often bizarre, their accounts include stories of unsanctioned cajoling, arrests, suspension of privileges, and even physically forced inoculation. Soldiers could be encouraged, convinced, and, in rare cases, even forced to undergo inoculation. For others, the opportunity to refuse was often not made clear, as inoculation became part of routine military life. Despite the fact that soldiers were supposed to have complete autonomy over their own inoculation, the reality was often different. Penalties for noncompliance and a lack of clarification about soldiers' rights demonstrated that throughout the war a clash developed between individual autonomy and an authoritarian regime determined to ensure the health of its fighting force.

A Suggested Improvement for Small Autonomous Energy System Reliability by Reducing Heat and Excess Charges

Devices operating in complete energy autonomy are multiplying: small fixed signaling applications or sensors often operating in a network. To ensure operation for a substantial period, for applications with difficult physical access, a means of storing electrical energy must be included in the system. The battery remains the most deployed solution. Lead-acid batteries still have a significant share of this market due to the maturity of their technology. However, even by sizing all the system elements according to the needs and the available renewable energy, some failure occurs. The battery is the weak element. It can be quickly discharged when the renewable energy source is no longer present for a while. It can also be overloaded or subjected to high temperatures, which affects its longevity. This paper presents a suggested improvement for these systems, systematically adding extra devices to reduce excess charges and heat and allowing the battery use at lower charges. The interest of this strategy is presented by comparing the number of days of system failure and the consequences for battery aging. To demonstrate the interest of the proposed improvement track, a colored Petri net is deployed to model the battery degradation parameters evolution, in order to compare them.

Autonomous station for recording radiation in a thunderstorm atmosphere at the Tien Shan high mountain cosmic-ray station

During the past decades, considerable attention has been paid to the search and registration of electromagnetic radiation accompanying lightning discharges in the atmosphere when studying processes occurring in thunderclouds. Such studies are of interest for understanding the mechanisms of lightning generation and its further development, leading to the generation of an avalanche of charged particles accelerated by an electric field, the hard bremsstrahlung of which is registered by the detectors. In this work we consider a compact measuring system, which was created at the Tien Shan High-Mountain Scientific Station for registering radiation during thunderstorm activity. A feature of the system is complete autonomy, when all its components (detectors, recording electronics, battery) are placed inside a solid metal casing, which plays the role of an electromagnetic screen and does not have any connections to external cable lines. This allows one to record radiation directly inside the thundercloud. Examples of gamma-radiation detection using a NaI crystal scintillation detector, as well as the detection of charged particles by a special detector, which is a stack of two flat scintillation detectors of a large area and a rubber filter placed between them, are considered.

Évolution et perspectives de la santé publique vétérinaire en Italie

Evolution and outlook of veterinary public health in Italy. Since their origin the Italian veterinary services have always given particular importance to public health and safety. Born after the unification of Italy in 1861, they were officially recognized in 1865 and assigned to the Ministry of the Interior with a connotation and tasks of public safety. After the Second World War a High Commissariat was established which ensured the transition until the creation of the Ministry of Health in 1958. Since 1978, with the establishment of the National Health Service, veterinary activities have left the Ministry of the Interior’s Police competences to assume complete autonomy in the Ministry of Health. It is however clear that the imprint of a century has left Italian veterinarians with the awareness of being, above all, part of a national security system. Currently there is a strong generational renewal of the Italian veterinary class both centrally and in the territory that requires careful consideration of the most suitable organization model for the future.

Developing a small photovoltaic power supply system with adaptive technologies for rural Africa: Design, cost and efficiency analyses

The objective of this study was to design a small-scale photovoltaic system to support electricity supply to a rural village in the Republic of Congo. A simple impedance-matching system and an innovative panel-tilting system were implemented as adaptive technologies to increase the power output of the system and reduce its capital and running costs. The experimentally obtained results showed that the daily energy output of a four-panel, 400 W photovoltaic system could be increased by 15% through a series parallel impedance match configuration, and by 36% from 3.3 kWh per day to approximately 4.5 kWh per day through implementing an automated panel tilting system with always normal incidence of solar irradiation on the panels in an equatorial environment. Implementing these technologies accordingly reduced the cost of energy supplied by the same percentages, with an eventual electricity cost of about ZAR 3.60 per kWhr, as calculated over an operation time of ten years, and an initial capital outlay of ZAR 37 per watt. These costs are much lower than for installing power grid lines to the village, and the technology also ensures complete autonomy of power supply to the community. The study also identified the potential to generate many new business and job opportunities locally in this community, as well as in the rest of Africa.

34 MYRE: An e-learning system for radiotherapy

Introduction The size of Radiotherapy (RT) departments makes difficult to organize a complete in-house training for the therapists. In a French center there are often 40 to 50 therapists and treatment time slots are large so it is difficult to achieve a classic training. Moreover the training is mainly achieved by people who are poorly available (physicists, physicians, therapists …). Nevertheless the needs of training are very important. Indeed, RT therapists have a central role in the patient security chain and technologies evolve very quickly. New skills and knowledge are continuously asked (new devices, new treatment techniques or a simple software or hardware update). We present in this work the MYRE (MY Recordable E-Learning) database developed in our cancer center that is a full solution of e-learning of RT therapists. Methods A Microsoft ACCESS database (BDD) was implemented. It contains all the information concerning the therapists and a link to approximately 200 micro-modules. It allows recording and requesting every training act (request can be done for a given therapist, a given module, a year…). These 200 micro-modules are separated in three types: 1. Simple written procedures from the institutional document database that the user must read. 2. Some particular techniques that the user must see. 3. SPOC (Small Private Online Classes): these videos that we made last generally 10 min and are associated to an online multiple-choice test (MCT). This MCT are auto-corrected: the user obtains a score and explanations are given to understand the correct answers. The therapists can access to MYRE in complete autonomy (training, evaluation, and recording of the acquired micro-modules). Results Between January and March 2018, approximately 600 training acts were recorded in MYRE. Special requests were implemented to allow the manager to edit some specific lists like “list of therapists with all the mandatory skills for a given medical device”. Some therapists are involved in the database maintenance and the making of videos and MCT. Conclusion A database with a link to 200 documents (videos or written procedures) was developed and deployed in the department. It allows the therapists to train in full autonomy. In this study we made a lot of videos and observed that they are an effective tool to introduce technical concepts while written procedures are better for the description of tasks. MYRE is well accepted by therapists (results of an internal audit).