Cronbach's Alpha Index Research Articles

Direct Comparison of Four Presurgical Stratifying Schemes for Prediction of Microvascular Invasion in Hepatocellular Carcinoma by Gadoxetic Acid-Enhanced MRI.

Microvascular invasion (MVI) is implicated in the poor prognosis of hepatocellular carcinoma (HCC). Presurgical stratifying schemes have been proposed for HCC-MVI but lack external validation. To perform external validation and comparison of four presurgical stratifying schemes for the prediction of MVI using gadoxetic acid-based MRI in a cohort of HCC patients. Retrospective. Included were 183 surgically resected HCCs from patients who underwent pretreatment MRI. This includes 1.5-3.0 T with T2 , T1 , diffusion-weighted imaging (DWI), and dynamic gadoxetic acid contrast-enhancement imaging sequences. A two-trait predictor of venous invasion (TTPVI), Lei model, Lee model, and Xu model were compared. We relied on preoperative characteristics and imaging findings via four independent radiologists who were blinded to histologic results, as required by the tested tools. Tests of accuracy between predicted and observed HCC-MVI rates using receiver operating characteristic (ROC) curve and decision curve analysis. The intraclass correlation coefficient (ICC) and Cronbach's alpha statistics were used to evaluate reproducibility. HCC-MVI was identified in 52 patients (28.4%). The average ROC curves (AUCs) for HCC-MVI predictions were 0.709-0.880, 0.714-0.828, and 0.588-0.750 for the Xu model, Lei model, and Lee model, respectively. The rates of accuracy were 60.7-81.4%, 69.9-75.9%, and 65.6-73.8%, respectively. Decision curve analyses indicated a higher benefit for the Xu and Lei models compared to the Lee model. The ICC and Cronbach's alpha index were highest in the Lei model (0.896/0.943), followed by the Xu model (0.882/0.804), and the Lee model (0.769/0.715). The TTPVI resulted in a Cronbach's alpha index of 0.606 with a sensitivity of 34.6-61.5% and a specificity of 76.3-91.6%. Stratifying schemes relying on gadoxetic acid-enhanced MRI provide an additional insight into the presence of preoperative MVI. The Xu model outperformed the other models in terms of accuracy when performed by an experienced radiologist. Conversely, the Lei model outperformed the other models in terms of reproducibility. 3 TECHNICAL EFFICACY STAGE: 2 J. Magn. Reson. Imaging 2020;52:433-447.

Validation of the Satisfaction Questionnaire with physical education classes (CSCEF) in the Latin American context

The objective of this study was to validate the Satisfaction Questionnaire in Physical Education Classes (CSCEF) in the context of Latin America (Dominican Republic). 1298 students aged between 15 and 21 participated. The psychometric properties of the instrument were analysed. The results demonstrated that the best factor solution would be a multidimensional model represented by nine dimensions for the satisfaction construct, as well as a higher-order model. According to Cronbach's alpha and omega index, values between .66 and .99 were obtained. The Latin American version of the CSCEF was invariant with respect to gender. Although the results of this study support the validity and reliability of the instrument, some limitations identified in both the original and Spanish version of the questionnaire remain.

Appraisal of Attitudes and Utilizations of Information and Communication Technology (ICT) Among Students in Nigerian Universities

The study examined the attitude and utilization of information and communication technology among university students. The study adopted descriptive – survey as its design, and a population of one thousand three hundred and seventy seven (1377) students were used for the study out of which three hundred and two (302) were purposively sampled from the Department of Science and Vocational Education of the Faculty of Education and Extension Services, Usmanu Danfodiyo University, Sokoto. Two research instruments were used Students’ attitude towards Information and Communication Technology (SAICT) and Information and Communication Technology utilization (ICTU). The instruments were pilot tested using Cronbach alpha and reliability index of 0.93 and 0.77 were obtained. The research found that students have positive attitude towards ICT, it was also found that students utilize ICT for academic purpose, and that students attitude is related to utilization. The study recommends that Science education students should be encouraged by the university to sustain their positive attitude towards ICT by ensuring that the students have easy access to the facilities at every point in time.

An Analysis of Student Satisfaction Level on Service and Facilities Quality Using Weighted Least

The present article aims to study the level of students satisfaction of PGRI Yogyakarta University towards service and facilities quality. To try and understand the factors which influence student satisfaction as well as consequences of it, this study test a weighted least squares model. This study investigate determinant and dominant factors of the students satisfaction and its characteristics. The data were collected through a questionnaire administered to 644 students of PGRI Yogyakarta University to investigate their perceptions of the universities services. A questionnaire containing 30 questions has been used for data collection. The data were analyzed using the descriptive technique and the weighted least sqares analysis. The measurement of the service quality is an important element to provide better, more efficient and more effective services. Spss Software and cronbach alpha index have been used for data analysis and reliability. The reliability factor should be improved first because it is dominant in determining the students’ satisfaction. Quality indicators constituting the reliability factor include classroom, library, laboratory, public area, and information system.The results show that, by percentage, 2 indicator is in the very good category, only 5 indicators are in the good category, 9 indicators are in the fairly good category, and 14 indicators are in the poor category. The results indicate that the universities service quality needs to be improving. The results of the analysis show that five determinant factors of the students’ satisfaction include tangibles, reliability, responsiveness, assurance, and empathy. By the priority scale, the reliability factor should be improved first because it is dominant in determining the students’ satisfaction.

Apreciaciones sobre la producción de vídeos a través del trabajo colaborativo en estudiantes universitarios

En este artículo, se presenta una actividad didáctica sobre la producción de vídeos bajo el enfoque del trabajo colaborativo realizado por 16 estudiantes de la materia Redes II de la licenciatura en informática perteneciente a la Universidad Veracruzana en el periodo 2015-2016. El objetivo fue conocer las apreciaciones de los estudiantes sobre la producción de vídeos mediante el enfoque del trabajo colaborativo. Para realizar lo anterior, los estudiantes formaron cuatro grupos de cuatro integrantes cada uno, con la finalidad de repartir las consignas a realizar con base en la experiencia interpersonal en el manejo de programas de cómputo en especial el manejo de vídeos. El método empleado fue de tipo mixto, para la parte cuantitativa, se aplicó la encuesta ColabUV con índice de alfa de Cronbach de 0,870. En cuanto a los datos cualitativos se realizó una entrevista de grupo focal para conocer las percepciones de la didáctica de aprendizaje utilizada. Los resultados muestran una aceptación favorable en la producción de vídeos por medio del trabajo colaborativo como parte complementaria del proceso de su aprendizaje.

Reliability and Validity of the Turkish Version of the Fremantle Back Awareness Questionnaire

Cross-cultural adaptation and psychometric analysis. To develop the Turkish version of the Fremantle Back Awareness Questionnaire (FreBAQ-T) and to evaluate its psychometric properties. There is a growing interest in the role that the disturbance of body perception may lead to long-lasting pain problems such as chronic low back pain (CLBP). The Fremantle Back Awareness Questionnaire (FreBAQ) is a simple and low-cost way of evaluating disturbed back awareness in people with CLBP. The FreBAQ was translated from English into Turkish using the forward-backward-forward method. One hundred four participants with low back pain completed the FreBAQ-T. The FreBAQ-T was repeated in 15 participants after 1 week to establish test-retest reliability. Although internal and external construct validity was investigated using Rasch analysis and Spearman correlation coefficient, respectively; reliability was evaluated in terms of internal consistency by Cronbach alpha and Person Separation Index. All items of the FreBAQ-T were found to fit the Rasch Model (chi-square 6.17 [df = 9], P = 0.723). The internal construct validity was good, overall mean item fit residual was -0.305 (standard deviation: 0.369) and mean person fit residual was -0.290 (standard deviation: 1.349). The reliability was good with Cronbach alpha of 0.87 and Person Separation Index of 0.82. When the test-retest was examined via differential item functioning by time, none of the items showed differential item functioning. The FreBAQ-T is a valid, reliable, and unidimensional scale for patients with CLBP. This scale will allow assessing back-specific perception in the Turkish population with CLBP. 3.

Avaliação do serviço de coleta para exame colpocitológico pela escala SERVQUAL.

To analyze women's perception of the quality of the service provided for colposcopy test in the city of Belém (PA), Brazil. Quantitative-descriptive study on 400 women who underwent Pap test on the public healthcare network, using the Service Quality (SERVQUAL) model. We used the Cronbach's alpha index to measure the reliability of the scale, and data were analyzed by quartiles of the gaps of the dimensions: tangibility, responsiveness, reliability, assurance, and empathy. The assurance dimension, corresponding to the knowledge and courtesy of staff, featured the highest degree of importance to users; and empathy, which corresponds to the staff's concern with women's needs, featured the lower degree. The most expressive negative gaps concerned the structure of services and the attitude of healthcare professionals when collecting the material. All gaps featured negative relationship between what was expected and perceived, expressing dissatisfaction regarding the service.

Cross-cultural adaptation and psychometric properties of the Brazilian-Portuguese version of the Quality of Prenatal Care Questionnaire (QPCQ).

ABSTRACTOBJECTIVETo translate and to observe the psychometric measures of the Brazilian version of the Quality of Prenatal Care Questionnaire.METHODSThe translation protocol followed the standards of the International Society for Pharmacoeconomics and Outcomes Research. Descriptive statistics were performed to identify characteristics of 280 literate postpartum women in a public hospital. We examined the internal consistency using Cronbach's alfa. To determine the test-retest reproducibility and the instrument's stability, we performed the intraclass correlation coefficient and Bland and Altman plot between two applications. We investigated the item's properties using the item response theory.RESULTSThe overall Cronbach's alpha index was 0.975. The intraclass correlation coefficient was 0.995 (95%CI 0.993-0.996) and a uniform distribution was visualized at the Bland and Altman plot. The item response theory identified the discriminatory power and the difficulty level of the instrument and of each item. The instrument showed acute angulation of the expected total score, and good concentrate information and good standard error curves, preserving the latent construct and its original items.CONCLUSIONSThis analysis concluded that the Brazilian version of the Quality of Prenatal Care Questionnaire is a high-quality, reliable and valid questionnaire to determine the quality of prenatal care among Brazilian women. The questionnaire is suitable for the cultural context represented.

Transcendent and Transcendental Time Perspective Inventory.

The purpose of this paper is to propose a tool to examine the transcendent and transcendental time perspective (TTTP). The inspiration to develop the scale were Philip G. Zimbardo and John N. Boyd studies, as well as by Lars Tornstam’s gerotranscendence theory and own research. The analysis of life from death to eternity is an interesting, heterogeneous and difficult subject of study. The proposed TTTP inventory can be utilized to investigate the future that extends beyond the frames of a personal time perspective, beyond the individual’s death as well as beyond the recognized, standard ways of understanding oneself, other people and the world. The inventory refers to changes of quantitative and qualitative nature relating to what is going to happen. It is composed of two sub-scales: the transcendental future and the transcendent future. The paper outlines the psychometric values of the qualities of the inventory, its validity and accuracy based on such indicators as the discriminative of items, the Cronbach alpha index for each of the sub-inventories and the exploratory factor analysis. The study findings come from analyses conducted on a group of 211 elderly subjects (the average age of 65; 70% women, 30% men). A confirmatory factor analysis was also conducted on a group of 238 elderly subjects (the average age of 66; 69% women, 28% men, 3% no gender data available). Additionally, the paper presents data on the accuracy of the external scale. The data are interpreted in the light of the time perspective theory as well as the existing studies.

Impact of social media on brand commitment: testing the mediation role of perceived value and brand image

Today, distinguishing brands by traditional methods has been difficult for firms, because branding is not only a company's share in the market, but it also contributes its share in customer's mind and memory and this is the main pivot of experimental marketing. Given that media encourages members to deep levels of engagement in the society, this leads to creation of trust and commitment of the members and it is beneficial for brand community. Therefore, according to media importance in brand commitment, the goal of this research is to evaluate the impact of social media on brand commitment by emphasising the mediation role of perceived value and brand image. Target sample of this research is the customers of LG Company. For evaluation of reliability and validity of this research, Cronbach's alpha and composite reliability indices used which have been obtained greater than 0.8 and 0.5, respectively for all variables which show that they are in acceptable level. Study results confirmed that the proposed model's fitness for evaluation of media social impact on brand commitment according to mediation role of perceived value and brand image. In addition, results indicated that brand commitment is significantly influenced by perceived value and brand image.

Assessment of reliability and validity of Montenegrin version of the oral health impact profile for use among the elderly in Montenegro

Introduction/Objective. The quality of life of elderly individuals has an active function in oral health; it is of great importance to learn that elders over the age of 65 years demonstrate an increase in seeking dental services. Oral Health Impact Profile-14 (OHIP-14) is especially suitable for use in the elderly. The aim of this study is to examine the reliability and validity of OHIP-14 in the Montenegrin population aged 65 and over and to determine the influence of oral health on the quality of their life. Methods. The research was conducted from September to December 2016 in the central region of Montenegro, at the Medical University in Podgorica and in the nursing homes of the elderly. The study covered 170 individuals, both sexes, with an average age of 72.32 ? 6.85. The research instrument is OHIP-14 index. Standard statistical tests were used. The statistical significance level is 0.05. Results. The OHIP-14is linguistically and culturally adapted for the Montenegrin population. The value of the Cronbach Alpha Index is 0.892. The relationship between correlations for individual issues and total correlations ranges from 0.21 to 0.69. The value of OHIP-14 is 19.24 ? 7.49. Listed by domains: functional constraints 3.31 ? 1.75; physical pain 4.19 ? 1.31; psychological discomfort 2.52 ? 1.46; physical fitness 4.38 ? 1.40; mental incompetence 1.42 ? 1.23; social incapacity 1.18 ? 1.27 and handicap 2.21 ? 1.32. Conclusion. The OHIP-14 index is reliable and valid and is recommended for use in the Montenegrinspeaking area, for the elderly. There is a significant impact of oral health on the quality of life of the elderly in the central part of Montenegro.

The determination of cooperative teacher’s knowledge problems: training device and attractiveness of Tunisian student-teachers

Purpose: This study was to explore the impact of the cooperative teacher’s (CT) knowledge on attractiveness of Physical Education Student Teachers (PE-ST) believed to be important for a successful process of learning to teach and training device in the workplace. The CT is considered, a key element, a person of alternation between academia and training contributing to the formation by advice and support that take place during the teaching practice. The Cooperative Teacher must have a style; develop a training contract, master interview techniques and make evaluation. Material: Data were collected with 302 student teachers (202 males and 100 females) after professional training. A descriptive/exploratory methodology based on a questionnaire consisting of twenty questions was used. The value of Cronbach alpha index is 0.729. Results: globally supported the hypotheses. Male and female student teachers in the internship shared several perceptions. However, significant differences emerged. Student-teachers’ perception of CT knowledge and practice developed relatively professional skills as well as the feeling of discomfort which can lead to work stoppage. However, the impact of CT knowledge on attractiveness was significant. The inefficiency advice between actors in the professional life and several aspects of CT knowledge are provided. In addition, data are provided indicating that overall there are more similarities than differences between male and female student teachers over a response number. Data also shows that females who participate in the internship may be at risk for discomfort, incapability and doubt their practices. Conclusions: This study will encourage Teacher’s to reflect on their own knowledge, training device and to include them in the process of educational development.

ANALISIS EMPIRIS TINGKAT KEPUASAN MAHASISWA PADA KUALITAS PELAYANAN DAN FASILITAS MENGGUNAKAN WEIGHTED LEAST SQUARES

The present article aims to study the level of students’ satisfaction of PGRI Yogyakarta University towards service and facilities quality. To try and understand the factors which influence student satisfaction as well as consequences of it, this study test a weighted least squares model of student satisfaction. This study investigate determinant and dominant factors of the students’ satisfaction and its characteristics. The data were collected through a questionnaire administered to 160 students of PGRI Yogyakarta University to investigate their perceptions of the universities services. A questionnaire containing 30 questions has been used for data collection. The data were analyzed using the descriptive technique and the weighted least squares analysis. The measurement of the service quality is an important element to provide better, more efficient and more effective services. SPSS Software and Cronbach alpha index have been used for data analysis and reliability. The reliability factor should be improved first because it is dominant in determining the students’ satisfaction. Quality indicators constituting the reliability factor include classroom, library, laboratory, public area, and information system. The results show that, by percentage, 2 indicators are in the very good category, only 5 indicators are in the good category, 9 indicators are in the fairly good category, and 14 indicators are in the poor category. The results indicate that the universities service quality needs to be improving. The results of the analysis show that five determinant factors of the students’ satisfaction include tangibles, reliability, responsiveness, assurance, and empathy. By the priority scale, the reliability factor should be improved first because it is dominant in determining the students’ satisfactionThe present article aims to study the level of students’ satisfaction of PGRI Yogyakarta University towards service and facilities quality. To try and understand the factors which influence student satisfaction as well as consequences of it, this study test a weighted least squares model of student satisfaction. This study investigate determinant and dominant factors of the students’ satisfaction and its characteristics. The data were collected through a questionnaire administered to 160 students of PGRI Yogyakarta University to investigate their perceptions of the universities services. A questionnaire containing 30 questions has been used for data collection. The data were analyzed using the descriptive technique and the weighted least squares analysis. The measurement of the service quality is an important element to provide better, more efficient and more effective services. SPSS Software and Cronbach alpha index have been used for data analysis and reliability. The reliability factor should be improved first because it is dominant in determining the students’ satisfaction. Quality indicators constituting the reliability factor include classroom, library, laboratory, public area, and information system. The results show that, by percentage, 2 indicators are in the very good category, only 5 indicators are in the good category, 9 indicators are in the fairly good category, and 14 indicators are in the poor category. The results indicate that the universities service quality needs to be improving. The results of the analysis show that five determinant factors of the students’ satisfaction include tangibles, reliability, responsiveness, assurance, and empathy. By the priority scale, the reliability factor should be improved first because it is dominant in determining the students’ satisfaction.

Psychometric Validation of the Short Form of the Smoking Consequences Questionnaire (S-SCQ) for Brazil.

Smoking accounts for 24% of deaths in the general population and is also the factor that explains the biggest amount of years of life lost. It is important to understand the expectations regarding smoking behavior. The present study aimed to validate the Short Form of the Smoking Consequences Questionnaire (S-SCQ) for a Brazilian version. The Researchers did the process of semantic adaptation to language and national context. The S-SCQ was applied in a sample of 129 people. The next step was to perform psychometric analyses for the set of 21 items. Exploratory Factor Analysis, with pairwise treatment for missing cases, was used to achieve construct validity. To carry out Factor Analysis, the method of Principal Component Analysis (PCA) was used initially. Afterwards, Principal Axis Factoring (PAF) using Varimax rotation with Kaiser normalization was applied. The reliability of the total scale (21 items) showed a Cronbach alpha index of 0.851 and a 0.870 Lambda2 of Gutmann. Quite satisfactory rates were also observed in the subscales. Similarly, the item-overall correlation values also confirmed the scale's good reliability indices.

Contrato psicológico en empleados mexicanos: Creencias de obligaciones relacionales y transaccionales

Se examinan las creencias de una muestra de empleados mexicanos sobre las obligaciones recíprocas en la relación empleado-empleador, con base en los tipos de Contrato Psicológico Relacional y Transaccional. Se realizó un estudio no experimental, correlacional, transversal. Participaron 345 empleados de diversas organizaciones de la Ciudad de México. Se pusieron a prueba modelos PATH sobre la relación de las creencias del empleado sobre las obligaciones empleado-empleador. En el modelo Relacional, se identificaron antecedentes sobre las creencias de Lealtad y Seguridad, el modelo mostró menos variables independientes con un mayor nivel predictivo. En el modelo Transaccional se identificaron más variables independientes relacionadas con un menor nivel predictivo. Se señala la necesidad de proponer modelos predictivos con otras variables, como el compromiso, la justicia y la adherencia organizacional, la satisfacción laboral, el desempeño y la rotación. Esta investigación contribuye a la Teoría del Intercambio Social en las Organizaciones y la dinámica del Contrato Psicológico como un enfoque que puede ayudar en la definición de estrategias, políticas organizacionales y prácticas orientadas a relaciones laborales sanas en México.

Italian Validation of the Capacity to Love Inventory: Preliminary Results

Introduction: Within a wider international research project aimed at operationalize the psychodynamic construct of capacity to love (Kernberg, 2011), the Capacity to Love Inventory (CTL-I) is a 41-items self-report questionnaire assessing six dimensions: interest in the life project of the other, basic trust, gratitude, common ego ideal, permanence of sexual passion, loss, and mourning.Objectives: The study is aimed at validating the Italian version of the CTL-I.Method: A total sample of 736 Italian non-clinical adults was administered a checklist assessing socio-demographic variables, and the CTL-I. A Confirmatory Factor Analyses (CFA) was conducted to examine the construct validity of the Italian version of the CTL-I. Only a part of the total sample (320 participants) was administered an additional series of concurrent measures in order to investigate the convergent validity of the CTL-I. Correlations with measures of socio-sexual orientation, quality of romance relations, and psychopathological questionnaires were examined through Pearson's correlation coefficients.Results: CFA results suggested that the Italian CTL-I fully replicated the six-factor structure of the original CTL-I. Cronbach's alpha index provided satisfactory results for all subscales and the correlations with concurrent measures were in expected direction.Conclusion: The results showed promising psychometric characteristics of the Italian version of CTL-I. Implications of the feasibility of the instrument in clinical and psychotherapeutic settings are discussed.

Developing Pupils Language in Primary School Based on Technology

This study aims to identify the level of language difficulties for children in primary school and to open teachers to use virtual methods in teaching through technology. The participants in this study were 122 Romanian teachers with different levels of experience. The method used was a questionnaire created by ourselves to which we applied the Cronbach alpha index to measure the fidelity of each item. The questionnaire aimed at identifying the sources of speech difficulties, teaching methods used by teachers, and teachers perceptions about the use of technology and its effectiveness in relieving language difficulties. The results of this research were introduced into statistical interpretation programs to confirm the hypotheses, the data obtained confirmed the use of teaching methods by teachers and their opening to the combination of technology in didactic activity.

The Role of Planning and Implementation of ICT in Operational Benefits

This article reports a model of structural equations that integrates four latent variables and six hypotheses among them: Integration of information and communication technology (ICT), investment in ICT, training in ICT, and operational benefits obtained in the supply chain (SC). The model is validated with information obtained from 80 surveys applied to manufacturing companies in the municipalities of Ensenada, Mexicali, Tecate, and Tijuana in Mexico. The information is validated by the Cronbach alpha index for internal validity and the R-square index for predictive validity. Partial least-squares algorithms are used to validate the hypotheses in the model and the results indicate that the integration of technology is the basis for the success of the implementation of information technologies, and that the application of these guarantees the obtaining of operational benefits in the productive system.

Clima Organizacional en las Industrias ecuatorianas de calzado

El objetivo de este estudio, es medir la percepción del clima organizacional por medio de cinco factores: condiciones de trabajo, compensaciones, comunicación, liderazgo, y motivación, en empresas productoras de calzado de la provincia de Tungurahua, Ecuador. Al respecto, se utilizó un método cualitativo a través de encuesta para medir el Clima organizacional, con análisis de consistencia interna mediante el índice alfa de Cronbach, dando un valor de 0,757. Se aplicaron 282 cuestionarios de encuesta in situ, al personal operativo de 17 empresas productoras de calzado. Los resultados procesados por medio del programa SPSS, generaron resultados con medias aritméticas en cada factor, siendo los factores de comunicación (3.02), liderazgo (3.20), y motivación (3.47), como los mejor valorados y los factores de condi-ciones de trabajo: (2.47), y compensaciones: (2.65) como los menos valorados por los encuestados. Se observa que, en estas organizaciones la comunicación fluye sólo cuando está relacionada al cumpli-miento de tareas; el personal se siente bastante motivado en el trabajo; y, existe un liderazgo Directivo; pero, las com-pensaciones no satisfacen plenamente a todo el personal; y, las condiciones de trabajo se consideran como tolerables.

Psychometric characteristics of the mutuality scale in heart failure patients and caregivers

BackgroundHigher patient-caregiver mutuality is associated with improved patient and caregiver outcomes, but no studies have tested the psychometric characteristics of the mutuality scale (MS) in heart failure (HF) patient and caregiver population. ObjectivesTo test the validity and reliability of the MS. MethodsA cross-sectional design. The MS validity and reliability were tested with confirmatory factor analysis (CFA) and hypothesis testing, and with Cronbach's alpha and model-based internal consistency index, respectively. ResultsCFA supported the validity of the MS in the HF patient and caregiver versions. Hypothesis testing showed significant correlations between both versions of the MS and anxiety, depression, quality of life, and self-care. Also, MS caregiver version scores correlated significantly with caregiver preparedness. Cronbach's alphas and the model-based internal consistency index ranged between 0.72 and 0.94 in both versions. ConclusionsThe Mutuality Scale showed supportive validity and reliability for HF patients and caregivers.