Objective. To describe the dynamics of development along the early years of life among children living under unfavorable socioeconomic conditions. Population and Methods. In 5401 children younger than 6 years old living in Florencio Varela and in the Matanza-Riachuelo River Basin (Matanza, Villa 21-24, Wilde, Villa Inflamable and Acuba), areas with a high proportion of families with unmet basic needs, a logistic regression analysis was used to estimate the median age at attainment of 13 psychomotor developmental milestones; differences between these ages and median age at attainment of milestones as per the national reference were plotted on the y-axis, while the median age as per the national reference was plotted on the x-axis. Results. Three stages were observed: the first one between 0 and 270 days with normal development, in which the median age at attainment was similar to that of the national reference; a second one of progressive development delay; and a third one of recovery at 1260 days. Adjusted linear spline slopes were 0.06 (not significant), -0.26 (p < 0.0001) and 0.26 (p < 0.01) for stages 1, 2 and 3, respectively. The three slopes were statistically different from each other. The stage of normal development (stage 1) was attributed to the protective effect of the mother and the family environment; stage 2 of progressive delay, to the unfavorable impact of the environment, and stage 3 of partial recovery was attributed to attending a daycare center. These findings allow the implementation of effective interventions at each stage. Conclusion. Three periods with different developmental tempos were identified.

Objetivo. Describir la dinámica del desarrollo en los primeros años en niños que viven bajo condiciones socioeconómicas desfavorables. Población y métodos. En 5401 niños menores de 6 años de zonas con alta proporción de población con necesidades básicas insatisfechas de Florencio Varela y de la Cuenca Matanza-Riachuelo (Matanza, Villa 21-24, Wilde, Villa Inflamable y Acuba), se estimó, por regresión logística, la edad mediana de cumplimiento de 13 pautas de desarrollo psicomotor y se graficaron, en el eje de las "y", las diferencias entre esas edades y las de la referencia nacional, y, en el eje de las "x", la edad mediana según la referencia nacional. Resultados. Se observaron tres fases: una primera entre 0 y 270 días con desarrollo normal, en que la edad mediana de cumplimiento fue similar a la de la referencia nacional; una segunda de retraso progresivo del desarrollo; y una tercera de recuperación a partir de los 1260 días. Las pendientes de las splines lineales ajustadas fueron 0,06 (no significativo), -0,26 (p < 0,0001) y 0,26 (p < 0,01) para las fases 1, 2 y 3, respectivamente. Las tres pendientes fueron estadísticamente diferentes entre sí. La fase de desarrollo normal (fase 1) se atribuyó al efecto protector de la madre y el medio familiar; la fase 2 de retraso progresivo, a la influencia desfavorable del ambiente, y la fase 3 de recuperación parcial, a la concurrencia a guardería. Estos hallazgos permiten intervenciones eficaces en cada fase. Conclusión. Se identificaron tres períodos con diferente tempo de desarrollo.

Objective. To obtain a psychomotor development index (PDI) for each Argentine province. Population and methods. Using a national, probabilistic, and stratified sample of 13 323 male and female children younger than 6 years selected for the National Survey on Nutrition and Health (Encuesta Nacional de Nutrición y Salud, ENNyS 2004), we estimated the PDI per province based on compliance with 10 developmental milestones. The median age at attainment (median age) of each milestone was estimated adjusting a logistic regression. The PDI was estimated as 100* (1 + b), where "b" is the regression coefficient of y= a + b x, where "y" is the median age as per the national reference (x) minus the median age at attainment of a milestone. The theoretical value expected for the PDI was 100. Results. The PDI per province ranged between 72.1 and 106.4. Most provinces showed a negative regression coefficient, which indicated a progressive increase of the delay in the age at attainment of milestones. The correlation coefficient between the PDI per province and infant mortality in 2005was extremely high: -0.85, suggesting that both indicators share similar biological and social determinants. The PDI was negative because the higher the mortality, the lower the PDI. Conclusion. We have now a positive health indicator available in Argentina: the psychomotor development index, which is a low-cost, easy to collect, and reliable tool that may be used in national health statistics.

Objetivo. Obtener el índice de desarrollo psicomotor (IDP) de cada provincia argentina. Población y Métodos. En una muestra nacional probabilística y estratificada de 13 323 niños y niñas menores de seis años seleccionada para la encuesta Nacional de Nutrición y Salud (ENNyS 2004) se calculó el IDP por provincia en base al cumplimiento de diez pautas de desarrollo. Se estimó la mediana de la edad de cumplimiento (edad mediana) de cada pauta ajustando una regresión logística. El IDP fue calculado como 100* (1 + b), siendo b el coeficiente de regresión de y= a + b x, donde y es: la edad mediana para la Referencia Nacional (x) menos la edad mediana de una pauta. El valor teórico esperable del IDP es 100. Resultados. Los valores obtenidos del IDP por provincia se encuentran en el rango de 72.1 a 106.4. En la mayoría de las provincias los coeficientes de regresión fueron negativos, indicando un aumento progresivo del retraso en la edad de cumplimiento de pautas con la edad de los niños. El coeficiente de correlación entre el IDP por provincia y la mortalidad infantil en 2005 fue extremadamente alto: -0.85, lo que sugiere que ambos indicadores comparten similares determinantes bio- sociales. El signo es negativo porque cuanto mayor es la mortalidad, menor es el IDP. Conclusión. El país dispone ahora de un indicador positivo de salud: el Índice de Desarrollo Psicomotor, simple de recoger, confiable y de bajo costo para ser incorporado a las estadísticas nacionales de salud.

Introduction. It is necessary to use health indicators describing the conditions of all individuals in a population, not just of those who have a disease or die. Objectives. To introduce a method to collect population indicators of psychomotor development in children younger than 6 years old and show its results. Population and methods. Data were obtained from a cross-sectional assessment regarding compliance with 13 developmental milestones (selected from the national reference) conducted in5465 children using five surveys administered by the Matanza-Riachuelo River Basin Authority in areas of this basin where a high proportion of families with unmet basic needs live. For each survey, a logistic regression analysis was used to estimate the median age at attainment of the 13 developmental milestones. A linear regression model between the estimated age at attainment of the 13 milestones was adjusted for each survey based on the corresponding age at attainment of the national reference. Based on this model, three indicators were defined: overall developmental quotient, developmental quotient at 4 years old, and developmental trend. Results. Results from the five surveys ranged between 0.74 and 0.85, 0.88 and 0.81, and -0.15 and -0.26 for the overall developmental quotient, developmental quotient at 4 years old, and developmental trend, respectively. A distinct developmental delay and an increasing trend in delay with age were observed. Conclusions. Indicators are easily interpreted and related to social indicators (unmet basic needs, etc.). Collecting the information necessary to make estimations takes little time and can be applied to population groups, but not on an individual level.

Introducción. Resulta necesario utilizar indicadores de salud que expresen las condiciones de todos los individuos de una población y no solo de aquellos enfermos o que mueren. Objetivos. Presentar un método para obtener indicadores poblacionales de desarrollo psicomotor en niños menores de seis años y mostrar sus resultados. Población y métodos. Los datos provienen de la evaluación transversal del cumplimiento de 13 ítems de desarrollo (seleccionados de la referencia nacional) de 5465 niños en cinco encuestas realizadas por la Autoridad de Cuenca Matanza Riachuelo en dicha cuenca en áreas con alta proporción de familias con necesidades básicas insatisfechas. Para cada encuesta, se estimó, por regresión logística, la edad mediana de cumplimiento de los 13 ítems de desarrollo. Se ajustó un modelo de regresión lineal entre la edad de cumplimiento estimada de los 13 ítems de cada encuesta en función de las correspondientes edades de la referencia nacional. A partir de este modelo, se definieron tres indicadores: el cociente global de desarrollo, el cociente a los 4 años y la tendencia del desarrollo. Resultados. Los resultados para las cinco encuestas variaron entre 0,74 y 0,85; 0,88 y 0,81 y -0,15 y -0,26 para el cociente global de desarrollo, cociente global a los 4 años y la tendencia del desarrollo, respectivamente. Se expresó un marcado retraso en el desarrollo y una tendencia progresiva del retraso con la edad. Conclusiones. Los indicadores sondeinterpretación sencilla y se relacionan con indicadores sociales (necesidades básicas insatisfechas, etc.). La obtención de la informaciónnecesaria para realizar los cálculos toma poco tiempo y es aplicable a grupos de población, pero no a individuos.

O envelhecimento da população idosa tem aumentado mundialmente, mesmo em países em desenvolvimento. Estes países têm grupos populacionais de poucos recursos, com necessidades básicas não satisfatórias, frequentemente omitidas nos estudos epidemiológicos. OBJETIVO: O propósito deste estudo foi determinar a prevalência de comprometimento cognitivo (CC) e demência em uma população socioeconomicamente vulnerável na Argentina. MÉTODOS: Foi realizada pesquisa observacional de base populacional porta-a-porta entre adultos acima de 60 anos numa área de vulnerabilidade social em Matanza Riachuelo, no subúrbio de Buenos Aires, Argentina. Psicólogos treinados entrevistaram o sujeito e um acompanhante. Um protocolo estandardizado que incluiu um questionário sociodemográfico, o MEEM, a escala de depressão geriátrica e um inventário funcional para ABVD e AIVD foram administrados. Os diagnósticos foram divididos em três categorias: função cognitiva normal, comprometimento cognitivo sem demência (CCSD) e demência. RESULTADOS: Foram avaliados um total de 2437 de idosos, dos quais 73,6% preencheram os critérios de inclusão. A prevalência de CC entre aqueles acima de 60 anos foi de 26,4% (18,1% CCSD e 8,3% de demência) com maiores prevalência de demência em indivíduos mais jovens do que os reportados em países desenvolvidos, provavelmente devido a controle inadequado dos fatores de risco vasculares. CONCLUSÃO: Esta informação pode contribuir para tomada de decisões em saúde pública para geração de programas e planos que apontem para a prevenção, diagnóstico e tratamento de CC neste tipo de população em vulnerabilidade social.

Population aging has taken place intensively worldwide, even in developing countries. These countries have population groups with low resources and basic unmet needs that are frequently omitted from epidemiological studies. OBJECTIVE: The purpose of this study was to determine the prevalence of cognitive impairment (CI) and dementia in an economic and socially vulnerable population from Argentina. METHODS: A door-to-door observational population-based survey among adults over 60 years of cognitive impairment and dementia in the social vulnerable area of the Matanza Riachuelo Basin, in the suburban area of Buenos Aires, Argentina was conducted. Trained psychologists interviewed subjects and a proxy informant. A standardized protocol including a socio-demographic questionnaire, the Mini-Mental State Examination, the Geriatric Depression Scale and a functional inventory for IADL and ADL was administered. Diagnoses were divided into three general categories: normal cognitive function, cognitive impairment-no dementia (CIND) and dementia. RESULTS AND CONCLUSIONS: A total of 2437 elderly persons were assessed, of which 73.6% fulfilled inclusion criteria. The prevalence of CI among those over 60 was 26.4% (18.1% CIND and 8.3% dementia) with higher prevalence of dementia in younger individuals than rates reported in developed counties, probably due to low control of vascular risk factors. This information can help inform health public decisions in the generation of programs and plans for the prevention, diagnosis and treatment of cognitive impairment in this type of socially vulnerable population.

Introduction.The administration of the National Screening Test (PruebaNacional de Pesquisa, PRUNAPE), a tool which is effective to screen inapparent developmental disorders in children under 6 years old, requires adequate training, time, space and furniture. A simple questionnaire to help screen large population groups could be useful to identify children at risk. Objective.To evaluate the validity of the PRUNAPE pre-screening questionnaire (cuestionario PRUNAPE pre-pesquisa, CPPP) to identify children at risk of not passing the test. Methods.Fifty seven PRUNAPE milestones were transformed into questions; they were organized in fve questionnaires (one for each age group between 6 and 71 months old) with illustrative pictures. The study was performed in Florencio Varela and in the Health Promotion Unit of Hospital de Niños "Ricardo Gutiérrez" in the Autonomous City of Buenos Aires. In a sample of 533 healthy children and their mothers, of a low socio-economic level, the CPPP was consecutively: a) self-administered by each mother (CPPP-SA), b) by healthcare personnel (CPPP-HP), and fnally, c) the PRUNAPE test was administered to each child by qualifed professionals. Each step was performed by a different professional in a triple-blind fashion. When choosing the cutoff point, the positive predictive value (PPV) was prioritized to reach the least possible number of false positives. Results.For the CPPP-SA and the CPPP-HP, the overall results were, respectively: Cohen's kappa coeffcient: 0.23 and 0.28; sensitivity: 0.41 and 0.42; specifcity: 0.81 and 0.85; negative predictive value 0.57 and 0.59; and PPV 0.71 and 0.76. Conclusions.The CPPP is a valid tool to identify children who most require the PRUNAPE to be administered.

Introducción. La administración de la Prueba Nacional de Pesquisa (PRUNAPE), herramienta efcaz para la detección de trastornos inaparentes del desarrollo en menores de 6 años, requiere capacitación, tiempo, espacio y mobiliario adecuados. Para facilitar esta pesquisa en grandes grupos de población, podría ser útil un cuestionario sencillo a fn de identifcar a los niños en riesgo. Objetivo. Evaluar la validez del cuestionario PRUNAPE pre-pesquisa (CPPP) para identifcar a los niños en riesgo de no pasar la prueba. Métodos. Se transformaron en preguntas 57 pautas PRUNAPE, organizadas en cinco formularios (uno para cada grupo etario entre 6 y 71 meses) con dibujos ilustrativos. El trabajo se realizó en Florencio Varela y en Promoción de la Salud del Hospital de Niños Ricardo Gutiérrez de la Ciudad Autónoma de Buenos Aires. En una muestra de 533 niños sanos con sus madres, de bajo nivel socioeconómico, el CPPP fue sucesivamente: a) autoadministrado por cada madre (CPPP-A), b) por personal de salud (CPPP-PS), y fnalmente, c) se administró la PRUNAPE a cada niño por profesionales capacitados. Cada paso fue realizado por un profesional diferente en forma de triple ciego. En la elección del punto de corte se priorizó el valor predictivo positivo (VPP) para lograr el menor número posible de falsos positivos. Resultados. Para el CPPP-A y el CPPP-PS, los resultados globales fueron respectivamente: coeficiente kappa de Cohen: 0,23 y 0,28; sensibilidad: 0,41 y 0,42; especifcidad: 0,81 y 0,85; valor predictivo negativo 0,57 y 0,59, y VPP 0,71 y 0,76. Conclusiones. El CPPP resulta una herramienta válida para identifcar a los niños que más necesitan que se les administre la PRUNAPE.

Chelonus elaeaphilus Silvestri (Hymenoptera: Braconidae) é um parasitóide específico da traça-da-oliveira, Prays oleae (Bernard), que, em Portugal, pode originar taxas de parasitismo próximas de 80%. Com este estudo, pretendeu-se contribuir para conhecer as possibilidades oferecidas por 18 espécies de plantas da flora espontânea do olival, na melhoria do desempenho de C. elaeaphilus, ao facultar-lhes açúcar, na forma de néctar. Analisou-se o efeito, de quatro açúcares do néctar (frutose, glucose, maltose e sacarose), na longevidade do parasitóide. Avaliou-se a possibilidade teórica de acesso do insecto ao néctar das espécies de plantas e analisou-se a sua composição em açúcar. A longevidade das fêmeas foi superior nos indivíduos alimentados com sacarose e glucose, comparativamente aos que consumiram maltose e frutose. Verificou-se que o parasitóide consegue aceder ao néctar das plantas estudadas, com excepção das Asteráceas. Os néctares analisados continham predominantemente glucose, frutose e sacarose, embora a sua importância relativa tenha diferido entre espécies.

Chelonus elaeaphilus Silvestri (Hymenoptera: Braconidae) is a specific parasitoid of the olive moth, Prays oleae (Bernard), that in Portugal can cause parasitism rates of about 80%. The objective of this study was to gain insight into the possibilities offered by 18 native plant species from the olive agro-ecosystem in enhancing the fitness of C. elaeaphilus, by providing it with sugars. Four naturally occurring sugars (sucrose, fructose, glucose and maltose) were tested with respect to their effect on the parasitoid longevity. Flowers from the studied plant species were analyzed with respect to their theoretically nectar accessibility, and the sugar composition of the nectars was analyzed. Female’s longevity was higher when they feed on both sucrose and glucose compared to either maltose or fructose. It was also found that C. elaeaphilusis theoretically able to make use of any of the tested plants, except for the Asteraceae. Nectars mainly contained glucose, fructose and sucrose, although they differed in their relative concentration.

BACKGROUND: Sickle cell disease is a genetic, hereditary and chronic disease that affects the health of its carriers and might impair their health-related quality of life. OBJECTIVE: The aim of the current study was to assess the health-related quality of life of individuals with sickle cell disease followed at referral centers in Alagoas, Brazil. METHODS: A total of 40 individuals with sickle cell disease aged 12 to 43 years old were evaluated by means of sociodemographic and clinical questionnaires, the Medical Outcomes Study 36-Item Short Form Health Survey and the Beck Depression Inventory. The latter was applied only to adults. RESULTS: Most participants were adults (62.5%) with a predominance of the SS genotype (85%) with pain being the commonest complication (95%). Mood disorder was found in 40% of the adults. The patients exhibited overall impairment of quality of life, which was more pronounced among the adults and under 15-year-old adolescents. Married adults exhibited less impairment of most quality of life domains compared to unmarried adults, and the adults with mood disorder exhibited greater impairment of all quality of life domains. CONCLUSIONS: These results suggest that interventions that aim to improve vitality, pain, and mental health might contribute to maintaining high levels of quality of life in patients with sickle cell disease, especially among adults and under 15-year-old adolescents.

Esta apresentação pretende fazer uma breve descrição dos estudos que têm sido investigados pelo nosso grupo de pesquisa na área de valorização de alimentos fibrosos, utilizando o fungo de podridão branca (fungos basidiomicetos) complexos enzimáticos.

This presentation intends to make a brief description of the studies being investigated by our research group in the area valorization of fibrous feed utilizing the white-rot fungi (basidiomycetes fungi) enzyme complexes.

OBJETIVOS: Avaliar a isquemia parcial ou total, através da ligadura com fio inabsorvível dos vasos do mesoapêndice do apêndice vermiforme de coelhos, bem como a obstrução mecânica, através da ligadura com fio inabsorvível da base do apêndice vermiforme, a 1 cm do ceco. Avaliar a histologia do apêndice ( normal e acometido ). Estudar a flora bacteriana residente no apêndice vermiforme ( normal e acometido ) e do exsudato peritoneal. MÉTODOS: Foram utilizados 72 coelhos ( "Oryctogalus cuniculos" ), machos da linhagem Nova Zelândia, com peso médio de 3,000 gramas. Foram divididos em grupos: piloto ( A ), flora bacteriana ( B ), controle ( H ) e experimento ( C, D, E, F e G ) com períodos de observação de 96 horas e 192 horas. Fez-se a ligadura dos vasos do mesoapêndice, com fio inabsorvível nos grupos ( D, E, F e G ) e da base do apêndice vermiforme a 1 cm do ceco, no grupo ( C ) . No grupo experimento (D,E,F e G ) foi praticado o modelo isquêmico. No grupo experimento ( C ) foi realizada a obstrução mecânica e no grupo controle ( H ) foi feita somente a simulação da cirurgia. RESULTADOS: No grupo controle ( H ), não ocorreu apendicite aguda. No grupo experimento ( C,D,E,F, e G ) ocorreu apendicite aguda. CONCLUSÃO: O procedimento utilizado causa apendicite aguda com alterações anatomopatológicas distintas. A bactéria residente encontrada na flora fisiológica do suco entérico do apêndice vermiforme e no exsudato peritoneal foi a Escherichia coli.

PURPOSE: To evaluate partial or total ischemia, through ligature with an unabsorbed thread of vessels from the vermiform appendix of rabbits, as well as the mechanical obstruction, through ligature with an unabsorbed thread at the basis of the vermiform appendix, at 1 cm from the cecum, of the acute appendicitis disease. To evaluate the histology of the appendix ( normal and affected ). To study the bacterium flora resident in the vermiform appendix (normal and affected) and the exudates peritonitis. METHODS: Seventy- two male rabbits ( Oryctogalus cuniculus ), from New Zealand lineage were used, weighing approximately 3,000 grams. The animals were divided into: pilot ( A ), bacterium flora ( B ), control ( H ) and experimental ( C, D, E, F and G ) groups, and were observed in periods of 96 and 192 hours. It was done the ligature with an unabsorbed thread of vessels from the meso appendix, and the base of the appendix within 1 cm from the cecal. In the ( C ) experimental group, the mechanical obstruction was carried out. In the (D, E, F and G) experimental groups, the ischemic model was used, and in the ( H ) control group, only the surgical simulation was done. RESULTS: In the control group ( H ), the acute appendicitis didn't happen. In the experimental group ( C, D, E, F and G ) the acute appendicitis happened. CONCLUSION: The method used causes acute appendicitis with distinct anatomopathological alterations. The main bacteria found at the physiological flora of the enteric juice from the vermiform appendix and at the exudates peritonitis was the Escherichia coli.

The authors present three cases report of appendicular diverticulum with associated diverticulitis, one of them asymptomatic. The clinical distinction between acute apendicitis and apendical diverticulitis is very difficult, the later usually with earlier suppuration. The are no consensus regarding preventive surgery for apendical diverticulitis. It is possible that incidence of apendicular diverticulum depends on careful anatomopathological exams.

OBJETIVO: Avaliar a isquemia parcial ou total do apêndice vermiforme de coelhos, através da ligadura com fio inabsorvível dos vasos do meso apêndice bem como a obstrução mecânica, através da ligadura com fio inabsorvível da base do apêndice a 1 cm do ceco, na patogênese da apendicite aguda. Avaliar a histologia do apêndice (normal e acometido). Estudar a flora bacteriana residente no apêndice vermiforme (normal e acometido) e do exsudato peritoneal. MÉTODO: Foram utilizados 72 coelhos (Oryctogalus cuniculos), machos, da linhagem Nova Zelândia, com peso médio de 3.000 gramas. Foram divididos em grupos: piloto (A), flora bacteriana (B), controle (H) e experimento (C, D, E, F e G) com períodos de observação de 96 horas e 192 horas. Fez-se a ligadura dos vasos do meso apêndice com fio inabsorvível nos grupos (D, E, F e G) e da base do apêndice vermiforme a 1 cm do ceco, no grupo (C). No grupo experimento (D, E, F e G) foi praticado o modelo isquêmico. No grupo experimento (C) foi realizada a obstrução mecânica e no grupo controle (H) foi feita somente a simulação da cirurgia. RESULTADOS: Ocorreu apendicite aguda no grupo experimento (C,D,E,F, e G). CONCLUSÕES: O método utilizado causa apendicite aguda com alterações anatomopatológicas distintas. A bactéria residente encontrada na flora fisiológica do suco entérico do apêndice vermiforme e no exsudato peritoneal foi Escherichia coli.

BACKGROUND: To evaluate partial or total ischemia, through ligature with an unabsorbed thread of vessels from the vermiform appendix of rabbits, as well as the mechanical obstruction, through ligature with an unabsorbed thread at the basis of the vermiform appendix, at 1 cm from the cecum, in the pathogenesis of acute appendicitis. To evaluate the histology of the appendix (normal and affected). To study the resident bacterium flora in the appendix (normal and affected) and the peritonitis exudate. METHODS: Seventy- two male rabbits (Oryctogalus cuniculus), from New Zealand lineage were used, weighting approximately 3.000 grams. The animals were divided into: pilot (A), bacterium flora (B), control (H) and experiment (C,D, E, F and G) groups, and were observed in periods of 96 hours and 192 hours. A ligature with an unabsorbed thread of vessels from the meso appendix was performed in group D,E,F,G (ischemic model), and of the base of the appendix, 1 cm from the cecum, in group C (mechanical obstruction). In the (H) control group only the surgical simulation was performed. RESULTS: Acute appendicitis was detected in experiment group (C, D, E, F and G). CONCLUSION: The method used causes acute appendicitis with distinct anatomopathological alterations. The main bacteria found in the physiological flora of the enteric juice of the vermiform appendix and in the exudates peritonitis was Escherichia coli.

Primary adenocarcinoma of the duodenum is an extremely rare disease, and represents only 0.35% of all gastrointestinal malignancies. Early detection of the disease may be difficult because of the absence of pathognomonic symptoms. The authors relate one case of a adenocarcinoma of the duodenum in a 61-year-old white man with a history of abdominal pain for a six-month period, associated with postprandial fullness, vomiting and weight loss. Contrasted x-ray and computerized tomography showed a tumor in the fourth segment of the duodenum, with partial obstruction of the lumen. Histological study revealed a moderate differentiated adenocarcinoma. Treatment consisted of resection of the fourth portion of duodenum. The authors comment on the most important aspects of this pathology.