Health Informatics Test Bank. Health Informatics Test Bank.
lOMoAR cPSD| 11700591
the oldest but best organized representation of that knowledge?
a. Conference presentations
FULL TEST BANK FOR b. Conference proceedings
c. Journal articles
Health Informatics: An Interprofessional Approach 1st Edition d. Books
Authors: Ramona Nelson, Nancy Staggers, PhD, RN, FAAN
ANS: D
The information source that includes the oldest but best organized representation of knowledge
Chapter 1: Introduction: The Evolution of Health Informatics is books.
Test Bank
DIF: Cognitive Level: Apply REF: p. 5
MULTIPLE CHOICE 5. Which technical development created a tension between centralized and decentralized computer
management in healthcare?
1. The historical roots of computer science can be traced to: a. The development of punch cards
a. language development, especially English. b. The elimination of punch cards
b. mathematics and engineering. c. The development of the mainframe computer
c. library science. d. The development of the personal computer
d. medicine and nursing.
ANS: D
ANS: B The development of the personal computer created tension between centralized and
The historical roots of computer science can be traced back decentralized computer management in healthcare. The other responses highlight aspects of
to mathematics and engineering. The historical roots of decentralized computer management.
information science began in library science. Language
development and medicine and nursing are not the roots of DIF: Cognitive Level: Apply REF: p. 3
computer science.
6. Which of the following is not a member organization but rather a group of organizations?
DIF: Cognitive Level: Understand REF: p. 3 a. AMIA
b. HIMSS
2. The historical roots of information science can be traced c. AHIMA
to: d. ANI
a. language development, especially English.
b. mathematics and engineering. ANS: D
c. library science. The Alliance for Nursing Informatics (ANI) is an organization of organizations. This is not a
d. medicine and nursing. member group. AMIA, HIMSS, and AHIMA are all member groups.
ANS: C DIF: Cognitive Level: Remember REF: p. 7
The historical roots of information science began in library science. The historical roots of
computer science can be traced back to mathematics and engineering. Language development 7. Which statement concerning educational programs in health informatics is correct?
and medicine and nursing are not the roots of information science. a. All health informatics programs are offered at the graduate level.
b. Informatics programs offered by medical schools always require students to have
DIF: Cognitive Level: Understand REF: pp. 3-4 earned an MD for admission.
c. All health informatics programs are located within health-related departments or
3. The first book to include the term nursing informatics in the title was written in the: schools such as nursing, medicine, or pharmacy.
a. 1960s. d. Health informatics programs range from certificate programs offered at the
b. 1970s. community college level to post-doctoral programs offered at major research
c. 1980s. institutions.
d. 1990s.
ANS: D
ANS: C The correct response is health informatics programs range from certificate programs offered at
The first book to include the term nursing informatics in the title was published in 1988. the community college level to post-doctoral programs offered at major research institutions.
Not all informatics programs require an MD, are at the graduate level, or are located within
DIF: Cognitive Level: Remember REF: p. 6
schools of health sciences.
4. As knowledge develops and expands within a discipline, which information source will include
DIF: Cognitive Level: Apply REF: pp. 9-10
, Health Informatics Test Bank. Health Informatics Test Bank.
Chapter 2: Theoretical Foundations of Health Informatics
8. Which statement related to certification in health informatics is correct? Test Bank
a. A master’s in nursing is required to sit for the NI examination offered by ANCC.
b. To be certified in clinical informatics in association with AMIA, one must first be a
physician. MULTIPLE CHOICE
c. There are no specific educational requirements for CPHIMS certification through
HIMSS, but three years of full-time clinical experience in health IT is required. 1. What is the primary difference between an open and closed system?
d. To be certified as CPHIMS, you must be a nurse. a. An open system has no boundary, and therefore there are no limits to the inputs and
outputs between an open system and the environment.
ANS: B b. An open system has a semipermeable boundary and therefore will filter both inputs
To be certified in clinical informatics in association with AMIA, one must first be a physician. and outputs when interacting with the environment.
You do not need to have an MSN to sit for the NI exam by the ANCC. There are specific c. A closed system has a semipermeable boundary and therefore will filter both inputs
requirements for CPHIMS, but being a nurse is not one of them. and outputs when interacting with the environment.
d. A closed system does not have a boundary and therefore will not interact with the
DIF: Cognitive Level: Apply REF: p. 11
environment.
ANS: B
MULTIPLE RESPONSE
With an open system the boundary is semipermeable, thereby controlling what will be accepted
9. The term informatics is derived from: (Select all that apply.) as input and what will be permitted to leave the system.
a. Dutch.
b. English. DIF: Cognitive Level: Understand REF: p. 20
c. Russian.
2. The primary characteristics used to analyze an open system include:
d. Arabic.
a. structure, purpose, and functions.
e. French.
b. sub-system, target system, and super-system.
ANS: B, C, E c. boundary, attributes, and environment.
The term informatics was derived from the following languages: English, Russian, and French. d. hierarchical, web, and hybrid.
DIF: Cognitive Level: Understand REF: p. 4 ANS: A
Using these three characteristics, one can determine why the system exists, what functions it
10. When the AMIA model is used, which subfields are categorized as clinical informatics? (Select performs to achieve its purpose, and how it is structured to achieve its purpose.
all that apply.)
a. Medical informatics DIF: Cognitive Level: Analyze REF: p. 20
b. Nursing informatics
3. A change made to any aspect of an open system, whether it is a health care system or a computer
c. Dental informatics
system, will produce change in other aspects of that same system. As a result, any change can
d. Chemical informatics
produce unintended consequences. This process is called:
e. Business informatics
a. dynamic homeostasis.
ANS: A, B, C b. semi-planned change.
When the AMIA model is used, the following disciplines are categorized as clinical informatics: c. negentropy.
medical informatics, nursing informatics, and dental informatics. The other responses are not d. reverberation.
clinically related.
ANS: D
DIF: Cognitive Level: Analyze REF: p. 14
Change within any part of the system will be reflected across the total system through a process
termed reverberation. Reverberation is reflected in the intended and unintended consequences
of system change.
DIF: Cognitive Level: Remember REF: p. 23
4. Chaotic systems are in a constant state of change. This degree or scope of change that can occur
has been described as the butterfly effect. The butterfly effect refers to:
4
3
, Health Informatics Test Bank. Health Informatics Test Bank.
a. a minor change in input can create a major change in output, or a major change in Wisdom is defined as the appropriate use of knowledge in managing or solving human
input can result in minor changes in output. problems. It is knowing when and how to use knowledge in managing patient need(s) or
b. a major change in input will create a major change in output, and a minor change in problem(s).
input will create minor changes in output.
c. a minor change in input can create a minor change in output; however, a major DIF: Cognitive Level: Remember REF: pp. 26-27
change in input will result in minor changes in output.
d. a minor change in input may create a major change in output; however, a major 8. Which concepts are used to describe the different types of learning outcomes and can be used
change in input will create a major change in output. to write learning objectives?
a. Input, throughput, and output
ANS: A b. Adult learning theories, constructionist theories, and learning styles
Chaotic systems are dynamic systems with reiterative feedback loops. A minor change in input c. Cognitive, affective, and psychomotor
can create a major change in output. This is often described as the butterfly effect. A butterfly’s d. Short, intermediate, and long-term memory
flapping wings in California can over time become a hurricane in New York.
ANS: C
DIF: Cognitive Level: Analyze REF: p. 24 Learning is defined as an increase in knowledge, a change in attitude or values, or the
development of new skills.
5. Which statement describes the measurement of information as defined by the Shannon and
Weaver model? DIF: Cognitive Level: Apply REF: p. 30-31
a. The amount of information is measured by the amount of data in the message.
b. The amount of information is measured by the number of meanings that can be 9. Which group will test out new technology but are not usually seen as leaders within an
assigned to a message. organization?
c. The amount of information is measured by the extent the message decreases entropy. a. Innovators
d. The amount of information is measured by the number of characters used to create b. Early adopters
the message. c. Early majority
d. Late majority
ANS: C
By decreasing entropy one decreases uncertainty. If a coin is thrown into the air, it may land on ANS: A
either of two possible sides, heads up or tails up. Once it lands, the other side of the coin can be Innovators will test out a new technology; however, they are too far ahead of the social group
determined. The options are coded zero (0) and one (1) and are the basis for building computer to be seen as leaders by other members of the social system. Early adopters are seen as much
code. more discreet in their selection of new technology and are therefore better at selling a new
technology to a group of potential users.
DIF: Cognitive Level: Remember REF: pp. 25-26
DIF: Cognitive Level: Understand REF: p. 33
6. The number 190 is an example of:
a. data.
MULTIPLE RESPONSE
b. information.
c. knowledge. 10. The systems life cycle (SLC) is a guide for informatics projects. Typical phases of the SLC
d. wisdom. include (select all that apply):
a. implementation.
ANS: A
The number 190 could refer to anything such as a person’s weight, blood glucose level, or b. planning.
systolic blood pressure reading and therefore has no meaning by itself. c. evaluation.
d. security.
DIF: Cognitive Level: Apply REF: p. 26 e. diagnosis.
ANS: A, B, C
7. Knowing when and how to use knowledge is referred to as:
According to published reports, the SLC contains between 3 and 7 stages. The three that are
a. procedural knowledge.
common in each of these reports are implementation, planning, and evaluation.
b. cognitive knowledge.
c. decision support system. DIF: Cognitive Level: Remember REF: p. 35
d. wisdom.
ANS: D
5 6
, Health Informatics Test Bank. Health Informatics Test Bank.
Chapter 3: Evidence-Based Practice and Informatics Evidence summaries include evidence synthesis, systematic reviews, integrative reviews, and
Test Bank reviews of the literature, with systematic reviews being the most rigorous approach to evidence
summary.
MULTIPLE CHOICE DIF: Cognitive Level: Remember REF: pp. 44-45
1. Knowledge is the point of convergence across the areas of: 5. A facility calls in experts to review evidence developed in research and develop guidelines for
a. evidence-based practice, quality assurance, and informatics. clinical practice. Which stage of EBP is represented?
b. evidence-based practice, improvement, and informatics. a. Evidence summary
c. evidence-based practice, quality assurance, and improvement. b. Translation to guidelines
d. improvement, quality assurance, and informatics. c. Practice integration
d. Evaluation of process and outcomes
ANS: B
Knowledge is the point of convergence across the areas of evidence-based practice, informatics, ANS: B
and improvement. None of the other answers include all of these aspects. In the third stage of EBP, translation, experts are called on to consider the evidence summary,
fill in gaps with consensus expert opinion, and merge research knowledge with expertise to
DIF: Cognitive Level: Remember REF: p. 42 produce clinical practice guidelines (CPGs).
2. Which two hurdles does the STAR Model address in employing evidence-based practice? DIF: Cognitive Level: Understand REF: pp. 46-47
a. The volume and form of knowledge
b. The quality and form of knowledge 6. Which indicators have been established for healthcare improvement and for public reporting?
c. The volume and outcomes of knowledge a. Quality indicators
d. The adequacy and form of knowledge b. Efficiency indicators
c. Cost indicators
ANS: A
d. Longevity indicators
The STAR Model addresses two major hurdles in employing evidence-based practice (EBP).
These two hurdles are the volume of current professional knowledge and the form of knowledge ANS: A
that healthcare professionals attempt to apply in practice. Evaluation of specific outcomes has risen to a high level of public interest. As a result, quality
indicators are being established for health improvement and public reporting.
DIF: Cognitive Level: Remember REF: pp. 43-44
DIF: Cognitive Level: Knowledge REF: p. 50
3. What is the form of knowledge in discovery research?
a. Single research studies
b. Meta-synthesis MULTIPLE RESPONSE
c. Systematic review
7. The goal of the intersection of informatics and evidence-based practice is to transform
d. Meta-analysis
healthcare to be: (select all that apply.)
ANS: A a. reliable.
Discovery research represents knowledge produced in the form of single research studies. The b. safe.
other three choices represent synthesis of multiple studies. c. effective.
d. efficient.
DIF: Cognitive Level: Remember REF: p. 44
ANS: A, B, C
4. Which type of review is considered the most rigorous? The field of informatics and the concept of evidence-based practice (EBP) intersect at the
a. Literature reviews crucial junction of knowledge for clinical decisions with the goal of transforming healthcare to
b. Systematic reviews be reliable, safe, and effective. While efficiency is always a goal in healthcare, it is not a primary
c. Integrative reviews goal of EBP.
d. Single study reviews
DIF: Cognitive Level: Knowledge REF: p. 40
ANS: B
8. Which of the following are evidence summaries: (select all that apply.)
a. Literature reviews
7 8
lOMoAR cPSD| 11700591
the oldest but best organized representation of that knowledge?
a. Conference presentations
FULL TEST BANK FOR b. Conference proceedings
c. Journal articles
Health Informatics: An Interprofessional Approach 1st Edition d. Books
Authors: Ramona Nelson, Nancy Staggers, PhD, RN, FAAN
ANS: D
The information source that includes the oldest but best organized representation of knowledge
Chapter 1: Introduction: The Evolution of Health Informatics is books.
Test Bank
DIF: Cognitive Level: Apply REF: p. 5
MULTIPLE CHOICE 5. Which technical development created a tension between centralized and decentralized computer
management in healthcare?
1. The historical roots of computer science can be traced to: a. The development of punch cards
a. language development, especially English. b. The elimination of punch cards
b. mathematics and engineering. c. The development of the mainframe computer
c. library science. d. The development of the personal computer
d. medicine and nursing.
ANS: D
ANS: B The development of the personal computer created tension between centralized and
The historical roots of computer science can be traced back decentralized computer management in healthcare. The other responses highlight aspects of
to mathematics and engineering. The historical roots of decentralized computer management.
information science began in library science. Language
development and medicine and nursing are not the roots of DIF: Cognitive Level: Apply REF: p. 3
computer science.
6. Which of the following is not a member organization but rather a group of organizations?
DIF: Cognitive Level: Understand REF: p. 3 a. AMIA
b. HIMSS
2. The historical roots of information science can be traced c. AHIMA
to: d. ANI
a. language development, especially English.
b. mathematics and engineering. ANS: D
c. library science. The Alliance for Nursing Informatics (ANI) is an organization of organizations. This is not a
d. medicine and nursing. member group. AMIA, HIMSS, and AHIMA are all member groups.
ANS: C DIF: Cognitive Level: Remember REF: p. 7
The historical roots of information science began in library science. The historical roots of
computer science can be traced back to mathematics and engineering. Language development 7. Which statement concerning educational programs in health informatics is correct?
and medicine and nursing are not the roots of information science. a. All health informatics programs are offered at the graduate level.
b. Informatics programs offered by medical schools always require students to have
DIF: Cognitive Level: Understand REF: pp. 3-4 earned an MD for admission.
c. All health informatics programs are located within health-related departments or
3. The first book to include the term nursing informatics in the title was written in the: schools such as nursing, medicine, or pharmacy.
a. 1960s. d. Health informatics programs range from certificate programs offered at the
b. 1970s. community college level to post-doctoral programs offered at major research
c. 1980s. institutions.
d. 1990s.
ANS: D
ANS: C The correct response is health informatics programs range from certificate programs offered at
The first book to include the term nursing informatics in the title was published in 1988. the community college level to post-doctoral programs offered at major research institutions.
Not all informatics programs require an MD, are at the graduate level, or are located within
DIF: Cognitive Level: Remember REF: p. 6
schools of health sciences.
4. As knowledge develops and expands within a discipline, which information source will include
DIF: Cognitive Level: Apply REF: pp. 9-10
, Health Informatics Test Bank. Health Informatics Test Bank.
Chapter 2: Theoretical Foundations of Health Informatics
8. Which statement related to certification in health informatics is correct? Test Bank
a. A master’s in nursing is required to sit for the NI examination offered by ANCC.
b. To be certified in clinical informatics in association with AMIA, one must first be a
physician. MULTIPLE CHOICE
c. There are no specific educational requirements for CPHIMS certification through
HIMSS, but three years of full-time clinical experience in health IT is required. 1. What is the primary difference between an open and closed system?
d. To be certified as CPHIMS, you must be a nurse. a. An open system has no boundary, and therefore there are no limits to the inputs and
outputs between an open system and the environment.
ANS: B b. An open system has a semipermeable boundary and therefore will filter both inputs
To be certified in clinical informatics in association with AMIA, one must first be a physician. and outputs when interacting with the environment.
You do not need to have an MSN to sit for the NI exam by the ANCC. There are specific c. A closed system has a semipermeable boundary and therefore will filter both inputs
requirements for CPHIMS, but being a nurse is not one of them. and outputs when interacting with the environment.
d. A closed system does not have a boundary and therefore will not interact with the
DIF: Cognitive Level: Apply REF: p. 11
environment.
ANS: B
MULTIPLE RESPONSE
With an open system the boundary is semipermeable, thereby controlling what will be accepted
9. The term informatics is derived from: (Select all that apply.) as input and what will be permitted to leave the system.
a. Dutch.
b. English. DIF: Cognitive Level: Understand REF: p. 20
c. Russian.
2. The primary characteristics used to analyze an open system include:
d. Arabic.
a. structure, purpose, and functions.
e. French.
b. sub-system, target system, and super-system.
ANS: B, C, E c. boundary, attributes, and environment.
The term informatics was derived from the following languages: English, Russian, and French. d. hierarchical, web, and hybrid.
DIF: Cognitive Level: Understand REF: p. 4 ANS: A
Using these three characteristics, one can determine why the system exists, what functions it
10. When the AMIA model is used, which subfields are categorized as clinical informatics? (Select performs to achieve its purpose, and how it is structured to achieve its purpose.
all that apply.)
a. Medical informatics DIF: Cognitive Level: Analyze REF: p. 20
b. Nursing informatics
3. A change made to any aspect of an open system, whether it is a health care system or a computer
c. Dental informatics
system, will produce change in other aspects of that same system. As a result, any change can
d. Chemical informatics
produce unintended consequences. This process is called:
e. Business informatics
a. dynamic homeostasis.
ANS: A, B, C b. semi-planned change.
When the AMIA model is used, the following disciplines are categorized as clinical informatics: c. negentropy.
medical informatics, nursing informatics, and dental informatics. The other responses are not d. reverberation.
clinically related.
ANS: D
DIF: Cognitive Level: Analyze REF: p. 14
Change within any part of the system will be reflected across the total system through a process
termed reverberation. Reverberation is reflected in the intended and unintended consequences
of system change.
DIF: Cognitive Level: Remember REF: p. 23
4. Chaotic systems are in a constant state of change. This degree or scope of change that can occur
has been described as the butterfly effect. The butterfly effect refers to:
4
3
, Health Informatics Test Bank. Health Informatics Test Bank.
a. a minor change in input can create a major change in output, or a major change in Wisdom is defined as the appropriate use of knowledge in managing or solving human
input can result in minor changes in output. problems. It is knowing when and how to use knowledge in managing patient need(s) or
b. a major change in input will create a major change in output, and a minor change in problem(s).
input will create minor changes in output.
c. a minor change in input can create a minor change in output; however, a major DIF: Cognitive Level: Remember REF: pp. 26-27
change in input will result in minor changes in output.
d. a minor change in input may create a major change in output; however, a major 8. Which concepts are used to describe the different types of learning outcomes and can be used
change in input will create a major change in output. to write learning objectives?
a. Input, throughput, and output
ANS: A b. Adult learning theories, constructionist theories, and learning styles
Chaotic systems are dynamic systems with reiterative feedback loops. A minor change in input c. Cognitive, affective, and psychomotor
can create a major change in output. This is often described as the butterfly effect. A butterfly’s d. Short, intermediate, and long-term memory
flapping wings in California can over time become a hurricane in New York.
ANS: C
DIF: Cognitive Level: Analyze REF: p. 24 Learning is defined as an increase in knowledge, a change in attitude or values, or the
development of new skills.
5. Which statement describes the measurement of information as defined by the Shannon and
Weaver model? DIF: Cognitive Level: Apply REF: p. 30-31
a. The amount of information is measured by the amount of data in the message.
b. The amount of information is measured by the number of meanings that can be 9. Which group will test out new technology but are not usually seen as leaders within an
assigned to a message. organization?
c. The amount of information is measured by the extent the message decreases entropy. a. Innovators
d. The amount of information is measured by the number of characters used to create b. Early adopters
the message. c. Early majority
d. Late majority
ANS: C
By decreasing entropy one decreases uncertainty. If a coin is thrown into the air, it may land on ANS: A
either of two possible sides, heads up or tails up. Once it lands, the other side of the coin can be Innovators will test out a new technology; however, they are too far ahead of the social group
determined. The options are coded zero (0) and one (1) and are the basis for building computer to be seen as leaders by other members of the social system. Early adopters are seen as much
code. more discreet in their selection of new technology and are therefore better at selling a new
technology to a group of potential users.
DIF: Cognitive Level: Remember REF: pp. 25-26
DIF: Cognitive Level: Understand REF: p. 33
6. The number 190 is an example of:
a. data.
MULTIPLE RESPONSE
b. information.
c. knowledge. 10. The systems life cycle (SLC) is a guide for informatics projects. Typical phases of the SLC
d. wisdom. include (select all that apply):
a. implementation.
ANS: A
The number 190 could refer to anything such as a person’s weight, blood glucose level, or b. planning.
systolic blood pressure reading and therefore has no meaning by itself. c. evaluation.
d. security.
DIF: Cognitive Level: Apply REF: p. 26 e. diagnosis.
ANS: A, B, C
7. Knowing when and how to use knowledge is referred to as:
According to published reports, the SLC contains between 3 and 7 stages. The three that are
a. procedural knowledge.
common in each of these reports are implementation, planning, and evaluation.
b. cognitive knowledge.
c. decision support system. DIF: Cognitive Level: Remember REF: p. 35
d. wisdom.
ANS: D
5 6
, Health Informatics Test Bank. Health Informatics Test Bank.
Chapter 3: Evidence-Based Practice and Informatics Evidence summaries include evidence synthesis, systematic reviews, integrative reviews, and
Test Bank reviews of the literature, with systematic reviews being the most rigorous approach to evidence
summary.
MULTIPLE CHOICE DIF: Cognitive Level: Remember REF: pp. 44-45
1. Knowledge is the point of convergence across the areas of: 5. A facility calls in experts to review evidence developed in research and develop guidelines for
a. evidence-based practice, quality assurance, and informatics. clinical practice. Which stage of EBP is represented?
b. evidence-based practice, improvement, and informatics. a. Evidence summary
c. evidence-based practice, quality assurance, and improvement. b. Translation to guidelines
d. improvement, quality assurance, and informatics. c. Practice integration
d. Evaluation of process and outcomes
ANS: B
Knowledge is the point of convergence across the areas of evidence-based practice, informatics, ANS: B
and improvement. None of the other answers include all of these aspects. In the third stage of EBP, translation, experts are called on to consider the evidence summary,
fill in gaps with consensus expert opinion, and merge research knowledge with expertise to
DIF: Cognitive Level: Remember REF: p. 42 produce clinical practice guidelines (CPGs).
2. Which two hurdles does the STAR Model address in employing evidence-based practice? DIF: Cognitive Level: Understand REF: pp. 46-47
a. The volume and form of knowledge
b. The quality and form of knowledge 6. Which indicators have been established for healthcare improvement and for public reporting?
c. The volume and outcomes of knowledge a. Quality indicators
d. The adequacy and form of knowledge b. Efficiency indicators
c. Cost indicators
ANS: A
d. Longevity indicators
The STAR Model addresses two major hurdles in employing evidence-based practice (EBP).
These two hurdles are the volume of current professional knowledge and the form of knowledge ANS: A
that healthcare professionals attempt to apply in practice. Evaluation of specific outcomes has risen to a high level of public interest. As a result, quality
indicators are being established for health improvement and public reporting.
DIF: Cognitive Level: Remember REF: pp. 43-44
DIF: Cognitive Level: Knowledge REF: p. 50
3. What is the form of knowledge in discovery research?
a. Single research studies
b. Meta-synthesis MULTIPLE RESPONSE
c. Systematic review
7. The goal of the intersection of informatics and evidence-based practice is to transform
d. Meta-analysis
healthcare to be: (select all that apply.)
ANS: A a. reliable.
Discovery research represents knowledge produced in the form of single research studies. The b. safe.
other three choices represent synthesis of multiple studies. c. effective.
d. efficient.
DIF: Cognitive Level: Remember REF: p. 44
ANS: A, B, C
4. Which type of review is considered the most rigorous? The field of informatics and the concept of evidence-based practice (EBP) intersect at the
a. Literature reviews crucial junction of knowledge for clinical decisions with the goal of transforming healthcare to
b. Systematic reviews be reliable, safe, and effective. While efficiency is always a goal in healthcare, it is not a primary
c. Integrative reviews goal of EBP.
d. Single study reviews
DIF: Cognitive Level: Knowledge REF: p. 40
ANS: B
8. Which of the following are evidence summaries: (select all that apply.)
a. Literature reviews
7 8
