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The moderating effects of coping strategies on major depression in the general population.

OBJECTIVES: To evaluate the moderating effects of various coping strategies on the association between stressors and the prevalence of major depression in the general population. METHODS: Subjects from the Alberta buy-in component of the 1994-1995 National Population Health Survey (NPHS) were included in the analysis (n = 1039). Each subject was asked 8 questions about coping strategies that dealt with unexpected stress from family problems and personal crises. Major depression was measured using the World Health Organization's (WHO) Composite International Diagnostic Interview-Short Form (CIDI-SF) for major depression. The impacts of coping strategies in relation to psychological stressors on the prevalence of major depression were determined by examining interactions between coping and life stress on major depression using logistic regression modelling. RESULTS: No robust impact of coping strategies in relation to various categories of stress evaluated in the NPHS was observed. There was evidence that the use of "pray and seek religious help" and "talks to others about the situations" as coping strategies by women moderated the risk of major depression in the presence of financial stress and relationship stress (with a partner). Using emotional expression as a coping strategy by women might decrease the risk of major depression in the presence of 1 or more recent life events, personal stress, relationship stress (with a partner), and environmental stress. CONCLUSION: Different coping strategies may have a differential impact on the prevalence of major depression in specific circumstances. These findings may be important both to prevent and to treat depressive disorders.

Adaptation, Psychological↗

A naturalistic study of ambulatory asthma severity and reported avoidant coping styles.

OBJECTIVE: To examine how the use of dispositional avoidant coping traits prospectively predicts ambulatory asthma severity in daily life. METHODS: An ecological momentary assessment (EMA) design enabled examination of stable coping styles across dynamic daily changes of ambulatory peak expiratory flow rate (PEFR), asthma symptoms and stress in the natural environment of patients with asthma. A community sample of 61 adults with asthma reported their typical use of avoidant coping styles and carried palmtop computers that alerted them to record their stress and symptoms five times per day for 1 week. RESULTS: Some aspects of dispositional avoidant coping predicted more asthma symptoms and worse PEFR. Denial and behavioural disengagement as typical coping styles predicted more symptoms and worse PEFR. Mental disengagement was unrelated to symptoms and PEFR. DISCUSSION: These data suggest that individuals with asthma who report typically utilizing avoidant coping may have worse health parameters in momentary reports when examined in their natural environments. Differences between avoidant coping styles emerged, suggesting the existence of moderating factors of coping effectiveness.

Adaptation, Psychological↗

Coping strategies, stress, physical activity and sleep in patients with unexplained chest pain.

BACKGROUND: The number of patients suffering from unexplained chest pain (UCP) is increasing. Intervention programmes are needed to reduce the chest pain and suffering experienced by these patients and effective preventive strategies are also required to reduce the incidence of these symptoms. The aim of this study was to describe general coping strategies in patients with UCP and examine the relationships between coping strategies, negative life events, sleep problems, physical activity, stress and chest pain intensity. METHOD: The sample consisted of 179 patients younger than 70 years of age, who were evaluated for chest pain at the emergency department daytime Monday through Friday and judged by a physician to have no organic cause for their chest pain. The study had a cross-sectional design. RESULTS: Emotive coping was related to chest pain intensity (r = 0.17, p = 0.02). Women used emotive coping to a greater extent than did men (p = 0.05). In the multivariate analysis was shown that physical activity decreased emotive coping (OR 0.13, p < 0.0001) while sex, age, sleep, mental strain at work and negative life events increased emotive coping. Twenty-seven percent of the patients had sleep problems 8 to 14 nights per month or more. Permanent stress at work during the last year was reported by 18% of the patients and stress at home by 7%. Thirty-five percent of the patients were worried often or almost all the time about being rushed at work and 23% were worried about being unable to keep up with their workload. Concerning total life events, 20% reported that a close relative had had a serious illness and 27% had reasons to be worried about a close relative. CONCLUSION: Our results indicated that patients with more intense UCP more often apply emotive coping in dealing with their pain. Given that emotive coping was also found to be related to disturbed sleep, negative life events, mental strain at work and physical activity, it may be of value to help these patients to both verbalise their emotions and to become cognizant of the influence of such factors on their pain experience.

Journal Article↗

Coping, quality of life, and hope in adults with primary antibody deficiencies.

BACKGROUND: Living with a chronic disease, such as primary antibody deficiency, will often have consequences for quality of life. Previous quality-of-life studies in primary antibody deficiency patients have been limited to different treatment methods. We wanted to study how adults with primary antibody deficiencies manage their conditions and to identify factors that are conducive to coping, good quality of life and hope. METHODS: Questionnaires were sent to all patients > or =20 years of age with primary antibody deficiencies who were served by Rikshospitalet University Hospital. The questionnaires consisted of several standardized scales: Ferrans and Powers Quality of Life Index (QLI), Short Form-36 (SF-36), Jalowiec Coping Scale (JCS), Nowotny Hope Scale (NHS), and one scale we devised with questions about resources and pressures in the past. Of a total of 91, 55 patients (aged 23-76 years) answered the questionnaires. The questionnaire study were supplemented with selected interviews of ten extreme cases, five with low and five with high quality of life scores. RESULTS: Among the 55 patients, low quality of life scores were related to unemployment, infections in more than four organs, more than two additional diseases, or more than two specific occurrences of stress in the last 2-3 months. Persons with selective IgA deficiency had significantly higher QLI scores than those with other antibody deficiencies. An optimistic coping style was most frequent used, and hope values were moderately high. Based on the interviews, the patients could be divided into three groups: 1) low QLI scores, low hope values, and reduced coping, 2) low QLI scores, moderate hope values, and good coping, and 3) high QLI scores, moderate to strong hope values, and good coping. Coping was related to the patients' sense of closeness and competence. CONCLUSION: Low quality of life scores in adults with primary antibody deficiencies were linked to unemployment and disease-related strains. Closeness and competence were preconditions for coping, quality of life and hope. The results are valuable in planning care for this patient group.

Activities of Daily Living↗

Information needs and coping styles of primary family caregivers of women following breast cancer surgery.

PURPOSE/OBJECTIVES: To determine the information needs and unmet needs of primary family caregivers of women with breast cancer, their informational coping styles, and the relationships among needs, coping styles, and caregiver and patient variables in the first three weeks after surgery. DESIGN: Descriptive, correlational survey. SETTING: Three surgical inpatient units at one private and two public hospitals in Perth, Western Australia. SAMPLE: 141 primary family caregivers of women having surgery for breast cancer. METHODS: Modified Family Inventory of Needs-Husbands and the Miller Behavioral Style Scale administered within one week after surgery and repeated one to two weeks later, after the postoperative visit with the surgeon. MAIN RESEARCH VARIABLES: Information needs, unmet needs, informational coping styles. FINDINGS: All 30 needs were rated as important by the majority of participants. A reduction in the median percentage of unmet needs occurred between time 1 (22%) and time 2 (10%) (p = 0.00004). Caregivers with children younger than 20 had a greater number of needs than the remaining sample (p = 0.001). Caregivers who received information from the breast nurse counselor and medical staff had the lowest percentage of unmet needs compared with those reporting any other source of information (p = 0.007). Caregivers of private patients had more unmet needs compared with public patients' caregivers (p = 0.035). Most caregivers displayed a high monitoring coping style, but further analysis of composite monitoring and blunting profiles revealed that 11%-16% were low monitors as well as low blunters and another 22%-26% displayed an apparently conflicting style of both high monitoring and high blunting. CONCLUSIONS: Western Australian caregivers have a similar range and priority of needs as those previously reported internationally. Caregivers in the private system, where breast centers are not established, are at risk for not having their needs met. Further studies are needed to determine how informational coping styles may affect family caregivers' need for and response to education given by nurses. IMPLICATIONS FOR NURSING: Breast nurse counselors and other nursing staff play an important role in caregiver support. Caregivers with young children need additional support. Caregivers' coping styles indicate the need for high levels of information, which, paradoxically, may lead to increased distress. Therefore, nurses should consider assessing caregivers' informational coping styles to balance the amount of information given with appropriate strategies for assisting caregivers to cope with stressful information.

Adaptation, Psychological↗

Coping strategies in relatives of people with schizophrenia before and after psychiatric admission.

BACKGROUND: Most research on expressed emotion (EE) has used an empirical approach to describe relatives' ways of coping with people with schizophrenia. AIMS: To use the stress and coping model proposed by Lazarus and Folkman to examine how relatives coped with patients. METHOD: Patients with DSM-III-R schizophrenia and their relatives were assessed just after hospitalisation of the patients and nine months after discharge. Both assessments included the symptoms of the patients and the coping strategies, burden, distress and levels of EE of the relatives. RESULTS: Fifty patients and 50 relatives were assessed at inclusion, and 31 patients and 36 relatives at follow-up. Coping strategies were used more frequently at inclusion than at follow-up. Problem-focused coping was the strategy used more often at both assessments. Avoidance coping was strongly associated with burden, distress and high EE at both assessments. CONCLUSIONS: Ways of coping are influenced by relatives' perceptions of the situation with patients. Avoidance strategies seem to be less effective in regulating the distress of care-givers than problem-focused strategies.

Adaptation, Psychological↗

Coping responses of emergency physicians and nurses to the 2003 severe acute respiratory syndrome outbreak.

OBJECTIVES: During the 2003 severe acute respiratory syndrome (SARS) outbreak, health care workers (HCWs) experienced unusual stressors. The study hospital introduced psychosocial interventions to help HCWs. This study aimed to examine the coping strategies adopted by the emergency department (ED) HCWs who cared for the SARS patients. METHODS: In November 2003, a self-administered questionnaire of physicians and nurses was conducted in the hospital ED that is the national SARS screening center in Singapore. Data collected included demographics and responses to these instruments: 1) the Coping Orientation to Problems Experienced (COPE) to assess coping strategies, 2) the Impact of Event Scale (IES) to measure psychological reactions, and 3) the General Health Questionnaire 28 (GHQ 28) to measure psychiatric morbidity. RESULTS: Thirty-eight of 41 (92.7%) physicians and 58 of 83 (69.9%) nurses responded. The respondents reported a preference for problem-focused and emotion-focused coping measures. The physicians chose humor as a coping response significantly more frequently (p < 0.001) than nurses, scoring 9.61/16 (95% CI = 8.52 to 10.69), compared with the nurses' score of 7.05/16 (95% CI = 6.28 to 7.83). The Filipino HCWs turned to religion as a coping response significantly more frequently (p < 0.001) than the non-Filipino HCWs, scoring 14.38/16 (95% CI = 13.33 to 15.42), compared with 9.93/16 (95% CI = 9.00 to 10.87) for the non-Filipinos. Psychiatric morbidity was 17.7% on the IES and 18.8% on the GHQ 28, with the trend for physicians to report lower psychiatric morbidity. CONCLUSIONS: With a supportive hospital environment, ED HCWs chose adaptive coping in response to the outbreak and reported low psychiatric morbidity. Physicians chose humor and Filipinos chose turning to religion as their preferred responses. Psychosocial interventions to help HCWs need to take these preferences into account.

Adaptation, Psychological↗

A telephone-delivered coping improvement group intervention for middle-aged and older adults living with HIV/AIDS.

BACKGROUND: By 2015, the Centers for Disease Control and Prevention predicts that 50% of all cases of HIV/AIDS in the United States will be in persons 50 years of age or older. PURPOSE: This pilot research tested whether a 12-session, coping improvement group intervention delivered via teleconference technology could improve life quality in 90 middle-age and older adults living with HIV/AIDS. METHOD: This research used a lagged-treatment control group design. Forty-four HIV-infected persons 50-plus years of age participated in a coping improvement group intervention immediately after study enrollment, whereas 46 individuals received the intervention after their time-matched immediate treatment participants completed the intervention. Participants completed self-administered surveys that assessed depressive and psychological symptoms, life-stressor burden, ways of coping, coping self-efficacy, and loneliness. RESULTS: Outcome analyses indicated that, compared to their delayed treatment counterparts, immediate treatment participants reported fewer psychological symptoms, lower levels of life-stressor burden, increased coping self-efficacy, and less frequent use of avoidance coping. After receiving the intervention, delayed treatment participants reported greater coping self-efficacy and less psychological symptomatology, life-stressor burden, and loneliness. However, the intervention demonstrated little ability to reduce depressive symptoms in this sample of HIV-infected older adults diagnosed with depression. CONCLUSIONS: Although findings from this research suggest that telephone-delivered, coping improvement group interventions have potential to facilitate the adjustment efforts of HIV-infected older adults, more rigorous evaluations of this intervention modality for this group are needed.

Acquired Immunodeficiency Syndrome↗

Coping strategies, hostility, and depressive symptoms: a path model.

Previous studies of coping, hostility, and depressive symptoms have highlighted the significant relations between all possible pairs of these 3 variables. To more completely explore the nature of depressive symptoms, we link them all together in this study by testing a coping-->hostility-->depressive symptoms path model. One hundred forty participants completed psychological questionnaires measuring coping strategies, hostility, and depressive symptoms. While controlling age and social class as covariates, SPSS stepwise regression analyses were used to examine relations among these 3 constructs. Results suggest that coping has a direct relation with depressive symptoms as well as an indirect relation mediated by hostility. Passive coping may lead to increased hostility, resulting in depressive symptoms. Active coping may have the opposite effect. These findings suggest that the inclusion of measures of both coping strategies and hostility yields a more thorough understanding of concomitants of depressive symptoms. From a clinical perspective, knowing what coping strategies a person uses and how much anger they experience and express may be useful in guiding the management of depressive symptoms.

Adaptation, Psychological↗

Multiple sclerosis: stressors and coping strategies in spousal caregivers.

Community health nurses, who have frequent and prolonged contact with patients afflicted with chronic disease, play a central role in the assessment and care of patients and their families who must deal with the many ramifications of long-term disease. The importance of multiple sclerosis in health care is a result of its worldwide prevalence rate of 57.9 per 100,000 population, its tendency to occur in the young adult, and its chronicity. This exploratory study was designed to describe the stressors of caregivers of individuals with multiple sclerosis, to identify coping behaviors used by caregivers, and to explore the relation between caregiver stress and caregiver coping behavior. The study sample included 20 caregiving spouses of individuals with multiple sclerosis. The data were collected through a semistructured interview of caregiving spouses. Caregiver coping behavior was measured with the Ways of Coping Checklist (Folkman & Lazarus, 1980), and caregiver stress was measured with the Caregiver Strain Index (B. C. Robinson, 1983). Descriptive statistics were calculated for each of the demographic and disability variables. Pearson product-moment correlations were employed to assess the relation between caregiver coping behavior and caregiver stress. Findings revealed significant correlations between caregiver stress and caregiver coping behavior. These findings indicate that as stress in the caregiving role increases, there is an increase in the use of various forms of coping behaviors, both problem focused and emotion focused. Types of stressors and coping strategies used by caregivers are described, and nursing implications are discussed.

Activities of Daily Living↗

Dispositional optimism and coping: a meta-analytic review.

The relation between dispositional optimism and better adjustment to diverse stressors may be attributable to optimism's effects on coping strategies. A meta-analytic review (K = 50, N = 11,629) examined the impact of dispositional optimism on coping. Dispositional optimism was found to be positively associated with approach coping strategies aiming to eliminate, reduce, or manage stressors or emotions (r = .17), and negatively associated with avoidance coping strategies seeking to ignore, avoid, or withdraw from stressors or emotions (r = -.21). Effect sizes were larger for the distinction between approach and avoidance coping strategies than for that between problem and emotion-focused coping. Meta-analytic findings also indicate that optimists may adjust their coping strategies to meet the demands of the stressors at hand, and that the optimism-coping relationship is strongest in English-speaking samples.

Adaptation, Psychological↗

Coping with HIV disease among seropositive women: psychosocial correlates.

With HIV becoming more of a chronic illness, and with a shift in the demographics of the HIV pandemic to women, it is important to understand which psychosocial factors relate to positive coping behaviors in HIV-infected women. Additionally, socioeconomic factors have frequently confounded the interpretation of results of many other studies of stress and coping in HIV-infected individuals. In the present study, 58 HIV-infected women were assessed. These women were generally well-educated, employed women and therefore did not suffer from socioeconomic factors associated with inner city living, commercial sex work, or drug use. We performed a discriminant function analysis to determine which of five psychosocial variables could discriminate between those who strongly self-identified with each of three coping styles from those with low self-identification. The three coping styles included an active, problem solving style, a hopeless, given-up style, and a stoic style. Different patterns of psychosocial variables discriminated between those who strongly identified with a coping style from those who did not. For fighting spirit, the best combination of predictors (loadings > .25) were: strong social support, lower loneliness, depression, and anger, and a belief in a chance locus of control. The best combination of predictors for identification with a helpless coping style were: loneliness, depression, and anger, lower social support and less belief in a chance locus of control. Stronger identification with a stoic coping style were belief in a chance locus of control and lower social support, loneliness, and anger. Results of the study point to areas of psychosocial functioning which need to be strengthened or diminished in order to maintain effective coping for HIV-infected women and enhance their quality of life.

Adaptation, Psychological↗

[Coping with conflict as pathogenetic link between psychosocial adversities in childhood and psychic disorders in adulthood].

OBJECTIVES: The present study explores the connection between neurotic or immature strategies for coping with conflict in the presence of specific psychosocial adversities during childhood and their cumulative effect. Here we test the hypothesis as to whether certain coping strategies can be viewed as a pathogenetic link between psychic illness in adulthood and adversities during childhood. METHODS: 407 consecutive patients referred to the outpatient unit of a psychosomatic university hospital were included in the study. The strategies for coping with conflict were assessed by means of two psychometric methods (FKBS, Hentschel et al., 1996; SBAK, Ehlers u. Peter, 1989), and the childhood adversities were assessed using the Mainz Structured Biographic Interview (Egle, 1993). RESULTS: Patients with sexual abuse and/or physical maltreatment during the first 14 years of life showed significantly higher values for immature coping mechanisms than patients without such traumatisation. Childhood adversities correlated negatively with mature coping strategies and positively with immature strategies. Significant differences also arise when patients with low risk are compared to those with a higher amount of childhood adversities. The latter group exhibits significantly higher scores for immature neurotic coping strategies, while the former exhibits mature ones. By means of a multivariate logistic regression analysis, 7 and 10% respectively of the variance of the predominant coping strategies within each group occurring in adulthood could be accounted for. CONCLUSIONS: The results suggest that in patients exposed to psychosocial stress during childhood an increased vulnerability for psychic disorders in adulthood is, in part, caused by the use of immature strategies for coping with conflict.

Adaptation, Psychological↗

Obesity-related coping and distress and relationship to treatment preference.

OBJECTIVES: The primary purpose was to define obesity-related strategies for coping with psychological problems connected with obesity. We also wanted to identify obesity-related distress and explore the effect of coping on distress. Thirdly, we wanted to investigate differences in coping and distress related to choice of surgery or conventional treatment. DESIGN: Cross-sectional data from patients in the Swedish Obese Subjects (SOS) intervention study. METHODS: An obesity-related questionnaire concerning coping and distress was created and evaluated in 2510 patients from the SOS study, using multitrait, exploratory and confirmatory factor analysis procedures. RESULTS: Three coping factors were defined. Social Trust and Fighting Spirit were problem-focused, whereas Wishful Thinking was emotion-focused. Surgical candidates displayed lower levels of problem-focused and higher levels of emotion-focused coping. We also identified two distress factors: Intrusion and Helplessness. Wishful Thinking was positively related to distress, and Social Trust and Fighting Spirit were inversely related, thus explaining the higher levels of distress reported by the surgical candidates. CONCLUSIONS: In our sample, emotion-focused coping proved maladaptive and was associated with increased distress. Problem-focused coping, however, was adaptive and associated with reduced distress. These findings partly explain psychological morbidity and should be taken into consideration in the treatment of obese people.

Adaptation, Psychological↗

Coping and caregivers of people with dementia.

PURPOSE: To critically review the research based on Lazarus and Folkman's (1984) stress and coping model, in respect to the coping of those caring for persons with dementia in the community, in an attempt to establish its implications for interventions aimed at improving caregiver adjustment. METHOD: Published material on the coping of caregivers of persons with dementia was identified through computerized literature searches (Med-line, Psych-Info) to December 1999, employing search terms including Alzheimer's disease, dementia, caregiving, caregiver burden, adaptation, psychological, coping, and stress. Studies were chosen to be considered in detail, based on the reviewer's opinion that they would contribute to an understanding of the current state of the research and its clinical implications. This material was then critically reviewed against the tenets of Lazarus and Folkman's (1984) model. RESULTS: Sixteen studies were selected to be included in the review, 12 cross-sectional and 4 longitudinal. Seven of the studies did not incorporate coping measures specific to caregiving and/or assess coping in respect of specific caregiver problems. Nine of the studies did do this. The research suggests that a general tendency towards problemsolving and acceptance styles of coping is likely to be advantageous to caregivers of people with dementia. CONCLUSIONS: Despite this finding, it is concluded that the ability of the research to inform the clinician is severely limited. It is proposed that while longitudinal studies considered specific caregiver problems which incorporate coping measures specific to the caregiving task may improve understanding, a substantial revision of methodology and perspective may be required to produce findings that are likely to influence practice.

Adaptation, Psychological↗

Personality disorders, depression, and coping styles in Argentinean bulimic patients.

This study investigates the coping styles of bulimic patients with personality disorders (PDs) and the effects of the level of depression on the relations between PDs and coping. The sample consisted of 75 Argentinean bulimic outpatients engaged in treatment. Patients completed the SCID II (Structural Interview for DSM IV-Personality Disorders), COPE (Coping Inventory), and the SCL-90-R (Symptom Checklist-90-Revised). No differences in the coping styles of bulimic patients with or without a PD were found. However, when three specific PDs were considered-Avoidant, Obsessive-Compulsive, or Borderline PDs-clear differences in the coping styles of the bulimics were found. However, the differences disappeared when depression was controlled. Regarding the severity of the three specific PDs, coping styles were only found to be associated with the Avoidant PD. Depression showed to affect the relations between coping styles and two specific PDs-Avoidant and Borderline PDs-in bulimic patients.

Adaptation, Psychological↗

Drinking to cope, emotional distress and alcohol use and abuse: a ten-year model.

OBJECTIVE: This study examines the ability of baseline drinking to cope to predict drinking behavior across an ensuing 10-year period. In addition, it examines whether a propensity to consume alcohol to cope with stressors strengthens the link between emotional distress and drinking behavior. METHOD: The study uses survey data from a baseline sample of 421 adults (54% women) assessed four times over a 10-year period (i.e., baseline and 1-, 4- and 10-year follow-ups). RESULTS: Baseline drinking to cope was associated with more alcohol consumption and drinking problems at all four observations across the 10-year interval. Baseline drinking to cope also predicted increases in both alcohol consumption and drinking problems in the following year. Moreover, change in drinking to cope was positively linked to changes in both alcohol consumption and drinking problems over the interval. Individuals who had a stronger propensity to drink to cope at baseline showed a stronger link between both anxiety and depressive symptoms and drinking outcomes. CONCLUSIONS: Findings demonstrate the power of alcohol-related coping strategies in predicting long-term drinking behavior and they illustrate one way in which such coping is linked to alcohol use and abuse. More broadly, they underscore the importance of considering individual differences in emotion-based theories of drinking behavior.

Adaptation, Psychological↗

[Chromatic study of all-ceramic restorations--influence of abutment tooth color on color tone of copings].

PURPOSE: Recently, the use of all-ceramic crowns has spread widely in clinical applications to meet the demand for both functional and esthetically-pleasing restorations. In making all-ceramic crowns, it is necessary to reproduce the shape and color near to those of the natural teeth. However, the color shades of abutments might influence the color of the copings which are made of material with high transparency. This study examined the influence of the color shades of the abutments on the final color of copings for three kinds of all-ceramic core materials: Empress, Empress 2 (IVOCLAR VIVADENT), and Procera AllCeram (Nobel Biocare). METHODS: Copings with 0.5 mm in thickness were fabricated by using Empress (TC1), Empress 2 (100), and Procera AllCeram (white) core materials for an upper-right central incisor. Abutments were made by using six kinds of die materials of the Empress system (ST1, ST2, ST3, ST5, ST8, ST9), gold-silver-palladium alloy, gold alloy, and experimental black body. Copings were inserted in each abutment and the final color of the central part of the buccal surface was measured using a spectrophotometer according to the L*a*b* color system. RESULTS: Regardless of the color shades of the abutments, the chroma values of the copings rose in the order of Empress, Empress 2, and Procera, and the values of lightness rose in the order of Empress, Procera, and Empress 2. When the final color of each coping measured under the wet and dry conditions were compared, the difference in chroma was great. CONCLUSIONS: Within the limitations of this study, the results suggest that the influence of the color shades of the abutments on the final color of the three kinds of copings is small in the order of Empress, Procera, and Empress 2. In clinical and dental laboratory operations, it is hoped to observe and measure the color of copings and restorations under the wet condition.

Ceramics↗