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A critical synthesis of literature review on the
selected John Hopkins Nursing Evidence Based
Practice Model.
Cattaliya Siripattarakul Sanluang1
Ph.D.candidate, Faculty of Nursing,
Chulalongkorn University, Bangkok, Thailand
cattaliya.s@cmu.ac.th
Yupin Aungsuroch , PhD, RN2
Associate Professor Faculty of Nursing,
Chulalongkorn University, Bangkok, Thailand
Yupin_a@chula.ac.th
Waraporn Chaiyawat , DNS, RN3
Associate Professor Faculty of Nursing,
Chulalongkorn University, Bangkok, Thailand
Chaiyawat_w@chula.ac.th
Kay Avant4
Zeller Distinguished Professor, University of
Texas Health science center, SanAntonio, USA.
AVANTK@UTHSCSA.EDU
Abstract Nursing administrators of various healthcare
organizations are required to improve nursing practice outcomes.
A mean toward the improvement of the nursing practice
outcomes is research utilization among professional nurse. To
understand internal organizational factors that increase nurses’
research utilization can help the nursing administrators in
managing their organization to have a climate of evidence based
practice and to facilitate the practicing nurses utilizing research
evidence in their practice. This study aim to examining
relationships between internal organizational factors and
research utilization in nursing practice, and reveal the
relationship strength. In addition, to map the internal
organizational factors against a well reported available model of
evidence based practice. Critical synthesis of literature review
was conducted. There are five key activities: searching, retrieving,
categorizing, analyzing and synthesizing. Electronic search and
retrieve of two online databases and a manual search of specific
journals were done. Inclusion criteria of the selected studies were;
1.Published in English, 2.Have internal organizational factors as
independent variables and research utilization as a dependent
variable, and 3.Relevant to clinical nursing practice. The steps of
categorizing and analyzing include the appraisal of the selected
studies for quality of design, sample, measurement and statistical
analysis. Lastly, semi-structured data abstraction tools and group
consensus were used to synthesize findings. Eleven articles met
the search criteria. They range from case reports to quantitative
studies. Eight factors were identified as having a statistically
significant relationship with research utilization, namely
organizational climate, education & research training, role and
responsibility, access to human resources, access to material
resources access, support, time, and multi-facet access to
research related resources. The strength of the relationship
between the eight internal organizational factors and nurses’
research utilization is low to moderate level. The results of
internal organizational are fit to dimensions of internal
organizational factors in the selected John Hopkins Nursing
Evidence Based Practice Model.
Index Terms—research utilization, nurses, internal
organizational factors, critical synthesis
I. INTRODUCTION
Global concern of the quality for healthcare delivery with
the best available evidence to base practice is increasing and
becoming the leading health care provider issue of this decade
[1]. It has been accepted that research utilization (RU) in
nursing practice is one high optimum strategy to enhance
quality of nursing care [2].
In general, RU refers to the use of research base for practice.
Research finding is the strongest type of evidence in which
decisions about nursing practice should be made. When the
strongest available evidence is considered, the odds of doing
the right thing at the right time for the right patient are
improved [3]. The utilization of research findings could
produce better patient outcome in healthcare organization
because patient-care decisions are conscientiously based on the
best scientific evidence [4-5]. This RU is not only a systematic
approach for decision making to achieve the best practice, but
also demonstrates nurses’ accountability. It has been accepted
as an essential activity among professional nurses for quality of
care enhancement and representative of professional
development and autonomy [6, 2].
Although RU is advantage and significant for nursing
practice, previous RU investigators argue that the use of this
knowledge is not reflected in the care that patients receive [ 7-
10] Around 30-40 % of patients in the United States and
Netherlands receive care that is not based on current scientific
evidence [11]. Only a small proportion of research findings are
translated into clinical nursing practices [12].
This gap between what is known and what is done are exist.
Implementing change, getting research into practice and
improving the quality of patient care are complex, difficult, and
demanding processes, which do not follow prescribed and
linear paths (Rycroft-Malone et al. 2004). In nursing, RU has
been proposed as the use of research findings in any and all
aspects of one’s work as a registered nurse [13]. In addition,
Titler et al. (1994) described RU as the process of using
research findings in practice, encompassing the dissemination
of scientific knowledge, critique of studies, synthesis of
findings, determination of applicability of findings, application
or implementation of findings into practice and evaluation of
the practice change. For this study, RU is conceptualized as
both indirect use (using research findings to influence thinking
at a general level) and direct use (the application of research
findings in clinical practice) [14-16].
Many individual and organizational factors have been
suggested to influence RU in health care [17-18]. Traditionally,
inquiry into the dissemination and use of research findings in
nursing has been interested in individual determinants of RU.
In a systematic review of the research literature on individual
determinants, factors such as beliefs and attitudes, education,
information-seeking and professional characteristics were
found to be associated with RU [17] Less attention has been
paid to the role of organizations in promoting research use in
clinical nursing practice [19-20].
More than a decade, nurses have been struggling with
shortages in staffing. Organizational programs that emphasize
conducting nursing research and evidence-based practice can
be expensive. Often programs that support research efforts tend
to be the first to go or become diminished when hospital
administrators are faced with budget control [21-24] Despite
these shortages and financial limitation, hospital cultures
continue to emphasize practices that are evidence based [21,25-
27]. Previous studies has been focused on the barriers that
nurses face in research utilization using the BARRIERS to
Research Utilization Scale developed by Funk, Champagne,
Wiese, and Tornquist [28]. These studies and review articles
have shown that the top barriers have been, not having the time
to read articles or be involved in research activities, lack of
support for research activities, and not possessing the skills to
critique or understand research results [29-32].
Stetler (2003) also emphasized the importance of nursing
administrators becoming attuned to the needs of staff to
promote the translation of nursing science by assessing current
programs as well as the capacity of their staff. Despite recent
evidence showing a more positive attitude (nurses becoming
more aware of research findings and willing to incorporate
them into practice), a gap continues to exist between
publication and utilization [33-37].
Less attention has been paid to the role of organizations in
facilitating research use in practice [3-4,17]. Rogers (1995)
claimed that in many cases an individual cannot implement
new ideas before the organization has formally adopted them
[38-40]. Many researchers claim that internal organizational
factors are important in predicting research utilization [23, 41].
The concern of internal organizational factors is also reflected
in the Johns Hopkins Nursing Evidence Based Practice
(JHNEBP) model, initially proposed by Newhouse et al [3].
The full JHNEBP Model is depicted as an open system
which the utilization of evidence (which research findings is
included as a type of evidence) among nurses are influenced by
internal and external organizational factors. Specifically, the
internal-organization factors are composed of organizational
culture (values and beliefs), environment (leadership support,
resource allocations, patient services, organizational mission,
organizational priorities, availability of technology, library
support, finance, and so on) as research climate, equipment and
supplies, staffing, and standards (the organization’s own
policies, procedures, and protocols) [3]. External- organization
factors are accreditation, legislation, quality measures,
regulation and standards (professional standards). This model
positions nurses to be a significant influence on health-care
decisions and a partner in improving quality of care. It has been
distributed thorough details, focusing on general evidence and
is implemented many projects within the Johns Hopkins
institutes only. However, this model mentioned several factors
similar to those mentioned in the previous studies. In addition,
this model won the Sigma Theta Tau International Research
Utilization awarded in 2005 .
The literatures related to RU reveal that there are various
determinants of external and internal organization factors
which are interplay and influence on RU among nurses in
organization. External factors are beyond the reach of the
nurse administrator while those internal are reachable, either
directly or indirectly. The nurse administrators have to
prioritize and focus on key internal-organization factors
involving RU among professional nurses. Through this, they
effectively further their management. Therefore, understanding
of predicting factors, especially the internal ones, of RU
among nurses is needed. This study purposes descriptions of if
and how relationship among the internal organization factors
and RU from previous studies in nursing field. The results
derived from the literature review are mapped against---
internal organization factors, elements of the selected model,
as described by Newhouse et al [3] to affirm their fitness.
II. METHODOLOGY
Design: this study is an applied systematic review using a
critical synthesis processes. Five key activities were done as
follows: searching, retrieving, categorizing, analyzing and
synthesizing.
1. Searching
The search strategy was guided by a preliminary literature
review since 1993 to 2013 which revealed that several
internal organization factors had an association with RU in
nursing (Table 1).
Table 1 Internal organizational factors identified by an initial
literature review.
Environment
Culture
Equipment/supply
Staffing
Standard
(Funk et al. 1991, Pettengill et al. 1994, Rizzuto et al. 1994, Titler,et
al. 1994, Funk et al. 1995, Shaffer, 1996, Hatcher & Tranmer 1997,
Nilsson Kajermo et al. 1998, Humphris & Littlejohns 2000, Parahoo
2000, Retsas 2000, Sitzia 2002, McClearly & Brown 2003,
McCloskey2008)
This informed the selection of inclusion criteria for the
electronic search of online databases (ISI web of Science
and Pro-Quest Dissertation &Thesis) and hand search from
selected journals and website (Table 3). An overview of the
key terms for searching strategy is given in Table 2 based on
our knowledge of the literature and anticipated sources of
research in this field The important key terms for this study
are pointed in inclusion criteria.
Table 2 Key terms for Searching strategy from databases
Sources:ISI Web of science, ProQuest dissertation &Thesis
OR AND
Research Utilization Nursing practice
Professional nurses
Organizational factors Hospital nurses
Clinical Nurses
Nurse
Inclusion criteria Papers in English, published up to March
2013, that met the following inclusion criteria, were
reviewed: the study population consisted of nurses working
in clinical practice; papers had to report primary research;
studies reporting a measure or analysis of the relationship
between internal organization factors and RU, where in
studies with a quantitative design. RU was operationalized
as the dependent variable and internal organization factors
as independent variables. Then all key terms are
environment, culture, staffing, equipment/supplies, standard,
research utilization, and nursing practice.
Table 3 Manual search strategy
2. Retrieving
The retrieving is a simultaneous activity of saving or install
information into personal computer while results of
searching appear and shortly after first screening occur.
Screening After removal of duplicates the first two authors
reviewed 280 topics from the search of online databases. A
total of 84 topics met the inclusion criteria. Another 5 titles
were found through the manual search for a total of 280
titles retained. Available abstracts for these topics were then
screened using the inclusion criteria. An abstract was
rejected if it failed to meet one of the criteria. Of the 48
abstracts that met the inclusion criteria, full manuscripts
were retrieved for screening. Of these 48 abstracts, 18 were
excluded as they reported use of the Barrier Scale [26] but
with no measurement of RU. Ten studies on the
implementation of clinical practice guidelines were also
excluded as they did not report a relationship between
internal organization factors and the use of research-based
guidelines. Nine papers were excluded because of lack of
clarity in the methods or results, specifically the
measurement of research use or internal organization
factors., therefore, the 11 studies that remained were
assessed for methodological quality in next two steps of
analyzing.
3. Categorizing
The categorizing is an activity of data grouping. After
screening, the include studies can be grouped into eight
categories : 1) Organizational climate, 2) Education/research
training, 3) Role & responsibility, 4) Access to human
resource, 5) Access to material resources, 6) Support, 7)Time
and 8) Multi-facet access to reach for several sources.
Table 4 Number of paper from searching & retrieving.
source
Search terms (topic)
Number
of paper
1.1 ISI web
of science
Environment & research utilization
43
Culture & research utilization
48
Staffing & research utilization
28
Equipment/supplies &research
utilization
16
Standard & research utilization
25
1.2Pro-
Quest
Disser-
tation
&Thesis
Environment & research utilization
21
Culture & research utilization
41
Staffing & research utilization
18
Equipment/supplies &research
utilization
24
Standard & research utilization
11
1.3
manual
References from key articles
5
Journal(1993-2013)
: International Journal of Nursing
: Journal of Advanced Nursing
: Journal of Nursing Management
: Journal of Clinical Nursing
: Nursing Research
Website of research institute
: Knowledge Utilization Studies in Practice (KUSP)
search
Total
280
First
selection
84
Minus
duplicate
48
Second
selection
20
Final
selection
11
4. Analyzing
The analyzing is series activities of quality assessment and
data extraction as follows.
Quality assessment
The 11 studies that met the inclusion criteria were
assessed for methodological strength using two quality
assessment tools. The first was the Quality Assessment and
Validity Tool for Correlation Studies [12-14]. All 11
quantitative studies were assessed using this tool. The
instrument used 13 questions to evaluate the design, sample,
measurement and statistical analysis, for a total of 14
possible points. Twelve questions were of dichotomous
answer format (‘yes’ = 1,‘no’ = 0). One exception was when
internal organizational factors were measured by self-report;
the study received a score of zero on that question. Whereas,
when the internal organization factors were measured by
independent observation, the study received a score of two.
Studies scoring 0–4 were rated as low quality, those scoring
5–9 were rated as medium quality, and those scoring 10–14
were rated as high quality studies.
The second tool was the Quality Research Appraisal
Checklist [48].This instrument used 41 evaluation criteria
for a total score between 0 and 123 points. Studies with a
score of 0–41 points were rated as low quality; those with a
score of 42–82 points were rated as medium quality; and
those with a score of 83–123 points were rated as high
quality.
Data extraction
Following the quality assessment, 11 studies remained for
data extraction. Table 6 illustrates the search and retrieval
process.
The following data were extracted from the 11 studies in
the final inclusion group: author, journal, subjects/sample,
theoretical model/framework, study design, research
utilization measure or instrument, , scoring, validity,
reliability, , in factors, relationship, results and discussion or
recommendations. One researcher in the RU field were
approached to provide feedback on the search strategy and
the list of included studies. She supported the process used
and identified no gaps. To achieve reliability in every phase
of assessment, the first two authors collectively read one-
third of the topics, abstracts and studies. Consensus was
effectively achieved in most cases in determining if a study
was included or excluded. When there was disagreement,
the articles were re-reviewed and discussed ,and the opinion
of others in the research group was sought leading to an
agreement in the end.
Table 5 Summary of quality score of the include studies for
extraction studies.
Author
journal
Qualit
y
score
Quantitative studies (point range 0–14)
Varcoe& Hilton
(1995)
Canadian Journal of Nursing
Research
9
Tsai (2003)
International Journal of Nursing
studies
8
Tsai (2000)
Tsai (2000) International Journal
of Nursing Studies
7
Wallin et al.
(2003)
Journal of Advanced Nursing
7
Rutledge et al.
(1996)
Oncology Nursing Forum
7
Hatcher
&Tranmer (1997)
Canadian Journal of Nursing
Administration
7
Butler (1995)
Canadian Journal of Nursing
Research
6
McCloskey
(2008)
Clinical research
6
Rodgers (2000)*
Nurse Education Today
6
McClearly &
Brown (2003)
Nurse Education Today
5
Champion &
Leach (1989)
Journal of Advanced Nursing
5
Qualitative studies (point range 0–123)
Rodgers (2000)*
Nurse Education Today
81
Score intervals of quantitative research: 0–4 = low, 5–9
=medium, 10–14= high;
Score intervals of qualitative research: 0–41 = below average,
42–82 = average, 83–123 = superior.
*Study combining qualitative and quantitative design.
5. Synthesizing
This activity means the combination of different
perspectives in order to create new knowledge or concept.
While some information are not exactly determined to point
them in which domain. Critical thinking and re-reading was
integrated. The definition of eight categories are synthesized,
defined and mapped to fit the selected model. The synthesis
results are summarized in table 7.
III. RESULT AND DISCUSSION
1. Quality of studies: No single included study was
assessed to be of high methodological quality. Six
quantitative studies and three qualitative studies of low
methodological quality were excluded. Excluded articles
essentially had shortcomings in measurement and analysis.
The excluded qualitative studies did not clearly report or
discuss the relationship between organizational factors and
RU. Rodgers [41] used both a qualitative and quantitative
design (the qualitative section exploring the quantitative
outcomes), and was counted as one study. In total, eleven
studies were considered to have an acceptable level of
quality. The results of the quality assessment are reported in
Table 5. All included studies showed limitations either in
design, sampling, measurement or statistical analysis (Table
6). All studies were designed as cross-sectional surveys,
with one study using a quasi-experimental design. Seven
studies used probability sampling and only one justified
sample size. All studies used self-reported instruments and
only five of 10 studies had a response rate above 60%. Three
studies employed a theoretical framework for guidance.
Internal organization factors and research utilization This
review identified 11 study findings that had a statistically
significant relationship with RU. Because of conceptual
overlap among the study findings, they were clustered into
eight internal organization factors. A summary of findings
is presented in Table 7.
2. Internal organizational factors
After critical synthesis the literature review, it can be
categorized the internal organizational factors into eight
groups and defined each group as follows;
Organizational climate
Organizational climate refers to surrounding environment
which enable members in organization to achieve mutual
goal. Existing studies revealed various results as follows.
Varcoe and Hilton [32] reported a statistically significant
relationship between research climate (an environment
where research use is encouraged and recognized) and
research utilization, whereas Rodgers (2000) found no
difference between research use in a teaching and non-
teaching hospital.
Education/ research training
Education/ research training was defined as degree gained
from institutes and research training learned from actual
practices. Education was considered to be an internal
organization factor in studies where the organization
provided nurses with specific education. Educational
activities including research methods, statistics courses and
training in RU over several days were reported. Three
studies examined education [35-38] of which McClearly and
Brown (2003) reported both statistically significant and non-
significant effects of different research courses on RU[44].
Rodgers (2000) found that the number of study days spent
on nursing research was significantly related to research
use[45]. However, during focus group interviews,
participating nurses reported that study days were not as
engaging and helpful as accredited courses[27]. However,
McCloskey (2008) revealed that higher education, higher
research use [47].
Role and responsibility
Role and responsibility are focused on range of job
responsibility which are associated with research conducted
previously. Base on the review, two studies pointed to a
relationship between the role of the nurse and RU (Rutledge
et al. 1996, Wallin et al. 2003). Rutledge found a
statistically significant relationship between the extent of job
responsibility and RU. Wallin investigated the effect of
nurses’ sustainability in participating in quality
improvement (QI) teams. Nurses who were involved in QI
work over a full three-year period reported more
implementation of research into practice than those who had
earlier discontinued their QI work[37-39].
Access to human resources
Access to human resources refers to the ability to
reach competent staff who are always available to provide
assistance in terms of research methodology and clinical
practice. Mixed results were reported regarding access to
human resources and its relationship to RU [32-36].
Access to material resources.
Access to material resources is defined as the ability
to get the valuable information for research such as journal,
research articles or nursing journals. The results of two
studies that examined access to material resources were
equivocal [35-36].
Support
Support is described as factors which enable nurses to
conduct research, categorized into three groups as follows;
1) Conducting research support is focused on promoting
the nurses’ activities relevant to research process.
2) Human support means encouragement and
reinforcement to do research based practice from
colleagues, supervisors and nursing care team.
3) Material support is defined as the availability of useful
facilities within organization such as internet, intranet and
libraries which can be easily accessed.
Previous studies revealed significance of supports for
RU as follows; Six studies examined various types of
support, which were grouped into human support, material
support and support for conducting research. Mixed results
were reported regarding human support [32-37]. The
number of conferences that nurses attended and supportive
infrastructures were ways of conceptualizing material
support. Two studies reported a statistically significant
relationship between material support and research
utilization [27,34]. Two studies that examined the
relationship between participation in research (initiated by
the organization) and use of research reported diverse
results [15,23].
Time
Time is focused on allocating appropriate time for
nurses who are responsible for certain responsibility in
order to complete the research. Some studies detailed
significance of time for RU as follows; Rodgers (2000)
conceptualized time as time on duty and time off duty to
read research reports. Approximately half of the nurses in
that study spent at least 4 hours per month off duty studying
research, which had a significant association to RU [35-37].
Multifacet access to research related resources.
Multifacet access to research related resources means
the ability to gain valuable information related to research
from several resources. a multi-faceted subscale called
availability, which had a statistically significant
association with research utilization. The scale included
items such as access to research findings, presentation of
research findings and time to read research [23-28].
3. Strength of relationship between internal
organization factors and research utilization among
nurses.
To assess the strength of the relationships between the
identified internal organization factors and research
utilization, each factor was examined in light of both
statistically significant and non-significant findings and the
results were found to be largely inconclusive. Because of
these mixed results and the moderate quality of included
studies; the strength of evidence for individual factors could
not be ascertained. In addition, methodological limitations
in reviewed studies hindered an investigation of inter-
correlations among the factors associated with research
utilization.
4. The selected JHNEBP model
This study used the selected JHNEBP model key
elements as an underlying theoretical structure. The 11
study findings categorized into eight factors were mapped
to the components of internal organizational factors,
understanding of the prevailing culture, the nature of
human relationships as summarized through leadership
roles and the organizational approach to routine monitoring
of systems and services – evaluation. All identified factors
could be mapped onto either. Eight internal organizational
factors had statistically significant associations with nurses’
RU. However, it was not possible to determine the ranked
importance of these factors because of the mixed results
and methodological limitations. The findings suggest that
internal organization factors may influence the
development of environments that are conducive to
implementing research in practice, and should be
investigated further.
5. Methodological quality
In general, included studies were limited by their design;
most were cross-sectional surveys based on self-reports
from participants. This field of research would benefit from
more effectiveness and intervention studies, employing
experimental and longitudinal designs. Designing studies
where internal organization factors are altered to determine
the impact of RU should yield more robust findings. The
ultimate aim of inquiry about RU is to determine the impact
of RU on patient outcomes.
6. Issues about Internal organizational factors and
research utilization
Clarity of the meaning of concepts used in research is
essential before claims about study results can be made.
The climate in which nursing practice occurs has been
described as unbounded, because it is influenced by
financial, social, political, economic, historical and
psychosocial factors [17] McCormack et al. (2002) also
suggest that other characteristics such as decision-making
within nursing, staff relationships, organizational systems,
power discrepancy and the authority of the organization to
innovate are important considerations in any expression of
the concept of internal organizational factors. Measuring
the concept of internal organizational factors is challenging
because the environments within which nurses work are so
complex, multi-faceted and varied based on the influences
described above. Existing researchers in the field argue for
the value of internal organizational factors but rarely go
beyond describing its importance 20-24]. Previous attempts
to measure the nursing practice environment have led to the
development of numerous instruments [31-35] each of
which appear to measure different constructs [41-42].
Cummings et al. concluded that the overall concept of the
nursing practice environment remains poorly specified and
inadequately measured, recommending that the most useful
advances in ongoing development of this concept will
result from advancing and testing robust theory about the
relationships among specific features within the practice
environment or context. The findings of this review will
contribute to the development of theory related to how
specific contextual features influence nurses’ research
utilization.
The selected JHNEBP model were used as an
underlying theoretical structure for the internal
organizational factors, although this model is still in the
developmental phase and not all components have been
clearly conceptualized. The mapping of factors to the
dimensions of environment, culture, staffing, equipment/
supplies and standard was, to some extent, subjective
because factors like ‘nurses’ involvement in data
collection’ and ‘nurses’ participation in research’ may have
fit under all five dimensions. However, all contextual
factors fit into one of the dimensions of the selected
JHNEBP model, suggesting that all the five factors have a
positive influence on research utilization by nurses. No
factor could be mapped to the dimension without the
explanation. Overall, studies that examine how audit and
feedback relate to research use are infrequent. Another
reason may be due to the lack of studies examining the
implementation of research-based guidelines that met our
inclusion criteria. We do not claim that this mapping
exercise provides construct validity for the selected
JHNEBP model; this study was not designed with a theory
validation objective. However, this selected JHNEBP
model is a fruitful starting point for better understanding of
the impact of internal organizational factors on research
utilization and more studies should explore this area of
inquiry.
In addition to the complexity of measuring the concept
of internal organizational factors, the measurement of the
concept of research utilization varied in the studies in this
review. Three studies used the Research Utilization
Questionnaire (RUQ) (Champion& Leach 1989). This
instrument measured research utilization using a multi-item
scale, which was not tested for construct validity
(Estabrooks et al. 2003b). The lack of construct clarity and
a theoretical framework for the RUQ made it difficult to
grasp what was measured by the research utilization
subscale. Other reported measures were the Nurses Practice
Questionnaire (NPQ) based on Rogers’s stages of
innovation adoption and the Edmonton Research
Orientation Survey (EROS). The NPQ used a process
approach to measure use of specific nursing practices,
implying that ‘reading and appraising research reports’ has
similar weight to ‘using research in practice’.
IV. CONCLUSION AND SUGGESTION
The main purpose of this study was to obtain a better
understanding of the state of evidence on whether internal
organization factors influence nurses’ RU. Based on the
analysis of findings from the final group of included studies,
authors recommend the following:
1. More theory and research are needed to conceptualize
and measure internal organization factors for research
utilization in nursing practice, within JHNEBP and other
frameworks.
2.Observational and intervention studies with less reliance
on self-report would strengthen the evidence obtained from
research in this field.
3. The impact of RU on patient outcomes has to be assessed,
as well as the sustainability of practice changes when
implementing research findings.
ACKNOWLEDGMENT
Authors would like to thank Dr.Ouyporn Tonmukayakul
for her assistance in valuable guidance at the beginning of
preparing this paper to think systematically outline
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