I
nte
rna
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l J
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Science
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J
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ttp
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//
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s
.
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The inte
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disa
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displ
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fam
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tempo
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Ra
nd
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a
n F
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lleg
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in
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HL
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b
M
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Qu
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t
o
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6
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fe
re
n
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e
s m
e
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th
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in
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n
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rit
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th
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l
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.
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c
o
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t
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a
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o
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e
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n
t
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ra
ti
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d
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v
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p
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:
i)
d
isa
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ts
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a
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ife
p
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tt
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ii
)
c
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ri
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d
isa
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v
)
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lt
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s
fo
r
d
isa
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b
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se
d
p
ra
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ti
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o
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rs.
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s
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th
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t
d
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sp
it
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h
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ll
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ften
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t
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y
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re
tu
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o
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sili
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c
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-
c
o
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m
e
c
h
a
n
ism
s e
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a
b
le p
e
o
p
le t
o
f
lo
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ris
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in
a
d
v
e
rsity
,
wit
h
c
u
lt
u
re
a
n
d
trad
i
ti
o
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p
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s
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e
n
t
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ircu
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sta
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e
s.
K
ey
w
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d
s
:
C
ar
in
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co
p
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p
atter
n
s
C
u
ltu
r
e
Dis
aster
d
is
p
lace
m
en
t
I
n
teg
r
ativ
e
r
esear
c
h
r
ev
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T
em
p
o
r
ar
y
s
h
elter
s
T
h
is i
s
a
n
o
p
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n
a
c
c
e
ss
a
rticle
u
n
d
e
r th
e
CC B
Y
-
SA
li
c
e
n
se
.
C
o
r
r
e
s
p
o
nd
ing
A
uth
o
r
:
R
an
d
y
I
an
Fer
e
n
al
Galleg
o
C
o
lleg
e
o
f
Nu
r
s
in
g
,
U
n
iv
er
s
ity
o
f
th
e
Ph
ilip
p
in
es M
an
ila
So
tejo
Hall,
UP M
an
ila,
Ped
r
o
Gil St.,
E
r
m
ita,
Ma
n
ila,
1
0
0
0
Ph
ilip
p
in
es
E
m
ail: r
f
g
alleg
o
1
@
u
p
.
ed
u
.
p
h
1.
I
NT
RO
D
UCT
I
O
N
T
h
e
n
ec
ess
ity
to
d
e
p
ar
t
f
r
o
m
th
e
co
m
f
o
r
t
o
f
o
n
e'
s
h
o
m
e
a
n
d
f
am
iliar
s
u
r
r
o
u
n
d
in
g
s
ca
n
a
r
is
e
wh
en
co
m
m
u
n
ities
f
ac
e
o
v
er
wh
elm
i
n
g
ev
en
ts
th
at
e
x
ce
ed
th
eir
ab
ilit
y
to
co
p
e
an
d
r
eso
lv
e.
Fo
r
in
s
tan
ce
,
d
is
aster
s
th
at
ar
e
n
atu
r
ally
im
p
ac
tf
u
l
in
s
ev
er
ity
d
r
iv
e
p
eo
p
le
to
f
lee
a
n
d
s
ee
k
s
af
e
r
ef
u
g
e
as
f
ar
awa
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f
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o
m
th
eir
h
o
m
es
as
im
m
ed
iately
as
p
o
s
s
ib
le.
Un
til
an
d
u
n
less
th
e
d
is
a
s
ter
s
eq
u
elae
h
av
e
wan
ed
an
d
clea
r
ed
u
p
,
d
is
p
lace
d
p
o
p
u
latio
n
s
ar
e
ad
v
is
ed
to
r
em
ain
in
th
eir
tem
p
o
r
ar
y
e
n
ca
m
p
m
en
ts
.
As
a
r
esu
lt,
t
h
e
ev
ac
u
atio
n
an
d
d
is
p
lace
m
en
t
p
h
en
o
m
en
a
h
a
v
e
in
cr
ea
s
in
g
ly
b
ec
o
m
e
c
o
m
m
o
n
p
lace
in
th
is
d
ay
an
d
ag
e.
E
v
er
y
y
ea
r
,
it
is
esti
m
ated
th
at
ab
o
u
t
a
m
illi
o
n
p
eo
p
le
ar
e
c
o
m
p
elled
t
o
ab
an
d
o
n
th
eir
h
o
m
es
to
escap
e
f
r
o
m
th
e
th
r
ea
t
a
n
d
d
an
g
er
o
f
p
o
te
n
tial
an
d
ac
tu
al
d
is
aster
s
[
1
]
.
E
v
ac
u
atio
n
s
h
e
lter
s
h
elp
p
r
o
v
id
e
tem
p
o
r
a
r
y
r
esp
ite
f
o
r
af
f
ec
ted
p
o
p
u
latio
n
s
am
id
s
t
th
e
b
u
r
d
en
o
f
liv
in
g
with
lim
ited
av
ailab
le
r
eso
u
r
ce
s
.
I
n
th
e
s
am
e
m
an
n
er
,
th
e
p
r
esen
ce
o
f
th
ese
ev
ac
u
atio
n
s
ites
aid
s
in
th
e
f
ac
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atio
n
o
f
p
eo
p
le
as
th
ey
p
r
ep
a
r
e
f
o
r
th
eir
r
e
-
en
tr
y
b
ac
k
to
th
eir
co
m
m
u
n
ities
as th
ey
tr
an
s
itio
n
to
war
d
r
ec
o
v
er
y
[
2
]
.
Ho
wev
er
,
it
is
n
o
tewo
r
th
y
to
em
p
h
asize
th
at,
wh
ile
ev
ac
u
atio
n
ce
n
ter
s
o
f
f
er
p
r
o
tectio
n
f
r
o
m
th
e
h
ar
r
o
win
g
th
r
ea
ts
o
f
d
is
aster
s
,
th
ey
m
ay
n
o
t
alwa
y
s
p
r
o
v
id
e
th
e
m
o
s
t
id
ea
l
lo
ca
tio
n
f
o
r
in
d
iv
id
u
als
an
d
f
am
ilies
to
th
r
iv
e
o
n
a
lo
n
g
-
t
er
m
s
ca
le.
Sev
er
al
s
tu
d
ies
r
ev
ea
l
th
at
s
o
m
e
d
eg
r
ee
o
f
h
ar
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(
b
o
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cially
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d
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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Hea
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N:
2252
-
8
8
0
6
Th
e
in
tercu
ltu
r
a
l c
a
r
in
g
-
co
p
in
g
p
a
tter
n
s
o
f d
is
a
s
ter
-
d
is
p
la
c
ed
fa
milies
in
…(
R
a
n
d
y
I
a
n
F
.
Ga
lleg
o
)
1979
p
s
y
ch
o
lo
g
ically
)
was r
ep
o
r
te
d
in
d
is
p
lace
d
p
o
p
u
latio
n
s
af
ter
f
ailin
g
to
r
etu
r
n
to
t
h
eir
o
r
i
g
in
al
co
m
m
u
n
ities
f
o
r
an
ex
ten
d
ed
p
er
io
d
,
e.
g
.
,
th
e
y
ten
d
to
g
et
af
f
ec
te
d
with
illn
e
s
s
at
twice
th
e
r
ate
th
an
t
h
o
s
e
wh
o
h
av
e
n
o
t
b
ee
n
d
is
p
lace
d
[
1
]
,
[
3
]
–
[
5
]
.
I
n
cid
e
n
tally
,
s
p
ec
if
ic
g
r
o
u
p
s
ar
e
p
la
ce
d
at
a
h
ig
h
er
r
is
k
o
f
v
u
ln
er
ab
ilit
y
th
r
o
u
g
h
th
e
co
u
r
s
e
o
f
th
eir
s
tay
in
tr
an
s
itio
n
al
s
h
elter
s
,
g
iv
en
th
e
n
atu
r
e
o
f
th
eir
s
o
cieta
l
p
o
s
itio
n
s
an
d
/o
r
p
h
y
s
io
lo
g
ic
co
n
d
itio
n
s
.
T
h
o
s
e
with
lo
w
s
o
cio
-
ec
o
n
o
m
ic
p
o
s
itio
n
s
,
ag
ed
,
an
d
i
n
f
ir
m
ed
a
r
e
ch
a
r
ac
ter
is
tically
m
o
r
e
s
u
s
ce
p
tib
le
to
co
n
tag
io
n
wh
ile
liv
in
g
in
co
n
g
ested
liv
in
g
q
u
ar
te
r
s
[
6
]
,
[
7
]
.
W
o
m
en
,
esp
ec
ially
y
o
u
n
g
m
en
s
tr
u
atin
g
g
ir
ls
,
m
ay
n
o
t
f
in
d
a
s
af
e
an
d
s
u
p
p
o
r
tiv
e
p
r
iv
ate
s
p
ac
e
to
m
ain
tain
th
eir
f
em
in
in
e
h
ea
lth
m
ea
s
u
r
es
[
8
]
.
L
i
k
ewise,
p
eo
p
le
co
m
in
g
f
r
o
m
d
is
tin
ct
c
u
ltu
r
a
l,
eth
n
ic,
an
d
in
d
ig
en
o
u
s
g
r
o
u
p
s
ar
e
also
f
o
u
n
d
to
b
e
m
o
r
e
v
u
ln
er
ab
le
wh
e
n
th
ey
ar
e
ex
p
o
s
ed
to
ca
r
e
r
s
wh
o
ar
e
in
ex
p
er
ien
ce
d
a
n
d
u
n
f
am
iliar
with
th
eir
tr
ad
itio
n
al
n
o
r
m
s
an
d
p
r
ac
tice
s
[
1
]
.
T
h
e
r
is
k
o
f
p
an
eth
n
ic
o
r
cu
l
tu
r
al
n
eg
lect
an
d
ex
p
lo
itatio
n
m
ay
b
e
h
ig
h
er
in
em
er
g
e
n
c
y
s
h
elter
s
wh
o
s
e
s
tr
u
ctu
r
es
an
d
p
r
o
ce
s
s
es
ar
e
n
o
t
s
en
s
itiv
e
to
p
r
o
t
ec
tin
g
th
e
r
ig
h
ts
an
d
d
ig
n
ity
o
f
th
e
e
v
ac
u
ee
s
.
Pan
eth
n
icity
ac
co
u
n
ts
f
o
r
th
e
d
y
n
am
is
m
b
etwe
en
c
u
ltu
r
e
a
n
d
id
en
tity
,
wh
ic
h
co
n
s
id
er
s
s
ev
er
al
in
ter
s
ec
tin
g
"c
o
eth
n
ics"
an
d
ex
p
a
n
d
in
g
in
ter
cu
ltu
r
al
p
atter
n
s
o
r
f
r
am
es
o
f
r
ef
er
en
ce
f
o
r
in
d
iv
i
d
u
als
h
av
in
g
s
h
ar
ed
in
ter
cu
ltu
r
al
o
r
s
o
cio
-
p
o
liti
ca
l
ex
p
er
ien
ce
s
in
th
eir
p
r
esen
t
co
m
m
u
n
ities
[
9
]
,
[
1
0
]
.
Dee
p
ly
i
n
g
r
ain
ed
p
a
n
eth
n
ic
b
elief
s
an
d
p
r
in
cip
les
h
a
v
e
th
e
p
o
ten
tial
to
b
e
u
n
d
e
r
v
alu
e
d
an
d
d
is
r
eg
a
r
d
ed
,
p
r
im
a
r
ily
wh
en
s
er
v
ice
an
d
ca
r
e
d
eliv
er
y
in
tem
p
o
r
ar
y
ac
co
m
m
o
d
atio
n
s
ar
e
b
ased
o
n
a
u
n
iv
er
s
al,
n
o
n
-
c
u
ltu
r
e
-
s
p
ec
if
ic
o
r
ien
tatio
n
.
T
o
th
e
ex
ten
t
p
o
s
s
ib
le,
s
h
elter
m
an
a
g
er
s
n
ee
d
to
o
r
ch
estra
te
a
well
-
d
ev
elo
p
e
d
ev
ac
u
atio
n
ce
n
ter
p
lan
with
p
r
o
ce
s
s
es
th
at
p
r
o
m
o
te
r
esp
ec
tf
u
l
an
d
d
ig
n
if
ied
liv
in
g
am
o
n
g
its
h
o
u
s
ed
ev
ac
u
ee
s
[
1
1
]
.
Dis
tr
ib
u
tio
n
o
f
ass
is
tan
ce
an
d
s
er
v
ices
to
all
h
o
s
ted
f
am
ilies
an
d
/o
r
th
eir
c
o
m
m
u
n
ities
m
u
s
t
b
e
d
o
n
e
eq
u
itab
ly
an
d
im
p
ar
t
ially
.
E
s
p
ec
ially
in
th
e
asp
ec
t
o
f
p
s
y
ch
o
s
o
cial
s
u
p
p
o
r
t,
e
v
ac
u
ee
s
'
n
ee
d
s
m
u
s
t
b
e
atten
d
ed
to
as
p
r
o
m
p
tly
as
p
o
s
s
ib
le
to
r
ed
u
ce
t
h
e
ex
p
er
ien
ce
o
f
s
u
f
f
er
in
g
an
d
d
i
s
tr
ess
,
wh
ich
ar
e
r
ef
r
ac
to
r
y
t
o
th
e
ca
r
in
g
,
co
p
i
n
g
,
a
n
d
a
d
ap
ta
tio
n
o
f
in
d
iv
id
u
als
at
a
tim
e
wh
en
th
ey
ar
e
m
o
s
t v
u
ln
er
ab
le
an
d
lack
in
g
in
ter
m
s
o
f
ca
p
ac
itatin
g
r
eso
u
r
ce
s
[
1
]
.
Ger
m
an
e
to
th
e
u
n
d
e
r
s
tan
d
in
g
o
f
th
e
p
h
en
o
m
en
o
n
o
f
in
ter
n
al
d
is
p
lace
m
en
t
is
th
e
n
ee
d
t
o
ex
am
in
e
h
o
w
p
eo
p
le
th
r
iv
e
an
d
s
u
r
m
o
u
n
t
th
e
ch
allen
g
es
ass
o
ciate
d
with
h
av
in
g
to
s
ettle
in
p
r
o
v
is
io
n
al
s
h
elter
s
f
o
llo
win
g
ex
p
o
s
u
r
e
to
a
n
ac
tu
al
o
r
p
o
te
n
tial
d
is
aster
th
r
ea
t.
So
cial
d
y
n
am
ics
in
th
e
co
n
tex
t
o
f
f
am
ilial
an
d
cu
ltu
r
al
in
ter
ac
tio
n
s
ar
e
n
ec
ess
ar
ily
g
o
in
g
to
b
e
r
e
-
s
tr
u
ct
u
r
e
d
an
d
r
e
-
f
r
am
ed
g
i
v
en
th
e
ch
an
g
ed
en
v
ir
o
n
m
e
n
t
th
e
ev
ac
u
ee
s
ar
e
n
o
w
b
ein
g
th
r
u
s
t
in
to
.
Nec
ess
ar
ily
,
n
ew
p
atter
n
s
o
f
b
eh
av
io
r
s
an
d
life
way
s
ar
e
ex
p
ec
ted
t
o
em
er
g
e
as
in
d
iv
id
u
als
co
n
s
cio
u
s
ly
g
r
a
p
p
le
with
th
e
r
ea
liti
es
o
f
th
eir
p
r
esen
t
s
tate.
T
h
e
tu
r
n
o
f
ev
e
n
ts
s
u
ch
as
th
ese
is
ex
p
ec
ted
t
o
im
p
ac
t
n
o
t
ju
s
t
th
e
p
h
y
s
io
lo
g
ic
well
-
b
ein
g
o
f
th
e
d
is
p
lace
d
p
o
p
u
latio
n
s
b
u
t
also
th
eir
s
o
cial,
p
s
y
ch
o
lo
g
ical,
s
p
ir
itu
al
,
an
d
cu
ltu
r
al
s
y
s
tem
s
.
Hen
ce
,
th
is
in
teg
r
ativ
e
r
esear
ch
r
ev
ie
w
s
ee
k
s
to
ex
p
lo
r
e
th
e
co
n
ce
p
ts
o
f
ca
r
in
g
a
n
d
c
o
p
in
g
in
th
e
c
o
n
tex
t
o
f
th
e
d
is
aster
-
d
is
p
lace
m
en
t
p
h
e
n
o
m
en
o
n
.
I
t
in
ten
d
s
to
d
escr
ib
e
an
d
ch
ar
ac
te
r
ize
th
e
p
r
o
ce
s
s
o
f
h
u
m
a
n
f
lo
u
r
is
h
in
g
am
id
s
t
cr
is
is
th
r
o
u
g
h
th
e
ca
r
in
g
an
d
c
o
p
in
g
ex
p
er
ien
ce
s
o
f
p
e
o
p
le
liv
in
g
t
em
p
o
r
ar
ily
in
e
m
er
g
e
n
cy
s
h
elter
s
as
d
ep
icted
in
th
e
v
ar
io
u
s
av
ailab
le
liter
atu
r
e.
T
h
is
r
ev
iew
f
u
r
th
er
aim
s
to
g
ath
er
cr
itical
p
o
in
ts
in
b
u
ild
in
g
an
d
u
n
d
e
r
s
tan
d
in
g
th
e
co
n
c
ep
ts
o
f
ca
r
in
g
an
d
ad
ap
tatio
n
as
a
b
asis
f
o
r
d
ev
elo
p
in
g
s
o
u
n
d
n
u
r
s
in
g
r
esp
o
n
s
es
f
o
r
in
teg
r
atio
n
in
to
th
e
d
i
s
aster
p
r
ep
ar
ed
n
ess
an
d
m
itig
atio
n
f
r
am
ewo
r
k
.
2.
M
E
T
H
O
D
An
in
teg
r
ativ
e
r
esear
ch
r
e
v
ie
w
was
u
s
ed
to
ex
p
lo
r
e
th
e
p
h
en
o
m
e
n
a
o
f
ca
r
in
g
-
co
p
in
g
p
atter
n
s
in
f
am
ilies
liv
in
g
in
tem
p
o
r
ar
y
s
h
elter
s
d
u
e
to
an
ac
tu
al
o
r
p
o
ten
tial
d
is
aster
th
r
ea
t.
A
s
y
s
tem
atic
in
teg
r
ativ
e
r
ev
iew
is
d
ef
in
ed
as
a
s
tr
u
ctu
r
ed
r
ev
iew
to
o
u
tlin
e
th
e
ev
id
en
ce
o
n
p
r
ac
tice
is
s
u
es
an
d
q
u
esti
o
n
s
u
tili
zin
g
a
th
o
r
o
u
g
h
an
d
co
m
p
r
eh
e
n
s
iv
e
s
tu
d
y
p
la
n
[
1
2
]
.
T
h
e
f
u
n
d
a
m
e
n
tal
s
tep
s
to
c
o
n
d
u
ct
th
e
r
e
v
ie
w
ef
f
ec
tiv
ely
b
eg
i
n
with
f
r
am
in
g
a
n
d
d
e
v
elo
p
in
g
th
e
r
esear
ch
q
u
esti
o
n
an
d
i
d
e
n
tify
in
g
r
elev
an
t
an
d
r
elate
d
l
iter
atu
r
e
[
1
3
]
,
[
1
4
]
.
T
h
e
q
u
ality
o
f
in
clu
d
ed
s
tu
d
ie
s
is
th
en
ap
p
r
aised
,
th
e
e
v
id
e
n
ce
s
u
m
m
ar
ized
,
an
d
t
h
e
r
esu
lts
in
ter
p
r
eted
[
1
3
]
,
[
1
4
]
.
Sp
ec
i
f
ically
,
th
is
r
ev
iew
ad
o
p
ted
t
h
e
m
eth
o
d
T
awf
ik
et
a
l
.
[
1
2
]
in
tr
o
d
u
ce
d
t
o
p
r
o
p
er
ly
an
d
s
u
cc
in
ctly
co
n
d
u
ct
a
s
y
s
tem
atic
in
teg
r
a
tiv
e
r
ev
iew.
Fo
r
p
r
ac
tical
r
e
aso
n
s
,
o
n
ly
th
e
c
r
u
cial
s
tep
s
wer
e
n
a
r
r
ativ
ely
ex
p
o
u
n
d
ed
,
to
wit:
(
i)
Step
1
:
f
o
r
m
u
latio
n
o
f
r
ese
ar
ch
q
u
esti
o
n
a
n
d
o
b
jectiv
es
.
As
in
th
e
ca
s
e
with
o
th
er
s
tu
d
y
m
eth
o
d
s
,
th
e
r
esear
ch
q
u
esti
o
n
o
f
an
I
R
R
n
ee
d
s
to
h
av
e
f
ea
s
ib
ilit
y
,
n
o
v
elty
,
a
n
d
r
elev
a
n
ce
[
1
2
]
.
Hen
ce
,
th
e
r
esear
ch
q
u
esti
o
n
n
ee
d
s
to
m
an
if
est
clar
ity
an
d
well
-
d
ef
in
ed
co
n
s
tr
u
c
tio
n
.
Me
th
ley
et.
a
l.
[
1
5
]
cited
two
p
o
p
u
lar
to
o
ls
th
at
ar
e
u
s
u
ally
u
s
ed
in
th
e
f
o
r
m
u
latio
n
o
f
r
esear
c
h
q
u
esti
o
n
s
:
th
e
PICO
m
eth
o
d
(
p
o
p
u
latio
n
,
in
ter
v
en
tio
n
/ex
p
o
s
u
r
e,
c
o
m
p
a
r
is
o
n
,
o
u
tco
m
e
)
an
d
t
h
e
SP
I
DE
R
m
eth
o
d
(
s
am
p
le,
p
h
e
n
o
m
en
o
n
o
f
in
ter
est,
d
esig
n
,
ev
alu
atio
n
,
r
esear
ch
t
y
p
e
)
.
PICO
is
r
ec
o
m
m
e
n
d
ed
f
o
r
q
u
a
n
titativ
e
d
ata
s
ea
r
ch
es
(
e.
g
.
,
clin
ical
tr
ials
)
wh
ile
SP
I
DE
R
i
s
g
en
er
ally
u
s
ed
f
o
r
s
ea
r
ch
es
in
v
o
l
v
in
g
q
u
alitativ
e
an
d
m
ix
ed
m
eth
o
d
o
l
o
g
ies
[
1
2
]
.
Fo
r
th
is
p
ar
ticu
lar
r
ev
iew,
th
e
PICO
ap
p
r
o
ac
h
was
u
tili
ze
d
b
ec
au
s
e
it
is
m
o
r
e
s
en
s
i
tiv
e
th
an
th
e
SP
I
DE
R
ap
p
r
o
ac
h
[
1
5
]
.
He
n
ce
,
th
e
PICO
q
u
esti
o
n
:
“
Ho
w
a
r
e
in
tercu
ltu
r
a
l
ca
r
in
g
-
co
p
i
n
g
p
a
tter
n
s
a
mo
n
g
fa
milies
livin
g
in
temp
o
r
a
r
y
s
h
elter
s
p
o
s
t
-
d
is
a
s
t
er
eme
r
g
en
cies
ex
p
lica
ted
in
t
h
e
liter
a
tu
r
e?
”
was
p
o
s
ed
.
(
P
:
f
am
ilies
liv
in
g
in
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
3
,
No
.
4
,
Dec
em
b
er
20
24
:
1
9
7
8
-
1
9
8
9
1980
tem
p
o
r
ar
y
s
h
elter
s
,
I
:
in
ter
cu
ltu
r
al
ca
r
in
g
-
co
p
in
g
p
atter
n
s
,
C
:
n
o
n
e,
O:
im
p
r
o
v
em
en
t
co
n
d
itio
n
s
in
in
ter
cu
ltu
r
al
ca
r
in
g
an
d
co
p
i
n
g
am
o
n
g
d
is
aster
-
d
is
p
lace
d
f
a
m
ilies
)
.
(
ii)
Step
2
:
p
r
elim
in
ar
y
r
esear
c
h
an
d
id
ea
v
alid
atio
n
.
A
p
r
elim
in
ar
y
s
ea
r
ch
is
g
en
e
r
ally
r
ec
o
m
m
en
d
e
d
to
o
b
tain
s
cien
tific
ally
-
r
ele
v
a
n
t
ar
ticles,
ascer
tain
th
e
v
ali
d
ity
o
f
c
o
n
ce
p
ts
,
m
in
im
ize
r
ep
etitio
n
o
f
alr
ea
d
y
r
esear
ch
ed
q
u
esti
o
n
s
,
a
n
d
ass
u
r
e
th
at
th
er
e
is
a
s
u
f
f
icien
t
b
o
d
y
o
f
liter
atu
r
e
n
ee
d
ed
in
th
e
g
en
e
r
atio
n
o
f
an
aly
s
is
[
1
2
]
.
T
aw
f
ik
et
a
l
.
[
1
2
]
s
u
g
g
ested
th
at
a
s
im
p
le
s
ea
r
ch
in
Pu
b
Me
d
o
r
Go
o
g
le
Sch
o
lar
with
s
ea
r
ch
ter
m
s
is
in
itially
co
n
d
u
cted
.
W
h
ile
d
o
in
g
th
is
s
tep
,
r
esear
ch
er
s
b
ec
o
m
e
co
g
n
izan
t
o
f
th
e
r
elev
an
t
p
ap
e
r
s
to
r
ea
d
to
g
ain
d
ee
p
er
in
s
ig
h
t
an
d
id
en
tif
y
g
ap
s
to
b
etter
f
o
r
m
u
late
th
e
r
esear
ch
q
u
esti
o
n
o
r
p
u
r
p
o
s
e.
Hen
ce
,
th
e
co
r
r
esp
o
n
d
in
g
au
th
o
r
(
R
I
G)
p
u
r
s
u
ed
th
e
I
R
R
o
n
th
e
to
p
ic
b
ec
au
s
e
th
e
in
itial
s
ea
r
ch
s
h
o
wed
p
r
o
m
is
in
g
b
o
d
ies
o
f
liter
atu
r
e
with
th
e
p
o
ten
tial
to
p
r
o
v
id
e
a
b
etter
u
n
d
er
s
tan
d
in
g
o
f
th
e
c
o
n
ce
p
t
o
f
i
n
ter
cu
l
tu
r
al
ca
r
in
g
-
c
o
p
in
g
p
atter
n
s
in
th
e
d
is
aster
-
d
is
p
lac
em
en
t p
h
e
n
o
m
en
o
n
.
(
iii
)
Step
3
:
e
s
tab
lis
h
m
en
t
o
f
in
clu
s
io
n
/ex
clu
s
io
n
c
r
iter
ia
.
I
n
th
is
r
ev
iew,
th
e
s
ea
r
ch
was
co
n
f
in
ed
to
th
e
p
er
io
d
f
r
o
m
J
an
u
ar
y
2
0
0
0
to
J
an
u
ar
y
2
0
2
2
.
Pap
er
s
n
ee
d
ed
to
b
e
p
u
b
lis
h
ed
in
E
n
g
lis
h
,
with
f
u
ll
-
tex
t
av
ailab
ilit
y
f
o
r
th
eir
in
clu
s
io
n
.
Ar
ticles
th
at
wer
e
d
u
p
licate
d
,
u
n
r
elate
d
,
a
b
s
tr
ac
t
-
o
n
ly
,
a
n
d
with
n
o
f
u
ll
tex
ts
wer
e
au
to
m
atica
lly
ex
clu
d
ed
.
I
n
ad
d
itio
n
to
u
s
in
g
t
h
e
two
d
atab
ases
,
m
an
u
al
ex
tr
ac
tio
n
o
f
r
eso
u
r
ce
s
was
also
u
tili
ze
d
u
s
in
g
th
e
Go
o
g
le
Sch
o
lar
en
g
in
e
.
(
iv
)
Step
4
:
i
d
en
tific
atio
n
o
f
t
h
e
k
ey
wo
r
d
s
/s
ea
r
ch
ter
m
,
s
ea
r
ch
s
tr
ateg
y
.
T
h
e
k
ey
wo
r
d
s
/s
ea
r
ch
ter
m
s
u
s
ed
f
o
r
th
is
r
ev
iew
wer
e
“in
t
er
cu
ltu
r
al
ca
r
in
g
-
co
p
i
n
g
p
atte
r
n
s
in
p
o
s
t
-
d
is
aster
em
er
g
en
ci
es”.
(
v
)
Step
5
an
d
Step
6
:
s
ea
r
ch
in
g
d
atab
ases
,
im
p
o
r
tin
g
all
r
esu
lts
to
a
lib
r
ar
y
,
an
d
e
x
p
o
r
tin
g
to
an
ex
c
el
s
h
ee
t
.
Usi
n
g
th
e
af
o
r
em
en
tio
n
ed
s
ea
r
c
h
ter
m
s
,
th
r
ee
d
atab
ases
wer
e
u
tili
ze
d
:
C
I
NAHL
,
Pu
b
Me
d
,
an
d
Pro
Q
u
est.
B
ased
o
n
th
e
AM
STAR
g
u
id
elin
es,
at
leas
t
two
d
atab
ases
m
u
s
t
b
e
s
ea
r
ch
ed
in
th
e
SR
/MA.
Ho
wev
er
,
if
th
e
s
ea
r
ch
ed
d
atab
ases
ar
e
in
cr
ea
s
ed
,
m
o
r
e
ac
cu
r
ate
an
d
co
m
p
r
e
h
en
s
iv
e
r
esu
lts
ar
e
y
ield
ed
[
1
2
]
,
[
1
6
]
.
T
h
e
k
e
y
wo
r
d
s
"c
ar
in
g
-
co
p
in
g
p
atter
n
s
in
p
o
s
t
-
d
is
aster
em
er
g
en
cies"
g
en
e
r
ated
a
to
tal
o
f
6
7
0
r
esu
lts
in
Pro
Qu
est.
On
th
e
o
th
er
h
an
d
,
th
er
e
wer
e
1
2
r
e
lev
an
t
ar
ticles
in
Pu
b
Me
d
an
d
1
6
4
in
C
I
NAHL
E
B
SC
O.
Hen
ce
,
th
e
r
ec
o
r
d
s
id
en
tifie
d
th
r
o
u
g
h
th
e
s
ea
r
ch
d
atab
ases
to
taled
8
4
6
r
ef
e
r
en
ce
s
.
All
co
llected
ar
ticles
wh
ich
h
av
e
(
i
)
s
im
ilar
titl
es
an
d
au
th
o
r
s
th
at
ar
e
p
u
b
l
is
h
ed
with
in
th
e
s
am
e
y
ea
r
a
n
d
(
ii
)
s
im
ilar
titl
es
an
d
a
u
th
o
r
s
th
at
ar
e
p
u
b
lis
h
ed
u
n
d
er
th
e
s
am
e
jo
u
r
n
al
p
u
b
licatio
n
will
b
e
ex
clu
d
ed
.
All
r
e
m
ain
in
g
r
ef
er
en
ce
s
f
o
llo
win
g
th
is
s
tep
n
ee
d
ed
to
b
e
ex
p
o
r
ted
u
s
in
g
a
n
MS
E
x
c
el
f
ile
th
at
co
n
tain
s
ess
en
tial
in
f
o
r
m
atio
n
f
o
r
f
u
r
th
e
r
s
cr
ee
n
in
g
.
T
h
ese
in
clu
d
e
th
e
au
th
o
r
s
'
n
am
es,
p
u
b
licatio
n
y
ea
r
,
j
o
u
r
n
al,
DOI
,
UR
L
lin
k
,
an
d
ab
s
tr
ac
t
[
1
2
]
.
(
v
i)
Step
s
7
an
d
8
:
t
itle,
a
b
s
tr
ac
t,
an
d
f
u
ll
-
tex
t
s
cr
ee
n
in
g
.
T
o
r
ed
u
c
e
th
e
p
o
s
s
ib
ilit
y
o
f
in
clu
d
in
g
ar
ticles
th
at
ar
e
n
o
t
r
elev
an
t
t
o
th
e
s
ea
r
ch
,
th
e
eli
g
ib
ilit
y
cr
i
ter
ia
will
s
er
v
e
as
t
h
e
p
r
im
ar
y
b
asis
f
o
r
s
elec
tin
g
th
e
f
in
al
a
r
ticles
f
o
r
in
clu
s
io
n
.
I
t
is
p
r
ef
er
ab
le
to
h
av
e
a
m
i
n
im
u
m
o
f
th
r
ee
r
ev
iewe
r
s
in
d
e
p
en
d
en
tly
s
cr
u
tin
ize
th
e
ar
ticles to
d
im
in
is
h
th
e
p
o
t
en
tial o
f
co
m
m
itti
n
g
er
r
o
r
s
.
T
h
e
th
ir
d
r
e
v
iewe
r
s
h
all
ac
t a
s
th
e
ar
b
iter
wh
e
n
ev
er
two
au
th
o
r
s
h
av
e
d
if
f
er
i
n
g
o
p
in
io
n
s
in
a
p
a
r
ticu
lar
r
e
v
iew
[
1
2
]
.
I
n
th
is
r
ev
iew,
th
e
c
o
r
r
esp
o
n
d
in
g
au
th
o
r
f
ac
ilit
ated
th
e
titl
e,
ab
s
tr
ac
t,
an
d
ar
ticle
r
ev
iews.
T
o
est
ab
lis
h
ap
p
r
o
p
r
iaten
ess
an
d
m
in
im
ize
b
ias,
th
e
ass
is
tan
ce
o
f
two
m
o
r
e
in
d
e
p
en
d
en
tly
-
o
u
ts
o
u
r
ce
d
r
ev
iewe
r
s
was
s
o
u
g
h
t
(
T
L
P
an
d
NDA
)
.
T
h
e
two
o
u
ts
id
e
r
ev
iewe
r
s
wer
e
c
o
lleag
u
es
a
n
d
r
esear
ch
e
r
s
f
r
o
m
t
h
e
c
o
r
r
es
p
o
n
d
in
g
a
u
th
o
r
’
s
in
s
titu
tio
n
.
T
h
ey
wer
e
ask
ed
to
d
o
th
e
in
itial
titl
e
an
d
ab
s
tr
a
ct
s
cr
ee
n
in
g
.
T
h
e
co
r
r
esp
o
n
d
in
g
au
t
h
o
r
th
en
s
er
v
ed
as
th
e
th
ir
d
r
ev
iewe
r
in
s
itu
atio
n
s
wh
er
e
th
e
two
in
d
e
p
en
d
en
t r
e
v
iewe
r
s
co
u
ld
n
o
t d
e
cid
e
wh
eth
er
to
i
n
clu
d
e
o
r
ex
c
lu
d
e
p
ap
e
r
s
.
(
v
ii)
S
tep
9
:
m
an
u
al
s
ea
r
ch
.
M
ater
ials
th
at
m
ay
h
av
e
b
ee
n
in
ad
v
e
r
ten
tly
ex
clu
d
e
d
d
u
r
in
g
th
e
f
ir
s
t
s
ea
r
ch
u
s
in
g
th
e
o
n
lin
e
en
g
in
e
[
1
7
]
.
T
o
m
a
x
im
ize
th
is
m
an
u
al
s
ea
r
ch
,
th
er
e
a
r
e
f
iv
e
m
eth
o
d
s
to
f
o
llo
w:
lo
o
k
in
g
at
th
e
r
ef
er
en
ce
s
o
f
t
h
e
in
clu
d
e
d
s
tu
d
ies/
r
ev
iews,
co
r
r
esp
o
n
d
in
g
with
o
r
ig
i
n
al
a
u
th
o
r
s
an
d
ex
p
er
ts
,
an
d
ex
p
lo
r
in
g
all
r
elate
d
ar
ti
cles/cited
ar
ticles
in
Pu
b
Me
d
an
d
Go
o
g
le
Sch
o
lar
[
1
2
]
.
H
en
ce
,
in
ad
d
itio
n
to
u
s
in
g
th
e
two
d
atab
ases
,
m
an
u
al
ex
tr
ac
tio
n
o
f
r
elate
d
r
eso
u
r
ce
s
was
al
s
o
u
tili
ze
d
in
th
i
s
r
ev
iew
u
s
in
g
th
e
Go
o
g
le
Sch
o
lar
e
n
g
in
e.
T
h
e
r
e
s
ea
r
ch
er
s
wer
e
ab
le
to
ex
t
r
ac
t
1
1
r
elev
a
n
t r
ef
er
e
n
ce
s
f
r
o
m
th
e
m
an
u
al
s
ea
r
ch
.
(
v
iii)
Step
1
0
:
a
p
p
r
aisal
o
f
s
ea
r
ch
ed
ar
ticles
.
A
d
ata
-
ch
ec
k
i
n
g
s
tep
m
u
s
t
also
b
e
in
teg
r
at
ed
in
to
th
e
r
ev
iew
p
r
o
ce
s
s
.
T
h
is
is
d
o
n
e
b
y
co
m
p
ar
i
n
g
all
in
d
iv
id
u
al
ar
ticles
wi
th
th
e
co
r
r
esp
o
n
d
in
g
co
n
ten
t
an
d
in
f
o
r
m
atio
n
lis
ted
in
th
e
ex
tr
a
ctio
n
s
h
ee
t
f
o
r
s
im
ilar
ity
an
d
co
m
p
leten
ess
o
f
d
ata.
T
h
is
d
r
am
atica
lly
r
ed
u
ce
s
h
u
m
an
er
r
o
r
an
d
p
o
s
s
ib
le
b
ias.
T
o
d
o
th
is
s
tep
,
it
m
ay
b
e
r
ec
o
m
m
en
d
e
d
to
en
lis
t
2
-
3
m
o
r
e
in
d
ep
e
n
d
en
t
r
ev
iewe
r
s
wh
o
a
r
e
n
o
t
in
v
o
lv
ed
in
t
h
e
in
itial
ex
tr
ac
tio
n
a
n
d
s
cr
ee
n
in
g
.
Ho
wev
e
r
,
if
th
er
e
ar
e
lim
itatio
n
s
in
ter
m
s
o
f
r
eso
u
r
ce
s
,
th
e
o
r
ig
i
n
al
r
ev
iewe
r
s
m
a
y
p
er
f
o
r
m
th
is
task
b
u
t
ar
e
ad
v
is
ed
to
b
e
ass
ig
n
ed
t
o
a
d
if
f
er
en
t
s
et
o
f
ar
ticles th
an
th
e
o
n
es p
r
ev
io
u
s
ly
ass
ig
n
ed
to
e
x
tr
ac
t
[
1
2
]
.
(
x
i)
Step
1
1
:
an
aly
s
is
,
d
is
cu
s
s
io
n
,
a
n
d
i
n
ter
p
r
etatio
n
o
f
r
esu
lts
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W
h
en
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m
m
en
ci
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g
t
h
e
d
a
ta
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aly
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is
p
h
ase,
it
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el
p
f
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l
f
o
r
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r
esear
ch
er
t
o
co
n
s
tr
u
ct
a
r
ev
iew
m
atr
ix
[
1
8
]
.
I
t
p
r
o
v
id
es
a
s
tr
u
ct
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r
e
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o
r
t
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aly
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d
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y
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ata.
I
t
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s
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ally
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ak
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s
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o
f
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le
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at
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o
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ata
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tr
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ted
f
r
o
m
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ch
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f
th
e
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er
en
ce
s
[
1
8
]
.
I
n
th
is
r
ev
iew,
th
e
co
n
s
tan
t
co
m
p
ar
is
o
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was
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tili
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to
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d
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o
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ize
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ata
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tr
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f
r
o
m
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ch
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f
t
h
e
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ef
er
en
ce
s
.
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h
e
c
o
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s
tan
t
c
o
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ar
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o
n
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eth
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d
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n
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is
ts
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f
f
o
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r
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h
ases
:
d
ata
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ed
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ctio
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ata
d
is
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lay
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ata
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o
m
p
ar
is
o
n
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an
d
c
o
n
clu
s
io
n
d
r
awin
g
an
d
v
er
if
icatio
n
[
1
9
]
,
[
2
0
]
.
T
h
e
d
is
cu
s
s
io
n
o
f
th
e
r
esu
lts
is
g
en
er
ally
f
ac
ilit
ated
b
y
co
m
p
ar
in
g
an
d
co
n
t
r
asti
n
g
th
e
d
ata
ex
tr
ac
ted
f
r
o
m
th
e
r
e
v
iew
o
f
th
e
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J
Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
Th
e
in
tercu
ltu
r
a
l c
a
r
in
g
-
co
p
in
g
p
a
tter
n
s
o
f d
is
a
s
ter
-
d
is
p
la
c
ed
fa
milies
in
…(
R
a
n
d
y
I
a
n
F
.
Ga
lleg
o
)
1981
b
ac
k
g
r
o
u
n
d
liter
atu
r
e
n
ar
r
ate
d
in
th
e
in
tr
o
d
u
ctio
n
,
th
e
t
h
e
o
r
etica
l
f
r
am
ewo
r
k
,
a
n
d
t
h
o
s
e
o
f
s
im
ilar
r
esear
c
h
[
2
1
]
.
C
o
m
p
ar
in
g
wh
at
is
s
im
ilar
an
d
d
if
f
er
e
n
t
in
th
e
r
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f
in
d
in
g
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an
d
th
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atu
r
e
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el
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o
f
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th
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n
clu
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o
llo
wed
[
2
2
]
.
I
n
th
is
p
ar
t
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lar
p
h
ase,
th
e
co
-
a
u
th
o
r
(
A
OB
)
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wh
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e
d
as
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p
er
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r
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al
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ter
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r
e
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ar
ticle.
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o
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d
er
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p
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ld
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jectiv
ity
d
u
r
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r
o
ce
s
s
,
th
e
r
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n
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s
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n
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atic
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r
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th
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liter
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r
e
ac
r
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m
u
ltip
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atab
ases
,
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u
ar
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teein
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t
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e
in
clu
s
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o
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tin
e
n
t
s
tu
d
i
es.
T
h
e
s
tu
d
y
also
en
g
ag
ed
two
(
2
)
ex
ter
n
al
ex
p
e
r
ts
in
th
e
f
ield
to
p
er
f
o
r
m
p
ee
r
r
ev
iew,
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ess
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eth
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d
f
in
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tem
atic
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to
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etec
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n
d
r
ec
tify
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y
p
o
ten
tial b
i
ases
o
r
in
ac
cu
r
ac
ies.
T
o
en
s
u
r
e
tr
an
s
p
ar
en
cy
a
n
d
r
ep
r
o
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ilit
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,
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e
r
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ch
e
r
s
also
m
eticu
lo
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s
ly
d
o
cu
m
e
n
ted
ev
er
y
p
h
ase
o
f
th
e
r
ev
i
ew,
en
co
m
p
ass
in
g
s
ea
r
ch
s
tr
ateg
ies,
d
ata
ex
tr
ac
tio
n
,
an
d
an
aly
s
is
,
an
d
m
ad
e
th
e
s
e
r
ec
o
r
d
s
ac
ce
s
s
ib
le
to
th
e
wid
er
au
d
ie
n
ce
.
3.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
Sear
ch
es
id
en
tifie
d
8
4
6
p
o
te
n
tial
citatio
n
s
.
A
f
u
r
th
er
1
1
p
o
ten
tial
s
tu
d
ies
wer
e
id
en
tifie
d
an
d
m
an
u
ally
ex
tr
ac
ted
f
r
o
m
t
h
e
Go
o
g
le
Sch
o
lar
s
ea
r
ch
en
g
in
e.
Af
ter
an
in
itial
s
cr
ee
n
i
n
g
o
f
th
e
titl
es
an
d
ab
s
tr
ac
ts
,
1
1
2
f
u
ll
s
tu
d
ies
we
r
e
ass
ess
ed
f
o
r
p
o
s
s
ib
le
in
clu
s
io
n
in
th
e
r
ev
iew.
Ho
wev
er
,
o
n
ly
1
6
r
ef
e
r
en
ce
s
m
et
th
e
in
clu
s
io
n
cr
iter
ia
,
s
ee
Fig
u
r
e
1
.
T
o
d
ev
elo
p
a
lo
g
ical
an
d
co
h
er
en
t
ap
p
r
ec
iatio
n
o
f
th
e
im
p
o
r
tan
t
p
o
in
ts
o
f
ea
ch
o
f
th
e
r
ef
er
en
ce
s
,
m
ajo
r
th
em
es
wer
e
co
n
s
tr
u
ct
ed
.
T
h
e
f
in
d
i
n
g
s
r
elate
d
t
o
t
h
e
to
p
ic
o
f
i
n
ter
est
wer
e
ca
t
eg
o
r
ized
u
n
d
e
r
th
e
f
o
llo
win
g
h
ea
d
in
g
s
:
i
)
d
is
aster
im
p
ac
ts
o
n
d
aily
life
p
atter
n
s
an
d
cu
ltu
r
al
life
way
s
;
ii
)
ca
r
in
g
p
atter
n
s
d
u
r
in
g
d
is
aster
d
is
p
lace
m
en
t;
iii
)
c
o
p
in
g
p
atter
n
s
d
u
r
i
n
g
d
is
aster
d
is
p
lace
m
en
t;
an
d
iv
)
cu
ltu
r
al
lear
n
in
g
s
f
o
r
d
is
aster
-
b
ased
p
r
ac
titi
o
n
er
s
.
T
h
ese
m
ajo
r
th
em
es e
m
er
g
ed
in
th
e
an
aly
tical
r
ev
iew
o
f
th
e
s
c
r
ee
n
ed
ar
ticles.
3
.
1
.
Dis
a
s
t
er
im
pa
c
t
s
o
n da
ily
life
pa
t
t
er
ns
a
nd
cult
ura
l lif
ewa
y
s
B
y
th
eir
u
n
p
r
e
d
ictab
ilit
y
,
d
is
aster
em
er
g
en
cies
u
s
u
ally
s
tr
ik
e
wh
en
p
eo
p
le
ar
e
least
p
r
e
p
ar
ed
o
r
h
a
v
e
less
lik
ely
to
tak
e
an
y
p
r
e
-
em
p
tiv
e
ac
tio
n
s
an
d
s
tr
ateg
ies
ag
ain
s
t
a
p
ar
ticu
lar
h
az
ar
d
;
th
at
m
ay
b
e
clim
atic
o
r
an
th
r
o
p
o
g
en
ic
i
n
o
r
ig
i
n
.
B
y
th
en
,
u
n
p
r
ec
ed
e
n
ted
d
estru
cti
o
n
to
liv
es
an
d
p
r
o
p
er
ties
is
u
s
u
ally
s
u
s
tain
ed
,
esp
ec
ially
in
co
m
m
u
n
ities
with
s
ig
n
if
ican
tly
h
ig
h
lev
els
o
f
v
u
ln
er
ab
ilit
y
.
Hen
c
e,
ex
p
e
r
ien
ce
s
with
d
is
aster
s
m
ay
co
m
e
with
tr
au
m
atic
im
p
ac
ts
eith
er
in
th
e
p
h
y
s
ical
o
r
p
s
y
ch
o
lo
g
ical
h
ea
lth
d
o
m
ai
n
s
.
W
h
en
s
tr
u
ctu
r
in
g
r
ec
o
v
er
y
ef
f
o
r
ts
,
p
r
io
r
ity
m
u
s
t b
e
p
lace
d
n
o
t o
n
ly
o
n
th
e
r
e
b
u
ild
in
g
o
f
d
am
a
g
ed
in
f
r
astru
ct
u
r
es b
u
t m
o
r
e
s
o
o
n
r
eh
ab
ilit
atin
g
th
e
liv
es a
n
d
m
i
n
d
s
ets o
f
th
e
p
e
o
p
le
af
f
ec
te
d
[
2
3
]
,
[
2
4
]
.
Fig
u
r
e
1
.
T
h
e
f
lo
w
o
f
p
a
p
er
s
th
r
o
u
g
h
a
s
tu
d
y
u
s
in
g
t
h
e
PR
I
SMA
m
o
d
el
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
3
,
No
.
4
,
Dec
em
b
er
20
24
:
1
9
7
8
-
1
9
8
9
1982
T
h
e
m
ater
ial
lo
s
s
th
at
o
f
ten
a
cc
o
m
p
an
ies
ty
p
h
o
o
n
s
an
d
f
lo
o
d
in
g
,
th
e
in
ter
f
er
e
n
ce
i
n
th
e
n
o
r
m
ativ
e
f
u
n
ctio
n
in
g
,
th
e
d
is
cu
r
s
iv
e
im
p
ac
t
o
n
s
o
cial
s
u
p
p
o
r
t
n
etwo
r
k
s
ca
u
s
ed
b
y
co
n
s
eq
u
e
n
t
ev
ac
u
atio
n
,
an
d
th
e
lo
s
s
o
f
liv
elih
o
o
d
o
p
p
o
r
tu
n
ities
ar
e
ju
s
t
s
o
m
e
o
f
th
e
s
tr
ess
f
u
l
cir
cu
m
s
tan
ce
s
co
n
f
r
o
n
tin
g
ev
ac
u
ee
s
as
a
r
esu
lt
o
f
d
is
aster
em
er
g
en
cies
[
2
5
]
,
[
2
6
]
.
T
h
ese
ad
v
er
s
ities
n
eg
ativ
e
ly
im
p
ac
t
th
eir
p
s
y
c
h
o
s
o
cial
a
d
ju
s
tm
en
t
[
2
7
]
an
d
h
av
e
th
e
p
o
ten
tial
to
m
ag
n
i
f
y
th
e
ex
p
e
r
ien
ce
o
f
th
e
tr
a
u
m
ati
zin
g
s
tr
ess
in
itially
f
elt
at
th
e
tim
e
o
f
th
e
d
is
aster
its
elf
[
2
8
]
.
So
m
u
ch
s
o
th
at
w
h
en
d
is
aster
s
u
r
v
iv
o
r
s
ar
e
d
is
p
lace
d
,
th
ey
ten
d
to
s
u
s
tain
a
d
is
tr
ac
ted
s
en
s
e
o
f
cu
ltu
r
al
s
tr
u
ctu
r
e
a
n
d
s
o
cial
co
m
m
u
n
it
y
f
r
am
ewo
r
k
,
w
h
ich
wo
u
ld
h
av
e
n
o
r
m
ally
b
u
f
f
er
ed
th
e
ad
v
er
s
e
s
eq
u
elae
o
f
th
e
d
is
aster
ex
p
er
i
en
ce
[
2
8
]
,
[
2
9
]
.
C
u
ltu
r
al
d
y
n
am
ics
h
av
e
b
ee
n
s
ee
n
to
im
p
ac
t
d
is
aster
r
ec
o
v
er
y
b
o
th
p
o
s
itiv
ely
an
d
n
e
g
ativ
ely
[
3
0
]
.
T
h
er
ef
o
r
e,
lo
ca
l
cu
ltu
r
al
p
r
ac
tices
h
av
e
to
b
e
p
u
t
in
p
lace
an
d
co
n
s
id
er
ed
wh
e
n
ad
d
r
ess
in
g
th
e
n
ee
d
s
o
f
d
is
aster
v
ictim
s
if
th
ey
ar
e
to
b
e
s
u
p
p
o
r
te
d
ef
f
ec
tiv
ely
to
war
d
r
ec
o
v
er
y
an
d
r
ein
teg
r
atio
n
.
T
h
ey
ar
e
n
o
t m
er
ely
to
b
e
s
ee
n
as
p
ass
iv
e
r
ec
eiv
er
s
o
f
aid
an
d
s
u
p
p
o
r
t.
I
f
an
y
th
in
g
,
s
tu
d
ies
ass
er
t
th
at
co
m
m
u
n
ities
will
h
av
e
b
etter
ch
an
ce
s
o
f
th
r
iv
in
g
if
t
h
ey
ar
e
allo
wed
to
h
av
e
a
h
a
n
d
in
th
e
r
ec
o
n
s
tr
u
ctio
n
o
f
th
ei
r
h
o
u
s
es
u
s
in
g
th
eir
s
o
cio
-
cu
ltu
r
al
wh
e
r
ewith
al
in
s
tead
o
f
p
ass
iv
ely
ju
s
t
r
ec
eiv
i
n
g
d
o
n
ated
te
n
ts
an
d
r
elief
it
em
s
[
3
1
]
,
[
3
2
]
.
T
h
e
ex
p
er
ien
ce
o
f
ac
tiv
ely
h
el
p
in
g
b
u
ild
th
eir
n
ew
h
o
m
es
g
iv
es
d
is
aster
-
af
f
ec
ted
in
d
iv
id
u
als
a
s
en
s
e
o
f
p
er
s
is
ten
ce
,
s
u
cc
ess
,
an
d
d
ep
en
d
en
ce
[
3
3
]
.
I
n
ess
en
ce
,
t
h
ese
allo
w
s
u
r
v
iv
o
r
s
to
s
ee
th
em
s
elv
es
as
th
e
p
er
s
o
n
if
icatio
n
o
f
r
esil
ien
ce
.
Dis
aster
s
af
f
ec
t
v
ital
co
m
m
u
n
ity
s
y
s
tem
s
an
d
life
way
s
m
o
r
e
c
o
m
p
lex
l
y
th
a
n
ca
n
b
e
ex
p
r
ess
ly
ac
k
n
o
wled
g
e
d
.
Kr
ü
g
er
et
a
l.
[
3
4
]
h
ig
h
lig
h
te
d
d
is
tin
ct
cu
l
tu
r
al
p
atter
n
s
in
th
e
p
e
r
ce
p
ti
o
n
,
p
r
o
d
u
ctio
n
,
an
d
m
an
ag
em
en
t
o
f
d
is
aster
r
is
k
s
th
at
m
ay
b
e
o
b
liv
io
u
s
to
an
o
u
ts
id
er
'
s
p
o
in
t
o
f
v
iew.
T
h
ese
m
ay
in
clu
d
e
eth
n
ic,
b
eh
av
io
r
al,
an
d
d
esig
n
s
tr
u
ct
u
r
es
th
at
p
r
o
m
o
te
p
eo
p
le'
s
ca
p
ac
ity
to
liv
e
with
n
atu
r
ally
b
u
ilt
r
is
k
s
in
th
ei
r
h
o
m
e
e
n
v
ir
o
n
m
en
ts
.
T
h
ese
d
is
tin
ct
p
atter
n
s
m
ay
co
m
e
in
t
h
e
f
o
r
m
o
f
r
elig
io
u
s
t
r
ad
itio
n
s
,
s
o
cial
o
r
g
an
izatio
n
,
an
d
tr
ad
itio
n
al
m
o
r
es
an
d
n
o
r
m
s
.
Fo
r
in
s
tan
ce
,
in
th
e
p
o
s
t
-
d
is
aster
p
h
ase,
wo
m
en
in
Mid
d
le
-
ea
s
ter
n
co
u
n
t
r
ies
wh
o
ar
e
p
r
ac
ticin
g
I
s
lam
m
a
y
b
e
af
f
ec
ted
b
y
a
d
ec
r
ea
s
ed
p
r
esen
ce
o
f
f
em
ale
s
taf
f
b
e
ca
u
s
e
th
ey
m
ay
b
e
r
elu
ctan
t
to
ask
f
o
r
r
elief
g
o
o
d
s
if
th
ey
ar
e
d
is
tr
ib
u
ted
m
ain
ly
th
r
o
u
g
h
m
en
,
o
r
th
e
y
m
a
y
n
o
t
av
ail
o
f
a
m
u
ch
-
n
ee
d
ed
h
ea
lth
in
ter
v
en
tio
n
if
t
h
er
e
ar
e
o
n
ly
m
ale
d
o
cto
r
s
d
i
s
p
en
s
in
g
s
u
ch
s
er
v
ice
in
th
eir
tem
p
o
r
a
r
y
s
h
elter
s
[
3
5
]
.
T
h
er
e
a
r
e
also
s
p
ec
if
ic
is
s
u
es
with
p
r
iv
ac
y
in
p
o
p
u
latio
n
-
d
en
s
e
ev
ac
u
atio
n
ce
n
ter
s
.
Yo
u
n
g
m
en
s
tr
u
atin
g
g
ir
ls
,
p
r
eg
n
an
t
wo
m
e
n
,
an
d
b
r
ea
s
tf
ee
d
in
g
m
o
th
er
s
m
ay
n
o
t
f
in
d
v
er
y
s
u
itab
le
s
af
e
s
p
ac
es
to
atten
d
to
th
eir
n
ee
d
s
in
s
h
elter
s
with
v
er
y
c
o
n
s
tr
icted
liv
in
g
q
u
ar
ter
s
.
I
n
Af
g
h
an
is
tan
,
wh
er
e
wo
m
en
a
r
e
r
estricte
d
f
r
o
m
b
ein
g
u
n
n
ec
ess
ar
ily
d
is
p
lay
ed
to
m
en
o
u
ts
id
e
o
f
th
eir
h
o
u
s
eh
o
ld
,
r
elig
io
-
c
u
ltu
r
al
co
n
s
id
er
atio
n
s
m
u
s
t
b
e
ac
co
r
d
ed
s
u
ch
th
at
d
aily
ac
t
iv
ities
in
ev
ac
u
atio
n
ce
n
ter
s
ar
e
s
till
d
o
n
e
in
a
m
a
n
n
er
th
at
r
esp
ec
ts
th
eir
tr
ad
itio
n
al
g
en
d
er
r
o
les an
d
p
o
s
itio
n
s
in
s
o
ciety
[
3
6
]
.
Oth
er
th
an
its
im
p
ac
t
o
n
cu
ltu
r
ally
-
b
ased
co
n
v
en
tio
n
s
,
d
is
aster
d
is
p
lace
m
en
t
also
h
as
f
ar
-
r
ea
ch
in
g
r
am
if
icatio
n
s
o
n
v
u
ln
er
ab
le
p
o
p
u
latio
n
s
'
r
o
u
tin
es
an
d
d
aily
f
u
n
ctio
n
in
g
.
C
alam
ities
an
d
o
th
er
d
is
aster
s
ca
n
in
cite
s
tr
ess
an
d
tr
au
m
a
in
th
e
eld
er
ly
,
ev
e
n
tu
ally
e
x
ac
er
b
atin
g
th
eir
p
r
e
-
ex
is
tin
g
m
e
d
ical
co
n
d
itio
n
s
[
3
7
]
.
W
h
en
ex
p
o
s
ed
to
th
e
ch
ao
s
o
f
ca
tast
r
o
p
h
ic
cr
is
es,
eld
er
ly
ad
u
lts
(
esp
ec
ially
th
o
s
e
wh
o
h
av
e
m
en
tal
h
ea
lth
is
s
u
es
lik
e
Alzh
eim
er
'
s
d
is
ea
s
e)
m
ay
b
ec
o
m
e
cr
itically
o
v
er
wh
elm
ed
an
d
i
n
ca
p
ac
itated
to
p
r
o
tect
th
eir
s
af
ety
an
d
well
-
b
ein
g
with
o
u
t
th
e
as
s
is
tan
ce
o
f
a
s
ig
n
if
ican
t
o
th
er
.
T
h
is
is
u
n
d
er
s
tan
d
ab
ly
t
h
e
r
ea
s
o
n
wh
y
th
er
e
is
alm
o
s
t
alwa
y
s
a
s
p
ik
e
in
e
m
er
g
en
cy
d
ep
ar
tm
en
t
v
is
its
an
d
in
p
atien
t
co
n
f
i
n
em
en
t
a
m
o
n
g
o
ld
e
r
ad
u
lts
im
m
ed
iately
f
o
llo
win
g
a
d
is
aster
in
cid
en
t
[
3
7
]
.
Hen
ce
,
lo
ca
l
co
m
m
u
n
ity
p
r
o
c
ess
es
h
av
e
to
b
e
s
er
io
u
s
ly
ta
k
en
in
to
p
er
s
p
ec
tiv
e
wh
en
p
l
an
n
in
g
f
o
r
p
o
s
t
-
d
is
aster
s
tr
ateg
ies
am
o
n
g
th
o
s
e
wh
o
ar
e
tem
p
o
r
ar
ily
ac
co
m
m
o
d
ated
in
tr
an
s
ien
t
s
h
elter
s
.
So
cial
an
d
f
am
ilial d
y
n
am
ics ca
n
n
o
t b
e
tak
en
to
th
e
s
id
elin
es b
ec
au
s
e
t
h
ese
ar
e
in
h
er
en
t stru
ctu
r
es in
th
e
liv
es o
f
d
is
aster
v
ictim
s
.
W
h
er
e
th
ese
c
u
ltu
r
al
life
lin
es
ar
e
in
ten
tio
n
ally
o
r
u
n
in
ten
tio
n
ally
d
is
m
is
s
ed
,
o
n
e'
s
ad
ap
tiv
e
ca
p
ac
ity
to
h
ab
itu
ate
to
h
ar
s
h
s
itu
atio
n
a
l c
o
n
d
itio
n
s
ca
n
b
e
ac
u
tely
co
m
p
r
o
m
is
ed
.
3
.
2
.
Ca
ring
pa
t
t
er
ns
du
ring
dis
a
s
t
er
di
s
pla
ce
m
ent
Du
r
in
g
th
e
r
ec
o
v
er
y
p
er
io
d
f
o
llo
win
g
a
d
is
aster
,
th
e
u
s
e
o
f
cu
ltu
r
e
-
r
elate
d
f
ac
to
r
s
lik
e
f
am
ily
ties
an
d
b
o
n
d
s
,
s
o
cial
n
etwo
r
k
s
,
a
n
d
c
o
m
m
u
n
ity
wo
r
k
s
tr
u
ct
u
r
e
s
ar
e
s
ee
n
t
o
e
n
g
en
d
er
m
o
r
e
f
r
u
itfu
l
a
n
d
e
f
f
ec
tiv
e
s
o
cial
o
u
tco
m
es
[
3
8
]
.
Pro
g
r
am
s
an
d
s
er
v
ices
th
at
ar
e
m
ain
ly
co
m
m
u
n
ity
-
b
ased
te
n
d
to
r
ein
f
o
r
ce
th
e
im
p
o
r
tan
ce
o
f
ca
taly
zi
n
g
r
en
e
wed
s
en
s
e
o
f
h
o
p
e
an
d
co
n
f
i
d
en
ce
,
p
ar
ticu
lar
ly
i
n
p
e
o
p
le
s
tr
u
g
g
lin
g
with
th
e
s
eq
u
elae
o
f
m
ajo
r
ca
tast
r
o
p
h
ic
ev
en
ts
[
3
9
]
.
T
h
is
b
ec
o
m
es
e
v
en
m
o
r
e
co
m
p
ellin
g
in
th
e
d
i
s
aster
-
d
is
p
lace
m
en
t
ex
p
er
ien
ce
,
wh
er
e
f
am
ilies
ar
e
s
u
d
d
e
n
ly
th
r
u
s
ted
i
n
to
a
n
u
n
f
am
iliar
en
v
ir
o
n
m
e
n
t
th
at
ab
o
u
n
d
s
with
c
h
ao
s
an
d
u
n
ce
r
tain
ty
.
B
esid
es
p
r
io
r
itizin
g
th
e
r
e
-
estab
lis
h
m
en
t
o
f
in
f
r
astru
ctu
r
al
life
lin
es,
in
d
iv
i
d
u
als
also
n
ee
d
to
f
ee
l
ca
r
in
g
ac
ts
an
d
g
estu
r
es
f
r
o
m
o
th
er
s
an
d
to
war
d
s
o
th
er
s
if
co
llectiv
e
h
ea
lin
g
is
to
b
e
ac
h
iev
ed
b
ec
au
s
e
,
o
f
ten
tim
es,
tem
p
o
r
ar
y
s
h
elter
s
ca
n
b
e
s
ec
lu
s
iv
e.
Fo
r
th
is
r
ea
s
o
n
,
s
o
cial
s
h
ar
in
g
ap
p
r
o
ac
h
e
s
n
ee
d
to
b
e
s
et
in
p
lace
to
f
ac
ilit
ate
co
h
esio
n
a
n
d
f
ello
wsh
ip
am
o
n
g
c
o
m
m
u
n
ity
m
em
b
er
s
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J
Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
Th
e
in
tercu
ltu
r
a
l c
a
r
in
g
-
co
p
in
g
p
a
tter
n
s
o
f d
is
a
s
ter
-
d
is
p
la
c
ed
fa
milies
in
…(
R
a
n
d
y
I
a
n
F
.
Ga
lleg
o
)
1983
Kn
o
wled
g
e
o
f
th
e
co
m
m
u
n
ity
'
s
lo
ca
l
p
r
ac
tices
allo
ws
th
e
d
i
s
p
o
s
itio
n
o
f
c
u
ltu
r
ally
-
ac
ce
p
tab
le
ca
r
in
g
b
eh
av
io
r
s
in
tim
es
o
f
g
r
ea
t
cr
is
es.
Fo
r
in
s
tan
ce
,
in
th
e
Hu
r
r
ican
e
Katr
in
a
ex
p
e
r
ien
ce
,
th
e
in
teg
r
atio
n
o
f
Af
r
o
ce
n
tr
ic
n
o
r
m
s
in
th
e
d
esig
n
ed
co
m
m
u
n
ity
-
b
ased
p
r
o
g
r
am
s
led
to
th
e
en
h
a
n
ce
m
en
t
o
f
g
r
o
wth
,
co
h
esio
n
,
an
d
r
esil
ien
cy
am
o
n
g
th
e
Af
r
ican
-
Am
er
ican
d
is
aster
v
ictim
s
[
4
0
]
.
I
n
ess
en
ce
,
cu
ltu
r
e
im
p
ac
ts
h
o
w
in
d
iv
id
u
als
ex
p
er
ie
n
ce
d
is
aster
s
,
s
h
ap
e
co
p
in
g
s
tr
ateg
ies,
an
d
d
eter
m
in
e
th
e
ac
ce
p
ta
b
ilit
y
o
f
ex
ter
n
al
ass
is
tan
ce
[
4
1
]
,
[
4
2
]
.
Sin
ce
s
h
elter
s
ca
n
b
e
is
o
latin
g
,
m
u
tu
al
s
u
p
p
o
r
t
m
ay
s
u
b
s
e
q
u
en
tly
wea
k
e
n
.
T
h
is
ca
n
b
e
ab
etted
b
y
p
lacin
g
en
o
u
g
h
s
y
s
tem
s
th
at
allo
w
d
is
aster
p
er
s
o
n
n
el
to
o
p
er
ate
in
way
s
th
at
r
esp
ec
t
th
e
I
DP
'
s
ch
ar
ac
ter
an
d
p
ac
in
g
[
4
3
]
.
Un
d
er
s
tan
d
in
g
th
e
co
m
m
u
n
ity
'
s
s
o
cial
s
tr
u
ctu
r
e
h
elp
s
ac
k
n
o
wled
g
e
th
e
n
ee
d
n
o
t
to
r
u
s
h
p
eo
p
le'
s
r
ec
o
v
er
y
p
r
o
ce
s
s
.
Oth
er
wis
e,
lo
s
s
o
f
tr
u
s
t
m
ay
en
s
u
e.
Similar
ly
,
s
o
cial
r
elatio
n
s
h
ip
s
am
o
n
g
s
h
elter
r
esid
en
ts
b
en
ef
it
p
o
s
itiv
ely
wh
en
th
e
y
ar
e
m
ain
tain
ed
o
r
r
ec
o
n
s
tr
u
ct
ed
.
C
o
n
f
licts
ar
e
b
etter
r
eso
lv
ed
an
d
p
r
e
v
en
ted
i
n
th
e
co
n
tex
t
o
f
c
o
h
esiv
e
s
o
cial
n
etwo
r
k
s
.
L
ik
ewise,
d
is
aster
v
ictim
s
n
ee
d
to
h
av
e
en
o
u
g
h
tim
e
to
p
r
o
ce
s
s
th
e
im
m
in
en
t
ch
an
g
es
ass
o
ciate
d
with
th
eir
d
is
p
lace
m
en
t
an
d
h
o
w
b
alan
ce
ca
n
b
e
s
tr
u
ck
,
g
iv
en
th
eir
lo
n
g
-
h
el
d
cu
s
to
m
s
an
d
tr
ad
itio
n
s
[
4
3
]
.
C
u
ltu
r
al
n
eg
o
tiatio
n
f
ac
ilit
ates
th
e
lear
n
in
g
o
f
n
ew
p
atter
n
s
o
f
b
e
h
av
io
r
th
at
ar
e
ad
ap
tiv
e
to
th
e
p
r
esen
t m
ilieu
.
T
h
e
d
is
p
lace
m
en
t
p
r
o
ce
s
s
f
r
o
m
d
is
aster
s
also
in
cites
a
lo
s
s
o
f
id
en
tity
[
2
5
]
,
[
4
4
]
.
Giv
e
n
t
h
is
co
n
tex
t,
I
DPs
ex
p
r
ess
ed
th
eir
ap
p
r
ec
iatio
n
f
o
r
g
estu
r
es
th
at
em
p
h
asize
ac
tiv
e
lis
ten
in
g
,
s
y
m
p
ath
etic
s
u
p
p
o
r
t,
in
f
o
r
m
atio
n
al
s
h
ar
in
g
,
a
n
d
i
n
itiatio
n
o
f
a
"n
u
m
b
er
o
f
g
o
o
d
talk
s
"
th
at
ex
p
lo
r
es
h
o
w
th
e
y
ar
e
b
ea
r
in
g
wit
h
th
eir
s
tr
ess
es
an
d
tr
au
m
as
[
4
5
]
.
Ma
r
u
ta
n
i
et
a
l.
[
4
3
]
p
o
s
e
th
at
allo
win
g
d
is
aster
v
ictim
s
(
e
s
p
ec
ially
is
lan
d
er
s
)
to
ac
ce
p
t th
eir
f
ee
lin
g
s
u
n
til th
ey
r
eg
ain
t
h
eir
s
en
s
e
o
f
c
o
m
f
o
r
t w
ill f
o
s
ter
th
e
r
eten
tio
n
o
f
a
s
en
s
e
o
f
id
en
tity
.
Sin
ce
m
o
s
t
tr
an
s
itio
n
ar
y
s
h
elt
er
s
d
o
n
o
t
h
av
e
liv
in
g
s
p
ac
es
th
at
ar
e
lar
g
e
en
o
u
g
h
f
o
r
all
ev
ac
u
ee
s
,
r
esid
en
ts
b
ec
o
m
e
co
m
p
elled
t
o
b
e
in
clo
s
e
p
r
o
x
im
ity
to
p
eo
p
le
with
in
an
d
o
u
ts
id
e
o
f
th
eir
d
o
m
esti
c
s
p
h
er
es.
T
h
ese
cr
am
p
ed
co
n
d
itio
n
s
,
in
a
way
,
h
av
e
p
o
s
itiv
e
im
p
licatio
n
s
.
T
h
e
em
o
tio
n
al
ties
o
f
f
am
ilies
ar
e
n
ec
ess
ar
ily
s
tr
en
g
th
en
ed
in
t
h
ese
tim
es
o
f
g
r
ea
t
ad
v
er
s
ity
.
I
t
lay
s
th
e
g
r
o
u
n
d
wo
r
k
f
o
r
in
d
iv
id
u
als
to
f
in
d
s
tab
ilit
y
to
co
p
e
with
th
e
s
tr
ess
es
an
d
u
n
ce
r
tain
ties
o
f
d
is
p
lace
m
en
t
[
4
6
]
.
W
ith
clo
s
e
r
elativ
es
an
d
f
r
ien
d
s
ar
o
u
n
d
,
ev
ac
u
e
es
ar
e
b
etter
ab
le
to
ass
es
s
th
eir
co
n
d
itio
n
s
in
th
e
ce
n
ter
s
.
T
h
ey
r
ec
eiv
e
m
u
ch
-
n
ee
d
e
d
ca
r
e
an
d
em
o
tio
n
al
s
u
p
p
o
r
t
to
m
o
v
e
f
o
r
war
d
with
life
d
esp
ite
d
is
m
al
cir
cu
m
s
tan
ce
s
.
Am
o
n
g
Fil
ip
in
o
s
,
th
e
p
r
ac
tice
o
f
ex
ten
d
in
g
ass
is
tan
ce
,
o
r
"
ta
b
a
n
g
"
(
in
th
e
Vis
ay
an
d
ialec
t)
is
a
n
o
tewo
r
th
y
a
n
d
h
ig
h
ly
v
alu
ed
ca
r
in
g
tr
ait
[
4
6
]
.
Ta
b
a
n
g
o
f
ten
co
m
es
f
r
o
m
c
lo
s
e
k
in
s
,
r
elativ
es,
an
d
f
r
ien
d
s
o
f
f
er
e
d
to
f
am
ily
m
em
b
er
s
wh
o
ar
e
in
an
u
n
f
o
r
t
u
n
ate
s
itu
atio
n
(
e.
g
.
,
d
is
aster
s
,
d
ea
th
,
an
d
in
ju
r
y
,
am
o
n
g
o
th
er
s
)
.
T
a
b
an
g
u
s
u
ally
c
o
m
es
in
th
e
f
o
r
m
o
f
m
o
n
etar
y
h
elp
o
r
r
elief
item
s
s
u
ch
as r
ice,
ca
n
n
ed
g
o
o
d
s
,
clo
th
es,
an
d
ten
ts
,
am
o
n
g
o
th
er
s
.
I
n
th
e
Ph
ilip
p
in
es,
Ab
a
d
[
4
7
]
r
eg
ar
d
ed
th
e
p
r
o
ce
s
s
o
f
c
o
o
p
e
r
atio
n
in
tim
es o
f
d
is
aster
em
er
g
en
cies a
s
a
s
h
ar
ed
c
o
p
in
g
m
ec
h
an
is
m
b
ased
o
n
th
e
c
u
ltu
r
al
p
r
ac
tice
o
f
b
a
y
a
n
ih
a
n
.
E
ty
m
o
l
o
g
ically
,
th
e
wo
r
d
is
d
er
i
v
e
d
f
r
o
m
t
h
e
Fil
ip
in
o
wo
r
d
b
ay
an
,
wh
ich
m
ea
n
s
to
wn
o
r
c
o
m
m
u
n
ity
.
"
B
a
y
a
n
ih
a
n
"
th
e
r
ef
o
r
e
tr
an
s
lates
to
"b
ein
g
a
b
ay
an
":
th
at
w
h
ich
is
r
ef
er
r
in
g
to
a
s
p
ir
it
o
f
co
m
m
u
n
al
u
n
ity
an
d
ac
co
m
p
lis
h
in
g
th
i
n
g
s
to
g
e
th
er
as
o
n
e
p
eo
p
le
[
4
8
]
.
B
an
k
o
f
f
[
4
9
]
d
escr
ib
es
b
a
ya
n
i
h
a
n
as
"to
ilin
g
o
n
an
o
t
h
er
'
s
b
eh
alf
an
d
ass
u
m
in
g
an
o
th
er
'
s
b
u
r
d
en
s
".
I
n
ess
en
ce
,
th
e
o
b
s
er
v
an
ce
o
f
t
h
is
cu
ltu
r
al
co
n
v
en
tio
n
r
ep
r
e
s
en
ts
Fil
ip
in
o
s
o
lid
ar
ity
an
d
ca
r
in
g
at
its
f
in
est.
B
ein
g
with
an
d
n
o
t
leav
in
g
an
o
th
er
p
er
s
o
n
in
h
is
d
is
tr
ess
is
o
n
e
t
h
in
g
,
b
u
t
s
h
ar
in
g
t
h
e
b
u
r
d
en
a
n
d
p
ar
tak
i
n
g
in
th
e
s
tr
u
g
g
le
to
m
a
k
e
th
in
g
s
lig
h
ter
is
b
en
ev
o
len
ce
ex
e
m
p
lifie
d
.
T
h
is
s
p
ir
it
o
f
o
n
e
n
ess
h
elp
s
co
cr
ea
te
co
llectiv
e
h
ea
lin
g
o
p
p
o
r
tu
n
ities
f
o
r
c
o
m
m
u
n
ities
b
elea
g
u
e
r
ed
with
h
ar
d
s
h
ip
s
.
C
o
x
an
d
C
o
x
[
5
0
]
l
o
o
k
at
B
ay
an
ih
an
as "a
cu
ltu
r
al
im
m
u
n
e
s
y
s
tem
th
at
h
ea
ls
o
v
e
r
wo
u
n
d
s
…
allo
win
g
life
to
ca
r
r
y
o
n
".
T
h
e
v
alu
e
o
f
b
a
ya
n
ih
a
n
is
in
ten
s
ely
p
alp
ab
le
in
p
o
s
t
-
d
is
aster
p
er
io
d
s
.
I
t
h
elp
s
s
u
r
v
iv
o
r
s
to
th
r
iv
e,
r
ep
air
th
eir
h
o
m
es,
r
eg
ai
n
th
ei
r
lo
s
s
es,
an
d
r
e
p
o
s
s
ess
th
eir
r
e
s
o
u
r
ce
s
[
5
1
]
.
I
DPs
ex
p
r
ess
ed
th
at
s
o
cial
s
u
p
p
o
r
t
f
r
o
m
f
a
m
ilies
an
d
f
r
ie
n
d
s
r
ein
v
ig
o
r
ated
th
eir
s
en
s
e
o
f
h
o
p
e,
m
ad
e
th
em
f
ee
l
m
o
r
e
ass
er
tiv
e,
an
d
e
n
ab
led
t
h
em
to
ad
d
r
ess
th
e
ch
allen
g
es
n
ee
d
ed
in
s
o
u
r
cin
g
th
eir
b
asic
n
ee
d
s
[
5
1
]
,
[
5
2
]
.
T
h
r
o
u
g
h
b
a
y
an
ih
an
,
r
elatio
n
s
h
ip
ev
en
am
o
n
g
s
tr
an
g
e
r
s
ar
e
b
r
id
g
ed
[
5
3
]
.
T
h
is
s
y
s
tem
o
f
ca
r
in
g
f
o
r
o
n
e
an
o
th
er
is
b
e
co
m
in
g
a
n
atio
n
al
ex
p
r
ess
io
n
o
f
"tea
m
s
p
ir
it a
n
d
s
h
ar
in
g
o
f
lab
o
r
"
[
5
1
]
.
C
er
tain
ly
,
ev
ac
u
atio
n
ce
n
ter
s
ar
e
r
if
e
with
u
n
f
r
ien
d
ly
co
n
d
itio
n
s
.
T
h
er
e
ar
e
tr
ad
itio
n
al
g
e
n
d
er
r
o
les
th
at
h
av
e
to
b
e
tem
p
o
r
a
r
ily
s
et
asid
e
to
p
av
e
th
e
way
f
o
r
th
e
r
esto
r
atio
n
o
f
o
r
d
er
an
d
n
o
r
m
alcy
[
4
6
]
.
So
m
e
co
n
v
en
tio
n
al
ca
r
in
g
n
o
r
m
s
n
ee
d
to
b
e
s
u
p
er
s
ed
ed
b
y
aty
p
i
ca
l
p
atter
n
s
o
f
co
n
d
u
ct
to
ac
h
iev
e
s
o
m
e
r
elativ
e
d
eg
r
ee
o
f
r
ec
o
v
e
r
y
.
Fo
r
e
x
am
p
le,
in
th
e
r
ec
o
n
s
tr
u
ctio
n
o
f
h
o
m
es,
b
o
th
m
en
an
d
wo
m
en
ar
e
co
n
s
tr
ain
ed
to
wo
r
k
to
g
et
h
er
an
d
s
h
ar
e
th
e
lab
o
r
if
th
e
y
wer
e
to
b
u
ild
s
h
elter
s
f
o
r
th
eir
f
am
ilies
.
T
h
is
r
u
n
s
co
n
tr
ar
y
to
tr
ad
itio
n
al
s
tan
d
ar
d
s
wh
er
e
m
en
ar
e
ex
p
ec
ted
to
p
e
r
f
o
r
m
h
ar
d
an
d
m
an
u
al
wo
r
k
.
T
h
is
is
also
th
e
s
am
e
with
f
o
o
d
p
r
e
p
ar
atio
n
an
d
ca
r
in
g
f
o
r
ch
ild
r
en
.
W
o
m
en
ty
p
ically
o
v
er
s
ee
t
h
ese
f
u
n
ctio
n
s
.
I
n
t
em
p
o
r
ar
y
s
h
elter
s
,
h
o
wev
er
,
g
en
d
er
ce
ases
to
m
atter
b
ec
au
s
e
eith
er
m
en
o
r
wo
m
en
will
h
av
e
to
atten
d
to
th
ese
ch
o
r
es
as
war
r
an
ted
[
4
6
]
.
T
h
is
s
h
o
ws
th
at
th
e
tr
ad
itio
n
al
d
is
p
lay
o
f
m
ac
h
is
m
o
ten
d
s
t
o
b
e
s
et
asid
e
in
in
s
tan
ce
s
wh
er
e
h
u
m
an
s
u
r
v
iv
al
is
th
e
f
o
r
em
o
s
t
p
r
io
r
ity
.
Similar
ly
,
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r
p
o
r
atin
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r
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h
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Evaluation Warning : The document was created with Spire.PDF for Python.
I
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:
2
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5
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8
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6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
3
,
No
.
4
,
Dec
em
b
er
20
24
:
1
9
7
8
-
1
9
8
9
1984
p
r
ep
ar
e
d
n
ess
ef
f
o
r
ts
an
d
as
s
ig
n
in
g
th
em
an
em
er
g
e
n
cy
p
r
io
r
ity
s
tatu
s
ak
in
to
h
o
s
p
itals
is
ad
v
is
ab
le
p
ar
ticu
lar
ly
f
o
r
th
e
el
d
er
ly
m
e
m
b
er
s
o
f
th
e
co
m
m
u
n
ity
[
5
4
]
.
3
.
3
.
Co
pin
g
pa
t
t
er
ns
du
ring
dis
a
s
t
er
dis
pla
ce
m
ent
Un
p
r
ec
ed
en
te
d
d
is
r
u
p
tio
n
s
in
th
e
ty
p
ical
co
m
m
u
n
ity
s
y
s
tem
s
an
d
life
lin
es
co
n
f
r
o
n
t
v
ictim
s
in
m
o
r
e
way
s
th
an
u
s
u
al
d
u
r
in
g
lar
g
e
-
s
ca
le
d
is
aster
ev
en
ts
.
W
h
en
p
eo
p
le
ar
e
co
n
s
tr
ain
e
d
to
s
tay
in
ev
ac
u
atio
n
ce
n
ter
s
,
th
ey
o
f
ten
c
o
n
ten
d
with
u
n
k
i
n
d
liv
in
g
s
tan
d
a
r
d
s
,
wh
ich
i
n
clu
d
e
h
a
v
in
g
a
n
in
s
u
f
f
icien
t
s
u
p
p
ly
o
f
p
o
tab
le
wate
r
,
lim
ited
ch
o
ices
in
av
ail
ab
le
f
o
o
d
f
o
r
co
n
s
u
m
p
tio
n
,
co
n
s
tan
t
p
o
wer
o
u
tag
e
,
an
d
p
o
o
r
s
an
itar
y
co
n
d
itio
n
,
am
o
n
g
o
th
er
s
.
Hec
h
a
n
o
v
a
et
a
l.
[
5
5
]
h
ig
h
lig
h
ted
th
at
wate
r
s
o
u
r
ce
is
o
f
p
ar
am
o
u
n
t
co
n
ce
r
n
in
tem
p
o
r
ar
y
r
esettlem
en
ts
b
ec
au
s
e,
o
f
ten
,
th
er
e
is
o
n
ly
o
n
e
r
eser
v
o
ir
f
o
r
an
en
tire
co
m
m
u
n
ity
,
an
d
th
at
wate
r
f
lo
w
wo
u
ld
u
s
u
ally
co
m
e
in
tr
ick
les.
I
n
s
u
ch
a
ca
s
e,
r
esid
en
ts
wo
u
ld
n
e
ed
to
b
ea
r
lo
n
g
q
u
eu
es
to
g
et
th
eir
s
u
p
p
ly
,
wh
ich
u
s
u
ally
last
s
o
n
ly
f
o
r
a
d
a
y
o
r
two
.
T
h
e
s
am
e
s
tu
d
y
also
p
o
in
ted
o
u
t
s
ev
er
al
o
th
er
p
r
ess
in
g
is
s
u
es
in
ev
ac
u
atio
n
s
ites
:
o
v
er
cr
o
wd
in
g
in
m
ak
esh
if
t
q
u
ar
ter
s
,
p
o
o
r
s
ec
u
r
ity
lead
in
g
to
th
e
p
r
ev
al
en
ce
o
f
cr
im
es,
th
e
p
r
esen
ce
o
f
d
is
ea
s
e
-
ca
r
r
y
in
g
v
ec
to
r
s
an
d
p
ests
,
an
d
th
e
n
ee
d
to
co
m
m
u
te
lo
n
g
d
is
tan
ce
s
f
r
o
m
th
e
ce
n
ter
'
s
lo
ca
tio
n
to
im
p
o
r
tan
t
wo
r
k
s
ites
an
d
to
wn
ce
n
ter
s
[
5
5
]
.
W
ith
th
e
o
n
s
et
o
f
t
h
e
g
lo
b
al
C
OVI
D
-
1
9
p
a
n
d
em
ic,
th
ese
p
r
o
b
lem
s
ar
e
m
ad
e
e
v
en
m
o
r
e
c
o
m
p
o
u
n
d
e
d
.
I
n
ter
n
ally
d
is
p
lace
d
p
er
s
o
n
s
(
I
DP)
r
e
p
o
r
t
th
e
ad
d
e
d
b
u
r
d
en
o
f
h
av
in
g
to
wea
r
f
ac
em
ask
s
all
d
ay
in
n
o
n
-
well
-
v
en
til
ated
s
h
elter
s
an
d
th
e
n
ee
d
to
ad
h
er
e
to
s
o
cial
d
is
tan
cin
g
p
r
o
to
co
ls
in
al
r
ea
d
y
cr
am
p
ed
e
v
ac
u
atio
n
s
ites
[
5
6
]
.
T
h
u
s
,
th
e
p
r
esen
t
d
is
aster
-
d
is
p
lace
m
en
t
p
h
en
o
m
en
o
n
en
d
u
r
es
a
m
o
r
e
co
m
p
licated
an
d
m
u
lti
-
lay
er
e
d
s
et
o
f
ch
allen
g
es
an
d
s
etb
a
ck
s
[
5
6
]
,
[
5
7
]
.
T
h
is
n
ec
ess
ar
ily
r
eq
u
ir
es
th
at
I
DPs
b
e
en
ab
led
to
m
o
u
n
t
a
s
tr
o
n
g
s
en
s
e
o
f
p
e
r
s
o
n
al
co
p
i
n
g
ab
ilit
ies
in
o
r
d
er
to
th
r
iv
e
an
d
r
is
e
ab
o
v
e
th
eir
s
itu
atio
n
.
B
y
d
ef
au
lt,
th
e
d
is
aster
-
d
is
p
lace
m
en
t
ex
p
er
ien
ce
is
f
r
a
u
g
h
t
with
p
r
ed
icam
en
ts
,
esp
ec
i
ally
in
th
e
asp
ec
ts
o
f
lo
g
is
tics
,
s
af
ety
,
an
d
well
-
b
ein
g
,
as
well
as
in
th
e
f
in
an
cial
af
f
air
s
o
f
t
h
e
b
u
r
d
en
e
d
p
o
p
u
latio
n
.
Alo
n
g
with
th
e
co
n
s
eq
u
e
n
t
lo
s
s
o
f
v
ital
p
er
s
o
n
al
r
eso
u
r
ce
s
,
r
esear
ch
er
s
h
av
e
also
b
eg
u
n
to
lo
o
k
at
ess
en
tial
ass
o
ciatio
n
s
b
etwe
en
p
eo
p
le'
s
in
cu
r
r
en
ce
o
f
lo
s
s
es
in
tim
es
o
f
d
is
aster
an
d
th
eir
co
p
in
g
b
eh
av
io
r
s
v
is
-
à
-
v
is
th
eir
cu
ltu
r
al
c
o
n
tex
t.
M
o
r
e
r
ec
en
tly
,
r
esear
ch
o
n
Hu
r
r
ic
an
e
Katr
in
a
r
ec
o
g
n
ized
th
e
v
alu
e
o
f
af
f
ir
m
i
n
g
Af
r
ican
Am
er
ican
s
'
u
n
iq
u
e
cu
ltu
r
al
p
r
ac
tices
an
d
tr
ad
itio
n
s
as
cr
u
cial
d
eter
m
in
an
ts
in
t
h
eir
co
p
in
g
jo
u
r
n
e
y
[
3
9
]
.
E
th
n
o
ce
n
tr
ic
h
ab
its
s
u
c
h
as
co
m
m
u
n
ity
co
n
v
er
s
atio
n
s
,
p
r
ay
er
an
d
wo
r
s
h
i
p
,
a
n
d
d
ialo
g
ic
p
r
o
ce
s
s
es
wer
e
f
o
u
n
d
to
b
e
im
p
o
r
tan
t p
r
e
d
icto
r
s
in
r
ed
u
cin
g
th
e
s
tr
ess
ass
o
ciate
d
with
ab
r
u
p
t r
elo
ca
tio
n
[
3
9
]
,
[
4
2
]
.
I
n
th
e
Ph
ilip
p
in
es,
th
e
n
ee
d
to
f
ac
to
r
in
all
v
ital
s
o
cio
-
cu
ltu
r
al
co
n
s
tr
u
cts
in
th
e
p
o
s
t
-
d
is
aster
m
an
ag
em
en
t
p
r
o
g
r
am
s
co
m
e
s
af
ter
r
ec
en
t
e
x
p
er
ien
ce
s
o
f
s
u
cc
ess
iv
e
ty
p
h
o
o
n
s
wh
er
e
d
is
aster
p
r
o
g
r
am
p
lan
n
er
s
h
av
e
b
ee
n
d
r
awn
to
ex
p
lo
r
e
h
o
w
an
d
wh
y
in
d
iv
id
u
als
r
ea
ct
to
h
az
ar
d
s
th
e
way
th
ey
d
o
[
4
6
]
.
I
t
is
d
ee
m
ed
th
at
s
o
cial
an
d
cu
ltu
r
a
l
d
r
iv
er
s
h
elp
s
h
ap
e
p
e
o
p
le'
s
r
esp
o
n
s
iv
en
ess
p
atter
n
s
to
d
is
aster
s
;
th
ese,
in
tu
r
n
,
allo
w
th
em
to
ad
ap
t
f
a
v
o
r
ab
l
y
(
o
r
o
t
h
er
wis
e)
to
th
e
ch
an
g
es
an
d
ch
allen
g
es
p
r
esen
t
in
t
h
eir
en
v
ir
o
n
m
en
tal
s
y
s
tem
s
[
4
6
]
,
[
5
5
]
.
I
n
g
en
er
al,
it
is
co
n
ten
d
e
d
th
a
t
p
eo
p
le
h
av
e
a
p
r
ed
ilectio
n
to
war
d
r
elig
io
u
s
co
p
in
g
ap
p
r
o
ac
h
es
wh
en
ex
p
o
s
ed
t
o
s
tr
ess
f
u
l
life
e
v
en
ts
s
u
ch
as
d
is
aster
em
er
g
en
ci
es
[
5
8
]
.
Po
s
itiv
e
r
elig
io
u
s
co
p
in
g
is
v
iewe
d
as
h
av
in
g
a
g
r
o
u
n
d
e
d
r
elatio
n
s
h
ip
with
th
e
c
r
ea
to
r
,
a
p
r
ev
ailin
g
s
tate
o
f
s
p
ir
itu
ality
with
a
d
ee
p
s
en
s
e
o
f
co
n
n
ec
ted
n
ess
in
s
p
ir
it
with
o
th
er
s
,
an
d
a
f
ir
m
co
n
v
ictio
n
th
at
life
h
as
m
ea
n
in
g
[
5
8
]
,
[
5
9
]
.
C
o
n
v
er
s
ely
,
n
eg
ativ
e
r
elig
io
u
s
c
o
p
in
g
is
th
e
o
p
p
o
s
ite
co
n
ce
p
t:
wh
er
e
a
p
er
s
o
n
h
as
d
if
f
icu
lty
estab
lis
h
in
g
a
s
ec
u
r
e
r
elatio
n
s
h
ip
with
Go
d
,
h
as
a
b
leak
p
er
ce
p
tio
n
o
f
th
e
w
o
r
ld
,
an
d
is
s
tr
u
g
g
lin
g
to
f
in
d
m
ea
n
in
g
in
o
n
e'
s
ex
is
ten
ce
[
5
9
]
.
Sch
o
lar
s
h
av
e
m
ain
tain
ed
t
h
at
r
elig
io
n
an
d
s
p
ir
itu
ality
p
r
o
m
o
te
a
f
av
o
r
a
b
le
im
p
ac
t
o
n
th
e
co
p
in
g
e
x
p
er
ien
ce
o
f
p
eo
p
le
s
u
f
f
er
in
g
f
r
o
m
tr
au
m
atic
en
co
u
n
ter
s
[
6
0
]
.
I
n
f
ac
t,
p
o
s
itiv
e
r
elig
io
u
s
co
p
in
g
h
as
b
ee
n
attr
ib
u
ted
to
b
etter
p
s
y
c
h
o
lo
g
ical
ad
ap
tatio
n
;
n
e
g
ativ
e
r
elig
io
u
s
co
p
in
g
,
o
n
th
e
o
th
er
h
an
d
,
is
ass
o
ciate
d
with
a
m
ar
k
ed
d
ec
lin
e
in
a
p
e
r
s
o
n
'
s
em
o
tio
n
al
an
d
p
h
y
s
ical
s
tate
[
6
1
]
.
As
in
th
e
ca
s
e
o
f
Hu
r
r
ican
e
Katr
in
a
,
v
ictim
s
wh
o
h
av
e
ascr
ib
ed
to
p
o
s
itiv
e
r
elig
io
u
s
co
p
in
g
wer
e
s
ee
n
to
s
h
o
w
less
en
ed
r
is
k
s
f
o
r
p
o
s
t
-
tr
au
m
atic
s
tr
ess
d
is
o
r
d
er
an
d
m
ajo
r
d
ep
r
ess
iv
e
s
y
m
p
to
m
s
wh
ile
m
an
i
f
esti
n
g
s
ig
n
s
o
f
im
p
r
o
v
ed
q
u
a
lity
o
f
life
[
5
9
]
.
I
n
an
o
th
er
s
tu
d
y
,
L
awso
n
an
d
T
h
o
m
as
[
6
2
]
s
tr
ess
ed
th
at
th
e
m
o
r
e
co
m
m
o
n
s
p
ir
itu
al
c
o
p
in
g
m
ec
h
an
is
m
s
u
tili
ze
d
b
y
v
ictim
s
at
th
e
tim
e
o
f
Hu
r
r
ican
e
Katr
in
a
h
a
d
th
em
es
th
at
in
clu
d
ed
co
n
s
tan
t
co
m
m
u
n
icatio
n
with
th
e
d
iv
in
e,
b
i
b
le
r
ea
d
i
n
g
an
d
d
e
v
o
tio
n
als,
an
d
h
elp
in
g
o
t
h
er
s
.
Hen
ce
,
th
e
s
tu
d
y
ass
er
ted
t
h
at
s
p
ir
itu
ality
h
as
in
d
ee
d
f
ac
ilit
ated
em
o
tio
n
al
r
e
s
ilien
ce
in
p
eo
p
le
b
eset w
ith
tr
au
m
atic
o
r
d
ea
ls
.
Oth
er
th
an
em
p
lo
y
in
g
f
aith
-
b
a
s
ed
p
r
o
ce
s
s
es,
d
is
a
s
ter
-
d
is
p
lace
d
in
d
iv
id
u
als
h
av
e
also
f
o
u
n
d
m
er
it
in
th
e
ac
ts
o
f
h
elp
i
n
g
o
th
er
s
as
a
way
to
ac
h
iev
e
a
s
en
s
e
o
f
p
er
s
o
n
al
co
p
i
n
g
[
6
3
]
.
As
p
eo
p
le
b
eg
in
to
e
x
ten
d
h
elp
to
th
o
s
e
less
f
o
r
tu
n
ate
th
an
th
e
m
s
elv
es,
th
ey
d
ev
elo
p
th
e
ca
p
ac
ity
to
"a
d
ju
s
t a
n
d
co
p
e
with
tr
ag
ed
y
"
[
6
2
]
.
T
h
is
f
in
d
s
s
u
p
p
o
r
t
in
liter
atu
r
e
with
s
tu
d
ies
s
u
g
g
esti
n
g
th
at
wh
en
h
u
m
an
s
ar
e
in
th
e
m
id
s
t
o
f
an
alm
o
s
t
in
s
u
r
m
o
u
n
ta
b
le
th
r
ea
t,
it
is
s
till
in
h
er
en
t
u
p
o
n
th
em
to
o
f
f
er
a
h
elp
in
g
h
a
n
d
wh
ic
h
,
in
o
n
e
way
o
r
an
o
th
er
,
s
tr
en
g
th
en
s
th
eir
s
elf
-
esteem
a
n
d
f
ac
ilit
ates e
m
o
tio
n
al
h
ea
lin
g
[
6
4
]
.
T
h
e
ab
ilit
y
to
co
p
e
with
an
d
d
ea
l
with
th
e
s
tr
es
s
es
o
f
d
is
aster
is
also
p
ar
tly
lin
k
ed
with
th
e
co
m
m
u
n
ity
'
s
s
en
s
e
o
f
co
llectiv
e
id
en
tity
.
Fo
r
Fil
ip
in
o
s
,
p
r
o
tectiv
e
f
ac
to
r
s
ag
ain
s
t
d
is
ast
er
cr
is
es
in
clu
d
e
a
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J
Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
Th
e
in
tercu
ltu
r
a
l c
a
r
in
g
-
co
p
in
g
p
a
tter
n
s
o
f d
is
a
s
ter
-
d
is
p
la
c
ed
fa
milies
in
…(
R
a
n
d
y
I
a
n
F
.
Ga
lleg
o
)
1985
g
en
er
ally
p
o
s
itiv
e
o
u
tlo
o
k
an
d
d
is
p
o
s
itio
n
[
5
5
]
.
T
h
is
o
p
tim
is
tic
co
u
n
ten
an
ce
r
ef
lects
r
esil
ien
ce
,
u
n
ity
in
th
e
f
ac
e
o
f
ad
v
e
r
s
ity
,
h
o
p
e
f
u
ln
ess
,
an
d
g
r
atitu
d
e
[
6
5
]
.
I
n
ess
en
c
e,
th
is
s
tate
o
f
cu
ltu
r
al
d
y
n
am
is
m
an
d
co
cr
ea
tio
n
en
h
an
ce
s
h
u
m
a
n
r
elatio
n
s
h
ip
s
.
T
h
is
p
av
es
f
o
r
th
e
ex
p
er
i
en
ce
tr
an
s
cu
ltu
r
alis
m
.
T
r
an
s
cu
ltu
r
alis
m
,
in
th
e
co
n
tex
t
o
f
d
aily
liv
i
n
g
,
is
m
an
if
ested
in
a
g
r
o
u
p
'
s
cu
s
to
m
s
,
r
itu
als,
s
to
r
ies,
an
d
s
y
m
b
o
lis
m
wh
ich
allo
ws
co
m
m
u
n
icativ
e
ca
r
in
g
a
n
d
s
u
p
p
o
r
ts
g
r
o
u
p
c
o
h
esio
n
,
c
o
cr
ea
ti
o
n
,
an
d
h
ar
m
o
n
y
[
6
6
]
.
Similar
ly
,
an
o
th
er
s
tr
ik
in
g
f
e
atu
r
e
in
th
e
Fil
ip
in
o
e
x
p
er
ie
n
ce
o
f
d
is
aster
co
p
i
n
g
is
th
e
co
n
tin
u
ed
d
is
p
lay
o
f
a
s
en
s
e
o
f
h
u
m
o
r
d
esp
ite
h
ar
d
s
h
ip
s
.
I
n
ess
en
ce
,
th
is
allo
ws
p
eo
p
le
to
s
till
s
m
ile
o
r
lau
g
h
,
alb
eit
with
life
'
s
s
tr
u
g
g
les.
Stu
d
ies
p
o
s
it
th
at
h
u
m
o
r
p
alliates
th
e
e
f
f
ec
t
o
f
s
tr
ess
[
6
7
]
,
[
6
8
]
.
Hav
i
n
g
a
g
o
o
d
s
en
s
e
o
f
h
u
m
o
r
h
el
p
s
b
u
f
f
er
th
e
n
e
g
ativ
e
im
p
ac
t
o
f
s
tr
ess
o
n
a
p
er
s
o
n
'
s
m
o
o
d
[
6
9
]
.
Mo
r
eo
v
er
,
B
an
k
o
f
f
[
7
0
]
d
escr
ib
es
h
av
in
g
a
s
en
s
e
o
f
h
u
m
o
r
in
t
h
e
co
n
tex
t
o
f
th
e
Fil
ip
in
o
'
s
ea
g
er
n
ess
to
"u
n
p
ac
k
u
n
n
ec
ess
ar
y
b
u
r
d
en
s
"
in
life
an
d
tak
e
th
in
g
s
an
d
s
itu
atio
n
s
as
lig
h
tly
as
ca
n
b
e.
T
h
is
h
as
b
ec
o
m
e
cr
ea
tiv
ely
s
o
,
s
u
ch
th
at
it
h
as
b
ec
o
m
e
cu
s
to
m
ar
y
to
in
teg
r
ate
th
r
ea
ts
(
e.
g
.
,
d
is
aster
h
az
ar
d
s
)
in
to
d
aily
ex
is
ten
ce
:
an
attitu
d
e
f
r
eq
u
en
tly
p
u
r
p
o
r
tin
g
s
o
m
e
f
o
r
m
o
f
"n
o
r
m
aliza
tio
n
o
f
th
r
ea
t"
[
3
4
]
,
[
4
9
]
.
T
h
er
e
ar
e
also
o
th
er
p
r
o
tectiv
e
co
p
in
g
s
y
s
tem
s
em
er
g
in
g
in
tim
es
o
f
d
is
as
ter
s
;
th
ese
in
cl
u
d
e
h
av
in
g
to
d
ep
en
d
o
n
s
tr
o
n
g
im
m
e
d
iate
f
am
ily
,
ex
ten
d
ed
f
am
ilies
,
an
d
co
m
m
u
n
ity
s
u
p
p
o
r
t
[
5
5
]
.
I
n
m
o
s
t
Asi
an
f
am
ilies
,
f
o
r
in
s
tan
ce
,
d
is
aster
r
esil
ien
cy
s
tem
s
f
r
o
m
p
r
o
f
o
u
n
d
ly
en
tr
e
n
ch
ed
f
am
ily
b
o
n
d
s
an
d
ties
[
6
7
]
.
C
o
n
v
en
tio
n
al
s
u
p
p
o
r
t
s
y
s
tem
s
in
th
e
Ph
ilip
p
i
n
es
ar
e
b
est
ex
em
p
lifie
d
b
y
th
e
tr
a
d
itio
n
al
a
ct
o
f
"
b
a
ya
n
ih
a
n
".
Hen
ce
,
in
tim
es
o
f
d
is
as
ter
e
m
er
g
en
cies,
B
ay
an
ih
an
is
th
e
co
m
m
u
n
al
en
g
a
g
em
en
t
to
h
elp
b
u
ild
b
ac
k
th
e
co
m
m
u
n
ity
an
d
p
ar
ticip
ate
in
s
o
cial
s
y
s
tem
p
r
o
ce
s
s
es
[
6
7
]
.
I
n
J
ap
an
,
v
u
ln
er
ab
le
d
is
aster
-
d
is
p
lace
d
p
o
p
u
latio
n
s
ar
e
p
la
ce
d
in
tr
an
s
ien
t
h
o
u
s
in
g
a
r
r
a
n
g
em
en
ts
ca
lled
k
asetu
.
I
n
th
is
ty
p
e
o
f
s
etu
p
,
it
was
co
m
m
o
n
to
h
ea
r
c
ases
o
f
k
o
d
o
k
u
s
h
i
(
d
e
ath
alo
n
e
wh
ich
o
f
ten
tim
es
g
o
es
u
n
n
o
ticed
)
.
Su
p
p
o
r
t
f
o
r
th
e
eld
er
ly
r
esid
en
ts
wh
o
liv
e
alo
n
e
in
th
e
k
asetu
co
m
e
s
f
r
o
m
co
m
m
u
n
ity
v
o
lu
n
teer
s
an
d
s
tu
d
e
n
ts
wh
o
s
e
r
eg
u
lar
v
is
itatio
n
s
wer
e
d
ir
ec
ted
at
ch
ec
k
in
g
o
u
t th
e
h
ea
lth
s
tatu
s
o
f
th
e
f
o
r
m
er
an
d
allay
in
g
th
e
s
ig
n
s
o
f
w
o
r
r
ies
an
d
co
n
ce
r
n
s
th
at
th
e
y
h
av
e
[
2
4
]
.
T
h
is
n
etwo
r
k
in
g
s
y
s
tem
g
iv
es
th
e
o
p
p
o
r
tu
n
ity
f
o
r
v
o
lu
n
teer
g
r
o
u
p
s
to
r
en
d
e
r
s
u
p
p
o
r
tiv
e
ca
r
e
an
d
p
r
o
m
o
te
p
o
s
itiv
e
co
p
in
g
am
o
n
g
d
is
p
lace
d
co
m
m
u
n
ity
m
em
b
er
s
[
2
4
]
.
I
n
ess
en
ce
,
d
is
aster
ex
p
e
r
ien
c
e
is
r
ep
lete
with
co
u
n
ter
-
c
o
p
i
n
g
m
e
ch
an
is
m
s
b
y
v
ictim
s
in
o
r
d
er
t
o
s
u
cc
ess
f
u
lly
o
v
er
co
m
e
d
is
tr
e
s
s
an
d
r
e
-
estab
lis
h
in
teg
r
ati
o
n
b
ac
k
in
to
s
o
ciety
.
W
h
ile
co
p
in
g
m
ay
b
e
in
tr
in
s
ically
in
cu
m
b
en
t,
a
g
o
o
d
b
o
d
y
o
f
liter
atu
r
e
p
o
in
ts
o
u
t
th
e
n
ee
d
to
lo
o
k
at
cu
ltu
r
e
as
a
f
ac
to
r
th
at
en
h
an
ce
s
th
e
co
p
in
g
e
x
p
er
ie
n
c
e.
3
.
4
.
Cultura
l
lea
rning
s
f
o
r
d
is
a
s
t
er
-
ba
s
ed
pra
ct
it
io
ners
B
ein
g
co
g
n
izan
t
o
f
th
e
s
o
cio
-
cu
ltu
r
al
b
ac
k
d
r
o
p
o
f
d
i
s
aster
s
i
s
o
n
e
o
f
th
e
cr
u
cial,
p
iv
o
tal
d
ev
elo
p
m
e
n
ts
in
th
e
p
r
esen
t
-
d
ay
d
is
aster
r
ea
d
in
ess
an
d
r
esp
o
n
s
iv
en
ess
s
tr
atag
em
.
Me
ch
an
is
m
s
in
th
e
d
is
aster
m
itig
atio
n
p
r
o
ce
s
s
h
av
e
n
o
w
ad
o
p
ted
a
m
o
r
e
co
m
p
r
eh
en
s
iv
e
p
er
s
p
ec
tiv
e
th
at
ac
k
n
o
wled
g
es
n
o
t
o
n
ly
th
e
in
teg
r
atio
n
o
f
tech
n
ical
r
esp
o
n
s
es
b
u
t
also
o
f
th
e
s
o
cial,
cu
ltu
r
al,
ec
o
n
o
m
ic,
an
d
p
o
liti
ca
l
s
y
s
tem
s
in
v
o
lv
ed
in
d
is
aster
m
an
ag
em
en
t
[
4
6
]
,
[
7
1
]
.
T
h
is
im
p
els
d
is
aster
r
esp
o
n
d
er
s
an
d
p
r
ac
titi
o
n
er
s
to
h
av
e
th
e
cu
ltu
r
al
co
m
p
eten
cy
to
b
len
d
tech
n
o
-
clin
ical
s
tr
ateg
ies
alo
n
g
with
em
p
o
wer
m
en
t
m
o
d
els
to
b
r
in
g
ab
o
u
t
r
esil
ien
cy
,
v
ig
o
r
,
an
d
p
er
s
ev
er
a
n
ce
am
o
n
g
v
ictim
s
tr
au
m
atize
d
b
y
d
is
a
s
ter
s
[
3
9
]
.
R
esp
o
n
d
er
s
lev
er
a
g
e
th
eir
p
r
o
f
ess
io
n
al
ex
p
er
tis
e
to
e
n
co
u
r
ag
e
t
h
e
p
u
b
lic
to
ad
o
p
t
a
p
r
o
ac
tiv
e
s
tan
ce
in
d
is
aster
r
esp
o
n
s
e
,
ad
d
r
ess
in
g
o
f
ten
o
v
er
lo
o
k
ed
d
im
en
s
io
n
s
o
f
c
ar
e
s
u
ch
as
s
p
ir
itu
ality
,
em
o
tio
n
s
,
m
en
tal
h
ea
lth
,
an
d
c
u
ltu
r
e
with
in
b
o
th
in
d
iv
id
u
al
a
n
d
co
m
m
u
n
ity
co
n
tex
ts
[
7
2
]
.
C
o
n
s
id
er
in
g
th
at
to
d
ay
'
s
s
o
ci
etal
p
r
o
f
ile
is
r
if
e
with
d
iv
er
s
ity
in
ter
m
s
o
f
r
ac
e
an
d
s
o
ci
o
ec
o
n
o
m
ic
ca
teg
o
r
ies,
s
er
v
ice
p
r
o
v
id
er
s
(
e.
g
.
,
n
u
r
s
es)
ar
e
ex
p
e
cted
to
c
o
m
e
ac
r
o
s
s
m
u
ltip
le
ch
allen
g
es
in
r
esp
o
n
d
in
g
to
th
e
n
ee
d
s
o
f
d
is
aster
-
d
is
p
lace
d
p
o
p
u
latio
n
s
in
a
cu
ltu
r
ally
ap
p
r
o
p
r
iate
m
a
n
n
er
[
2
9
]
.
C
u
ltu
r
ally
-
co
m
p
eten
t
ca
r
in
g
in
v
o
lv
es
k
n
o
win
g
th
e
n
u
an
ce
s
o
f
h
o
w
tr
au
m
atic
s
y
m
p
to
m
s
ca
n
b
e
m
an
if
ested
ac
r
o
s
s
d
if
f
er
en
t
cu
ltu
r
es
an
d
h
o
w
e
n
g
ag
em
e
n
t
s
tr
ateg
ies
ar
e
in
f
lu
en
ce
d
b
y
p
e
o
p
le'
s
et
h
n
ic
b
ac
k
g
r
o
u
n
d
s
[
7
3
]
.
C
u
ltu
r
al
co
m
p
eten
cy
h
as
b
ee
n
p
o
in
ted
o
u
t
as
a
cr
u
cial
p
r
ed
icto
r
o
f
life
-
s
av
in
g
a
d
v
a
n
ce
s
an
d
r
esil
ien
cy
in
co
m
m
u
n
ities
af
f
ec
ted
b
y
ca
tast
r
o
p
h
e
[
3
8
]
,
[
4
3
]
,
[
7
2
]
,
[
7
3
]
.
I
n
d
is
aster
n
u
r
s
in
g
,
p
r
ac
titi
o
n
er
s
ar
e
ex
p
ec
ted
to
u
tili
ze
cu
ltu
r
al
f
ea
t
u
r
es
s
u
ch
as
b
o
n
d
s
an
d
r
elatio
n
s
h
ip
s
to
d
is
s
em
in
ate
im
p
o
r
tan
t
in
f
o
r
m
atio
n
to
lo
ca
l
s
[
4
3
]
.
T
h
is
is
b
ec
au
s
e
wh
en
eth
n
o
-
ce
n
te
r
ed
r
u
les
an
d
ch
a
r
ac
ter
s
ar
e
ac
k
n
o
wl
ed
g
ed
,
r
esid
en
ts
b
ec
o
m
e
m
o
r
e
m
an
a
g
ea
b
le
a
n
d
ar
e
b
e
tter
ab
le
to
o
f
f
er
co
m
p
en
s
ativ
e
h
elp
[
4
3
]
.
C
lu
s
ter
in
g
o
f
I
DPs
in
ca
m
p
s
ites
also
h
as
to
b
e
d
o
n
e
in
a
wa
y
wh
er
e
th
o
s
e
wh
o
o
r
ig
in
ate
f
r
o
m
th
e
s
am
e
g
eo
g
r
ap
h
ical
lo
ca
tio
n
s
ar
e
p
lace
d
alo
n
g
s
id
e
o
r
n
ea
r
to
g
eth
er
to
p
r
eser
v
e
s
o
cial
a
n
d
eth
n
ic
co
h
esio
n
[
7
4
]
.
Fo
r
J
ap
an
ese
n
u
r
s
es,
th
e
p
r
o
v
is
io
n
o
f
cu
ltu
r
ally
s
en
s
itiv
e
c
ar
e
n
ee
d
s
to
s
p
a
n
f
r
o
m
n
o
r
m
a
l
tim
es
u
p
u
n
til th
e
p
o
s
t
-
d
is
aster
p
er
io
d
.
T
o
th
is
ef
f
ec
t,
a
co
m
p
r
eh
en
s
iv
e
co
m
m
u
n
ity
d
iag
n
o
s
is
n
ee
d
s
to
b
e
f
o
r
m
u
lated
s
o
th
at
g
eo
g
r
a
p
h
ical
ar
ea
s
an
d
h
ea
lth
p
r
o
g
r
am
s
ar
e
co
n
s
is
ten
t
th
r
o
u
g
h
o
u
t,
ev
en
b
ef
o
r
e
th
e
o
n
s
et
o
f
clim
atic
h
az
ar
d
s
[
4
3
]
,
[
7
5
]
.
I
f
s
u
ch
is
th
e
ca
s
e,
n
u
r
s
es
ca
n
b
etter
o
f
f
er
h
ea
lth
-
cr
is
is
m
an
ag
em
en
t
i
n
s
tead
o
f
th
e
u
s
u
al
d
is
aster
-
em
er
g
en
cy
r
esp
o
n
s
e,
wh
ich
is
m
o
r
e
lim
ited
in
s
co
p
e
[
4
3
]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
3
,
No
.
4
,
Dec
em
b
er
20
24
:
1
9
7
8
-
1
9
8
9
1986
Similar
ly
,
d
is
aster
r
esp
o
n
d
er
s
ar
e
also
u
r
g
ed
t
o
co
n
s
id
er
t
h
e
r
elig
io
u
s
p
er
ce
p
tio
n
s
an
d
r
elig
io
u
s
co
p
in
g
s
tr
ateg
ies
o
f
d
is
aster
v
ictim
s
in
th
e
co
n
ce
p
tu
ali
za
tio
n
o
f
r
esp
o
n
s
e
[
5
9
]
.
T
h
is
g
iv
es
a
b
etter
u
n
d
er
s
tan
d
i
n
g
o
f
th
e
co
m
m
u
n
ity
'
s
p
o
ten
tial
wo
r
ld
v
iew
an
d
p
r
e
d
icts
h
o
w
in
d
i
v
id
u
al
s
m
ay
m
o
s
t
lik
ely
in
ter
p
r
et
an
d
r
esp
o
n
d
to
a
d
is
aster
in
cid
en
t
[
5
9
]
.
I
n
t
h
e
ca
s
e
o
f
Af
r
ican
-
Am
e
r
ican
s
,
th
e
a
ct
o
f
h
elp
in
g
o
th
er
s
was
s
ee
n
to
b
e
g
r
o
u
n
d
ed
o
n
f
aith
-
b
ased
in
ten
tio
n
s
[
6
2
]
.
T
h
is
m
ea
n
s
th
at
s
p
ir
itu
ality
was
a
d
r
iv
in
g
f
o
r
ce
in
th
eir
ef
f
o
r
ts
at
ex
ten
d
in
g
ass
is
tan
ce
in
tim
es
o
f
d
is
aster
.
T
h
e
ab
ilit
y
to
h
elp
o
th
er
s
allo
ws
i
n
d
iv
id
u
als
to
g
ain
im
p
r
o
v
e
d
s
elf
-
esteem
,
wh
ich
,
in
a
way
,
was f
ac
ilit
ativ
e
o
f
e
m
o
tio
n
al
h
ea
lin
g
.
Fu
r
th
er
m
o
r
e
,
d
is
aster
r
esp
o
n
d
er
s
also
n
ee
d
to
r
ec
o
g
n
iz
e
g
en
d
er
-
r
o
le
o
r
ien
tatio
n
s
i
n
af
f
ec
ted
co
m
m
u
n
ities
.
T
h
er
e
a
r
e
in
s
ta
n
ce
s
wh
en
w
o
m
en
v
ictim
s
a
r
e
n
o
t
co
m
f
o
r
tab
le
b
ein
g
in
th
e
p
r
esen
ce
o
f
a
r
esp
o
n
d
er
f
r
o
m
th
e
o
p
p
o
s
ite
s
ex
.
T
h
ese
s
ce
n
ar
io
s
m
ay
s
tr
ain
co
m
m
u
n
ity
-
b
u
ild
in
g
ef
f
o
r
ts
an
d
im
p
air
co
llectiv
e
h
ea
lin
g
.
Hen
ce
,
c
u
l
tu
r
al
s
en
s
itiv
ity
d
em
an
d
s
th
at
r
esp
o
n
d
er
s
a
r
e
awa
r
e
o
f
t
h
ese
p
r
o
p
r
ieties.
T
h
er
e
is
also
g
en
d
er
-
b
ased
d
o
m
esti
c
task
s
th
at
m
en
a
n
d
wo
m
en
ten
d
to
ass
u
m
e.
R
esp
o
n
d
er
s
n
ee
d
to
u
n
d
er
s
tan
d
th
ese
s
o
cial
d
y
n
am
ics an
d
d
esig
n
im
p
lem
e
n
tatio
n
p
lan
s
th
at
ar
e
co
n
s
is
ten
t w
ith
th
ese
co
n
s
id
er
atio
n
s
.
4.
CO
NCLU
SI
O
N
T
h
e
d
is
aster
-
d
is
p
lace
m
en
t
p
h
en
o
m
en
o
n
is
b
o
u
n
d
with
in
tr
icate
lay
er
s
o
f
s
o
cio
-
ec
o
n
o
m
i
c
-
cu
ltu
r
al
co
n
s
id
er
atio
n
s
to
b
r
in
g
a
b
o
u
t
an
ef
f
ec
tiv
e
r
ec
o
v
er
y
p
r
o
ce
s
s
an
d
m
o
v
em
en
t
f
o
r
war
d
f
o
r
af
f
ec
ted
co
m
m
u
n
ity
r
esid
en
ts
an
d
f
am
ilies
.
Desp
it
e
th
e
b
u
r
d
e
n
o
f
cr
is
es,
d
is
aster
v
ictim
s
ten
d
to
n
atu
r
ally
r
e
g
a
in
th
eir
b
ea
r
in
g
a
n
d
b
o
u
n
ce
b
ac
k
to
th
eir
p
r
ev
io
u
s
lev
els
o
f
f
u
n
ctio
n
i
n
g
.
C
ar
in
g
-
co
p
in
g
m
ec
h
an
is
m
s
allo
w
p
eo
p
le
to
th
r
iv
e
am
id
s
t
g
r
ea
t
ad
v
er
s
ities
.
C
en
tr
al
to
th
ese
h
ea
lin
g
p
r
o
ce
s
s
es
is
th
e
r
o
le
o
f
cu
ltu
r
e
an
d
tr
a
d
itio
n
s
,
wh
ich
ar
e
s
ee
n
to
s
ig
n
if
ican
tly
in
f
lu
e
n
ce
h
o
w
p
eo
p
le
ca
n
ad
ju
s
t
an
d
ad
a
p
t
to
th
eir
p
r
esen
t
r
ea
liti
es.
Dis
ast
er
ex
p
e
r
ien
ce
s
ar
e
v
iewe
d
d
if
f
e
r
en
tly
ac
r
o
s
s
d
if
f
e
r
en
t
cu
ltu
r
es.
He
n
ce
,
th
e
k
in
d
o
f
co
p
in
g
r
eq
u
ir
e
d
f
o
r
th
ese
e
v
en
ts
is
n
ec
ess
ar
ily
im
p
ac
ted
b
y
th
e
p
e
o
p
les'
wo
r
ld
v
iews a
n
d
b
elief
s
y
s
tem
s
.
Un
f
o
r
tu
n
atel
y
,
th
er
e
is
s
till
a
lo
n
g
way
a
h
ea
d
in
th
e
cu
ltu
r
al
d
is
p
en
s
atio
n
o
f
ca
r
e
i
n
d
is
aster
em
er
g
en
cies.
An
e
cd
o
tal
n
ar
r
ativ
es
an
d
r
ec
en
t
wo
r
k
s
h
av
e
s
h
o
wn
th
at
n
u
r
s
es
o
f
t
en
lack
s
u
f
f
icien
t
p
r
ep
ar
e
d
n
ess
an
d
tr
ain
in
g
in
cu
ltu
r
al
co
m
p
ete
n
ce
.
Ne
v
er
th
eless
,
th
e
o
n
g
o
in
g
s
ch
o
lar
s
h
ip
s
in
th
is
f
ield
d
em
o
n
s
tr
ate
in
cr
ea
s
in
g
ef
f
o
r
ts
to
cr
ea
te
a
s
ig
n
if
ican
t
a
m
o
u
n
t
o
f
k
n
o
wled
g
e
b
ase
an
d
c
o
m
p
eten
cy
ca
p
ac
itatio
n
am
o
n
g
n
u
r
s
es a
n
d
o
th
er
allied
p
r
ac
titi
o
n
er
s
.
Hen
ce
,
th
er
e
is
en
o
u
g
h
r
ea
s
o
n
to
b
eliev
e
th
at
tr
an
s
cu
ltu
r
al
ca
r
e
in
d
is
aster
r
esp
o
n
s
e
is
s
u
r
ely
m
ak
in
g
e
n
o
u
g
h
h
ea
d
way
to
ad
v
an
ce
th
e
n
ee
d
s
an
d
w
elf
ar
e
o
f
d
is
p
lace
d
p
o
p
u
latio
n
s
in
tim
es o
f
p
r
o
f
o
u
n
d
d
is
tr
ess
.
ACK
NO
WL
E
DG
E
M
E
NT
S
T
h
e
au
th
o
r
s
wo
u
ld
lik
e
to
ex
p
r
ess
th
eir
g
r
atitu
d
e
to
T
h
er
esa
L
in
d
a
N.
Pain
ag
an
,
R
N,
MA
N,
Prin
ce
s
s
J
eh
an
n
e
M.
Dim
ap
o
r
o
,
R
N,
MN
an
d
Nass
ef
ah
D.
Al
i,
R
N
,
MA
N
f
o
r
th
eir
in
v
alu
ab
le
ass
is
tan
ce
in
th
e
in
it
ial
r
ev
iew
an
d
s
cr
ee
n
in
g
o
f
th
e
i
d
en
tifie
d
ar
ticles.
T
h
e
au
th
o
r
s
ass
er
t
th
at
th
e
s
tu
d
y
was
ca
r
r
ied
o
u
t
with
o
u
t
an
y
af
f
iliatio
n
s
o
r
f
in
a
n
cial
in
ter
ests
th
at
m
ig
h
t b
e
in
ter
p
r
eted
as
a
p
o
s
s
ib
le
s
o
u
r
ce
o
f
co
n
f
lict
o
f
in
ter
est.
RE
F
E
R
E
NC
E
S
[
1
]
N
.
N
u
n
e
s,
K
.
R
o
b
e
r
s
o
n
,
a
n
d
A
.
Za
m
u
d
i
o
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2
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