I
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rna
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l J
o
urna
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bli
c
H
ea
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h Science
(
I
J
P
H
S)
Vo
l.
5
,
No
.
3
,
Sep
tem
b
er
201
6
,
p
p
.
2
6
7
~
2
7
3
I
SS
N:
2252
-
8806
267
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In
stit
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C
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A
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:
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s
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Dep
ar
t
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lic
Hea
lth
Scien
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,
Un
i
v
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s
ita
s
A
h
m
ad
Dah
lan
,
Stre
et
P
r
o
f
.
Dr
.
So
ep
o
m
o
,
J
an
t
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,
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m
b
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h
ar
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,
Yo
g
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k
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ta
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n
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E
m
ail: s
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li
s
t
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w
ati
s
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to
@
g
m
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co
m
1.
I
NT
RO
D
UCT
I
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C
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ch
a
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e
h
a
s
b
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ce
r
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i
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g
p
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b
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m
w
it
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u
n
d
en
iab
le
e
v
id
en
ce
w
h
ic
h
is
d
r
iv
en
b
y
h
u
m
a
n
ac
t
iv
i
t
y
.
L
o
w
a
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d
m
i
d
d
le
in
co
m
e
co
u
n
tr
ies
w
ill
b
e
af
f
ec
ted
m
o
s
tl
y
d
u
e
to
th
e
h
i
g
h
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u
m
b
er
o
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lo
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-
in
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citize
n
s
a
n
d
th
u
s
lo
w
ad
ap
tiv
e
ca
p
ac
it
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o
f
t
h
e
citizen
s
an
d
o
f
lo
ca
l
g
o
v
e
r
n
m
e
n
ts
[
1
]
.
A
s
a
c
o
n
s
eq
u
e
n
ce
,
ad
ap
tiv
e
s
tr
ate
g
ies
ai
m
i
n
g
to
in
cr
ea
s
e
t
h
e
r
esil
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o
f
th
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s
e
p
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p
u
latio
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s
ar
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tia
l
to
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ize
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v
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i
m
p
ac
t
s
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n
h
ea
lt
h
an
d
s
o
ciet
y
[
2
]
.
T
h
e
ev
id
en
ce
s
h
o
w
s
th
at
i
n
c
r
ea
s
in
g
te
m
p
er
at
u
r
es,
h
i
g
h
in
ten
s
i
t
y
o
f
r
ai
n
,
d
r
o
u
g
h
t
an
d
r
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in
g
s
ea
lev
els
ar
e
an
i
n
d
icatio
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th
at
t
h
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cli
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a
te
is
ch
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n
g
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d
h
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v
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,
f
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x
a
m
p
le
h
ig
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te
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it
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p
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lan
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lid
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d
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t
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p
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atu
r
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co
u
ld
b
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ca
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s
i
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f
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f
ir
es
[
3
]
.
T
h
is
w
il
l
af
f
ec
t
all
a
s
p
ec
ts
o
f
h
u
m
an
lif
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(
i.e
.
h
ea
lt
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,
f
o
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d
p
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o
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u
ctio
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etc.
)
[
4
]
an
d
m
a
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y
d
is
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s
e
s
,
s
u
ch
a
s
r
esp
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to
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is
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m
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ta
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d
is
o
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an
d
ca
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w
h
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ar
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tr
ig
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o
r
w
o
r
s
en
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b
y
a
ch
an
g
e
in
cl
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m
a
te
[
5
]
-
[
7
]
.
Gu
n
u
n
g
k
id
u
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Yo
g
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k
ar
ta,
I
n
d
o
n
esia
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a
d
i
s
tr
ict
v
u
ln
er
ab
le
to
cli
m
ate
c
h
a
n
g
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b
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au
s
e
o
f
it
s
g
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r
ap
h
ical
ch
ar
ac
ter
i
s
tics
.
T
h
e
d
is
tr
ict
co
n
s
is
t
s
o
f
a
co
astal
ar
ea
an
d
L
i
m
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to
n
e
Mo
u
n
tain
s
a
n
d
i
s
s
u
s
ce
p
tib
le
to
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r
o
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t,
s
ea
lev
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to
r
n
ad
o
s
an
d
to
in
f
e
ctio
u
s
d
is
ea
s
e
s
.
Dr
o
u
g
h
t
in
G
u
n
u
n
g
k
id
u
l
w
o
r
r
ied
tr
ig
g
er
s
f
o
o
d
in
s
ec
u
r
it
y
a
n
d
m
aln
u
tr
itio
n
.
Sea
le
v
el
r
i
s
e
en
d
an
g
er
p
o
p
u
latio
n
s
in
co
astal
a
r
ea
s
an
d
a
f
f
ec
ts
th
e
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8806
I
J
P
HS
Vo
l.
5
,
No
.
3
,
Sep
tem
b
er
201
6
:
2
6
7
–
2
7
3
268
m
ai
n
s
o
u
r
ce
o
f
in
co
m
e,
w
h
i
ch
is
f
i
s
h
in
g
.
Sev
er
al
m
o
u
n
t
ain
o
u
s
ar
ea
s
in
Gu
n
u
n
g
k
id
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ex
p
er
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ce
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n
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f
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f
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s
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ca
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s
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ac
cid
en
tal
d
e
ath
s
d
u
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to
f
alli
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co
l
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h
o
u
s
e
s
o
r
lan
d
s
lid
es.
I
t
is
also
p
r
ed
icted
th
at
an
in
cr
ea
s
e
i
n
te
m
p
er
a
tu
r
e
in
t
h
e
m
o
u
n
tai
n
s
w
ill
tr
i
g
g
er
m
o
s
q
u
ito
es
to
m
o
v
e
to
h
i
g
h
er
g
r
o
u
n
d
s
[
8
]
,
h
en
ce
in
cr
ea
s
in
g
t
h
e
r
is
k
o
f
G
u
n
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g
k
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to
b
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o
m
e
ex
p
o
s
ed
to
s
ev
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al
cli
m
at
e
s
en
s
iti
v
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in
f
ec
tio
u
s
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is
ea
s
es li
k
e
Ma
lar
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d
Den
g
u
e.
T
h
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g
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s
a
m
p
le
is
teen
a
g
er
s
th
at
ar
e
y
o
u
n
g
p
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p
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w
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1
6
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y
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r
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ld
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O
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d
d
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[
9
]
d
ef
in
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s
as
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p
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w
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1
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T
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ag
er
s
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a
v
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s
i
m
il
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W
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Hea
lth
Or
g
an
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s
io
lo
g
icall
y
n
o
r
m
al
p
u
b
er
t
y
,
a
n
d
en
d
s
w
h
en
a
n
ad
u
lt
id
en
tit
y
a
n
d
b
eh
av
io
r
ar
e
ac
ce
p
ted
.
T
h
is
p
er
io
d
o
f
d
ev
elo
p
m
e
n
t
co
r
r
esp
o
n
d
s
r
o
u
g
h
l
y
to
th
e
p
er
io
d
b
etw
ee
n
t
h
e
a
g
es
o
f
1
0
an
d
1
9
y
ea
r
s
”[
1
0
]
.
I
t
is
a
ti
m
e
o
f
h
ei
g
h
te
n
ed
v
u
ln
er
ab
ilit
y
to
m
a
n
y
en
v
ir
o
n
m
e
n
tal
an
d
e
m
o
tio
n
al
h
az
ar
d
s
an
d
a
p
er
io
d
w
h
en
t
h
e
y
o
u
n
g
p
er
s
o
n
’
s
i
m
p
r
o
v
e
s
t
h
eir
k
n
o
wled
g
e
an
d
t
h
eir
s
o
cial
ca
p
ac
it
y
.
T
h
er
ef
o
r
e
it
is
i
m
p
o
r
tan
t
to
u
n
d
er
s
tan
d
m
o
r
e
ab
o
u
t
ad
o
lescen
t
s
’
o
r
tee
n
a
g
er
s
p
er
ce
p
tio
n
s
to
cli
m
ate
c
h
an
g
e
a
n
d
h
ea
lt
h
i
n
or
d
er
to
s
u
g
g
est
i
n
ter
v
en
tio
n
s
.
I
n
th
i
s
p
ap
er
w
e
d
is
cu
s
s
a
n
d
s
u
g
g
es
t
s
tr
ate
g
ies
t
h
at
i
n
cl
u
d
e
teen
ag
er
s
a
s
ag
e
n
t
s
in
cl
i
m
ate
ch
a
n
g
e
ad
ap
tatio
n
a
d
d
r
ess
in
g
h
ea
lt
h
.
2.
RE
S
E
ARCH
M
E
T
H
O
D
2
.
1
.
Study
d
esig
n a
nd
s
a
m
ple
T
h
is
w
a
s
a
s
u
r
v
e
y
s
tu
d
y
d
esig
n
ed
to
ass
ess
t
h
e
p
er
ce
p
tio
n
o
f
cli
m
ate
c
h
an
g
e
w
it
h
p
ar
ticu
la
r
f
o
cu
s
o
n
th
e
i
m
p
ac
t
o
n
h
u
m
a
n
h
ea
lth
a
m
o
n
g
th
e
tee
n
a
g
er
s
.
A
s
tr
u
ct
u
r
ed
q
u
esti
o
n
n
air
e
u
s
ed
in
th
i
s
s
u
r
v
e
y
,
m
o
d
i
f
ied
f
r
o
m
p
r
ev
io
u
s
r
esear
ch
in
o
r
d
er
to
b
e
u
s
ed
w
i
th
y
o
u
n
g
p
eo
p
le
.
T
h
is
q
u
esti
o
n
n
air
e
w
as
d
ev
elo
p
ed
b
y
C
li
m
ate
C
h
a
n
g
e
‐
Mitig
at
io
n
an
d
A
d
ap
tatio
n
P
o
licies
in
t
h
e
h
ea
l
t
h
s
ec
to
r
(
C
C
‐
M
A
P
)
p
r
o
j
ec
t
[
1
1
]
.
T
h
is
p
r
o
j
ec
t
s
u
p
p
o
r
ted
b
y
S
w
ed
is
h
I
n
ter
n
atio
n
al
Dev
e
lo
p
m
en
t
Ag
en
c
y
(
SID
A
)
i
n
2
0
1
3
.
I
n
to
tal
,
th
e
q
u
e
s
tio
n
n
air
e
co
n
s
is
t
ed
o
f
4
5
q
u
esti
o
n
s
.
T
h
e
q
u
esti
o
n
n
air
e
w
a
s
ed
ited
a
n
d
tr
an
s
lated
to
B
ah
a
s
a
I
n
d
o
n
e
s
ia.
So
m
e
q
u
est
io
n
s
w
er
e
d
elete
d
as
th
e
y
r
eq
u
ir
ed
a
h
ig
h
er
lev
el
o
f
u
n
d
er
s
tan
d
i
n
g
t
h
a
n
co
u
ld
b
e
ex
p
ec
ted
f
r
o
m
th
e
r
esp
o
n
d
e
n
ts
.
T
h
e
q
u
esti
o
n
n
air
e
co
n
s
i
s
ted
o
f
r
atin
g
s
ca
le
q
u
e
s
tio
n
s
an
d
m
u
ltip
le
ch
o
ice
s
.
Qu
esti
o
n
s
ad
d
r
ess
in
g
r
esp
o
n
d
en
ts
’
p
r
io
r
ities
a
n
d
att
i
tu
d
es,
w
i
th
r
esp
ec
t
to
p
ar
ticu
l
ar
s
tate
m
en
t
s
,
w
er
e
p
r
o
v
id
ed
a
s
ca
le
f
r
o
m
1
to
1
0
L
i
k
er
t
ite
m
s
.
Fo
r
m
u
ltip
le
ch
o
ice
q
u
esti
o
n
s
an
d
s
tate
m
e
n
ts
,
an
s
w
er
s
w
er
e
p
r
o
v
id
ed
as
(
X)
ite
m
s
f
r
o
m
s
tr
o
n
g
l
y
d
is
a
g
r
ee
to
co
m
p
letel
y
ag
r
ee
,
o
r
d
o
n
’
t k
n
o
w
to
Kn
o
w
co
m
p
lete
l
y
.
2
.
2
.
P
a
rt
icipa
nts
W
e
ch
o
o
s
e
a
s
en
io
r
h
ig
h
s
c
h
o
o
l
in
th
e
h
ig
h
la
n
d
s
o
f
G
u
n
u
n
g
k
id
u
l
b
y
i
n
v
o
lv
i
n
g
1
4
7
s
tu
d
en
ts
o
f
ag
ed
16
-
1
7
y
ea
r
s
o
ld
f
r
o
m
t
h
e
s
ec
o
n
d
g
r
ad
e
as
p
o
p
u
latio
n
.
T
h
e
s
ec
o
n
d
g
r
ad
e
w
as
c
h
o
s
e
n
b
ec
au
s
e
o
n
t
h
is
s
ta
g
e
th
e
teen
ag
er
s
ten
d
to
b
e
g
r
o
w
i
n
g
t
h
e
m
i
n
d
s
et
an
d
lear
n
a
lo
t
f
r
o
m
th
e
t
h
eir
en
v
ir
o
n
m
en
t,
it
w
i
ll
b
e
ea
s
y
to
in
f
o
r
m
th
e
m
ab
o
u
t
cli
m
ate
c
h
an
g
e
i
m
p
ac
t
o
n
h
u
m
a
n
h
ea
lt
h
s
i
n
ce
at
t
h
is
ag
e
t
h
e
tee
n
ag
er
s
h
av
e
m
a
n
y
q
u
e
s
tio
n
s
i
n
o
r
d
er
t
o
d
ev
elo
p
o
f
th
e
ir
p
r
io
r
i
ties
an
d
v
a
lu
e
[
1
2
]
.
W
e
to
o
k
9
5
s
tu
d
en
t
s
as
th
e
r
esp
o
n
d
en
t,
i
n
o
r
d
er
to
f
u
lf
i
ll
at
th
e
m
i
n
i
m
u
m
s
a
m
p
le
s
ize
r
e
q
u
ir
ed
f
o
r
th
is
s
t
u
d
y
w
h
ic
h
w
a
s
7
8
to
8
0
%
co
n
f
id
en
ce
i
n
ter
v
al.
T
h
e
ca
lcu
latio
n
w
as
p
er
f
o
r
m
ed
u
s
i
n
g
Statca
lc
-
E
p
iI
n
f
o
.
W
e
u
s
ed
Qu
o
ta
s
a
m
p
li
n
g
in
th
is
s
t
u
d
y
.
T
h
e
teac
h
er
c
h
o
s
e
t
h
e
s
tu
d
e
n
ts
’
d
ir
ec
tl
y
in
t
h
e
cla
s
s
r
an
d
o
m
l
y
u
n
ti
l th
e
q
u
o
ta
w
er
e
f
u
l
f
il
led
.
2
.
3
.
E
t
hica
l
co
ns
idera
t
io
n
T
h
e
r
esp
o
n
d
en
ts
w
er
e
p
lace
d
in
a
class
r
o
o
m
.
P
r
io
r
to
th
e
s
tu
d
y
,
w
e
i
n
tr
o
d
u
ce
d
th
e
s
tu
d
y
a
n
d
its
p
u
r
p
o
s
e
b
y
a
s
h
o
r
t
p
r
esen
tati
o
n
to
th
e
r
esp
o
n
d
en
ts
.
T
h
o
s
e
u
n
w
i
lli
n
g
to
p
ar
ticip
ate
w
er
e
f
r
ee
to
leav
e.
No
in
ter
ac
tio
n
a
m
o
n
g
r
esp
o
n
d
en
t
s
w
a
s
allo
w
ed
b
u
t
r
esp
o
n
d
en
ts
w
er
e
allo
w
ed
to
co
n
tact
t
h
e
r
esear
ch
er
w
h
en
th
e
y
f
ailed
to
u
n
d
er
s
ta
n
d
a
q
u
esti
o
n
.
2
.
4
.
Da
t
a
a
na
ly
s
is
Data
w
er
e
a
n
al
y
ze
d
u
s
in
g
SP
SS
s
tat
is
tical
s
o
f
t
w
ar
e
1
7
.
0
0
v
er
s
io
n
.
W
e
ap
p
lied
d
escr
ip
tiv
e
s
tat
is
tic
s
to
p
r
esen
t
q
u
an
titati
v
e
d
escr
ip
tio
n
s
o
f
t
h
e
v
ar
iab
les
(
Un
i
v
ar
i
ate
an
al
y
s
is
)
b
y
p
er
f
o
r
m
i
n
g
p
r
o
p
o
r
tio
n
,
m
ea
n
a
n
d
Stan
d
ar
d
Dev
iatio
n
(
SD)
f
o
r
ea
ch
q
u
est
io
n
.
3.
RE
SU
L
T
S
A
ND
D
I
SCU
SS
I
O
N
3
.
1
.
Resul
t
s
T
h
e
9
5
s
tu
d
en
t
s
w
er
e
s
elec
te
d
b
y
th
e
s
a
m
p
li
n
g
p
r
o
ce
d
u
r
e
all
o
f
th
e
m
ag
r
ee
d
to
p
ar
ticip
ate
o
n
th
is
r
esear
ch
.
A
t
t
h
e
en
d
o
f
d
ata
co
ll
ec
tio
n
,
w
e
clea
n
ed
u
p
th
e
d
ata
an
d
th
er
e
w
er
e
1
5
r
esp
o
n
d
en
t
s
d
r
o
p
p
e
d
o
u
t
f
r
o
m
th
is
r
esear
ch
b
ec
au
s
e
o
f
th
e
in
co
m
p
lete
an
s
w
er
.
8
0
r
es
p
o
n
d
en
ts
p
ar
ticip
atin
g
in
t
h
is
s
tu
d
y
ar
e
teen
a
g
er
s
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
P
HS
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N:
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terven
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269
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7
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f
r
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m
r
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Gu
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R
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ee
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ter
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R
esp
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w
er
e
d
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in
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m
ate
ch
a
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ch
an
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e,
t
h
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02
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5
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o
u
t
th
e
ca
u
s
e,
th
e
co
n
s
eq
u
en
ce
an
d
e
f
f
o
r
t
to
co
p
in
g
o
f
cli
m
ate
c
h
an
g
e
th
e
y
an
s
w
er
ed
m
o
s
t
l
y
r
e
s
p
o
n
d
en
t
s
an
s
w
er
ed
w
it
h
h
a
v
e
s
o
m
e
w
h
at
k
n
o
w
led
g
e
ab
o
u
t.
T
h
is
s
u
g
g
est
s
t
h
at
alth
o
u
g
h
r
esp
o
n
d
en
ts
u
n
d
er
s
ta
n
d
th
e
ter
m
in
o
lo
g
y
o
f
cli
m
ate
ch
a
n
g
e
th
e
y
d
o
n
’
t
u
n
d
er
s
tan
d
cli
m
a
te
ch
a
n
g
e
i
n
d
ep
th
.
T
h
e
m
a
j
o
r
it
y
o
f
r
esp
o
n
d
en
ts
e
x
p
lain
ed
cli
m
ate
c
h
a
n
g
e
as
ch
a
n
g
in
g
f
r
o
m
co
ld
to
h
o
t
o
r
th
e
ch
a
n
g
e
o
f
w
ea
t
h
er
; i
n
o
th
er
w
o
r
d
th
e
r
es
p
o
n
d
en
t k
n
o
w
led
g
e
li
m
ited
o
n
d
aily
cl
i
m
a
te
v
ar
iab
ilit
y
.
Mo
s
t
o
f
th
e
r
esp
o
n
d
en
ts
a
n
s
wer
ed
th
at
t
h
e
y
h
ad
f
elt
th
e
i
m
p
ac
t
o
f
c
li
m
ate
c
h
a
n
g
e
in
r
ec
en
t
d
a
y
s
;
t
h
e
te
m
p
er
atu
r
e
w
ea
t
h
er
w
a
s
h
o
tt
er
an
d
th
e
y
s
o
m
eti
m
es
h
ad
ex
p
er
ien
ce
d
ex
tr
e
m
e
w
ea
th
er
l
ik
e
to
r
n
ad
o
s
.
T
h
e
m
aj
o
r
ity
o
f
t
h
e
r
esp
o
n
d
en
ts
p
lace
d
th
e
s
er
io
u
s
n
e
s
s
le
v
el
o
f
cli
m
ate
ch
a
n
g
e
as
a
5
o
n
a
s
ca
le
f
r
o
m
1
to
1
0
.
Fu
r
t
h
er
m
o
r
e,
th
e
y
d
is
a
g
r
ee
d
w
it
h
t
h
e
s
tate
m
en
t t
h
at
cli
m
at
e
ch
an
g
e
ca
n
’
t b
e
s
to
p
p
ed
an
d
th
at
i
t is ca
u
s
ed
o
n
l
y
b
y
n
atu
r
al
p
r
o
ce
s
s
es.
I
t
m
ea
n
s
th
at
r
esp
o
n
d
en
ts
ar
e
alr
ea
d
y
a
w
ar
e
th
at
h
u
m
a
n
s
h
av
e
a
r
o
le
in
th
e
ch
a
n
g
in
g
o
f
th
e
cli
m
ate.
T
h
is
is
co
n
s
i
s
ten
t
w
it
h
t
h
e
f
in
d
i
n
g
s
b
y
t
h
e
E
n
v
ir
o
n
m
e
n
tal
P
r
o
tectio
n
A
g
e
n
c
y
(
E
P
A
)
[
1
6
]
an
d
T
h
e
I
n
ter
g
o
v
er
n
m
en
ta
l P
an
el
o
n
C
li
m
ate
C
h
a
n
g
e
(
I
P
C
C
)
th
at
cli
m
ate
ch
a
n
g
e
is
d
r
iv
e
n
b
y
h
u
m
an
ac
tiv
it
y
[
2
]
.
W
h
en
r
esp
o
n
d
e
n
ts
w
er
e
a
s
k
ed
ab
o
u
t
cli
m
a
te
ch
a
n
g
e
an
d
h
ea
lth
,
m
o
s
t
o
f
th
e
r
esp
o
n
d
en
t
s
a
g
r
ee
d
th
at
th
e
ch
a
n
g
i
n
g
cli
m
ate
h
ad
an
i
m
p
ac
t
o
n
h
u
m
a
n
h
ea
lt
h
,
p
ar
tic
u
lar
l
y
w
i
th
r
e
s
p
ec
t
to
ex
tr
e
m
e
w
ea
t
h
er
ev
e
n
t
s
an
d
in
f
ec
tio
u
s
d
is
ea
s
es.
I
n
G
u
n
u
n
g
k
id
u
l,
p
ar
ticu
lar
l
y
i
n
Ged
an
g
s
ar
i
s
u
b
d
is
tr
ict,
th
e
in
h
ab
ita
n
ts
h
as
b
ee
n
ex
p
o
s
ed
s
ev
er
al
ti
m
e
s
b
y
s
o
m
e
ex
tr
e
m
e
w
ea
t
h
er
e
v
en
ts
li
k
e
s
to
r
m
s
(
to
r
n
ad
o
s
)
an
d
lan
d
s
lid
es
d
u
e
t
h
e
h
ig
h
i
n
te
n
s
i
t
y
o
f
r
ain
f
al
l
[
1
7
]
,
[
1
8
]
.
B
u
t
r
esp
o
n
d
en
t
s
ap
p
ea
r
ed
n
o
t
to
u
n
d
er
s
tan
d
th
at
n
o
n
-
co
m
m
u
n
ic
ab
le
d
is
ea
s
es
lik
e
ca
r
d
io
v
ascu
lar
co
u
ld
b
e
ca
u
s
e
d
o
r
ag
g
r
a
v
ated
b
y
c
li
m
ate
c
h
an
g
e.
E
v
e
n
t
h
o
u
g
h
,
t
h
e
e
v
id
en
ce
s
tate
th
at
cli
m
ate
ch
an
g
e
w
ill t
h
r
ea
t
m
en
ta
l h
ea
l
th
[
1
9
]
,
[
2
0
]
,
r
esp
ir
ato
r
y
d
is
ea
s
e
[
2
1
]
,
ca
r
d
io
v
ascu
lar
d
is
ea
s
e
an
d
s
tr
o
k
e
[
6
]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
P
HS
I
SS
N:
2252
-
8806
C
lima
te
C
h
a
n
g
e
a
n
d
Hea
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h
Teen
a
g
er's P
ercep
tio
n
s
a
s
a
B
a
s
is
fo
r
I
n
terven
tio
n
s
(
S
u
lis
tya
w
a
ti)
271
On
e
i
n
ter
esti
n
g
f
i
n
d
i
n
g
f
r
o
m
t
h
is
r
esear
c
h
is
r
e
g
ar
d
in
g
th
e
i
n
f
o
r
m
atio
n
s
o
u
r
ce
s
t
h
at
tee
n
a
g
er
s
u
s
e
to
lear
n
ab
o
u
t
cli
m
ate
ch
a
n
g
e.
T
h
e
t
h
r
ee
to
p
r
an
k
in
g
s
o
u
r
ce
s
o
f
in
f
o
r
m
a
tio
n
c
h
o
s
e
n
b
y
th
e
r
esp
o
n
d
en
ts
w
er
e;
f
a
m
il
y
,
m
a
s
s
m
ed
ia
(
r
ad
io
an
d
telev
i
s
io
n
)
a
n
d
th
e
i
n
ter
n
e
t.
T
h
is
f
i
n
d
in
g
ca
n
g
u
id
e
d
ec
is
io
n
m
a
k
er
s
an
d
h
ea
lt
h
p
r
o
f
ess
io
n
al
s
w
h
en
d
eter
m
i
n
i
n
g
w
h
at
to
o
ls
an
d
m
et
h
o
d
s
to
u
s
e
to
co
m
m
u
n
icate
ab
o
u
t
cl
i
m
ate
c
h
a
n
g
e
w
it
h
y
o
u
n
g
p
eo
p
le
an
d
w
h
e
n
d
ev
el
o
p
in
g
s
tr
ate
g
ies
ai
m
in
g
to
in
c
r
ea
s
e
th
e
a
w
ar
e
n
ess
a
n
d
r
esil
ien
ce
o
f
th
e
y
o
u
n
g
co
m
m
u
n
it
y
to
w
it
h
s
ta
n
d
its
i
m
p
ac
ts
.
Fo
r
ex
a
m
p
le
co
u
n
s
elin
g
to
th
e
co
m
m
u
n
it
y
(
d
el
eg
atio
n
f
r
o
m
ea
ch
h
o
u
s
e
h
o
ld
)
ab
o
u
t
th
e
i
m
p
ac
t
o
f
cli
m
a
te
ch
a
n
g
e
o
n
h
ea
lth
ca
n
b
e
p
r
o
v
id
ed
[
2
2
]
.
A
n
o
th
er
s
t
r
ateg
y
w
o
u
ld
b
e
to
o
f
f
er
tr
ain
i
n
g
f
o
r
teen
a
g
er
s
i
n
clu
d
i
n
g
w
a
y
s
to
co
m
m
u
n
ic
ate
cli
m
ate
c
h
a
n
g
e
i
m
p
ac
t
s
o
n
h
u
m
a
n
h
ea
lt
h
to
h
o
u
s
e
h
o
ld
s
o
r
to
p
ee
r
g
r
o
u
p
;
d
if
f
er
en
t
w
a
y
s
u
s
i
n
g
t
h
e
m
a
s
s
m
ed
ia,
li
k
e
h
o
w
to
w
r
ite
in
ter
n
e
t
b
lo
g
s
an
d
d
eb
ates in
n
e
w
s
p
ap
er
s
a
n
d
/o
r
s
o
cial
m
ed
ia.
I
n
li
n
e
w
ith
t
h
is
t
h
e
r
o
le
o
f
ad
o
lescen
ts
as
p
r
o
m
o
ter
s
i
n
th
e
h
ea
lt
h
s
ec
to
r
h
a
s
b
ee
n
tes
ted
i
n
T
an
za
n
ia
f
o
r
HI
V
A
I
DS
p
r
ev
en
t
io
n
[
2
3
]
w
it
h
g
o
o
d
r
esu
lts
w
h
ic
h
co
u
ld
also
b
e
ap
p
lied
in
th
is
co
n
te
x
t.
T
h
e
h
y
p
o
th
esi
s
f
r
o
m
th
i
s
s
tu
d
y
i
s
t
h
at
y
o
u
n
g
p
eo
p
le
n
ee
d
t
o
b
e
i
n
f
o
r
m
ed
ab
o
u
t
cli
m
ate
c
h
an
g
e
an
d
i
ts
i
m
p
ac
ts
o
n
h
u
m
a
n
h
ea
lt
h
an
d
th
a
t
s
h
o
u
ld
b
e
s
p
r
ea
d
v
ia
in
ter
n
et,
m
a
g
az
i
n
es,
n
e
w
s
p
ap
er
s
,
tele
v
is
io
n
,
r
ad
io
an
d
o
th
er
m
a
s
s
m
ed
ia
to
in
cr
ea
s
e
th
e
u
n
d
er
s
ta
n
d
in
g
o
f
t
h
e
tee
n
a
g
er
s
[
2
4
]
.
Ma
n
y
s
t
u
d
ies
h
a
v
e
f
o
u
n
d
t
h
at
t
ee
n
ag
er
s
ar
e
ea
s
il
y
af
f
ec
ted
b
y
tele
v
is
io
n
a
n
d
i
n
t
er
n
et
(
m
ass
m
ed
ia)
[
2
5
]
.
C
o
n
s
eq
u
en
tl
y
,
w
e
p
r
o
p
o
s
e
to
e
m
p
o
w
er
tee
n
ag
er
s
as
ag
en
t
s
o
f
ch
a
n
g
e
to
an
ticip
ate
an
d
co
m
m
u
n
ica
te
t
h
e
i
m
p
ac
t
o
f
cli
m
ate
c
h
an
g
e
o
n
h
ea
l
th
.
T
h
is
w
o
u
ld
b
en
e
f
it
s
o
ciet
y
a
s
t
h
e
y
ar
e
i
m
p
o
r
tan
t
ag
en
t
s
t
h
at
ca
n
b
o
th
i
n
s
p
ir
e
p
o
s
itiv
e
c
h
a
n
g
e
s
i
n
t
h
e
co
m
m
u
n
it
y
,
s
u
ch
s
t
u
d
y
i
n
HI
V
A
I
DS b
y
u
s
in
g
y
o
u
t
h
as
ag
en
t o
f
ch
a
n
g
e
[
2
6
]
.
Un
l
u
ck
i
l
y
,
t
h
is
s
tu
d
y
is
li
m
it
ed
b
y
th
e
lo
w
n
u
m
b
er
o
f
r
es
p
o
n
d
en
ts
an
d
t
h
e
co
n
v
e
n
ie
n
c
e
s
a
m
p
le.
Hen
ce
,
t
h
e
r
es
u
lts
m
u
s
t
b
e
i
n
t
er
p
r
eted
w
i
th
s
o
m
e
ca
u
t
io
n
.
Ho
w
e
v
er
th
e
y
g
e
n
er
ate
h
y
p
o
t
h
ese
s
w
h
ich
th
r
o
u
g
h
d
is
cu
s
s
io
n
w
it
h
alr
ea
d
y
e
x
is
t
i
n
g
e
v
id
e
n
ce
i
n
t
h
is
f
ield
ca
n
g
u
id
e
t
h
e
cr
ea
tio
n
o
f
i
n
ter
v
en
tio
n
s
tr
ate
g
ie
s
.
A
s
th
er
e
ar
e
n
o
s
u
ch
p
r
ev
io
u
s
s
t
u
d
ies
in
So
u
th
E
ast
A
s
ia
th
i
s
s
tu
d
y
ca
n
s
er
v
e
as
a
s
tar
tin
g
p
o
in
t
f
o
r
d
esig
n
i
n
g
in
ter
v
e
n
tio
n
s
tr
ate
g
ies a
n
d
f
o
r
f
u
tu
r
e
r
esear
ch
.
4.
CO
NCLU
SI
O
N
I
n
s
u
m
m
ar
y
,
c
li
m
ate
ch
a
n
g
e
p
er
ce
p
tio
n
s
a
m
o
n
g
t
h
is
s
a
m
p
le
o
f
teen
a
g
er
s
ca
n
b
e
ca
teg
o
r
ized
as
in
ter
m
ed
iate.
T
h
e
y
w
er
e
a
w
a
r
e
o
f
h
u
m
a
n
ac
ti
v
itie
s
a
s
t
h
e
m
ai
n
ca
u
s
e
o
f
cli
m
ate
ch
a
n
g
e,
w
er
e
r
at
h
er
w
el
l
a
w
ar
e
o
f
t
h
e
i
m
p
licatio
n
s
f
o
r
h
u
m
a
n
h
ea
lt
h
.
Ho
w
ev
er
,
t
h
e
y
b
eliev
e
t
h
at
t
h
e
cli
m
ate
ch
a
n
g
e
p
r
o
ce
s
s
ca
n
s
to
p
,
th
is
s
tate
m
en
t
b
e
s
u
p
p
o
r
ted
b
y
th
e
n
ex
t
s
tate
m
en
t
th
at
m
o
s
tl
y
o
f
r
esp
o
n
d
en
t
ag
r
ee
t
h
at
th
e
y
ca
n
d
o
s
o
m
e
t
h
i
n
g
to
s
to
p
clim
ate
ch
a
n
g
e
p
r
o
ce
s
s
.
T
ee
n
ag
er
s
ca
n
b
e
g
o
o
d
ag
en
ts
o
f
ch
an
g
e
[
2
7
]
to
p
r
ev
en
t
th
e
i
m
p
ac
t
o
f
cli
m
at
e
ch
an
g
e
o
n
h
u
m
an
h
ea
lth
b
ec
a
u
s
e
teen
a
g
er
s
h
av
e
i
n
ef
f
ec
ti
v
e
in
ter
p
er
s
o
n
al
co
m
m
u
n
icatio
n
s
k
i
lls
[
2
8
]
an
d
ar
e
also
o
p
en
m
in
d
ed
(
ea
s
i
l
y
in
f
l
u
en
ce
d
b
y
e
x
ter
n
a
l
f
ac
to
r
s
)
.
C
o
n
s
eq
u
e
n
tl
y
,
t
h
i
s
w
il
l
b
e
b
en
e
f
i
cial
to
i
m
p
r
o
v
e
th
e
teen
ag
er
’
s
p
er
ce
p
tio
n
r
e
g
ar
d
in
g
cl
i
m
a
te
ch
a
n
g
e
i
m
p
ac
t
o
n
h
u
m
a
n
h
ea
lth
.
T
o
p
r
ev
en
t
t
h
e
i
m
p
ac
t
o
f
cl
i
m
ate
ch
an
g
e
o
n
h
ea
lt
h
b
y
u
s
i
n
g
teen
ag
er
s
as
ag
e
n
t
s
o
f
ch
an
g
e
w
e
p
r
o
p
o
s
e
to
f
ac
il
itate
in
ter
p
er
s
o
n
a
l
co
m
m
u
n
icatio
n
s
k
i
ll
b
y
d
esi
g
n
i
n
g
an
d
co
n
d
u
ct
in
g
tr
ain
i
n
g
p
r
o
g
r
a
m
m
e
s
[
2
8
]
.
Fo
r
ex
am
p
le,
w
e
s
u
g
g
e
s
t
in
v
o
l
v
i
n
g
tee
n
ag
er
s
i
n
s
h
o
r
t
co
u
r
s
es
a
n
d
co
m
m
u
n
it
y
ca
m
p
aig
n
s
,
o
r
i
n
clu
d
i
n
g
i
n
f
o
r
m
a
tio
n
ab
o
u
t
cli
m
ate
ch
an
g
e
an
d
it
s
s
h
o
r
t
-
an
d
lo
n
g
ter
m
i
m
p
a
ct
s
in
t
h
e
s
c
h
o
o
l c
u
r
r
icu
lu
m
.
ACK
NO
WL
E
D
G
E
M
E
NT
S
T
h
is
s
tu
d
y
w
as
f
in
a
n
ce
d
b
y
t
h
e
Facu
lt
y
o
f
P
u
b
lic
Hea
lt
h
,
Ah
m
ad
Dah
la
n
U
n
iv
er
s
it
y
,
Y
o
g
y
a
k
ar
ta,
I
n
d
o
n
esia.
T
h
e
au
t
h
o
r
s
ar
e
g
r
ate
f
u
l
to
all
civ
i
tas
ac
ad
e
m
i
c
o
f
v
o
ca
tio
n
al
s
e
n
io
r
h
i
g
h
s
ch
o
o
l
o
f
SM
K
1
Ged
an
g
s
a
r
i,
Gu
n
u
n
g
k
id
u
l
f
o
r
s
u
cc
ee
d
i
n
g
s
u
r
v
e
y
.
RE
F
E
R
E
NC
E
S
[1
]
S
a
tt
e
rth
w
a
it
e
D.
,
“
Cli
m
a
te
Ch
a
n
g
e
a
n
d
Urb
a
n
iza
ti
o
n
:
Ef
f
e
c
ts
a
n
d
Im
p
li
a
c
ti
o
n
s
f
o
r
Urb
a
n
G
o
v
e
r
n
a
n
c
e
,”
Un
it
e
d
Na
ti
o
n
s
Exp
e
rt
Gr
o
u
p
M
e
e
ti
n
g
o
n
Po
p
u
l
a
ti
o
n
Distrib
u
ti
o
n
,
Ur
b
a
n
iza
ti
o
n
,
In
ter
n
a
l
M
ig
ra
ti
o
n
a
n
d
De
v
e
lo
p
me
n
t
,
Ne
w
Yo
rk
,
2
1
-
2
3
Ja
n
u
a
ry
2
0
0
8
.
[2
]
W
HO
,
“
Co
m
m
e
n
t
Cli
m
a
te
Ch
a
n
g
e
A
n
d
He
a
lt
h
:
o
n
t
h
e
L
a
tes
t
IP
CC
Re
p
o
rt
,”
E
lse
v
e
ir
,
v
o
l/
issu
e
:
6
7
3
6
(1
4
)
,
p
p
.
1
–
5
,
2
0
1
4
.
[3
]
A
n
d
e
rso
n
J
.
,
Ba
u
sc
h
C.
,
“
Cli
m
a
te
Ch
a
n
g
e
a
n
d
Na
tu
ra
l
Disa
ste
rs:
S
c
ien
ti
f
ic
e
v
id
e
n
c
e
o
f
a
p
o
ss
ib
le
r
e
latio
n
b
e
tw
e
e
n
re
c
e
n
t
n
a
tu
r
a
l
d
isa
ste
rs
a
n
d
c
li
m
a
te
c
h
a
n
g
e
,”
L
o
n
d
o
n
,
2
0
0
6
.
C
o
rv
a
lan
C,
Ha
les
S
,
M
c
M
ich
a
e
l
A
.
,
“
Eco
sy
st
e
m
s
a
nd
Hu
m
a
n
Well
-
Be
in
g
:
He
a
lt
h
S
y
s
n
th
e
sis
,”
G
e
n
e
v
a
,
2
0
0
5
.
[4
]
Co
rv
a
lan
C
.
,
Ha
les
S
.
,
M
c
M
ich
a
e
l
A
.
,
“
Eco
s
y
ste
m
s
a
n
d
Hu
m
a
n
Well
-
Be
in
g
:
H
e
a
lt
h
S
y
sn
th
e
sis
,”
Ge
n
e
v
a
,
2
0
0
5
.
[5
]
Ka
lt
e
n
b
a
c
h
M
.
,
M
a
sc
h
k
e
C
.
,
Kli
n
k
e
R.
,
“
He
a
lt
h
Co
n
se
q
u
e
n
c
e
s o
f
Cli
m
a
te Ch
a
n
g
e
,”
L
o
n
d
o
n
,
2
0
0
8
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8806
I
J
P
HS
Vo
l.
5
,
No
.
3
,
Sep
tem
b
er
201
6
:
2
6
7
–
2
7
3
272
[6
]
P
o
rti
e
r
C
.
J
.
,
T
h
ig
p
e
n
T
.
K
.
,
Ca
rter
S
.
R
.
,
e
t
a
l.
,
“
A
Hu
m
a
n
He
a
lt
h
P
e
rsp
e
c
ti
v
e
On
C
li
m
a
te
Ch
a
n
g
e
:
A
Re
p
o
rt
Ou
tl
in
i
n
g
th
e
Re
se
a
rc
h
Ne
e
d
s
o
n
th
e
Hu
m
a
n
He
a
lt
h
Eff
e
c
ts
o
f
Cli
m
a
te
Ch
a
n
g
e
.
Re
se
a
rc
h
T
ri
a
n
g
le
P
a
rk
,
”
NC:
En
v
iro
n
m
e
n
tal
He
a
lt
h
P
e
rsp
e
c
ti
v
e
s/N
a
ti
o
n
a
l
I
n
stit
u
te
o
f
En
v
iro
n
m
e
n
tal
He
a
lt
h
S
c
ien
c
e
s
,
2
0
1
0
.
d
o
i:
1
0
.
1
2
8
9
/eh
p
.
1
0
0
2
2
7
2
A
v
a
il
a
b
le:
ww
w
.
n
ieh
s.n
i
h
.
g
o
v
/clim
a
tere
p
o
rt.
[7
]
Ha
in
e
s
A
.
,
Ko
v
a
ts
R
.
S
.
,
Ca
m
p
b
e
ll
L
.
D
.
,
Co
rv
a
lan
C.
,
“
Cli
m
a
te
c
h
a
n
g
e
a
n
d
h
u
m
a
n
h
e
a
lt
h
:
im
p
a
c
ts,
v
u
ln
e
ra
b
il
it
y
a
n
d
p
u
b
li
c
h
e
a
lt
h
,”
Pu
b
li
c
He
a
lt
h
,
v
o
l/
issu
e
:
1
2
0
(7
)
,
p
p
.
5
8
5
–
96
,
2
0
0
6
.
A
v
a
il
a
b
le
f
ro
m
:
h
tt
p
:
//
ww
w
.
n
c
b
i.
n
lm
.
n
ih
.
g
o
v
/p
u
b
m
e
d
/1
6
5
4
2
6
8
9
.
[8
]
Ep
ste
in
P
.
R.
,
“
Cli
m
a
te
c
h
a
n
g
e
a
n
d
e
m
e
rg
in
g
in
f
e
c
ti
o
u
s
d
ise
a
se
s
,”
M
icr
o
b
e
s
In
fec
ti
o
u
s
,
v
o
l/
iss
u
e
:
3
(9
)
,
p
p
.
7
4
7
–
54
,
2
0
0
1
.
A
v
a
il
a
b
le f
ro
m
:
h
tt
p
:/
/www
.
n
c
b
i.
n
lm
.
n
i
h
.
g
o
v
/p
u
b
m
e
d
/1
1
4
8
9
4
2
3
.
[9
]
Ox
f
o
rd
Un
iv
e
rsit
y
P
re
ss
,
“
Tee
n
a
g
e
rs
[
In
tern
e
t
]
,”
W
e
b
.
2
0
1
5
[
c
it
e
d
2
0
1
5
A
u
g
2
8
]
.
p
.
1
.
Av
a
il
a
b
le
f
ro
m
:
h
tt
p
s:/
/www
.
g
o
o
g
le.c
o
.
id
/w
e
b
h
p
?
so
u
rc
e
id
=
c
h
ro
m
e
-
in
sta
n
t&io
n
=
1
&
e
sp
v
=
2
&
ie=
UT
F
-
8
#
q
=
a
d
o
les
c
e
n
t
.
[1
0
]
A
d
o
les
c
e
n
t
He
a
lt
h
Co
m
m
it
tee
,
“
Ag
e
li
m
it
s
a
n
d
a
d
o
les
c
e
n
ts
,”
Pa
e
d
ia
tric
Ch
il
d
He
a
l
,
v
o
l/
iss
u
e
:
8
(9
)
,
p
p
.
9
3
9
7
,
2
0
0
3
.
[1
1
]
Ng
N.
,
“
P
e
rc
e
p
ti
o
n
a
b
o
u
t
c
l
im
a
te
c
h
a
n
g
e
a
n
d
th
e
r
o
le
o
f
h
e
a
lt
h
p
r
o
f
e
ss
io
n
a
ls:
A
p
il
o
t
stu
d
y
i
n
Yo
g
y
a
k
a
r
ta
P
r
o
v
in
c
e
,”
Yo
g
y
a
k
a
rta
,
2
0
1
3
.
[1
2
]
P
u
b
l
ic
He
a
lt
h
A
g
e
n
c
y
o
f
Ca
n
a
d
a
,
“
A
RCHIV
ED
-
Be
c
a
u
se
L
i
fe
Go
e
s
On
.
He
lp
i
n
g
Ch
il
d
re
n
a
n
d
Y
o
u
t
h
L
iv
e
W
it
h
S
e
p
a
ra
ti
o
n
a
n
d
Div
o
rc
e
-
S
e
c
t
io
n
4
[
I
n
tern
e
t
]
,”
W
e
b
.
2
0
1
5
[
c
it
e
d
2
0
1
5
A
u
g
2
4
]
.
p
.
1
.
A
v
a
il
a
b
le
f
ro
m
:
h
tt
p
:
//
ww
w
.
p
h
a
c
-
a
sp
c
.
g
c
.
c
a
/p
u
b
li
c
a
t/
m
h
-
s
m
/d
iv
o
rc
e
/4
-
e
n
g
.
p
h
p
.
[1
3
]
F
u
ss
e
l
H
.
M.
,
“
W
h
o
is
m
o
st
a
ffe
c
ted
b
y
th
e
im
p
a
c
t
o
f
c
li
m
a
te
c
h
a
n
g
e
,”
i
n
:
L
u
d
e
rm
a
n
n
B,
e
d
it
o
r
,
“
Cli
m
a
te
Ch
a
n
g
e
a
n
d
P
o
v
e
rty
:
A
c
h
a
ll
e
n
g
e
f
o
r
a
fa
ir
w
o
rld
p
o
li
c
y
,”
F
ra
n
k
f
u
rt
,
W
e
lt
S
ich
ten
,
p
p
.
7
–
8
,
2
0
0
8
.
[1
4
]
Co
rre
c
t
c
it
a
ti
o
n
:
V
e
rm
e
u
len
S
.
J.
,
“
Cli
m
a
te
c
h
a
n
g
e
,
f
o
o
d
se
c
u
rit
y
a
n
d
sm
a
ll
-
sc
a
le
p
ro
d
u
c
e
rs.
CCAFS
In
f
o
Brief
.
CG
I
A
R
,”
Res
e
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ric
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rity (
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v
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li
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e
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t:
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c
c
a
f
s.cg
iar.o
rg
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5
]
In
tern
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ti
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l
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n
e
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y
Ag
e
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y
,
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Cli
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ter
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p
r
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tt
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[1
6
]
EP
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,
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tern
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r
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[1
7
]
S
u
n
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rt
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o
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A
n
g
in
p
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ti
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g
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5
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m
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h
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ra
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a
rian
Jo
g
ja,
S
o
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o
s [
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tern
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]
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u
n
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0
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l
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p
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ro
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tt
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8
]
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u
h
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rj
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n
o
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n
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n
sh
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DIY
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ra
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in
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o
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n
tern
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u
n
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4
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.
[1
9
]
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n
n
a
E
.
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.
,
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ll
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m
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.
,
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n
n
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tt
C
.
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r
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,
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Cli
m
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te
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h
a
n
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e
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n
d
risi
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e
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t:
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lati
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n
A
u
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P
a
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p
p
l)
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p
p
.
1
4
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–
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0
1
1
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0
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Na
ti
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ter
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iro
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late
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tt
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lt
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1
]
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m
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ise
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ro
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ira
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p
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–
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v
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m
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tt
p
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c
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lm
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2
]
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K
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lo
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m
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l/
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e
:
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p
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e
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le f
ro
m
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tt
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d
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7
9
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4
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3
]
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m
o
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rlso
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.
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IDS
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p
p
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0
1
–
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0
8
.
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4
]
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k
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d
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.
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m
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th
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.
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u
t
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r
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rn
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l
Of
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ma
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it
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An
d
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ia
l
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e
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v
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l/
issu
e
:
1
0
(
1
)
,
p
p
.
37
–
43
,
2
0
1
3
.
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5
]
IOM
(In
stit
u
te
o
f
M
e
d
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e
)
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n
d
NRC
(Na
ti
o
n
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l
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u
n
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)
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d
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t
Risk
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T
a
k
in
g
:
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rk
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p
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p
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rt
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m
m
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e
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l
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c
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d
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ies
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re
ss
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2
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1
.
[2
6
]
P
e
a
rlm
a
n
D
.
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.
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m
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e
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L
.
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y
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o
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rn
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l
Of
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o
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lt
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v
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issu
e
:
3
1
(
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p
p
.
31
–
9
,
2
0
0
2
.
[2
7
]
Bu
rk
e
A
.
,
Hu
g
h
e
s
J
.
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rd
w
a
r
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S
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.
,
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u
e
1
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2
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u
c
M
a
tt
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l/
issu
e
:
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(
2
)
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p
p
.
65
–
87
,
2
0
1
3
.
[2
8
]
G
ro
b
ler
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.
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y
b
u
rg
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.
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.
,
P
o
g
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p
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in
ter
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l
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o
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m
u
n
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p
a
tt
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s
,”
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ra
ti
o
n
is
,
v
o
l/
issu
e
:
2
2
(4
)
,
p
p
.
35
–
40
,
1
9
9
9
.
Evaluation Warning : The document was created with Spire.PDF for Python.
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.
Evaluation Warning : The document was created with Spire.PDF for Python.