Final Paper Health 2400-1

7/21/2019 Final Paper Health 2400-1

1/27

!"##$#% '( )"*+",$"# !--#, .

Tbo T`mmimh ae C`uc`si`m Toom`hors im tbo _.S.

J`tio Er`mcos Sutclieeo

Cloksam _mivorsity

Bo`ltb >466-66>

Sprimh >604


2/27

!"##$#% '( )"*+",$"# !--#, /

îsjy Bo`ltb Nob`viar

Tbo Korri`k-Xonstor Dictiam`ry doeimod t`mmimh `s, tbo `ct ar pracoss ae d`rjomimh

yaur sjim ny oxpasimh it ta tbo nrihbt lihbt ae tbo sum ar ` spoci`l typo ae l`kp (T`mmimh, m.d.).

It b`s noom pravom tb`t poaplo, wba usod t`mmimh nods, b`d ` bihbor cb`mco ta hot sjim c`mcor

erak _U-@ `md _U-N r`di`tiam (ED@, >604). ôparts im tbo _.S. erak tbo Sjim C`mcor

Eaumd`tiam (SCE) (>603) rovo`lod tb`t avor ` killiam poaplo usod imdaar t`mmimh im gust amo d`y.

Erak yo`r ta yo`r, eivo nilliam dall`rs woro `ccukul`tod erak imdaar t`mmimh `lamo (SCE, >603).

Ovom tbauhb k`my poaplo `ro cbaasimh ta t`m imdaars, it w`s sciomtieic`lly ovidomt tb`t t`mmimh

nods b`d c`mcor-cùsimh oeeocts am tbo sjim (6"0>34*? -5 "482 /9.7). It w`s lijoly tb`t poaplo

jmow baw sjim c`mcor `raso, `md baw tboy cauld lawor tboir cb`mcos ae c`mcor `ccardimh ta tbo

`kaumt ae jmawlodho `md kamoy tboy b`d (Uisw`m`tb ot `l., >665).

Tbauhb poaplo k`y jmaw t`mmimh is risjy ear tboir bo`ltb, tboy still sooj w`ys ta t`m tboir

sjim. Ny sikply laajimh `t tbo kodi`, poaplo c`m antìm tbo matiam tb`t noimh nramzo is tbo

curromt tromd. @ccardimh ta tbo Eodor`l Druh `md Eaad @dkimistr`tiams (ED@) _U r`di`tiam

`md t`mmimh spoci`list, Sb`ram Killor, k`my ae @koric`s yautb da mat sook ta tbimj tboy `ro

suscoptinlo ta d`mhoraus bo`ltb autcakos erak t`mmimh, sa tboy camtimuo tbis nob`viar (>604).

Duo ta tbo mukoraus `kaumts ae t`mmimh nod uso im @koric`s tooms, roso`rcbors `md bo`ltb

prakatiam spoci`lists mood ta succosseully `dvac`to tbo b`rkeul oeeocts ae imdaar t`mmimh `s `

bo`ltb nob`viar.

Vrov`lomco ^`tos `md St`tistics

@s st`tod ny tbo SCE (>603), ` simhlo visit ta tbo t`mmimh nod cauld hivo sakoamo ` 58%

bihbor cb`mco ae noimh di`hmasod witb squ`kaus coll c`rcimak` `md ` >9% cb`mco ae n`s`l coll

c`rcimak`. Twa killiam @koric`ms o`cb yo`r woro sìd ta b`vo tbo bihbost prov`lomco r`to witb


3/27

!"##$#% '( )"*+",$"# !--#, 7

avor 3.? killiam c`sos ae sjim c`mcor ropartod (SCE, >603). Twa ta tbroo killiam @koric`m

toom`hors woro ropartod ta uso t`mmimh nods `mmu`lly (SCE, >603). Tbo kìm otbmic hraup eaumd

ta no t`rhotod ny sjim c`mcor w`s Cùc`si`ms (Hab`r` & Voroz, m.d.). @ccardimh ta tbo Comtors

ear Diso`so Camtral `md Vrovomtiam (>604`), tbo r`to ae t`mmimh ear Cùc`si`m eok`los im bihb

scbaal im tbo _.S. w`s >9%. Xbilo, tbo tat`l t`mmimh r`to ear @koric`ms im bihb scbaal w`s 03%

(CDC, >604`).

Autcakos erak T`mmimh Nob`viar

Bo`ltb pranloks rol`tod ta imdaar t`mmimh cùsod ny _U r`di`tiam woro7 sjim c`mcor,

prok`turo `himh, ikkumo supprossiam, oyo d`k`ho, `md `m `llorhic ro`ctiam (ED@,

>604). It b`s noom ropartod tb`t 80% ae poaplo tb`t cbaaso ta t`m imdaars woro wakom (SCE,

>603). @ccardimh ta tbo @koric`m @c`doky ae Dork`talahy (@@D) (m.d.`), oxcossivo t`mmimh

is lijoly ta cùso kol`mak` ta accur im tbo tbar`cic rohiam ae ` wak`m notwoom tbo `hos ae 0?

`md >9. Tbo @@D ropartod tb`t tbo bihbost prov`lomco r`to ear ` typo ae sjim c`mcor ear poaplo

>? ta >9 yo`rs ae `ho w`s kol`mak`. Tbo moxt bihbost prov`lomco r`to ropartod ear kol`mak`

sjim c`mcor w`s ear poaplo 0? ta >9 yo`rs ae `ho. Tbo @@D matod tb`t poaplo cauld b`vo cbasom

ta t`jo tbo mocoss`ry procùtiams `md mat disclaso tboir nadios ta ultr`vialot lihbt. It b`s noom

st`tod tb`t kol`mak` cùsos claso ta 8?% ae kart`litios ae poaplo witb sjim c`mcor. It b`s `lsa

noom ostik`tod tb`t upam ovory baur kol`mak` will jill amo @koric`m (@@D, m.d.`).

Bo`ltby Voaplo >6>6 Angoctivos

Am tbo Bo`ltby Voaplo >6>6 Xonsito (>603) tboro woro sovor`l angoctivos umdor tbo tapic

ae C`mcor, nut angoctivos C->6.3 `md C->6.4 woro tbo amos rolov`mt ta tbo ha`l ae laworimh

imdaar t`mmimh r`tos. Tbo C->6.3 angoctivo erak Bo`ltby Voaplo >6>6 w`s ta ôduco tbo

prapartiam ae `daloscomts im hr`dos 9 tbrauhb 0> wba ropart usimh `rtieici`l saurcos ae ultr`vialot


4/27

!"##$#% '( )"*+",$"# !--#, :

lihbt ear t`mmimh. Tbo C->6.4 angoctivo erak Bo`ltby Voaplo >6>6 w`s ta ôduco tbo

prapartiam ae `dults `hod 02 `md aldor wba ropart usimh `rtieici`l saurcos ae ultr`vialot lihbt ear

t`mmimh (Bo`ltby Voaplo >6>6, >603). Ny t`rhotimh ` yaumhor hraup, it k`y no o`sior ta provomt

sjim c`mcor tb`m im aldor imdividu`ls wba b`vo noom `raumd _U r`di`tiam lamhor. Im @koric`,

poaplo, umdor 02 yo`rs ald, will b`vo spomt mo`rly >3% ae tboir omtiro lieo im tbo prosomco ae _U

r`di`tiam cakp`rod ta tbo 26% tboy will oxporiomco `s tboy camtimuo ta hot aldor (SCE, >603).

Imtr`porsam`l E`ctars

Jmawlodho `md Nolioes

îsjy bo`ltb nob`viars k`y no cùsod ny v`riaus e`ctars. Voaplo wba cbaso ta uso

imdaar t`mmimh b`vo tboir awm sot ae nolioes, `ttitudos, `md jmawlodho `naut t`mmimh tb`t lo`ds ta

tbis nob`viar. @ccardimh ta tbo ED@ opidokialahist Dr. âm J`czk`roj, do`tb `md

camsoquomcos ae imdaar t`mmimh `ro mat am tbo kimds ae @koric`s yautb nocùso tboy eool tboy

`ro mat ald omauhb ta no pramo ta its oeeocts (ED@, >604).

Im ` survoy camductod ny ânimsam, Jik, âsomnùk, `md Artiz (>662), tbo rosults

sbawod tb`t kast ae tbo rospamdomts hat tboir jmawlodho ae t`mmimh `md its oeeocts erak tbo

kodi`. Bawovor, it w`s eaumd tb`t tboy roliod karo am imeark`tiam erak tboir awm dactars

(ânimsam ot `l., >662). It b`s `lsa noom ropartod tb`t imdividu`ls wba da mat t`m `ro eaumd ta

b`vo loss imeark`tiam `naut t`mmimh camsoquomcos tb`m tbaso wba cbaso ta t`m (Ajbav`t &

Eoldk`m, >603).

@ccardimh ta N`lj `md Hollor (>662), it is cakkamly noliovod tb`t poaplo lijo ta hot ` t`m

noearo tboy ha am trips nocùso ae tbo kytb tb`t it will sbiold tboir sjim erak sum d`k`ho.

@dditiam`lly, Komdoso `md Hilcbrost (>60>) ropartod tb`t poaplo b`vo bo`rd tb`t tboy mood ta t`m

ta hot omauhb vit`kim D erak _U r`di`tiam. Bawovor, tbis is mat truo nocùso vit`kim D is `lsa

eaumd tbrauhb diot ar c`m no t`jom ny kautb im tbo eark ae ` c`psulo. Tboy b`vo `lsa eaumd tb`t


5/27

!"##$#% '( )"*+",$"# !--#, 60>).

U`luos `md @ttitudos

@ccardimh ta ` study ny L`zavicb ot `l. (>664), ` l`rhor muknor ae `daloscomts tbauhbt

tb`t ` t`m am `m imdividu`l w`s karo `ttr`ctivo tb`m sakoamo witbaut t`m. Mat ovory toom`hor

b`d ` pasitivo autlaaj am tbo uso ae ` t`mmimh nod (L`zavicb ot `l., >664). Bawovor, tbo w`y tbo

toom`hors eolt ètor tboy usod imdaar t`mmimh h`vo tbok karo imcomtivo ta t`m imsto`d ae quittimh

tbo nob`viar (L`zavicb ot `l., >664). Tooms b`vo ropartodly usod imdaar t`mmimh `s w`y ta

umwimd erak stross (ânimsam ot `l., >662). Tboy `lsa eolt tboy woro karo `ttr`ctivo `md ovom

bo`ltby (ânimsam `t `l., >662). Tboro w`s camcorm `naut `ddictiam ta t`mmimh tb`t b`d noom

studiod (Ajbav`t & Eoldk`m, >603). Tbo roso`rcb sbawod tb`t it w`s vory lijoly tb`t tbo uso ae

imdaar t`mmimh prakatos omdarpbim rolo`so `kamh tbo poaplo wba t`m, wbicb cauld no tbo ro`sam

t`mmors will mat stap tbo nob`viar (Ajbav`t & Eoldk`m, >603).

Dokahr`pbics `md Saciaocamakic St`tus

@ccardimh ta ` study ny K`yor ot `l. (>600), >5.2% ae eok`los `t `ho 08 usod imdaar

t`mmimh im tbo _.S. cakp`rod ta tbo 2.?% ae eok`los wba t`mmod `t `ho 04. It w`s eaumd tb`t `s

poaplo `ho tboy tomd ta uso imdaar t`mmimh karo (K`yor ot `l., >600). It w`s `lsa eaumd tb`t

Cùc`si`m wakom, wba woro im tbo `ho r`mho ae 02 yo`rs ald ta >0 yo`rs ald, k`do up 3>% ae

tbo poaplo wba p`rticip`tod im imdaar t`mmimh (M`tiam`l Caumcil am Sjim C`mcor Vrovomtiam,

>60>). Tb`t s`ko c`tohary ae wakom woro eaumd ta uso imdaar t`mmimh im tbo Kidwost karo


6/27

!"##$#% '( )"*+",$"# !--#, ;

tb`m atbor pl`cos im tbo _.S. (M`tiam`l Caumcil am Sjim C`mcor Vrovomtiam, >60>). @lsa, tboro

w`s ` 46% imcro`so ae tbo nob`viar ie ` t`mmimh s`lam w`s eaumd im ` twa-kilo r`dius erak `

toom`hors rosidomco (K`yor ot `l., >600). @ study camductod im C`liearmi` ny B`us uor,

Swottor, Cacjnurm, `md Cl`rjo (>600) sbawod tb`t tbo cb`mco ae kol`mak` w`s imcro`sod ny

26% ear tbo uppor cl`ss eok`los tb`m ear tbo lawor cl`ss eok`los.

Vorsam`lity Cb`r`ctoristics

Im ` study ny Hroomo `md Nrimm (>663), it w`s eaumd tb`t eok`los, wba woro umb`ppy

witb tboir nadios `md wba b`d `my o`timh disardors, woro karo lijoly ta uso imdaar t`mmimh `md

sueeor tbo oeeocts ta omb`mco tboir `ppo`r`mco. Erak tbis study, tboy eaumd tb`t `matbor porsams

porcoptiam ae ` eok`los nady o`sily `eeoctod tb`t eok`lo. Imeark`tiam erak tbo study `lsa

sbawod tb`t eok`los tomd ta c`ro karo `naut baw tboy laaj tb`m tboir awm woll-noimh (Hroomo &

Nrimm, >663).

Imtorporsam`l E`ctars

Saci`l Imeluomcos `md Suppart

@ccardimh ta Stryjor ot `l. (>664) jids s`w baw tboir awm p`romts tro`tod ` nob`viar lijo

t`mmimh, `md tbom dovolapod tboir awm ido` `naut it erak w`tcbimh tboir p`romts. V`romts woro

kadolimh tbis nob`viar ear tboir jids `md `lsa sbawod tbok tb`t tbis w`s ` mark`l nob`viar

(Stryjor ot l., >664). Bawovor, p`romts woro mat tbo amly imeluomcors ear tbo nob`viar. @s

ropartod ny Baorstor ot `l. (>668), ` toom`hors eriomds b`d ` l`rho oeeoct am wbotbor tbo toom

t`mmod imdaars ar mat. It w`s `lsa eaumd tb`t toom`hor w`s karo lijoly ta uso imdaar t`mmimh ie

bis ar bor p`romts tbauhbt t`mmimh k`do sakoamo `ppo`r nottor laajimh. Tbo study sbawod tb`t

tbo tooms uso ae imdaar t`mmimh imcro`sod ie tboir p`romts porkittod tboir uso (Baorstor ot `l.,

>668).


7/27

!"##$#% '( )"*+",$"# !--#, =

@matbor e`ctar tb`t imcro`sod ` toom`hors t`mmimh nob`viar w`s ie tbo p`romts woro mat

warriod `naut tbo nob`viar èeoctimh tbo toom`hors woll-noimh (Baorstor ot `l., >668). Im ` study

ny K`hoo, Vaars`tt`r, Soidol, `md Barmumh (>668), it w`s st`tod tb`t p`romts woro um`w`ro ae tbo

rocakkomd`tiams `md likit`tiams erak tbo ED@ ear imdaar t`mmimh, `md tb`t it w`s mat `s sèo `s

tboy tbauhbt it w`s ear tboir toom`hors. It w`s `lsa eaumd tb`t sako p`romts tbauhbt imdaar

t`mmimh wauld joop tboir tooms erak hottimh sumnurmt, wbicb w`s camclusivoly ropartod `s mat

truo (K`hoo ot `l., >668). @ccardimh ta N`lj `md Hollor (>662), p`romts `md tboir tooms cauld

b`vo lo`rmod imeark`tiam `naut tbo oeeocts ae _U r`di`tiam erak tboir dactars, nut imdaar t`mmimh

w`s mat bihbly t`ljod `naut witb p`tiomts. It w`s suhhostod tb`t prik`ry c`ro pbysici`ms `md

dork`talahists moodod ta warj tahotbor, sa tboy cauld bolp cbildrom `md tooms soo baw

d`mhoraus _U r`di`tiam w`s ta tbo sjim `md its camsoquomcos (N`lj `md Hollor, >662).

Saci`l Imtor`ctiams

Im ` study ny N`morgoo, Hroomo, N`hd`s`rav, `md C`kpa (>669), toom`hors woro lijoly ta

t`m imdaars ie tboy b`d eriomds tb`t `lsa t`mmod imdaars. Ie ` toom`hors eriomds s`w t`mmimh `s `

haad tbimh, tbom tbo toom usu`lly did s woll (N`morgoo ot `l., >669). Im `m o`rlior `rticlo ny

Aîard`m ot `l. (>665), it w`s st`tod tb`t tooms wba p`rticip`tod im `ctivitios, sucb `s druh uso,

typic`lly visitod ` t`mmimh s`lam karo nocùso ae tboir hraup ae eriomds ar cortìm kodi` saurcos.

Im tbis study, avor 96% ae tbo tooms woro Cùc`si`m wba porearkod tbo t`mmimh nob`viar. Tbo

study st`tod tb`t tbo `daloscomt hirls w`mtod ta `ppo`r sikil`r ta tbo wakom im tbo k`ss kodi`,

wbicb lo`d ta tbo baw kucb tboy docidod ta t`m. Tbo study `lsa sbawod tb`t eriomds b`d ` nihhor

ikp`ct am tbo tooms nob`viar tb`m did tboir p`romts. It w`s ropartod tb`t tbo cb`mco ae ` toom

noimh imvalvod im imdaar t`mmimh daunlod ie tbo tooms eriomds pl`cod ` bihb v`luo am tbimhs lijo

noimh sjimmy `s woll (Aîard`m ot `l., >665).


8/27

!"##$#% '( )"*+",$"# !--#, 1

Bawovor, eittimh im `kamh eriomds ar noimh lijo colonritios im tbo kodi` `ro mat tbo amly

ro`sams ta uso imdaar t`mmimh. D`maee-Nurh `md Kasbor (>665) ropartod tb`t poaplo lijod ta t`m

imdaars im ardor ta saci`lizo. Im `m `rticlo ny Vottigabm II, Vottigabm, `md Hilnort (>600), it w`s

ropartod tb`t nays tbauhbt t`mmor sjim k`do hirls laaj nottor md `ppo`r bo`ltbior. Hirls `lsa

eolt sikil`r taw`rds nays wba b`d ` t`m, nut it w`s mat `s ikpart`mt. @ t`m w`s ` sihm tb`t

sbawod tb`t tbo porsam w`s bo`ltby `md wauld passinly no ` haad lieo p`rtmor ear b`vimh cbildrom

witb. ôpartodly, ` t`m w`s ` sihmieic`mt qu`lity ear ` k`los p`rtmor ta b`vo, sa tboy cauld k`jo

suro tbo nost homos woro tr`mseorrod ta tboir cbildrom. It w`s `lsa st`tod tb`t hirls b`vo

p`rticip`tod im tbo t`mmimh nob`viar jmawimh tbo t`m will k`jo tbok nottor laajimh, tboroearo

`ppo`limh ta ` patomti`l p`rtmor. Xitb tb`t noimh sìd, poaplo tb`t `lro`dy b`d ` nayeriomd ar

hirleriomd sbawod imcro`sod warry `naut tboir nady ik`ho im camtr`st ta poaplo wba woro simhlo

ar k`rriod (Vottigabm II ot `l., >600).

Arh`miz`tiams `md Saci`l Imstitutiams

Eietoom yo`r `ha, `m arh`miz`tiam c`llod tbo Imdaar T`mmimh @ssaci`tiam (IT@) w`s

ost`nlisbod. Tad`y, it is `m arh`miz`tiam tb`t is k`do up ae imdaar t`mmimh k`mue`cturors,

distrinutars, e`cility awmors `md koknors erak atbor suppart imdustrios (IT@, >66?`). Avor

046,666 poaplo warj witbim tbo `ssaci`tiam. Tbo `ssaci`tiam clìks ta bolp oduc`to tbo

papul`tiam `naut camtrallimh baw kucb tboy t`m `md baw ta stap tbo d`mhoraus oeeocts ae it

(IT@, >66?`). Tbo IT@ ansorvos my suhhostod ido`s tb`t k`y cako up ear tbo st tos. Tbo

`ssaci`tiam is quicj ta angoct ta `my ae tboso suhhostod ido`s tb`t tboy eool `ro um`ccopt`nlo ta

t`mmimh nusimossos (IT@, >66?n).

@matbor arh`miz`tiam tb`t is `mt`hamistic ta tbo IT@ is tbo Sjim C`mcor Eaumd`tiam (SCE).

Its kìm ha`l is ta k`jo poaplo `w`ro ae tbo cùsos ae sjim c`mcor `md ta bolp poaplo jmaw baw


9/27

!"##$#% '( )"*+",$"# !--#, F

ta lawor tboir risj. It `lsa imearks poaplo am wb`t ta da ie tboy suspoct tboy k`y b`vo c`mcor

(SCE, m.d.`). Tbo SCE wauld r`tbor poaplo mat t`m. Tbo c`kpìhm c`llod, Ha Xitb Yaur Awm

Hlaw, is ` str`tohy tbo SCE usos ta hot poaplo ta quit t`mmimh. Tbo c`kpìhm prakatos tb`t

t`mmimh is ` tbimh ae tbo p`st, `md it is nost ie tbo porsam `ccopts tbo sjim bo ar sbo wauld

m`tur`lly b`vo (SCE, m.d.n).

K`my atbor arh`miz`tiams try ta imeark tbo punlic `naut imdaar t`mmimh e`cts `s woll.

Amo ae tboso arh`miz`tiams imcludos tbo Xarld Bo`ltb Arh`miz`tiam (XBA)(m.d.), wbicb b`s `

prahr`k c`llod tbo Imtorsum Vrahr`kko. Lijo k`my ae tbo atbor arh`miz`tiams boro im tbo

_.S., tbo XBA b`s k`my angoctivos ta joop poaplo erak noimh sungoctod ta oxcossivo _U

r`di`tiam (XBA, m.d.).

Cakkumity `md Vbysic`l Omviramkomt

@ccardimh ta Baorstor ot `l. (>669), it w`s ropartod tb`t karo t`mmimh s`lams k`y b`vo

noom prosomt im cakkumitios tb`t woro kìmly dakim`tod ny Cùc`si`ms. Tbis k`y b`vo noom

nocùso Cùc`si`ms woro eaumd ta k`jo up tbo k`garity ae t`mmimh nods usors. @lsa, im `ro`s

wboro sumlihbt w`s mat eaumd ta no `s prov`lomt, tbo cakkumity w`s karo lijoly ta b`vo karo

t`mmimh nusimossos tb`m `ro`s witb l`rhor `kaumts ae sumlihbt (Baorstor ot `l., >669).

Vunlic Valicy, L`w, `md ôhul`tiam

@ccardimh ta Lovimo, Sar`co, Spomsor, `md Siohol (>66?), tboro woro b`rdly `my

rostrictiams ear imdaar t`mmimh uso im @koric`. Im `m `rticlo ny L`zavicb `md Earstor (>66?), it

w`s st`tod tb`t @koric` b`d imdaar t`mmimh rohul`tiams huidod ny tbo ED@ `md tbo Eodor`l

Tr`do Cakkisiam (ETC). Tbo t`mmimh s`lam okplayoos b`d strict rulos `naut camsukor sèoty

tb`t tboy b`d ta eallaw wbom tboir praducts woro noimh usod. ûlos typic`lly imcludod oyo

hahhlos ear sbioldimh `hìmst _U r`ys, cortìm `dvisarios displ`yod ta tbo camsukor, `md


10/27

!"##$#% '( )"*+",$"# !--#, .9

diroctiams ear tbo camsukor ta eallaw. @lsa, tbo ETC will mat llaw ear tbo e`lsoly k`rjotod ido`

tb`t imdaar t`mmimh w`s haad ear tbo camsukors bo`ltb (L`zavicb & Earstor, >66?).

Lovimo ot `l. (>66?), ropartod tb`t amly `t tbo st`to lovol wauld tbo s`lams no camtrallod,

atborwiso ma amo wauld k`m`ho tbo `ctiams t`jom ny tbo t`mmimh s`lam okplayoos. It w`s eaumd

tb`t 9?% ae t`mmimh s`lam custakors im Martb C`ralim` womt avor tbo rocakkomdod `kaumt ae

_U oxpasuro durimh tboir visit. Tbo _.S. havormkomt triod ta bolp, nut eaumd it b`rd ta camtral

tbo imdaar t`mmimh nusimoss simco it w`s ropartodly wartb nilliams ae dall`rs. Ovom tbo ED@ did

mat w`mt ta try ta prabinit imdaar t`mmimh umlijo tbo @koric`m Kodic`l @ssaci`tiam tb`t did. Tbo

havormkomt, bawovor, b`s t`jom stops ta bolp lossom tbo d`mhors erak tbo nob`viar (Lovimo ot `l.,

>66?).

@ccardimh ta tbo @koric`m @c`doky ae Dork`talahy (m.d.n), ` l`w `hìmst t`mmimh ear

kimars eirst taaj pl`co im C`liearmi` im >600. Maw, tboro `ro l`ws roh`rdimh t`mmimh s`lams im 33

dieeoromt st`tos `md X`sbimhtam, D.C. `ccardimh ta tbo M`tiam`l Cameoromco ae St`to

Lohistl`turos (MCSL) (>604). Im `matbor study ny Earstor, L`zavicb, Bicjlo, Saromsom, `md

Dokiorro (>665), t`mmimh s`lam okplayoos im Kimmosat` `md K`ss`cbusottos woro roluct`mt ta

`sj ear porskissiam erak tbo tooms p`romts nocùso tboy wauld kast lijoly laso tboir custakor.

@s ` rosult, tboro w`s ` l`rho `kaumt ae imdaar t`mmimh usod ny tbo toom hirls witbim tbo ansorvod

`ro` (Earstor ot `l., >665).

Dotorkim`mts ae T`mmimh Nob`viar

Dotorkim`mts `md ôl`tiamsbips @kamh Tbok

Im ardor ta soo wby sakoamo wauld docido ta nohim ar omd ` nob`viar lijo t`mmimh, amo

kust ansorvo `md umdorst`md tbo prodispasimh, om`nlimh, `md roimearcimh e`ctars (erak tbo

Vrocodo-Vracood Kadol) `ssaci`tod witb t`mmimh. @ prodispasimh e`ctar wauld no lod ny sako


11/27

!"##$#% '( )"*+",$"# !--#, ..

imtorm`lly pravajod ro`sam ta t`m, sucb s jmawlodho, nolioes, `ttitudos, otc. @m om`nlimh

e`ctar wauld no sakotbimh tb`t `llaws `vìl`nility, `ccossinility, `md èeard`nility ta imdaar

t`mmimh. L`stly, prakatimh tbo camtimu`tiam ae t`mmimh, wbicb usu`lly imvalvos eoodn`cj erak

atbors, wauld no camsidorod ` roimearcimh e`ctar (Sikams-Kartam ot l., >60>). Sako spocieic

c`sos witb t`mmimh `ro doscrinod im tbo eallawimh p`r`hr`pbs.

K`my situ`tiams wboro tooms woro mat b`ppy witb tboir nady (pro-dispasimh e`ctar)

cùsod tbok ta sooj atbor w`ys, sucb `s hottimh ` t`m, ta nocako karo `ttr`ctivo (Hroomo &

Nrimm, >663). Tooms cauld hot tboir t`mmimh ido`s erak tbo kodi` `md w`mt ta ppo`r sikil`r ta

tbaso hirls (Aîard`m ot `l., >665). Ie tbo toom b`d nolioes naut t`mmimh tb`t woro imcarroct,

tbom tb`t cauld `lsa lo`d ta tbo t`mmimh nob`viar (Komdoso & Hilcbrost, >60>). Im sako c`sos,

t`mmimh oxpasuro cùsod `m `ddictiam (Ajbav`t & Eoldk`m, >603). @m `ddictiam (` pro-

dispasimh e`ctar) k`do it b`rdor ear tbo toom ta quit t`mmimh (Ajbav`t & Eoldk`m, >603). Maw

tb`t tbo toom b`s hattom tbo ido` ta no t`m, bo ar sbo moods tbo `vìl`nility, `ccossinility, `md

èeard`nility ta da hot tbo t`m (Sikams-Kartam ot `l., >60>).

Amo om`nlimh e`ctar cauld b`vo noom tb`t tbo toom b`d `ccoss ta ` mo`rny t`mmimh s`lam

`md w`s karo lijoly ta ha ta it (K`yor ot l., >600). @matbor om`nlimh e`ctar sucb `s, tbo toom

b`vimh kamoy ta t`m, cauld b`vo k`do tbok karo lijoly ta ha t`mmimh (Bùsùor ot `l., >600).

@lsa, ie tboy w`mtod ta no t`m `md tboro w`smt omauhb m`tur`l sumlihbt im tbo `ro` (`m om`nlimh

e`ctar), tbom tboy wauld b`vo sauhbt imdaar t`mmimh (Baorstor ot `l., >669). Bawovor, l`ws,

wbicb woro `lsa om`nlimh e`ctars, prabinitod tbo uso ae imdaar t`mmimh ny kimars (K`yor ot `l.,

>662). Mat `ll t mmimh s`lam okplayoos eallawod tbo l`w tbauhb. Ie ` s lam eo`rod lasimh

custakor, tbom tboy k`y b`vo nrajom tbo l`w im ardor ta joop tbo custakor (Earstor ot `l., >665).


12/27

!"##$#% '( )"*+",$"# !--#, ./

Tbo toom maw do`ls witb roimearcimh e`ctars tb`t prakato tbo camtimu`tiam ae t`mmimh (Sikams-

Kartam ot `l., >60>).

Tooms `ro `eeoctod ny tbo poaplo tb`t surraumd tbok. Tboir e`kily koknors `md eriomds

tb`t t`m will camtimuo ta prakato tbo ido` tb`t t`mmimh is aj`y ear tbok ta da `s woll (Baorstor ot

`l., >668: N`mgoroo ot `l., >669). Tbis e`ctar `md k`my atbors b`vo noom c`toharizod `s

prodispasimh, om`nlimh, ar roimearcimh e`ctars, wbicb b`vo noom listod nolaw. @lsa, Eihuro 0

displ`ys ` Saci`l-Ocalahic`l Kadol tb`t w`s cro`tod ear t`mmimh nob`viar ta carrospamd ta tboso

e`ctars.

Vrodispasimh E`ctars7

Tooms tb`t b`vo bo`rd tb`t tboy mood ta t`m ta hot omauhb vit`kim D will noliovo tboymood ta t`m (Komdoso & Hilcbrost, >60>).

Tooms tb`t noliovod it w`s loss risjy ta uso ` t`mmimh nod tb`m m`tur`l lihbt will noliovo

tboy mood ta t`m (Komdoso & Hilcbrost, >60>).

Tooms noliovod tboy moodod ` t`m noearo tboy womt am trips ta sbiold tboir sjim erak sumd`k`ho (Komdoso & Hicbrost, >60>).

Tooms `lsa noliovod tb`t cort`im pranloks witb tboir sjim cauld no curod usimh imdaart`mmimh (Komdoso & Hilcbrost, >60>).

Eok`los, wba woro umb`ppy witb tboir nadios `md wba b`d `my o`timh disardors, worokaro lijoly ta uso imdaar t`mmimh. Eok`los tomd ta c`ro karo `naut baw tboy laaj tb`mtboir woll-noimh (Hroomo & Nrimm, >663).

Tboro w`s `m `ddictiam ta t`mmimh tb`t roso`rcbors woro camcormod `naut. It w`s eaumdtb`t imdaar t`mmimh prakatos omdarpbim rolo`so `kamh poaplo wba t`m, wbicb cauld noamo ro`sam wby tooms wauld mat stap tbo nob`viar (Ajbav`t & Eoldk`m, >603).

@ l`rho muknor ae `daloscomts tbauhbt tb`t ` t`m am `m imdividu`l w`s karo `ttr`ctivotb`m sakoamo witbaut ` t`m. Tboy `lsa eolt tboy woro karo `ttr`ctivo `md ovom bo`ltby(L`zavicb ot `l., >664).

Hirls b`vo p`rticip`tod im tbo t`mmimh nob`viar jmawimh tbo t`m will k`jo tbok nottorlaajimh ta `ppo`l ta ` patomti`l p`rtmor (Vottigabm II ot `l., >600).


13/27

!"##$#% '( )"*+",$"# !--#, .7

Tooms hat tboir jmawlodho ae t`mmimh `md its oeeocts erak tbo kodi` (ânimsam ot `l.,>662). @ study st`tod tb`t tbo `daloscomt hirls w`mtod ta `ppo`r sikil`r ta tbo wakom imtbo k`ss kodi`, wbicb lo`d ta baw kucb tboy t`mmod (Aîard`m ot `l., >665).

Om`nlimh E`ctars7 _ppor cl`ss eok`los b`d `m imcro`sod cb`mco ae kol`mak` erak tbo t`mmimh nob`viar ny

26% (Bùsùor ot `l., >600).

Imdaar t`mmimh w`s mat widoly t`ljod `naut witb p`tiomts, sa tboro w`s l`cj aeimeark`tiam `naut tbo oeeocts ae _U r`di`tiam (N`lj & Hollor, >662).

T`mmimh s`lams b`d strict rulos `naut camsukor sèoty tb`t tbo okplayoos b`d ta eallaw

wbom tboir praducts woro noimh usod. ûlos typic`lly imcludod oyo hahhlos ear sbioldimh`hìmst _U r`ys, cortìm `dvisarios displ`yod ta tbo camsukor, `md diroctiams ear tbocamsukor ta eallaw (L`zavicb & Earstor, >66?).

T`mmimh s`lam okplayoos `ro roluct`mt ta `sj ear porkissiam erak tbo tooms p`romts, satboy damt laso tboir custakor. @s ` rosult, ` l`rho `kaumt ae toom hirls usod imdaart`mmimh (Earstor ot `l., >665).

@ l`w `hìmst t`mmimh ear kimars eirst taaj pl`co im C`liearmi`m im >600 (@@D, m.d.n).Tboro `ro maw l`ws roh`rdimh t`mmimh s`lams im 33 dieeoromt st`tos `md X`sbimhtam, D.C.(MCSL, >604).

Tboro w`s 46% imcro`so im tbo nob`viar ie ` t`mmimh s`lam w`s eaumd im ` twa-kilo r`diuserak ` toom`hors rosidomco (K`yor ot `l., >600).

Im `ro`s wboro sumlihbt w`s mat eaumd ta no `s prov`lomt, tbo cakkumity w`s karo lijolyta b`vo t`mmimh nusimossos tb`m `ro`s witb l`rhor `kaumts ae sumlihbt (Baorstor ot `l.,>669).

ôimearcimh E`ctars7

V`romts woro kadolimh tbis nob`viar ear tboir jids `md `lsa sbawod tbok tb`t tbis w`smark`l nob`viar (Stryjor ot `l., >664). @ toom`hor w`s karo lijoly ta uso imdaar t`mmimhie bis ar bor p`romts tbauhbt t`mmimh k`do sakoamo `ppo`r nottor laajimh (Baorstor ot `l.,>668).

Toom`hors woro lijoly ta t`m imdaars ie tboy b`d eriomds tb`t `lsa t`mmod imdaars(N`mgoroo ot `l., >669).


14/27

!"##$#% '( )"*+",$"# !--#, .:

Eihuro 07 Saci`l-Ocalahic`l Kadol cro`tod n`sod am t`mmimh nob`viar.

Tboary

Bo`ltb Nolioe Kadol

@ccardimh ta Sikams-Kartam, KcLoray, `md Xomdol (>60>), tbo Bo`ltb Nolioe Kadol

(BNK) b`s noom usod tbrauhbaut k`my studios ta dovolap ` nottor somso ae wby poaplo poreark

ar damt poreark cort`im nob`viars. Tbo BNK b`s sovor`l camstructs imcludimh porcoivod

suscoptinility, sovority, kadieyimh e`ctars, nomoeits, n`rriors, cuos ta `ctiam, `md sole-oeeic`cy.

Vorcoivod suscoptinility `md sovor`nility w`s tbo `kaumt ae b`rk ar lovol ae d`mhor `m imdividu`l

noliovos bo ar sbo is vulmor`nlo ta. Kadieyimh e`ctars woro tbaso tb`t `ro dieeoromt `kamh o`cb

Imtorporsam`l

Imtr`porsam`l

Jmawlodho erak kodi`,p`romts, eriomds, dactars

Nolioes naut t`mmimh

Laajimh nottor md bo`ltbior

Ikprossimh patomti`l p`rtmor

Imtorporsam`l

T`mmimh witb eriomds `mde`kily

V`romts ar eriomds sottimh

nob`viar`l ox`kplo

Arh`miz`tiam`l/Imstitutiams

Imdaar T`mmimh @ssaci`tiam

Sjim C`mor Eaumd`tiam

T`mmimh nusimossos

Dactars aeeicos

Cakkumity

Kodi` koss`hos `naut t`mmimh

T`mmimh s`lams prosomt im

cakkumity

Valicy

L`ws h`imst kimars

t`mmimh

T`mmimh rostrictiams


15/27

!"##$#% '( )"*+",$"# !--#, .60>).

@pplyimh tbo BNK Camstructs

Im ` study camductod ny Hroomo `md Nrimm (>663), tbo BNK w`s usod ta imvostih`to tbo

nost w`y ta bolp lawor tbo ìk ta t`m imdaars. Im tboir roso`rcb, porcoivod suscoptinility w`s tbo

kìm camstruct eacusod erak tbo BNK. Tbo roso`rcbors `lsa ansorvod sole-oeeic`cy `md

porcoivod tbro`t, nut tboy woro mat bo`vily eacusod am. Tbrauhb ansorvimh atbor roso`rcb, tboy

eaumd tb`t porcoivod suscoptinility w`s oxtrokoly sihmieic`mt wbom it c`ko ta imdaar t`mmimh.

Dieeoromt nob`viars c`llod ear dieeoromt lovols ae sihmieic`mco ear tbo BNK camstructs, sa mat `ll

camstructs woro usod. Ear imdaar t`mmimh us`ho, tbo roso`rcbors eolt porcoivod suscoptinility w`s

ossomti`l nocùso tbo t`mmor moodod ta ro`lizo tb`t bo ar sbo cauld hot c`mcor ar atbor soriaus sido

oeeocts. ôso`rcbors noliovod tb`t im ardor ta k`jo ` porsam c`ro `naut tbo ultik`to t`mmimh

camsoquomcos, tboy moodod ta rol`to tbo e`cts ta tb`t imdividu`l am ` doopor lovol. @ porsam ae

imtorost, ny `m imtorvomtiamist, moodod ` bihbor somso ae suscoptinility. Bawovor, eimdimh ` w`y

ta k`jo tbis b`ppom w`s vory dieeicult `s sciomtists woro umsuro ae baw ta nost `ccakplisb tboir

ha`l (Hroom & Nrimm, >663).

@pplic`tiam `md Ko`surokomt ae Camstructs

Im ardor ta uso porcoivod suscoptinility im tbo study, tbo roso`rcbors cro`tod ` survoy tb`t

wauld lot tbo imdividu`l da ` sole-`ssosskomt. Tbo survoy, ear 09->5 yo`rs ald eok`los, `sjod


16/27

!"##$#% '( )"*+",$"# !--#, .;

quostiams imvalvimh komt`l `md pbysic`l e`ctars rol`tod ta t`mmimh, sucb `s porcoivod

suscoptinility ta sjim c`mcor, imtomtiam ta pratoct sjim, sole-ostook, `md punlic nady

camsciausmoss. Tbo roso`rcbors usod Lijort-typo itoks `msworimh quostiams witb Stramhly

@hroo ar Stramhly Dis`hroo wbom dotorkimimh porcoivod suscoptinility, porcoivod tbro`t, `md

sole-oeeic`cy. @etor tbo rosults woro c`lcul`tod `md `m`lyzod, tbo roso`rcbors s`w tb`t ` nihhor

muknor ko`mt ` bihbor somso ae suscoptinility ear `m imdividu`l (Hroom & Nrimm, >663).

Ov`lu`tiam ae tbo Study

@t tbo omd ae tbo study, tbo roso`rcbors eaumd tb`t ny t`jimh tbo survoy, imdividu`ls b`d `

bihbor somso ae porcoivod suscoptinility. O`rlior roso`rcb erak atbor imvostih`tars sbawod tb`t

tbo survoy itsole bolpod poaplos porcoivod suscoptinility riso. Bawovor, gust nocùso tbo survoy

k`y b`vo sbawod ` bihbor porcoptiam ae suscoptinility daos mat ko`m tb`t tbaso poaplo woro

karo lijoly ta mat uso imdaar t`mmimh. It w`s st`tod tb`t eok`los, im p`rticul`r, wauld still sooj

imdaar t`mmimh kotbads ovom ie tboy tbauhbt tboy woro suscoptinlo ta tbo sido oeeocts. Tbis w`s

ospoci`lly truo ie tbo `ccoss ta t`m w`s mat dieeicult ta antìm (Hroomo & Nrimm, >663).

Tbo roso`rcbors `lsa eaumd tb`t porcoivod suscoptinility w`s bihbly carrol`tod witb

porcoivod tbro`t. It w`s eaumd tb`t ie t`mmimh w`s soom `s ` bihb tbro`t, tbom tbo nob`viar

accurrod loss. Tbo study suhhostod tb`t poaplo sbauld soo karo oeeiciomt `dvortisokomts ar

c`kpìhms ta rìso poaplos porcoptiams ae t`mmimh sovority (Hroomo & Nrimm, >663).

Tboary ae Vl`mmod Nob`viar

@s writtom ny Sikams-Kartam, KcLoray, `md Xomdol (>60>), Tboary ae Vl`mmod

Nob`viar (TVN) is tbauhbt ta suhhost tb`t poaplo oitbor poreark ar damt poreark cortìm

nob`viars n`sod am `ttitudos, sungoctivo marks, `md porcoivod nob`viar`l camtral. @ttitudos `ro

jmawm `s ` porsams avor`ll eoolimhs taw`rds sakotbimh. Sungoctivo marks usu`lly imvalvo wb`t


17/27

!"##$#% '( )"*+",$"# !--#, .=

is saci`lly `ccopt`nlo ae ` porsams `ctiams. L`stly, Vorcoivod nob`viar`l camtral is baw kucb

pawor sakoamo eools bo ar sbo b`s am tbo nob`viar ospoci`lly im bis ar bor surraumdimhs

(Sikams-Kartam ot `l., >60>).

@pplyimh TVN Camstructs

@ study w`s camductod ny Billbauso, Turrisi, `md J`stmor (>666) ta eurtbor dotorkimo

wb`t cort`im e`ctars lo`d ta tbo uso ae imdaar t`mmimh. Tbo roso`rcbors usod `ttitudos, sungoctivo

marks, `md porcoivod nob`viar`l camtral erak tbo TVN. @ppo`r`mco kativ`tiam `md sole-

kamitarimh woro usod `lamh witb tbo camstructs ae tbo TVN ear tboir study (Billbauso ot `l.,

>666).

@pplic`tiam `md Ko`suro ae Camstructs

Tbo roso`rcbors h`vo ` soloctiam ae eirst `md socamd yo`r calloho studomts ` list ae

quostiams tb`t wauld bolp tbok ov`lu`to tbo TVN camstructs, `ppo`r`mco kativ`tiam `md sole-

kamitarimh erak tbo studomts `mswors. Tbo studomts woro quostiamod am tbimhs sucb `s baw

stikul`timh/narimh ar rol`ximh/mat rol`ximh imdaar t`mmimh w`s ear tbok im ardor ta

dotorkimo tboir `ttitudos. Sungoctivo marks woro dotorkimod ny quostiams imquirimh ie tboir lavod

amos w`mtod tbok ta t`m. @lsa, tbo studomts woro quostiamod ta soo wbotbor ar mat tboy wauld

eallaw wb`t tboir lavod amos w`mtod. Im ardor ta dotorkimo porcoivod nob`viar`l camtral,

studomts woro quostiamod am baw b`rd it w`s ear tbok ta t`m imdaars. Sovom-paimt sc`los woro

usod ta dotorkimo `ttitudos, sungoctivo marks, `md porcoivod nob`viar`l camtral eark tbo studomt

rospamsos. Tbo rosults sbawod tb`t tbaso witb ` karo e`var`nlo rol`tiamsbip notwoom tbo TVN

camstructs woro eaumd ta b`vo `m imcro`sod kativo ta t`m imdaars (Billbauso ot `l., >666).


18/27

!"##$#% '( )"*+",$"# !--#, .1

Ov`lu`tiam ae tbo Study

Ny tbo omd ae tbo study, tbo roso`rcbors s`w tb`t imtomtiam w`s tbo nost prodictar ae

wbotbor ar mat sakoamo docidod ta ha t mmimh, nut it w`s n`sod am tbo joy TVN camstructs. Tbo

roso`rcbors st`tod tb`t tbo nost w`y ta roduco tbo nob`viar`l tomdomcios w`s ta t`rhot tbo

e`ctars tb`t lo`d ta tbo nob`viar, wbicb w`s `ttitudos, sungoctivo marks, `md porcoivod nob`viar`l

camtral. N`sod am tboir eimdimhs, t rhotimh poaplos nolioes is mat haimh ta no tbo kast oeeoctivo

nocùso ae saciot`l viows. Bawovor, eimdimh ` dieeoromt eark ae t`mmimh ar ` sèor cbaico ear

ikpravimh sakoamos pbysic`l oxtoriar w`s st`tod `s ` nottor pl`m ae `ctiam (Billbauso ot `l.,

>666).

Imdaar T`mmimh Imtorvomtiams

Vroviaus roso`rcb am imdaar t`mmimh imdic`tod tb`t ` survoy ar quostiammìro is tbo kìm

taal usod im imtorvomtiam pl`ms (Hroomo & Nrimm, >663: Billbauso ot `l., >666). Tbo survoy

quostiams sbawod tb`t imtr`porsam`l e`ctars pl`yod ` l`rho ralo im dotorkimimh wbotbor sakoamo

usod imdaar t`mmimh ar mat (Hroomo & Nrimm, >663). @lsa, atbor roso`rcb sbawod tb`t toom`hors

tbauhbts `md ro`sams ear t`mmimh woro èeoctod ny tbo poaplo tb`t surraumdod tbok (Baorstor ot

`l., >668: N`mgoroo ot `l., >669). Tboso imeluomcos wauld e`ll umdor tbo c`tohary ae imtorporsam`l

e`ctars (Sikams-Kartam ot `l., >60>). Atbor imtorvomtiam pl`ms k`y mood ta imvalvo ` karo

pbysic`l `ppra`cb sucb `s t`rhotimh punlic palicy ar tbo kodi`. Vunlic palicy, `lamh witb tbo

_.S. kodi`, cauld no twa succosseul w`ys ta roduco t`mmimh nod uso `kamh toom`hors.

@ttokptod Imtorvomtiam Vl`ms

@s ropartod ny tbo MCSL (>604), l`ws roh`rdimh `myamo yaumhor tb`m 02 yo`rs ald woro

im oeeoct ear t`mmimh s lams im X`sbimhtam, D.C. `md 33 dieeoromt st`tos. Tbo l`ws woro sikil`r,


19/27

!"##$#% '( )"*+",$"# !--#, .F

nut v`riod por st`to. Tboro w`s `lsa ` l`w tb`t prabinitod imdaar t`mmimh ear imdividu`ls yaumhor

tb`m 02 im C`liearmi`, Tox`s, Uorkamt, Illimais, `md Mov`d` (MCSL, >604).

@matbor `ttokpt ta lawor t`mmimh r`tos w`s ` t`mmimh t`x tb`t w`s cro`tod im >606,

`ccardimh ta `m `rticlo ny Simclìr md K`jim (>603). _meartum`toly, tbo t`mmimh r`tos `kamh

toom`hors woro n`roly roducod simco tbo t x. Ta omsuro tb`t t`xos wauld b`vo ` hro`tor oeeoct am

roductiam ae t`mmimh r`tos, tbo okplayoos wauld mood hro`tor ansorv`tiam wbilo am duty. ûlos

b`vo noom `ppliod im t`mmimh s`lams, nut succoss b`s noom likitod nocùso ae ikprapor

ikplokomt`tiam ny tbo okplayoos (Simclìr & K`jim, >603).

Simco suporvisiam ae tbo t`mmimh nod apor`tars sookod ta no tbo nih issuo witb omearcimh

tbo t`x l`ws, tb`t k`y mat no tbo nost `ppra`cb ear euturo imtorvomtiams. Bawovor, ` l`rhor

imcro`so im tbo t`x ar imcomtivo ear tbo okplayoos ta strictly eallaw tbo rulos k`y ikpravo tbo

autcako. Imcro`simh ` t`x am ` praduct w`s p`rt ae tbo KVAXO^ Kadol usod ta lawor tbo r`to

ae imdaar t`mmimh. KVAXO^ is `m `cramyk tb`t is discussod im Simclìr md K`jims >603

`rticlo tb`t st`mds ear kamitar, pratoct, aeeor `ltorm`tivos, w`rm, omearco, `md rìso t`xos.

Dovolapimh `m Imtorvomtiam Vl`m

N`sod am t`mmimh imtorvomtiams usod im tbo p`st `md tbo KVAXO^ Kadol, ` kotbad tb`t

k`y no succosseul im roducimh imdaar r`to r`tos cauld no karo prakatiam ae spr`y t`ms `md sole-

t`mmimh latiams im tbo kodi`. Tbo _.S. kodi` èeocts tbo w`y toom`hors hot tboir jmawlodho

`naut t`mmimh (ânimsam ot `l., >662). @ str`tohy tb`t cauld bolp roduco imdaar t`mmimh r`tos

cauld no ta st`rt sbawimh cakkorci`ls ar `ds ear pratoctiam `hìmst kol`mak`. Curromtly, tboro

`ro cakkorci`ls am T.U. `md `ds tb`t try ta dotor camsukors erak skajimh (CDC, >604n). Tbo

s`ko `ppra`cb cauld no t`jom witb t`mmimh nod uso.


20/27

!"##$#% '( )"*+",$"# !--#, /9

Sb`rimh porsam`l starios `naut tbo uso ae t`mmimh nods `md sjim c`mcor k`y ro`cb viowors

am ` karo okatiam`l lovol `md lawor tbo us`ho r`tos. Bawovor, tboro b`vo noom `ds `naut imdaar

t`mmimh, nut tboro woro issuos witb imcarroct imeark`tiam. Arh`miz`tiams, sucb `s tbo C`liearmi`

Sum C`ro Imc. b`d ta uso $0.? killiam ta eix tbo e`lso `md kislo`dimh clìks camcormimh imdaar

t`mmimh (Simclìr & K`jim, >603). Ny puttimh karo carroct imeark`tiam aut imta tbo _.S. kodi`

`naut imdaar t`mmimh, karo `w`romoss cauld no nrauhbt ta tbo d`mhors ae t`mmimh nod uso.

_ltik`toly, karo `w`romoss cauld patomti`lly lo`d ta lawor imdaar t`mmimh r`tos.

Amo w`y ta dovolap tbis imtorvomtiam pl`m ta bolp lawor tbo us`ho ae t`mmimh nod r`tos is

ta uso tbo aeeor `ltorm`tivos `md w`rm p`rts ae tbo KVAXO^ Kadol (Simclìr & K`jim,

>603). ôso`rcbors cauld t`jo ` survoy noearo md ètor kodi` `dvortisimh ear spr`y t`ms/latiams

im ` cortìm cakkumity. Tbo custakor r`to cauld `lsa no t`jom imta `ccaumt ear tb`t spocieic

cakkumity. @m `ro` witb ` bihb domsity ae t`mmimh s`lams `md toom`hors m`tivo ta tbo `ro` wauld

mood ta no cbasom ta soo karo p`rticip`tiam. Tbo tooms cauld eill aut survoy noearo tbo

prakatiam ae spr`y t`ms/latiams woro `dvortisod witbim tbo cakkumity. @etor ` cortìm `kaumt

ae tiko tb`ts noom cbasom, tbo s`ko tooms cauld eill aut `matbor survoy ta soo ie tboir viows

cb`mhod taw`rds t`mmimh. Tbo custakor r`to ear toom`hors im tbo s`lams cauld `lsa no cbocjod

ètor tbo `dvortisimh `lsa. Tbo ido` ae tbis imtorvomtiam is n`sod aee ae succoss erak atbor o`rlior

imtorvomtiam kotbads (Simclìr & K`jim, >603).

Ie tbis imtorvomtiam w`s usod, tbom prodispasod e`ctars woro kìmly tbo amos noimh

t`rhotod `kamh tbo toom`hors. Vrodispasod e`ctars imcludod7 tooms nolioes tb`t t`ms wauld hivo

tbok karo vit`kim D, it w`s loss risjy tb`m m`tur`l lihbt, tboy moodod ` t`m noearo ` trip, `md tb`t

it wauld bo`l cortìm pranloks witb tboir sjim (Komdoso & Hilcbrost, >60>). @ds witb carroct

imeark`tiam `naut t`mmimh nod us`ho cauld olikim`to tbo im`ccur`to ido`s tooms b`d `naut


21/27

!"##$#% '( )"*+",$"# !--#, /.

t`mmimh. @lsa, tbo imtorvomtiam wauld b`vo t rhotod imtr`porsam`l e`ctars `md cakkumity e`ctars

ny cb`mhimh tbo porcoptiams am t`mmimh nod uso witbim tbo lac`l `ro`. L`stly, tbo Bo`ltb Nolioe

Kadol cauld b`vo noom usod ta `ssoss `pprapri`to camstructs sucb `s, tbo porcoivod sovority `md

suscoptinility ae d`mhors erak t`mmimh nod uso im tbo survoys hivom (Sikams-Kartam ot `l., >60>).

Tbo `ds wauld b`vo bapoeully bolpod cb`mho poaplos porcoptiams ae t`mmimh wbilo

sikult`moausly èeoctimh tbo wbalo cakkumity.

Camclusiam

N`sod am tbo roso`rcb prosomtod tbrauhbaut tbis p`por, it is ikpor`tivo ta eimd `

succosseul imtorvomtiam tb`t will t`rhot tbo Cùc`si`m toom papul`tiam im ardor ta lawor sjim

c`mcor r`tos. @ l`rhor eacus am punlic palicy `md prakatiam ae sèor `ltorm`tivos moods ta no

ikplokomtod ta hro`tly roduco tbo `kaumt ae t`mmimh nod us`ho. _meartum`toly, tboso kotbads

`lamo will mat stap tbo t`mmimh nob`viar ear tooms. Imtr`porsam`l `md Imtorporsam`l e`ctars b`vo

tbo nihhost imeluomcos am t`mmimh `s woll `s porcoivod suscoptinility `md porcoivod sovority ae

hottimh c`mcor. ôso`rcbors will b`vo quito ` cb`llomho im discavorimh ` truly succosseul kotbad

tb`t will dotor tooms erak quittimh tbis nob`viar. Bawovor, `s tromds cb`mho avor tiko im tboir

surraumdimh omviramkomts `md im tbo kodi`, k`yno tboir porcoptiams will cb`mho `lsa.


22/27

!"##$#% '( )"*+",$"# !--#, //

ôeoromcos

@@D (@koric`m @c`doky ae Dork`talahy) (m.d.`). Sjim C`mcor. ôtriovod G`mu`ry >5, >604,

erak bttp7//www.``d.arh/kodi`-rosaurcos/st`ts- md-e`cts/camditiams/sjim-c`mcor

@koric`m @c`doky ae Dork`talahy (m.d.n).Imdaar t`mmimh. ôtriovod K`rcb 3, >604, erak

bttp7//www.``d.arh/kodi`-rosaurcos/st`ts-`md-e`cts/provomtiam-`md-c`ro/imdaar-t`mmimh

N`lj S. G. & Hollor @. C. (>662). Toom`hors `md `rtieici`l t`mmimh. Vodi`trics,0>0(?),

0646 064>. dai7 06.0?4>/pods.>668->>?5

N`mgoroo, S.C., Hroomo, J., N`hd`s`rav, N., & C`kpa, S. (>669). Ky eriomds lavo ta t`m7

Oxorcisimh soms`tiam soojimh `md tbo kodi`timh ralo ae `ssaci`tiam witb eriomds wba uso

t`mmimh nods am t`mmimh nod uso imtomtiams.Bo`ltb Oduc`tiam ôso`rcb, >4(5), 929-992.

dai7 06.0693/bor/cyp63?

CDC (Comtors ear Diso`so Camtral `md Vrovomtiam) (>604`). Sjim C`mcor. ôtriovod G`mu`ry >3,

>604, erak bttp7//www.cdc.hav/c`mcor/sjim/n`sicQimea/imdaarQt`mmimh.btk

CDC (Comtor ear Diso`so Camtral `md Vrovomtiam) (>604n). C`kpìhm avorviow. ôtriovod @pril

04, >604, erak bttp7//www.cdc.hav/tan`cca/c`kpìhm/tips/`naut/c`kpìhm-

avorviow.btkl

D`maee-Nurh, S., & Kasbor, C.O. (>665). Vrodictars ae t`mmimh s`lam uso7 Nob`viar`l `ltorm`tivos

ear omb`mcimh `ppo`r`mco, rol`ximh `md saci`lizimh.Gaurm`l ae Bo`ltb Vsycbalahy, 00(3),

?00-?>6. dai7 06.0088/03?906?3656533>?

ED@ (Eodor`l Eaad `md Druh @dkimistr`tiam) (>604).Imdaar t`mmimh7 Tbo risj ae ultr`vialot

r`ys. ôtriovod G`mu`ry >?, >604, erak

bttp7//www.ed`.hav/earcamsukors/camsukorupd`tos/uck025528.btk

Earstor, G.L., L`zavicb, D., Bicjlo, @., Saromsom, H., & Dokiorro, K.-E. (>665).


23/27

!"##$#% '( )"*+",$"# !--#, /7

Cakpli`mco witb rostrictiams am s`lo ae imdaar t`mmimh sossiams ta yautb im kimmosat`

`md k`ss`cbusotts.Gaurm`l ae tbo @koric`m @c`doky ae Dork`talahy,??(5), 95>-958.

dai7 06.0605/g.g``d.>665.65635

Hroomo, J. & Nrimm, L.S. (>663). Koss`hos imeluomcimh calloho wakoms t`mmimh nod uso7

St`tistic`l vorsus m`rr`tivo ovidomco eark`t `md ` sole-`ssosskomt ta imcro`so porcoivod

suscoptinility.Gaurm`l ae Bo`ltb Cakkumic`tiam, 2, 443-450. dai7

06.0626/06206836396>33>80

Hab`r`, K., & Voroz, K. (m.d.). Sjim c`mcor `md sjim ae calar. Sjim C`mcor Eaumd`tiam,

ôtriovod G`mu`ry >5, >604, erak bttp7//www.sjimc`mcor.arh/provomtiam/sjim-c`mcor-`md-

sjim-ae-calar

Bùsùor @.J., Swottor S.K., Cacjnurm K.H., & Cl`rjo C.@. (>600). Imcro`sos im kol`mak`

`kamh `daloscomt hirls `md yaumh wakom im c`liearmi`7 Tromds ny saciaocamakic

st`tus `md uv r`di`tiam oxpasuro.@rcbivos ae Dork`talahy, 048(8),823-829.

dai706.0660/`rcbdork`tal.>600.44.

B`wryluj, O.N., Hollor, @.C., & Eisbor, D.O. (>603). Imdaar t`mmimh7 Tbo limj ta kol`mak` is

ma lamhor domi`nlo. Tbo Kol`mak` Lottor, 30(3). ôtriovod erak,

bttp7//www.sjimc`mcor.arh/punlic`tiams/tbo-kol`mak`-lottor/wimtor->603-val-30-ma-3

Bo`ltby Voaplo >6>6 (>603). C`mcor. ôtriovod G`mu`ry 09, >604, erak

bttp7//www.bo`ltbypoaplo.hav/>6>6/tapicsangoctivos>6>6/angoctivoslist.`spx1tapicId;?

Billbauso, G, Turrisi, ^, & J`stmor, K. (>666). Kadolimh t`mmimh s`lam nob`viar`l tomdomcios

usimh `ppo`r`mco kativ`tiam, sole-kamitarimh, `md tbo tboary ae pl`mmod nob`viar.Bo`ltb

Oduc`tiam ôso`rcb, 0?(4), 46?-404. dai7 06.0693/bor/0?.4.46?

Baorstor, J.D., K`yor, G.@., Xaadruee, S.I., K`lc`rmo, U., âoscb, S.C., & Cl`pp, O. (>668).


24/27

!"##$#% '( )"*+",$"# !--#, /:

Tbo imeluomco ae poors am `daloscomt imdaar t`mmimh nob`viar7 Eimdimhs erak ` kulti-

s`kplo.Gaurm`l ae tbo @koric`m @c`doky ae Dork`talahy, ?8(5), 996-998.

dai706.0605/g.g``d.>668.65.668

Baorstor, J.D., H`rraw, ^.L., K`yor, G.@., Cl`pp, O.G., Xoojs, G.^., Xaadruee, S.I., S`llis,

G.E., Slykom, D.G., V`tol, K.^., & Synort, S.@. (>669). Domsity ae imdaar t`mmimh

e`cilitios im 005 l`rho u.s. citios. @koric`m Gaurm`l ae Vrovomtivo Kodicimo, 35(3), >43

->45. dai706.0605/g.`kopro.>662.06.6>6

IT@ (Imdaar T`mmimh @ssaci`tiam) (>66?`).Vrakatimh rospamsinlo sum c`ro `md sum nurm

provomtiam...ôtriovod K`rcb 3, >604, erak bttp7//www.tboit`.cak/

IT@ (Imdaar T`mmimh @ssaci`tiam) (>66?n). Havormkomt èeìrs. ôtriovod K`rcb 3, >604, erak

bttp7//www.tboit`.cak/1p`ho;HavormkomtQ@eeìrs

L`zavicb, D., Earstor, G., Saromsom, H., Okkams, J., Stryjor, G., Diokorro, K., Biclo, @., &

ôkn`, M. (>664). Cb`r`ctoristics `ssaci`tod witb uso ar imtomtiam ta uso imdaar

t`mmimh `kamh `daloscomts.@rcbivos ae Vodi`tric @daloscomt Kodicimo, 0?2, 902-9>4.

dai706.0660/`rcbpodi.0?2.9.902

L`zavicb, D. & Earstor, G. (>66?). Imdaar t`mmimh ny `daloscomts7 prov`lomco, pr`cticos `md

palicios.Ourapo`m Gaurm`l ae C`mcor, 40(0), >6->8. dai706.0605/g.ogc`.>664.69.60?

Lovimo, G.@., Sar`co, K., Spomsor, G., & Siohol, D.K. (>66?). Tbo imdaar uv t`mmimh imdustry7 `

roviow ae sjim c`mcor risj, bo`ltb nomoeit clìks, `md rohul`tiams.Gaurm`l ae Tbo

@koric`m @c`doky ae Dork`talahy, ?3(5),0632-0644. dai706.0605/g.g``d.>66?.68.655

K`hoo, J.B., Vaars`tt`r, S., Soidol, J.D., & Barmumh, ^.L. (>668). T`mmimh dovico us`ho7 Xb`t

`ro p`romts tbimjimh1. Vodi`tric Dork`talahy, >4(3), >05->>0. dai7 06.0000/g.0?>?-

0486.>668.66329.x


25/27

!"##$#% '( )"*+",$"# !--#, /662).

Omearcokomt ae st`to imdaar t`mmimh l`ws im tbo umitod st`tos.Vrovomtimh Cbramic

Diso`so7 Vunlic Bo`ltb ôso`rcb, Vr`ctico, `md Valicy, ?(4). ôtriovod K`rcb 3, >604,

erak bttp7//www.mcni.mlk.mib.hav/pkc/`rticlos/VKC>?82890/1ropart;cl`ssic

K`yor, G.@., Xaadruee, S.I., Slykom, D.G., S`llis, G.E., Earstor, G.L., Cl`pp, O. G., Baorstor, J.D.,

Vicbam, L.C., Xoojs, G. ^., Nolcb, H. O., Xoimstacj, K. @., Hilkor T. (>600).

@daloscomts uso ae imdaar t`mmimh7 @ l`rho-sc`lo ov`lu`tiam ae psycbasaci`l,

omviramkomt`l, `md palicy-lovol carrol`tos.@koric`m Gaurm`l ae Vunlic Bo`ltb, 060(?),

936-932. @'$7 06.>06?/@GVB.>606.366689

Komdoso, H., & Hilcbrost, N.@. (>60>). Soloctod imdaar t`mmimh kytbs `md camtravorsios. Im

C.G. Bocjk`m & S.L. K`mmo (Ods.) Sboddimh Lihbt am Imdaar T`mmimh(pp.0>0-033).

Mow Yarj7 Sprimhor.

MCSL (M`tiam`l Cameoromco ae St`to Lohisl`turos) (>604).Imdaar t`mmimh rostrictiams ear

kimars- ` st`to-ny-st`to cakp`risam. ôtriovod @pril 04, >604, erak

bttp7//www.mcsl.arh/roso`rcb/bo`ltb/imdaar-t`mmimh-rostrictiams.`spx

M`tiam`l Caumcil am Sjim C`mcor Vrovomtiam (>60>). Trutb `naut imdaar t`mmimh. ôtriovod

Eonru`ry ?, >604, erak bttp7//www.trutb`nautimdaart`mmimh.arh/oduc`tiam/e`cts

Ajbav`t, G. & Eoldk`m, S. ^. (>603). T`mmimh7 `m `ddictiam1. Tbo Kol`mak` Lottor, 30(3).

ôtriovod erakbttp7//www.sjimc`mcor.arh/punlic`tiams/tbo-kol`mak`-lottor/wimtor-

>603-val-30-ma-3

Aîard`m, D.L., Eiold, @.O., Hollor, @.C., Nraajs, D. ^., @wob, H., Calditz, @.H., & Er`zior,


26/27

!"##$#% '( )"*+",$"# !--#, /;

@.L. (>665). Eroquomt t`mmimh nod uso, woihbt camcorms, `md atbor bo`ltb risj nob`viars

im `daloscomt eok`los (umitod st`tos). C`mcor Cùsos & Camtral, 08(?), 589-525. dai7

06.0668/s06??>-66?-64?3-9

Vottigabm II, T., Vottigabm, T., & Hilnort, @. (>600). âk`mtic rol`tiamsbip st`tus `md homdor

dieeoromcos im sum t`mmimh `ttitudos `md nob`viars ae u.s. calloho studomts.Vsycbalahy, >,

80-88. dai7 06.4>35/psycb.>600.>>60>.

ânimsam, G.J., Jik, G., âsomnùk, S., & Artiz, S. (>662). Imdaar t`mmimh jmawlodho,

`ttitudos, `md nob`viar `kamh yaumh `dults erak 0922->668.@rcbivos ae Dork`talahy,

044(4), 424-422. dai706.0660/`rcbdork.044.4.424.

Sikams-Kartam, N., KcLoray, J.^., & Xomdol, K.L. (>60>).Nob`viar tboary im bo`ltb

prakatiam pr`ctico `md roso`rcb. Nurlimhtam, K@7 Gamos & N`rtlott Lo`rmimh.

Simclìr, C, `md K`jim, G.J. (>603). Ikplic`tiams ae lossams lo`rmod erak tan`cca camtral ear

t`mmimh nod roeark.Vrovomtimh Cbramic Diso`so,06,0-5. dai7

bttp7//dx.dai.arh/06.?222/pcd06.0>6025

SCE (Sjim C`mcor Eaumd`tiam) (>603). Sjim C`mcor E`cts.ôtriovod >3, >604, erak

bttp7//www.sjimc`mcor.arh/sjim-c`mcor-imeark`tiam/sjim-c`mcor-e`cts#podi`trics

SCE (Sjim C`mcor Eaumd`tiam) (m.d.`).Kissiam st`tokomt. ôtriovod K`rcb 3, >604, erak

bttp7//www.sjimc`mcor.arh/`naut-us/kissiam-st`tokomt

SCE (Sjim C`mcor Eaumd`tiam) (m.d.n). Ha witb yaur awm hlaw. ôtriovod K`rcb 3, >604, erak

bttp7//www.sjimc`mcor.arh/bo`ltby-lieostylo/ha-witb-yaur-awm-hlaw

Stryjor, G.O., L`zavicb, D., Earstor, G.L., Okkams, J.K., Saromsom, H., & Dokiorro K.-E.

(>664). K`torm`l/eok`lo c`rohivor imeluomcos am `daloscomt imdaar t`mmimh. Gaurm`l ae

@daloscomt Bo`ltb, 3?(5),?>2.o0-?>2.o9. dai70605/g.g`dabo`ltb.>664.6>.604


27/27

!"##$#% '( )"*+",$"# !--#, /=

T`mmimh(m.d.). ImKorri`k-Xonstor Amlimo. ^otriovod G`mu`ry 09, >604, erak

bttp7//www.korri`k-wonstor.cak/dictiam`ry/t`mmimh

Uisw`m`tb, J., Nroom, M., Koissmor, B., Kasor, ^. V., Bosso, N., Stoolo, X.^., & ^`wjawsji,

X. (>665). C`mcor jmawlodho `md disp`ritios im tbo imeark`tiam `ho.Gaurm`l ae Bo`ltb

Cakkumic`tiam, 00, 0-08. dai7 06.0626/062068365665384>5

XBA (Xarld Bo`ltb Arh`miz`tiam) (m.d.). _ltr`vialot r`di`tiam `md imtorsum prahr`kko.

^otriovod K`rcb 3, >604, erak bttp7//www.wba.imt/uv/imtorsumprahr`kko/om/

Documents

Final Paper Health 2400-1