Overview
The prevention of disease is recognised internationally as being of fundamental importance to quality of life and is a core skillset for any public health professional. This unit covers the important public health topic of communicable diseases and their control. Students will learn the value of participation by engaging in team activities and tutorial activities. They will learn about prevention by exploring the aetiologies, risk factors, epidemiological trends and underlying issues relating to a wide range of communicable diseases. Students will critique the public health literature and public health campaigns to discover the importance of partnerships in the effective control of communicable diseases. Topics will include the aetiology, transmission, epidemiological trends and control strategies relating to a range of communicable diseases, including enteric, vaccine preventable and sexually transmitted infections. The impact of communicable disease upon individual and population health will be explored, with particular emphasis on the indigenous community and global context. Students will develop skills in disease surveillance and/or the prevention or management of disease outbreaks. Residential school will be compulsory for Environmental Health students but optional for Health Promotion and other students.
Details
Pre-requisites or Co-requisites
48 credit points
Important note: Students enrolled in a subsequent unit who failed their pre-requisite unit, should drop the subsequent unit before the census date or within 10 working days of Fail grade notification. Students who do not drop the unit in this timeframe cannot later drop the unit without academic and financial liability. See details in the Assessment Policy and Procedure (Higher Education Coursework).
Offerings For Term 1 - 2023
Attendance Requirements
All on-campus students are expected to attend scheduled classes – in some units, these classes are identified as a mandatory (pass/fail) component and attendance is compulsory. International students, on a student visa, must maintain a full time study load and meet both attendance and academic progress requirements in each study period (satisfactory attendance for International students is defined as maintaining at least an 80% attendance record).
Residential Schools
This unit has a Compulsory Residential School for distance mode students and the details are:
Click here to see your Residential School Timetable.
Recommended Student Time Commitment
Each 6-credit Undergraduate unit at CQUniversity requires an overall time commitment of an average of 12.5 hours of study per week, making a total of 150 hours for the unit.
Class Timetable
Assessment Overview
Assessment Grading
This is a graded unit: your overall grade will be calculated from the marks or grades for each assessment task, based on the relative weightings shown in the table above. You must obtain an overall mark for the unit of at least 50%, or an overall grade of ‘pass’ in order to pass the unit. If any ‘pass/fail’ tasks are shown in the table above they must also be completed successfully (‘pass’ grade). You must also meet any minimum mark requirements specified for a particular assessment task, as detailed in the ‘assessment task’ section (note that in some instances, the minimum mark for a task may be greater than 50%). Consult the University’s Grades and Results Policy for more details of interim results and final grades.
All University policies are available on the CQUniversity Policy site.
You may wish to view these policies:
- Grades and Results Policy
- Assessment Policy and Procedure (Higher Education Coursework)
- Review of Grade Procedure
- Student Academic Integrity Policy and Procedure
- Monitoring Academic Progress (MAP) Policy and Procedure – Domestic Students
- Monitoring Academic Progress (MAP) Policy and Procedure – International Students
- Student Refund and Credit Balance Policy and Procedure
- Student Feedback – Compliments and Complaints Policy and Procedure
- Information and Communications Technology Acceptable Use Policy and Procedure
This list is not an exhaustive list of all University policies. The full list of University policies are available on the CQUniversity Policy site.
Feedback, Recommendations and Responses
Every unit is reviewed for enhancement each year. At the most recent review, the following staff and student feedback items were identified and recommendations were made.
Feedback from Self-reflection
Continue to update lecture material content
Some content needs to be updated and aligned with PBHL11001 to facilitate scaffolded learning. Also, some content needs to be revised to better reflect the current health affairs post-pandemic
Feedback from Student feedback evaluation
The residential school should have been spread across three or four days, not two. The field trip to the water treatment plant would have been more suitable for the unit where we were learning about water treatment, not this unit. Assessment Four was interesting but felt very outdated and limited learning as it was very much a regurgitation of information rather than learning; practicing; assessing. A smaller scale outbreak investigation topic would have been far better to investigate and it would have been far more beneficial to actually run through the assessment from week one, providing a little more data each week and learning epi info across each week as well, putting in the data and interpreting the results at the same time so that the assessment had some meaning. Hands on learning for this assessment would be far more beneficial for students to actively learn testing methods, data gathering and interpreting, data input (epi info) and output (graphs/figures) and finish off with a small scale investigation report with data we have gathered rather than been provided.
Run residential school for three days Explain to students the purpose of the field trips so that they can relate it to their outbreak investigation. Alternatively, the outbreak investigation exercise should be changed to reflect an outbreak due to a contaminate in a water treatment plant Consider revising the outbreak investigation assessment to reflect an Australian case and asking students to complete the investigation assessment on Epi Info
Feedback from Personal reflection
Residential school was run for two days (Thursday and Friday), which many students found too intensive. The difficulty of catching flights in the afternoon out of Rockhampton meant that many students could not attend the planned report writing session on Saturday because they had to catch their flights home on Saturday morning.
it is recommended that no residential school is scheduled to extend into weekend. Also, residential school should run for three days to allow ample time for students' discussions and engagement with the learning materials.
- Describe risk factors and aetiology for a range of communicable diseases important to public health.
- Explain the impact of communicable diseases in the context of individual and population health.
- Identify and analyse primary, secondary and tertiary approaches for the prevention and control of communicable diseases.
- Evaluate the social and cultural impact of notifiable diseases.
- Explain the methods of measurement, monitoring, prioritisation and surveillance of communicable disease and how they are used to safeguard public health.
The learning outcomes of this unit relate to the enHealth Skills and Knowledge Matrix:
Part 1- all generic attributes
Part 2- underpinning skills and knowledge in the areas of
-
Science
- basic human anatomy and physiology related to identifying disease causation and exposure pathways
- microorganisms of significance for human health
- transmission mechanisms and likely carriers
- infective dose levels
-
Public & Environmental Health Concepts
- The points of impact to influence environmental health determinants and related methods of impact
-
Research methods
- Effective design and implementation of studies, policies and programs to protect public and environmental health and minimise risks
Part 3- Applied Skills and Knowledge
- Prevention and control of notifiable and communicable conditions.
Alignment of Assessment Tasks to Learning Outcomes
| Assessment Tasks | Learning Outcomes | ||||
|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | |
| 1 - Online Test - 15% | |||||
| 2 - Online Test - 15% | |||||
| 3 - Online Test - 15% | |||||
| 4 - Written Assessment - 55% | |||||
Alignment of Graduate Attributes to Learning Outcomes
| Graduate Attributes | Learning Outcomes | ||||
|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | |
| 1 - Communication | |||||
| 2 - Problem Solving | |||||
| 3 - Critical Thinking | |||||
| 4 - Information Literacy | |||||
| 5 - Team Work | |||||
| 6 - Information Technology Competence | |||||
| 7 - Cross Cultural Competence | |||||
| 8 - Ethical practice | |||||
| 9 - Social Innovation | |||||
| 10 - Aboriginal and Torres Strait Islander Cultures | |||||
Alignment of Assessment Tasks to Graduate Attributes
| Assessment Tasks | Graduate Attributes | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | |
| 1 - Online Test - 15% | ||||||||||
| 2 - Online Test - 15% | ||||||||||
| 3 - Online Test - 15% | ||||||||||
| 4 - Written Assessment - 55% | ||||||||||
Textbooks
Communicable Disease Control and Health Protection Handbook
Edition: 4 (2019)
Authors: Jeremy Hawker, Norman Begg, Ralf Reintjes, Karl Ekdahl, Obaghe Edeghere, and Jim E. van Steenbergen
John Wiley & Sons
ISBN: 9781119328049
Binding: eBook
Additional Textbook Information
Textbooks can be accessed online at the CQUniversity Library website. If you prefer your own copy, you can purchase either paper or eBook versions at the CQUni Bookshop here: http://bookshop.cqu.edu.au (search on the Unit code)
IT Resources
- CQUniversity Student Email
- Internet
- Unit Website (Moodle)
- Zoom Capacity (microphone required; webcam optional)
All submissions for this unit must use the referencing style: Harvard (author-date)
For further information, see the Assessment Tasks.
w.mude@cqu.edu.au
Module/Topic
Introduction to communicable disease and the principles of disease causation
Chapter
Cragg (2018). A brief history of the development of communicable disease control. edited by Cragg, Nutland, and Rudge. Applied Communicable Disease Control. (Link in eReading)
Hill. (2015). The environment and disease: association or causation? (Reprinted from JRSM, vol 58, 1965). Journal of the Royal Society of Medicine, 108(1), 32–37. https://doi.org/10.1177/0141076814562718
Reading 1-2 Gerstman, B. B (2003) "Causal Concepts", in Gerstmann, B. Burt Epidemiology Kept Simple: An Introduction to Traditional and Modern Epidemiology, Second Edition, pp 33-48, John Wiley & Sons Inc. (Link in Readings)
Reading 1-1 Pennington, H. (2014). Five diseases that are worse than Ebola. Prospect, October 2014. (Link in eReadings)
Events and Submissions/Topic
Module/Topic
Communicable Diseases and Social Determinants of Health, Emergencies, and Disasters
Chapter
Bambra. (2022). Pandemic inequalities: emerging infectious diseases and health equity. International Journal for Equity in Health, 21(1), 6–6. https://doi.org/10.1186/s12939-021-01611-2
Butler-Jones, & Wong, T. (2016). Infectious disease, social determinants and the need for intersectoral action. Canada Communicable Disease Report, 42(S1), S1–S1–20. https://doi.org/10.14745/ccdr.v42is1a04
Connolly, Gayer, M., Ryan, M. J., Salama, P., Spiegel, P., & Heymann, D. L. (2004). Communicable diseases in complex emergencies: impact and challenges. The Lancet (British Edition), 364(9449), 1974–1983. https://doi.org/10.1016/S0140-6736(04)17481-3
Braveman, & Gottlieb, L. (2014). The Social Determinants of Health: It’s Time to Consider the Causes of the Causes. Public Health Reports (1974), 129(Suppl 2), 19–31. https://doi.org/10.1177/00333549141291S206
Events and Submissions/Topic
Module/Topic
Enteric diseases
Chapter
Read Section 3 Diseases from the Communicable Disease Control and Health Protection Handbook by Hawker et al.2019) for the following diseases. You can access this book online using the eReading list tab.
Alternatively, you can read about these diseases from the Control of Communicable Disease Manual by Heymann (2015), if you have a copy of the book.
Events and Submissions/Topic
Module/Topic
Parasitic Diseases
Chapter
Read Section 3 Diseases from the Communicable Disease Control and Health Protection Handbook by Hawker et al. (2019) for the following diseases. You can access this book online using the eReading list tab.
Alternatively, you can read about these diseases from the Control of Communicable Disease Manual by Heymann (2015), if you have a copy of the book.
Events and Submissions/Topic
Module/Topic
Vaccine Preventable Diseases
Chapter
Read Section 3 Diseases from the Communicable Disease Control and Health Protection Handbook by Hawker et al. (2019) for the following diseases. You can access this book online using the eReading list tab
Alternatively, you can read about these diseases from the Control of Communicable Disease Manual by Heyman (2015), if you have a copy of the book.
Events and Submissions/Topic
Module/Topic
Chapter
Events and Submissions/Topic
Module/Topic
Sexually Transmitted Infections
Chapter
Noah, N (2006) Chapter 18 (link in eReading list)
Read Section 3 Diseases from the Communicable Disease Control and Health Protection Handbook by Hawker et al (2019).
Unemo, M., Bradshaw, C. S., Hocking, J. S., de Vries, H. J., Francis, S. C., Mabey, D., ... & Fairley, C. K. (2017). Sexually transmitted infections: challenges ahead. The Lancet infectious diseases, 17(8), e235-e279.
A Review of Sexually Transmitted Infections in Australia–Considerations in 2018. Academic forensic pathology, 8(4), 938-946.
Events and Submissions/Topic
Module/Topic
HIV
Chapter
Read the entries in your textbook Cragg et al (2018) for HIV Infection and AIDS.
Mitchell, L et al (eds) Chapter 37 HIV Intro and Epidemiology Oxford Handbook of Genitourinary Medicine, HIV, and Sexual Health, Oxford: Oxford University Press. pp449-456 (e-book link in Readings)
Holt, M. (2017). Progress and challenges in ending HIV and AIDS in Australia. AIDS and Behavior, 21(2), 331-334.
Stewart, J., & Baeten, J. M. (2020). Preventing Disease, Not Sex—Harm Reduction, HIV Preexposure Prophylaxis, and Sexually Transmitted Infections. JAMA Network Open, 3(12), e2031102-e2031102.
Okoli, C., Van de Velde, N., Richman, B., Allan, B., Castellanos, E., Young, B., ... & de Los Rios, P. (2021). Undetectable equals untransmittable (U= U): awareness and associations with health outcomes among people living with HIV in 25 countries. Sexually transmitted infections, 97(1), 18-26.
Events and Submissions/Topic
Module/Topic
Introduction to disease surveillance and observational Studies
Chapter
Cragg, Nutland & Rudge (2018) Chapter 4
Events and Submissions/Topic
Module/Topic
Communicable Disease Control and Surveillance - residential school
Chapter
Events and Submissions/Topic
Residential School for Environmental Health majors (optional for all other students), Rockhampton Campus 8:30 am-4:30 pm 10-12 May.
Students who are not attending residential school should use this week to start working on their assessment 4 and revise materials for week 8 on surveillance and observational studies.
Module/Topic
Public Health Interventions - historical and contemporary approaches
Chapter
Tognotti, E., 2013, Lessons from the History of Quarantine, from Plague to Influenza A., Emerging Infectious Diseases, 19(2) pp 254-259
Markel, H., 2014, Worldly approaches to global health: 1851 to the present, Public Health, 128(2), pp 124-128
Piret, J., & Boivin, G. 2021. Pandemics Throughout History, Frontiers in microbiology, 11(631736) https://doi.org/10.3389/fmicb.2020.631736
Events and Submissions/Topic
Module/Topic
Public Health Interventions - emerging approaches
Chapter
Brown, G., O'Donnell, D., Crooks, L., & Lake, R. 2014, Mobilisation, politics, investment and constant adaptation: lessons from the Australian health-promotion response to HIV. Health Promotion Journal Of Australia, 25(1)
McCaffery KJ, Dodd RH, Cvejic E, Ayre J, Batcup C, Isautier JMJ, Copp T, Bonner C, Pickles K, Nickel B, Dakin T, Cornell S, Wolf MS.2020. Health literacy and disparities in COVID-19–related knowledge, attitudes, beliefs and behaviours in Australia. Public Health Research & Practice.
Loewenson, R., Colvin, C. J., Szabzon, F., Das, S., Khanna, R., Coelho, V. S. P., Gansane, Z., Yao, S., Asibu, W. D., Rome, N. & Nolan, E. 2021. Beyond command and control: A rapid review of meaningful community-engaged responses to COVID-19. Global Public Health, 1-15.
Events and Submissions/Topic
Module/Topic
Emerging Key Issues in Communicable Diseases
Chapter
Sabin, N.S., Calliope, A.S., Simpson, S.V. et al. Implications of human activities for (re)emerging infectious diseases, including COVID-19. J Physiol Anthropol 39, 29 (2020). https://doi.org/10.1186/s40101-020-00239-5
Jones KE, Patel NG, Levy MA, Storeygard A, Balk D, Gittleman JL, Daszak P. Global trends in emerging infectious diseases. Nature. 2008 Feb 21;451(7181):990-3. doi: 10.1038/nature06536.
Joseph A Lewnard, Arthur L Reingold, Emerging Challenges and Opportunities in Infectious Disease Epidemiology, American Journal of Epidemiology, Volume 188, Issue 5, May 2019, Pages 873–882, https://doi.org/10.1093/aje/kwy264
Events and Submissions/Topic
Module/Topic
Chapter
Events and Submissions/Topic
Module/Topic
Chapter
Events and Submissions/Topic
1 Online Test
- Assessment 1 takes the form of quiz format.
- The quiz will open on the Monday of Week 5 and remain open until 9:00am on the following Monday (Vacation Week).
- There is no time limit to complete the quiz and you can save your quiz and return to it later (while the quiz is available).
- You will get your final result from the quiz showing which questions you got right or wrong. This will let you know what areas you need to study/revise.
- You should choose the most correct answer.
Vacation Week Monday (10 Apr 2023) 9:00 am AEST
Results will be available once the quiz has closed.
This quiz will assess the student's knowledge of the principles of disease causation, disease transmission and the aetiology, prevention and control of enteric and parasitic diseases.
- Describe risk factors and aetiology for a range of communicable diseases important to public health.
- Explain the impact of communicable diseases in the context of individual and population health.
- Identify and analyse primary, secondary and tertiary approaches for the prevention and control of communicable diseases.
- Communication
- Critical Thinking
- Information Literacy
- Information Technology Competence
2 Online Test
- Assessment 2 takes the form of quiz format.
- The quiz will become available at 9:00am on the Monday of Week 7 and remain open until 9:00am Monday of Week 8.
- There is no time limit to complete the quiz and you can save your quiz and return to it later (while the quiz is available).
- You will get your final result from the quiz showing which questions you got right or wrong. This will let you know what areas you need to study/revise.
- You should choose the most correct answer.
Week 8 Monday (1 May 2023) 9:00 am AEST
Results will be available once the quiz has closed.
This quiz will assess the student's knowledge of the principles of vaccination, the immune response and the aetiology of vaccine preventable diseases.
- Describe risk factors and aetiology for a range of communicable diseases important to public health.
- Explain the impact of communicable diseases in the context of individual and population health.
- Identify and analyse primary, secondary and tertiary approaches for the prevention and control of communicable diseases.
- Explain the methods of measurement, monitoring, prioritisation and surveillance of communicable disease and how they are used to safeguard public health.
- Communication
- Critical Thinking
- Information Literacy
- Information Technology Competence
3 Online Test
-
Assessment 3 takes the form of short essay-style questions to assess your knowledge of the aetiology, prevention and control of sexually transmitted infections and HIV.
-
It will comprise of 5 short essay-style questions. Each question is worth 3 marks. Answers are expected to be succinct (approximately 150 to 200 words). Marks will be lost if you go over the word limit.
- The questions will become available at 9:00 am on the Monday of Week 10 and remain open until 9:00 am on the Monday of Week 11.
- There is no time limit to complete the responses, and you can save your responses and return to them later (while the question is available).
- You will get your final result from the question after 1 week (to allow for marking).
Week 11 Monday (22 May 2023) 9:00 pm AEST
Week 12 Monday (29 May 2023)
Results will be released online.
This short essay format assessments will assess the student's knowledge of the aetiology, prevention and control of sexually transmitted infections and HIV.
- Describe risk factors and aetiology for a range of communicable diseases important to public health.
- Explain the impact of communicable diseases in the context of individual and population health.
- Identify and analyse primary, secondary and tertiary approaches for the prevention and control of communicable diseases.
- Evaluate the social and cultural impact of notifiable diseases.
- Explain the methods of measurement, monitoring, prioritisation and surveillance of communicable disease and how they are used to safeguard public health.
- Communication
- Critical Thinking
- Information Literacy
- Information Technology Competence
4 Written Assessment
There are two options for this assessment task. Option 1 is for Environmental Health students and students from other disciplines who have attended residential school for this unit. Option 2 is for Health Promotion students and students from other disciplines who have not attended residential school.
Option 1: Environmental Health majors and other students who have attended residential school
While at residential school, you will be involved in the investigation of a simulated outbreak of a communicable disease.
For this assignment, you will write a report including:
- a description of the disease, its aetiology and the mechanism of the outbreak
- factors leading to the outbreak
- the actions taken to control the spread of the disease
- a critical evaluation of these actions
- future public health interventions that could prevent the outbreak from reoccurring.
Although you will work as a team while investigating the outbreak, you will need to submit an individual report. Students will be evaluated on their critical evaluation of the outbreak, drawing on the core themes and topics presented throughout the unit. If you use any information provided by your team members, you should reference these appropriately in your report. Report writing will be addressed at residential school and an exemplar will be provided on Moodle.
Word count: 2500- 3000 words
Option 2: Health Promotion majors
For this assignment, you will need to write a report which argues for HIV/AIDS or STIs to be given priority as part of a State Health Strategy. You will use the Kirby report (https://kirby.unsw.edu.au/report/asr2022). The links to specific state policy/strategy documents will be on Moodle. You must refer to one of these strategies for your home state.
The report will include the following:
1. a background to the disease, including
- the nature of the problem (description of the disease and a brief aetiology);
- the extent of the problem (trends in diagnosis, prevalence and morbidity); and
- the risk factors and protective factors.
2. a description of the population of concern, including
- a definition of the population group at risk;
- an explanation of the extent of the problem in the population group (eg. trends in diagnosis, prevalence and morbidity); and
- an investigation of the factors contributing to trends in the population group.
3. a rationale for inclusion in State policy, including
- the impact of the disease (eg. cost to individuals and community); and
- the potential for prevention and early intervention in reducing this burden.
Week 12 Friday (2 June 2023) 11:59 pm AEST
Submit online through the unit Moodle page
Exam Week Friday (16 June 2023)
After confirmation of grades
Option 1: Environmental Health majors and other students who have attended residential school
Relevance (30%)
- summarises relevant disease information from credible and reputable sources
- report is relevant to the disease under investigation
- interventions are appropriate
- interventions are thoroughly explained
- effectiveness of the intervention is evaluated
- public health interventions to prevent future outbreaks are presented
Validity (50%)
- depth and extent of discussion of the investigation
- evaluation is thorough and logically presented
- accuracy of the information used to support statements
- recommendations for future public health interventions have been based on critical thought, analysis of the
- evidence and synthesis of new ideas
- depth and range of research
Organisation (10%)
- structure and flow of information
- coherence and clarity of expression (spelling, grammar, syntax)
- all sources attributed
Presentation (10%)
- style and formatting of report
- typographical matters (types, font, headings etc)
- referencing is consistent and in accordance with Harvard style
- length
Option 2: Health Promotion majors and other students not attending residential school
Relevance (30%)
- summarises relevant disease information from credible and reputable sources
- population group is appropriate and justified
- impact of disease is thoroughly explained
- potential for prevention and early intervention in reducing burden has been thoroughly explored
Validity (50%)
- depth and extent of discussion of the disease, priority population and rationale for inclusion
- argument for rationale is thorough and logically presented
- accuracy of the information used to support statements
- depth and range of research
Organisation (10%)
- structure and flow of information
- coherence and clarity of expression (spelling, grammar, syntax)
- all sources attributed
Presentation (10%)
- style and formatting of report
- typographical matters (types, font, headings etc)
- referencing is consistent and in accordance with Harvard style
- length
- Explain the impact of communicable diseases in the context of individual and population health.
- Identify and analyse primary, secondary and tertiary approaches for the prevention and control of communicable diseases.
- Evaluate the social and cultural impact of notifiable diseases.
- Communication
- Problem Solving
- Critical Thinking
- Information Literacy
- Team Work
- Information Technology Competence
- Cross Cultural Competence
- Ethical practice
As a CQUniversity student you are expected to act honestly in all aspects of your academic work.
Any assessable work undertaken or submitted for review or assessment must be your own work. Assessable work is any type of work you do to meet the assessment requirements in the unit, including draft work submitted for review and feedback and final work to be assessed.
When you use the ideas, words or data of others in your assessment, you must thoroughly and clearly acknowledge the source of this information by using the correct referencing style for your unit. Using others’ work without proper acknowledgement may be considered a form of intellectual dishonesty.
Participating honestly, respectfully, responsibly, and fairly in your university study ensures the CQUniversity qualification you earn will be valued as a true indication of your individual academic achievement and will continue to receive the respect and recognition it deserves.
As a student, you are responsible for reading and following CQUniversity’s policies, including the Student Academic Integrity Policy and Procedure. This policy sets out CQUniversity’s expectations of you to act with integrity, examples of academic integrity breaches to avoid, the processes used to address alleged breaches of academic integrity, and potential penalties.
What is a breach of academic integrity?
A breach of academic integrity includes but is not limited to plagiarism, self-plagiarism, collusion, cheating, contract cheating, and academic misconduct. The Student Academic Integrity Policy and Procedure defines what these terms mean and gives examples.
Why is academic integrity important?
A breach of academic integrity may result in one or more penalties, including suspension or even expulsion from the University. It can also have negative implications for student visas and future enrolment at CQUniversity or elsewhere. Students who engage in contract cheating also risk being blackmailed by contract cheating services.
Where can I get assistance?
For academic advice and guidance, the Academic Learning Centre (ALC) can support you in becoming confident in completing assessments with integrity and of high standard.
What can you do to act with integrity?
