English for nurses (esp)

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English for nurses (esp)

  1. 1. English for Nurse: A curriculum Design and Material Development for a Nursing Program at University of SingaperbangsaKarawang 1. BACKGORUND A nurse is a person who, having been formally admitted to a nursing education programme duly recognized by the Member State in which it is located, has successfully completed the prescribed course of studies in nursing and has obtained the required qualifications to be registered and/or legally licensed to practise nursing. Nurses help patients, families and groups to determine and achieve their physical, mental and social potential, and to do so within the context of the environment in which they live and work. Nurses require competency to develop and perform functions that promote and maintain health as well as prevent illness. They also assess, plan, give and evaluate their professional care during illness and rehabilitation, which encompasses the physical, mental and social aspects of life as they affect health, illness, disability and dying. They may practise in hospitals and the community. They are competent to work autonomously and as members of the health care team. In certain circumstances they may delegate care to health care assistants, but they retain responsibility for care, supervise where necessary and are accountable for their decisions and actions. (WHO : 2001) Nursing is both an art and a science. It requires the understanding and the applicationin practice of specific nursing knowledge and skills, which, wherever possible, areresearch- and/or evidence-based. It draws on knowledge and techniques derived fromthe humanities, from the physical, biological and behavioural sciences, frommanagement and leadership theories and from theories of education (WHO 1996a). The role and function of nurse which was released by WHO (World Health Organization) requires nurses to achieve both art and science. In term of art, nurses which spend most of their time to help patients, families and groups to determine and achieve their physical, mental and social potential, and to do so within the context of the environment, need such a competence to communicate well with peoples. They need English, which has been an international language, to get a better interaction and communication. Nowadays, competence in English has become an urgent need for nurses whoare involved in medical services. It is due to the fact that they are required to have theability
  2. 2. to communicate with the other people in their field including doctors and patients.There are demands of professional nursingwhich includes English Competence in listening, reading, speaking and writing (Indah D. Pratiwi: 2010). In matter concerning this issue, curriculum design and material development on this program should follow the procedures and techniques with the underlying ground and teaching principles. To design a curriculum, teacher should pay attention to the principles of curriculum design. A curriculum is an attempt to communicate the essential features and principles of an educational proposal in such a form that it is open to critical scrutiny and capable of effective translation into practice ( Stenhouse: 1975). To design a curriculum is exactly to develop its contents based on students’ need. Curriculum development is an essential component of an educational programme. Richards states that “Curriculum development focuses on determining what knowledge, skills, and values students learn in schools, what experiences should be provided to bring about intended learning outcomes, and how teaching and learning in schools or educational systems can be planned, measured, and evaluated”(2001, p. 2). Let's see some steps in designing curriculum and developing its material for English for nurse to help students bridge the English skills gap. 1. Needs analysis 2. Define programme goals and objectives of the instruction 3. Data Analysis 4. Findings: Curriculum design and material development 5. Conclusion 2. NEED ANALYSISMETHODOLOGY In conducting need analysis, a designer should remember that the course has to fulfill students’ expectation, and they want a course that relates to their professional language needs. Richard, Platt and Weber in Brown define: “the process of determining the needs for which a learner or group of learners requires a language and arranging the needs according to priorities“. 1. Population The target population of this study was 5 professional nurses and 5 nursing students in practitionerlevel of RSUD Karawang. They were working in nursing units,which weredispersed all over the hospital.
  3. 3. 2. Sampling Procedures Five professional nurses and five nursing students were randomly selected from nursing units to representthe total number of nurses. Random sampling was claimed to be the best method inselecting samples because all population of the target group had an equal chance to beselected (Pleansaisurb. 1984: 30). The selection criteria were focused early on the nursingunits’ head, followed by the staff in each nursing unit. 3. Questionnaire The questionnaire is constructed to study English speaking skill ofnurses at RSUD Karawang consisted of five parts. Part 1: General Information of Respondents This part only required the respondents to indicate their personal data; age, position,office, the highest education and time spent in working. Part 2: Frequency of English Speaking Skill Used at Work This part only required the respondents to specify how often they spoke English intheir work. There were four choices: often (20 – 30 times a month), sometimes (10 – 19times a month), rarely (1 – 9 times a month), or never (0 times a month). Part 3: Frequency of the Use of English Speaking Skill in DifferentContact Situations A question covered data regarding the use of speaking skill. Four-point scales(often, sometimes, rarely and never) were used. This part only asked the respondents tospecify how often they spoke English in different contact situations. Eight sub-items wereincluded. An open-ended statement was also provided if the respondents would like to add comments. Part 4:Nurses’ Speaking Problems This part included open-ended questions regarding speaking problems therespondents faced when using English at work concentrating on pronunciation, vocabulary,grammar and confidence in speaking. Part 5: Types of English Speaking Courses Preferred by Nurses This part only required the respondents to specify the nurses’ opinions about theirneeds concerning the English syllabus, and contents.
  4. 4. 4. Data Collection The questionnaire was constructed based on the informal interview questions withthe nurses at RSUD Karawang because the results from the interviews revealed the day today real work done by such nurses, but not the theoretical ideas presented in textbooks.The first draft was translated from Indonesia into English in order to get clear understandingamong the respondents. Then the bilingual questionnaires were distributed to 5 professional nurses 5 nursing students. In some cases if the nurses or students were unclear, the researcher guidedlyinterviewed them to get detailed answers as well as related examples. 5. Data Analysis After collecting the completed questionnaire, the researcher categorized the data,tabulated and analyzed them by using percentage to identify the current English uses,problems and types of the needed English syllabus. 3. FINDINGS The findings of the data analysisconsist of narrative andtables. Five main sections are discussed 1) general information of respondents 2) frequencyof English speaking skill used at work 3) frequency of the use of English speaking skill indifferent contact situations 4) nurses’ speaking problems and 5) types of speaking coursespreferred by nurses. A. Analyzing Data Part I: General Information of Respondents Ten copies of questionnaire were distributed to the nurses and nursing students at RSUD Karawang.The respondents’ information was classified in Table 1. TABLE 1 GERNERAL INFORMATION OF RESPONDENTS Items Age 17 – 25 26 – 35 41 – 50 Position Practitioner (Professional Nurse) Nursing Students as practitioner Education Below a Bachelor degree Bachelor degree or any equivalent degree Frequency Percentage 6 2 2 60% 20% 20% 5 5 50% 50% 5 5 50% 50%
  5. 5. Experience in Working 0–5 years 6 – 10 years 10 – 15 years 16 years or more 5 3 2 0 50% 30% 20% 0% The sample in this study compiled 10 professional nurses from 5 practitioners and 5nursing students in different nursing units. Their age levels werecategorized as between 17 – 25 years (50%), 26 – 35 years (20%) and 36 – 45 years(20%). They had bachelor degree or any equivalent degree (50%), and Below a bachelor degree(50%). For experience in working, there were 50% of respondents, who have not experiencesbefore, they were the nursing students, 30% of respondents who have been working between 6 – 10years, and 20% of respondents who have been working between 10 – 15 years . As shown in Table 1, 50% of the respondents were 31 – 40 years of age and had6 – 10 years experience in working, but 50% of the respondents have not graduated from Nursing School. This inferred that the nurses had nursing experience, butthey might lack of technical vocabulary because Bachelor of Nursing Sciences studentsmostly used Indonesian language to study nursing course, so they rarely speak English asinterviewed from Ms. EkaPuspitaMerdeka, the nurse at RSUDKarawang. Additionally, the samples were composed of 50 to 50 percent of the practitioner andnursing students working for different department. Therefore, the English speakingproblems revealed in this research were equally faced by practitioner and managerialnurses. Part II: Frequency of English Speaking Skill Used at Work The respondents were asked about the frequency of usage in their work. The datawere then classified and summarized in Table 2. TABLE 2 A FREQUENCY DISTRIBUTION OF ENGLISH SPEAKING SKILL USED AT WORK Rarely Never Total Skill Often Sometimes Speaking 10 1% 5 50% 4 40% 0 0% 10 100%
  6. 6. Table 2 shows the frequency and percentage of English speaking skill usage ofnurses at Rajavithi hospital. It can be concluded from Table 2 that the respondents ”often”used speaking skill for a value of 5% (20 – 30 times a month), followed by ”sometimes” for55% (10 – 19 times a month), by "rarely" for 40% (1 – 9 times a month), and by "never" for0% (0 times a month) respectively. As shown in Table 2, it was found that 55% of the respondents sometimes spokeEnglish at work. Consequently, speaking played important roles for nursing careers. Thisassumption was in compliance with the research of Ruth (1998: 31) stated that speakingwas a key tool that medical needed to call for cooperation among individuals in the deliveryof health care services. Part III: Frequently of the Use of English Speaking Skill in Different Contact Situations The respondents were asked the percentage of situations in value use speakingskill. The data were then classified and summarized in Table 3. Often Sometimes Rarely Never Total TABLE 3 A FREQUENCY DISTRIBUTION OF THE USE OF ENGLISHSPEAKING SKILLIN DIFFERENT CONTACT SITUATIONS Asking foreign patients’ background 1 (10%) 4 (40%) 5 (50%) 0 (0%) 20 (100%) Asking foreign patients’ signs and Symptoms Giving information to foreign patients 0 (0%) 4 (40%) 6 (60%) 0 (0%) 20 (100%) 0 (0%) 4 (40%) 6 (60%) 0 (0%) 20 (100%) Informing patients of your intended nursing care if taking care of foreign Patients Discussing with doctors and other nurses to find treatment or taking care of patients if working with foreign colleagues 0 (0%) 5 (50%) 5 (50%) 0 (0%) 20 (100%) 0 (0%) 10 (50%) 10 (50%) 0 (0%) 20 (100%) Speaking Activities
  7. 7. Giving instructions and health education about the disease patients have if taking care of foreign patients Asking doctors about the patients’ progress if working with foreign doctors Asking patients to get the results of treatment or nursing care 2 (20%) 3 (30%) 5 (50%) 0 (0%) 20 (100%) 0 (0%) 10 (50%) 10 (50%) 0 (0%) 20 (100%) 1 (10%) 4 (40%) 5 (50%) 0 (0%) 20 (100%) Table 3 indicates the frequency and percentages in using English speaking skill ofnurses at Rajavithi Hospital in different contact situations. It shows that the nurses rarelyspoke English to communicate with the foreign patients, doctors and nurses. However, 50%of therespondents revealed that they sometimes spoke English to foreign patients with thecase to give information and inform them of the nursing care. Part IV: Nurses’ Speaking Problems The respondents were asked about their speaking problems the respondents facedwhen using English at work. 1. Pronunciation The most important aspect of this problem was mispronunciation. They wereworried about pronunciation and they often pronounced words incorrectly.For example, the nurse would like to ask foreign doctor "Could you pleasecheck this pharmacy label?”, but they mispronounced "label” as "level”. Then, the doctor didnot get this message correctly. 2. Vocabulary The problem was vocabulary. They were unable to use proper words to expresstheir ideas fluently. This was due to their limited knowledge of the meaning of words,technical terms and vocabulary an especially roots,prefixes and suffixes. There were twoexamples to clarify this problem. The first example was the word "chripodist". This word derived from threewords combined together: chiro, podium and ist. Chiro is the prefix means arm or head.Podium is the Greek root means foot, and ist is the suffix means a person practicing orstudying an art or science. The nurses didn’t know the structure of this word that it camefrom prefix, root
  8. 8. and suffix attached together. Therefore, it was difficult for them to analysethe word structure and guess the meaning of words or medical terminologies. The second example was that the nurse didn't realize the real meaning of "OR".Once the doctor told the nurse that "the patient needs legs OR”. Even if the nurse knewthat "OR" technically means operation, they didn’t know that "operate" was the verb form.Then, they said to the patient, "the doctor needs to cut your legs". This might shock thepatient. 3. Grammar The major problem was grammatical errors including errors in tenses, active andpassive voice. It was difficult for them to speak the most suitable words to express theirideas clearly and correctly.For example, the nurse said, "today you has fever high". As seen, the sentencewas incorrect in terms of subject and verb agreements and part of speech. The nurse alsofelt less confident in speaking English. 4. Confidence in Speaking Lack of self – confidence was the biggest problem in speaking English. Theyoften pronounced words incorrectly. Therefore, they were reluctant to speak Englishbecause they felt embarrassed. They felt excited when they were asked to show their ideasin English and they were not confident to show their ideas at meetings because they hadproblems in pronunciation, vocabulary and grammar. Part V: Types of English Speaking Courses Preferred by Nurses The respondents were asked the frequency of their English speaking course to beprovided for them. The data were then classified and summarized in Table 4. TABLE 4 A FREQUENCY DISTRIBUTION OF ENGLISH SPEAKING COURSE FORNURSES Rarely Never Total Skill Often Sometimes Speaking 2 (20%) 4 (40%) 4 (40%) 0 (0%) 20 (100%) Table 4 shows the frequency and percentage of English speaking course for nurses.The findings in this study clearly revealed that 100% of the
  9. 9. respondents needed theirorganization to provide the English speaking training for them. It can be concluded fromTable 4 that the speaking course should be provided "often" by the respondents for a valueof 20% (20 – 30 times a month), followed by "sometimes" for 40% (10 – 19 times a month),by "rarely" for 40% (1 – 9 times a month), and by "never" for 0% (0 time a month)respectively. It could be assumed that the nurses were willing to take English speakingcourse. This support the research of Siriwong (1984: abstract) stated that nurses wanted tolearn English, which emphasized speaking skill. A speaking training program should focus on related health contents. They preferredto study with native speakers and the training should be offered regularly every month orevery 3 months. They had an opportunity to speak English for their routine service. Therefore, theypreferred to have an opportunity to practise speaking. To develop their effectivecommunication skill in speaking, authorities concerned should take this into consideration. B. Planning a Program a. Goal and Objective The goals should provide a clear definition of the purpose of the programme; they should be a guideline for designer, the students and the organization requesting the services. The goals can be established in terms of extension or diversification of communicative language competences, or in terms of the enrichment of strategies, or in terms of the fulfilment of tasks. They are determined by the information you gathered during the needs analysis. According to Brown (1995, pp. 71-73) Goals is general statement about what must be accomplished in order to attain and satisfy students’ need. Objectives are Precise statements about what contents or skill the students must master in order to attain particular goal. Based on the findings data in need analysis, the designer formulates the goal of this program (English for Nurse) as below: “To facilitate the student to acquire the abilityto perform their duties in an environment where English especially speaking is used and needed”
  10. 10. In order to gain this target the designers formulate the objective of this program as below:  To introduce the students to some glossaries related to the need of their work  To acquire some useful expression they usually use in accomplishing their duty  To give authentic teaching material which is practiced directly in class finishing each topic b. Programs Needed 1. Teachers The specific teachers or lecturers needed for this program is atleast 30 years age of graduate of master program of English language education who has passed for IELT program and get a recent certificate. The teachers or lecturers also are suggested to join or at least to have a background of knowledge related to NCLEX-RN (National Council Licensure Examination for Registered Nurses) NCLEX-PN (National Council Licensure Examination for Practical Nurses) 2. Time Allotment As this program is planned to be implemented at the nursing program of UNSIKA, the time allotment of this will be based on rules and regulation of the nursing program department of UNSIKA. There will be 16 sixteen meeting for the overall teaching and learning in class includes mid test and final test. The duration of each meeting will spend the time of 3 credits point or in another word in will spend 150 minutes of teaching and learning. This duration includes the overall phases of teaching in classroom. 3. Students a. Needs of students The student needs is to acquire the abilityto perform their duties in an environment where English especially speaking is used and needed. b. Age of students The students participate in this program is undergraduate students of nursing program at University of UNSIKA with the age around 15 up twenty years old
  11. 11. c. Number of students The students participate in this program is the first semester of undergraduate students of nursing program at University of UNSIKA which consist of 245 students divided into 8 classes c. Material (Course book) 1. Syllabus Based on the analysis that has been achieved, the designer of this curriculum use the concept of Brown (2005) to set the syllabus for this program (English for Nurse) as below: University of SingaperbangsaKarawang Nursing Program Semester/ Year of Instruction Title of Course Office Instructor Name Phone Email Course description Goal Objective Course Content Overview SYLLABUS OF ENGLISH FOR NURSE 1/ 2012 – 2013 English for Nurse Nursing and Midwifery Program YousefBani Ahmad, S.S., M.Hum. 085691141196 yosh_sukses@yahoo.co.id This course is a basic material for nurse. It facilitates the student to acquire the abilityto perform their duties in an environment where English especially speaking is used and needed” To facilitate the student to acquire the abilityto perform their duties in an environment where English especially speaking is used and needed”  To introduce the students to some glossaries related to the need of their work  To acquire some useful expression they usually use in accomplishing their duty  To give authentic teaching material which is practiced directly in class finishing each topic Day 1 Intro to course and syllabus content Day 2 Vocabulary for nurse Day 3 English Greeting For Nurse Day 4-5Giving Direction In Hospital Day 6-7Parts Of The Body And Health Problem Day 8 Mid Test Day 9Health Problems Diagnose Day 10Making Observation Day 11General Assessment Day 12 Type Of Symptoms Day 13Patient Assessment Day 14-15 Checking Vital Sign Day 16 Final Test
  12. 12. Assesment Dialogue Role play 2. Lesson Plan Based on the need analysis, the designer of this program use the theory of National Capital Language Resource Center (NCLRC) by Catharine Keatley and Deborah Kennedy to construct the lesson plan of this program. The following is the sample of lesson plan taken from one the topic in the syllabus which use the theory of Scot Thornbury (2005) in implementing teaching speaking for nurse. University of SingaperbangsaKarawang Nursing Program LESSON PLAN Semester/ Year of Instruction Title of Course Office Instructor Name Phone Email Lesson Topic Lesson Goals Structure Preparation (8-10 minutes) Awareness Raising Activities Appropriation activities Autonomy 1/ 2012 – 2013 English for Nurse Nursing Program YousefBani Ahmad 085691141196 yosh_sukses@yahoo.co.id Giving Direction In Hospital After completed this chapter, students will be able to: 1. Use expressions related to giving directions correctly 2. Give directions to a certain place in or out of hospital (Scot Thurbury: 2005)  As students are arriving, chat with them about kinds of department and rooms in hospital  Ask how they find out the rooms in hospital  Review on preposition; for example asking them the location of certain room in hospital  Outline goals for today’s class  Discus with students the vocabularies related to the topic and the usage of the word in the field of nursing activity  Provide them such an authentic learning: video of nurse giving information or direction in class  Provide them some useful expression used for giving information or direction in hospital  Explore more the use of preposition in expressing the detail location of room in hospital  Provide them a sample of conversation related with giving information or direction to people in hospital  Task repetition, reading aloud and dialogue using the sample of conversation  Practice the dialogue in pair  Role play 1: students are given such a map of hospital building from the first and the second floor then the teacher
  13. 13. ask them to direct him to certain places written on the map Role play 2: students are directed to go outside the class and ask them to give direction and information of certain building or room in the school or campus or if can, the teacher can invite students to visit a hospital and ask them to give direction or information related with the location of departments or rooms in building Before leaving the class teacher gives students a kind of assignment. It is a worksheet paper.  Students are to work in pair  Each of them given a paper contains a map of building (sheet A and B)  There are rooms with no name on each paper  Students A should ask students B to complete the name of room in building of hospital using the expression of direction and vice versa  Projector  Laptop  Audio  Map  Worksheet paper Dialogue Role-play  Expansion (homework for next class) Media and tools Assessment d. Teaching Based on the setting of syllabus and lesson plan above, this program will elaborate two methodologies of teaching: 1. Teaching vocabulary (Apthorp : 2006) Research suggests that although many students acquire vocabulary naturallythrough activities at school, this cannot be left to chance in the case of childrenwith low vocabularies. Duke and Moses (2003) concluded that reading is the basis of vocabulary growth, together with engagingchildren in rich oral language and encouraging reading and talk at home. The National Reading Panel’s review (2000) identified five basic approaches tovocabulary instruction which should be used together:  explicit instruction (particularly of difficult words and words that are notpart of pupils’ everyday experience),  indirect instruction (i.e. exposure to a wide range of reading materials),  multimedia methods (going beyond the text to include other medias suchas visual stimulus, the use of the computer or sign language),  capacity methods (focusing on making reading an automatic activity), and
  14. 14.  association methods (encouraging learners to draw connections betweenwhat they do know and unfamiliar words). Evidence from Apthorp (2006) supports and extends the National Reading Panel’sconclusions. She concluded that there was a solid evidence base supporting threekey elements of vocabulary instruction:  defining and explaining word meanings;  arranging frequent encounters with new words (at least six exposures to anew word);  encouraging pupils’ deep and active processing of words and meaningsin a range of contexts.These kinds of activities are effective for vocabularydevelopment and improved reading comprehension. 2. Teaching speaking (Scot Thornbury edited by Jeremy Harmer : 2005) Essentiallly, there are kinds of knowledge that speakers bring to the skill of speaking. First, it is Extralinguistic knowledge.it is sociocultural knowledge that learners use when they communicate each others. Second isLinguistic knowledge. It consists ofgenre knowledge, discourse knowledge, pragmatic knowledge, Grammar, vocabulary, phonology So, In order to activate both knowledge (Extralinguistic and Linguistic knowledge), learners need experience three stages:  Awarness-raising:It is to help learners fill gap in theirknowledge, with regard to speaking and involves at least three process:Attention – Noticing – Undertsanding. To raise the awareness of learners about feature of speaking can be done by:Using recordings ang transcripts, Using live listening or it also can be enhanced by noticing the gap activities  Appropriation: It is a repetitive practice of language items in conditions where the possibility of making mistakes is minimized. This stage can be done through, drilling and chants, writing task, reading aloud, assisted performance and scaffolding, dialogue, communicative tasks, task repetation.  Autonomy: It is the capacity to self regulate performance as a consequence of gaining control over skill that were formally otherregulated. This phase of learning can be done through: giving presentation and talks, telling stories, jokes and anecdotes, drama
  15. 15. activities, including role-plays and simulation, discussion and debate, conversation and chat e. Testing The type of test that will be applied in this program is mostly role play. Role-playing as a teaching strategy offers several advantages for both teacher andstudent. First, student interest in the topic is raised. Research has shown that “integratingexperiential learning activities in the classroom increases interest in the subject mater andunderstanding of course content” (Poorman, 2002, pg. 32). Fogg (2001) tells of a collegeprofessor who felt that his history classes were boring and not involving the students.After trying out a role-playing type game one semester, he observed that students weremuch more interested in the material. Secondly, there is increased involvement on the part of the students in a roleplayinglesson. Students are not passive recipients of the instructor’s knowledge. Rather,they take an active part. Poorman (2002) observes that “true learning cannot take placewhen students are passive observers of the teaching process” (p. 32). One student atBarnard College who was enrolled in a roleplaying history class said, “This class trickyou into doing so much work” (Fogg, 2001). The result of the involvement is increasedlearning (Fogg, 2001). A third advantage to using role-playing as a teaching strategy is that it teachesempathy and understanding of different perspectives (Poorman, 2002). A typical roleplayingactivity would have students taking on a role of a character, learning and actingas that individual would do in the typical setting. Poorman (2002) found “a significantincrease among students in feeling another’s distress as their own” (pg. 34). Role-playinghas also been seen to be effective in reducing racial prejudice (McGregor, 1993). 4. CONCLUSSION The competence in English has become an urgent need for nurses whoare involved in medical services. It is due to the fact that they are required to have theabilityto communicate with the other people in their field including doctors and patients. This research have follows several procedures and steps in order to gain the target on how to facilitate the student to acquire the abilityto perform their duties in an
  16. 16. environment where English especially speaking is used and needed”. As a result, the writer or the designers of this program concludes their research as follow: a. The role and function of nurse which was released by WHO (World Health Organization) requires nurses to achieve both art and science. In term of art, nurses which spend most of their time to help patients, families and groups to determine and achieve their physical, mental and social potential, and to do so within the context of the environment, need such a competence to communicate well with peoples. They need English, which has been an international language, to get a better interaction and communication. b. Based on the findings data in need analysis, the designer formulates the goal of this program (English for Nurse) as below: “To facilitate the student to acquire the abilityto perform their duties in an environment where English especially speaking is used and needed” c. The students participate in this program is undergraduate students of nursing program at University of UNSIKA with the age around 15 up twenty years old consist of 245 students divided into 8 classes d. Based on the result of need analysis the course contents of this program comprise: Vocabulary for nurse, English Greeting For Nurse, Giving Direction In Hospital, Parts Of The Body And Health Problem, Health Problems Diagnose, Making Observation, General Assessment, Type Of Symptoms, Patient Assessment, Checking Vital Sign. e. Based on the setting of syllabus and lesson plan, this program will elaborate two methodologies of teaching: Teaching effective vocabulary (Apthorp :2006) and Teaching speaking (Scot Thornbury edited by Jeremy Harmer : 2005).

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