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THEORIES OF COMMUNITY
HEALTH NURSING
 Presented to/
Prof. Dr / Gehad abo elmaaty
Prof .Dr /Reda Mowafy
 Presented by:
Nourhan Dahshan
Introduction.
1.Definition of theory
2.Definition of nursing theory
3.Characteristics of theory
4. uses and importance of theory
5.major concepts of nursing theory
6.nursing theorists
7. Theory applied in community
8. Journal of theories of community
9.Application
9.Reference
 The concept of community is defined as "a
group of people who share some important
feature of their lives and use some common
agencies and institutions." The concept of
health is defined as "a balanced state of
well-being resulting from harmonious
interactions of body, mind, and spirit." The
term community health is defined by
meeting the needs of a community by
identifying problems and managing
interactions within the community
 A set of concepts, definitions, relationships, and assumptions
that project a systematic view of a phenomena.
 It may consist of one or more relatively specific and concrete
concepts and propositions that purport to account for, or
organize some phenomenon.
Definition of nursing theory
*Nursing theory ;are organized bodies of knowledge to define what nursing is
;what nurses do and why do they do it.
* Nursing theories provide a way to define nursing as a unique discipline that
is separate from other disciplines(e.g ; medicine)
Basic Elements
 The six basic elements of nursing practice
incorporated in community health programs
and services are:
(1) promotion of healthful living
(2) prevention of health problems
(3) treatment of disorders
(4) rehabilitation
(5) evaluation and
(6) research
1.Theories must be in nature.
2.theories should be generalizable.
3.theories can be the bases for hypotheses that
can be tested.
4. theories modified by research finding.
5 .theories developed to improve an existing
theory.
6.theories must be consistent with other
validated theory; laws and principle .
7.to be investigated.
 IN Practice;
*Assist nurses to describe; explain; and predict everyday
experiences.
*Serves to guide assessment; intervention and evaluation of
nursing care.
*Help to establish criteria to measure the quality of nursing
care
 IN education;
*Provide a general focus for curriculum design.
 *Guide curricular decision making.
 IN Research;
*offer a framework for generating knowledge and new ideas.
*assist in discovering knowledge gaps in the specific field of
study.
Major concepts of nursing theories
•Person:
Recipient of care including physical, spiritual, psychological, and
social cultural component.
•Environment:
All internal and external conditions, circumstances and influences
affecting the person.
•Health:
Degree of wellness or illness experiences by the person.
•Nursing:
Actions, characteristics and attributes of person giving care
 The commonly used theories are:
 Nightingale’s theory of environment.
 Roper, Logan & Tierney (ADL).
 Palau’s (interpersonal communication)
 Orem (Self-Care)
 Roy (adaptation model)
 Carper (personal explanations)
 Henderson's theory.
 Johnson behavioral systems model
Theories and models for community
health nursing
1.Florence nightingale ;environmental theory
 Major concept:
 Ventilation and warming
 Light, noise
 Cleanliness of room walls
 Health of houses
 Bed and bedding
 Personal cleanliness
 Variety
 Chattering hope and advices
 Taking food, what food ?
 Pretty management observation
Theory of Florence nightingale
Nursing paradigms
Nursing: nursing is different from medicine and the goal
nursing is to place the patient in the best possible condition for
nature to act .
Nursing : is the “activities that promote health (as outlined in
canons) which occur in any caregiving situation .they can be
done by anyone .
Person:
* People are multidimensional, composed of biological,
psychological, social and spiritual component.
Health:
* Health is” not only to be well ,but to be able to use well every
power we have .
* Disease is considered as dys-ease or the absence of comfort.
Environment:
* “poor or difficult environments lead to poor health and
disease.
* “environment could be altered to improve conditions so that
the natural laws would allow healing to occur.
2-Roper Model
 Person: A developing maturing individual throughout the life
span moving from dependence to independence
 Health: meeting a range of needs - health changes with
many separate facets
 Environment: Anything external to the person and is a
framework of the activities of living
 Nursing restoring or maintaining activities of daily living
when person cannot cope independently
3-Peplau's Interpersonal Relation Model
A- person
-As an individual that strives to reduce anxiety cost by
needs.
B- Environment
-It implied that nurse must consider culture and values when
caring the patient at the hospital environment.
C- Health
-Consist of interacting physiological and interpersonal
conditions promoted through the interpersonal process.
D- Nursing
- Is a significant therapeutic interpersonal process.
- Nursing is organized through building relationships to
support communication.
 4.Callista Roy's adaptation theory
* Focuses on the ability of individual; families; groups;
communities or societies to adapt to change.
* the role of nurses is to assist the patient to adapt to illness to
be able to respond to other stimuli.
 Roy's Adaptation Theory
A- person:
- Is an adaptive system who uses innate and acquired coping
mechanism to deal with stress.
- can be individual, group , family or society.
B- Environment
- All conditions, circumstances and influences affect the
development and behavior of individual and group it is
constantly changing and interacting.
- Internal and external systems that impact on equilibrium
C- Health
-equilibrium resulting from effective coping
D- Nursing
- Includes assessment, diagnosis, goal setting, intervention
and evaluation.
-Manipulating environment to enable coping.
 5-Carpers model
The four fundamental "patterns of knowing":
 Empirical
Factual knowledge from science, or other external sources, that
can be empirically verified.
 Personal
Knowledge and attitudes derived from personal self-
understanding and empathy, including imagining one's self in
the patient's position.
 Ethical
Attitudes and knowledge derived from an ethical framework,
including an awareness of moral questions and choices.
 Aesthetic
Awareness of the immediate situation, seated in immediate
practical action; including awareness of the patient and their
circumstances as uniquely individual).
6-Henderson's theory
A-Person:
- A person must maintain physiological and emotional balance and
requires help toward independency.
B- Health :
- Is basic to human functioning which require independence
and interdependence.
C- Nursing
- The nurse has a unique function to help sick and well
individual .
-She maintains good nurse physician relationship The 14
components of nursing care encompass all possible function of
nursing.
D- Environment
- Healthy individuals may be able to control their environment
but illness may interfere with that abilities .
 people routinely consider the consequences of their behaviors
before engaging in these behaviors.
 Intentions are determined by two factors, attitude toward the
behavior and beliefs regarding others people’s support of the
behavior.
 Explore the relationship between behavior and beliefs,
attitudes, and intentions.
 The theory emphasized the role of intention and suggested
that the likelihood of behavior change is dependent on the
amount of control a person has over a given behavior and the
strength of their intent to change.
 Social cognitive learning theory highlights the idea that much
of human learning occurs in a social environment.
 By observing others, people acquire knowledge of rules,
skills, strategies, beliefs, and attitudes.
Key components of the SCT related to
individual behavior change include:
 Self-efficacy: The belief that an individual has control over
and is able to execute a behavior.
 Behavioral capability: Understanding and having the skill to
perform a behavior.
 Expectations: Determining the outcomes of behavior change.
 Expectancies: Assigning a value to the outcomes of
behavior change.
 Self-control: Regulating and monitoring individual
behavior.
 Observational learning: Watching and observing
outcomes of others performing or modeling the desired
behavior.
 Reinforcements: Promoting incentives and rewards
that encourage behavior change.
 Tannahill health promotion model consisting of three
overlapping spheres of activity: (health education,
prevention, and health protection).
1-Health education is designed to change the
knowledge, beliefs, attitudes, and behavior in a way that
facilitates health
2-Disease prevention aims to decrease risk factors and
minimize the consequences of disease; it includes primary,
secondary, and tertiary prevention.
Primary prevention: Prevention of onset of disease, e.g.
immunization; encouraging non smoking.
Secondary prevention: Preventing progression of disease,
e.g. Screening.
Tertiary prevention: Reducing further disability and
suffering in those already ill.; e.g . Rehabilitation , patient
éducation, palliative
3-Health protection focuses on fiscal or legal controls
and policies and voluntary codes of practice aimed at
preventing ill health and enhancing well-being
 Epidemiology journal.
 Global journal of nursing and forensic
studies.
 Advanced practices in nursing journal.
 Journal of nursing and health sciences.
 Nursing and care journal .
 Health economic and outcome research
journal .
 Level of prevention of corona
virus according Tannahill Model
(An Intervention-Based Model)
 Primordial prevention
 Primary prevention
 Secondary prevention
 Tertiary prevention
Non-modifiable risk factors:
 Chronic disease this includes people with lung disease or
diabetes, those who have suppressed immune systems
 Age(elderly)
 Gender-males have been affected more often than females .
 Pregnant women
Modifiable risk factors
 Health workers are recommended to apply infection
prevention and control measures while dealing with patients.
 Recent travel from or residence in an area with ongoing
community spread of COVID-19.
 Close contact with someone who has COVID-19 such as when
a family member or health care worker takes care of an
infected person.
Health promotion
 Avoid large events and mass gatherings.
 Avoid close contact (within about 6 feet, or 2 meters) with
anyone who is sick or has symptoms.
 Keep distance between yourself and others if COVID-19 is
spreading in your community, especially if you have a higher
risk of serious illness.
 Avoid touching your eyes, nose and mouth.
 Wash your hands often with soap and water for at least 20
seconds, or use an alcohol-based hand sanitizer that contains
at least 60% alcohol.
 Cover your mouth and nose with your elbow or a tissue when
you cough or sneeze. Throw away the used tissue.
 Avoid sharing dishes, glasses, bedding and other household
items if you're sick.
 Clean and disinfect high-touch surfaces daily.
 Stay home from work, school and public areas if you're sick,
unless you're going to get medical care. Avoid taking public
transportation if you're sick
⦿Specific protection
⦿Vaccination:
⦿No vaccine
⦿Increase immunity
-Making healthy lifestyle choices by consuming nutritious foods
-getting enough sleep and exercise are the most important ways to
bolster your immune system
 Specific protection
For people at risk
 No direct close contact with person while they are infectious
 No close contact with a person with a confirmed infection
who coughs or sneezes
 No touching objects or surfaces such as door handles or
tables contaminated from a cough or sneeze from a person
with confirmed infection and then touching your mouth or
face.
Early diagnosis
 WHO recommends that all suspected cases be tested for
COVID-19 according to WHO case definitions (see: Global
Surveillance for human infection with coronavirus disease
(COVID-19))
 Prioritization for testing should be given to:
 People who are at risk of developing sever disease and
vulnerable population who will require hospitalization and
advanced care for covid-19.
 Health workers including emergency services and non-
clinical staff
 The first symptomatic individuals in a closed setting( schools,
prisons, hospitals)
 People traveled from infected areas.
Treatment
 Management of mild COVID-19: symptomatic
treatment and monitoring:
1. Patients with mild disease do not require hospital
interventions, but isolation is necessary to contain
virus transmission and will depend on national
strategy and resources.
2. Provide patients with mild COVID-19 with
symptomatic treatment such as antipyretics for fever.
3. Counsel patients with mild COVID-19 about signs and
symptoms of complicated disease. If they develop any
of these symptoms, they should seek urgent care
through national referral systems
 Management of severe COVID-19:
1. Give supplemental oxygen therapy immediately to patients
with COVID-19 and respiratory distress, hypoxemia or
shock and target SpO2 > 94%
2. Closely monitor patients with COVID-19 for signs of clinical
deterioration, such as rapidly progressive respiratory failure
and sepsis and respond immediately with supportive care
interventions.
3. Use conservative fluid management in patients with COVID-
19 when there is no evidence of shock.
 All measures available to reduce or limit impairments and
disabilities and to promote patients adjustment to
irremediable condition.
 Intervention that should be accomplished in the stage of
tertiary prevention are disability limitation and rehabilitation.
 Rehabilitation: after discharge from hospital patient's should
be rest at least 2 weeks before they get back to work.
 Wills M.Evelyn, McEwen Melanie (2002). Theoretical
Basis for Nursing Philadelphia. Lippincott Williams&
wilkins.
 Meleis Ibrahim Afaf (1997) , Theoretical Nursing :
Development & Progress 3rd ed.
Philadelphia, Lippincott.
 Taylor Carol,Lillis Carol (2001)The Art & Science Of
Nursing Care 4th ed. Philadelphia, Lippincott.
 Potter A Patricia, Perry G Anne (1992)
Fundamentals Of Nursing –Concepts Process &
Practice 3rd ed. London Mosby Year Book.
 Vandemark L.M. Awareness of self & expanding
consciousness: using Nursing theories to prepare
nurse –therapists Ment Health Nurs. 2006 Jul; 27(6)
: 605-15
 Reed PG, The force of nursing theory guided-
practice. Nurs Sci Q. 2006 Jul;19(3):22

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Theories of community health nursing finall (1).pptx

  • 2.  Presented to/ Prof. Dr / Gehad abo elmaaty Prof .Dr /Reda Mowafy  Presented by: Nourhan Dahshan
  • 3. Introduction. 1.Definition of theory 2.Definition of nursing theory 3.Characteristics of theory 4. uses and importance of theory 5.major concepts of nursing theory 6.nursing theorists 7. Theory applied in community 8. Journal of theories of community 9.Application 9.Reference
  • 4.  The concept of community is defined as "a group of people who share some important feature of their lives and use some common agencies and institutions." The concept of health is defined as "a balanced state of well-being resulting from harmonious interactions of body, mind, and spirit." The term community health is defined by meeting the needs of a community by identifying problems and managing interactions within the community
  • 5.  A set of concepts, definitions, relationships, and assumptions that project a systematic view of a phenomena.  It may consist of one or more relatively specific and concrete concepts and propositions that purport to account for, or organize some phenomenon.
  • 6. Definition of nursing theory *Nursing theory ;are organized bodies of knowledge to define what nursing is ;what nurses do and why do they do it. * Nursing theories provide a way to define nursing as a unique discipline that is separate from other disciplines(e.g ; medicine)
  • 7. Basic Elements  The six basic elements of nursing practice incorporated in community health programs and services are: (1) promotion of healthful living (2) prevention of health problems (3) treatment of disorders (4) rehabilitation (5) evaluation and (6) research
  • 8. 1.Theories must be in nature. 2.theories should be generalizable. 3.theories can be the bases for hypotheses that can be tested. 4. theories modified by research finding. 5 .theories developed to improve an existing theory. 6.theories must be consistent with other validated theory; laws and principle . 7.to be investigated.
  • 9.  IN Practice; *Assist nurses to describe; explain; and predict everyday experiences. *Serves to guide assessment; intervention and evaluation of nursing care. *Help to establish criteria to measure the quality of nursing care
  • 10.  IN education; *Provide a general focus for curriculum design.  *Guide curricular decision making.  IN Research; *offer a framework for generating knowledge and new ideas. *assist in discovering knowledge gaps in the specific field of study.
  • 11. Major concepts of nursing theories •Person: Recipient of care including physical, spiritual, psychological, and social cultural component. •Environment: All internal and external conditions, circumstances and influences affecting the person. •Health: Degree of wellness or illness experiences by the person. •Nursing: Actions, characteristics and attributes of person giving care
  • 12.
  • 13.  The commonly used theories are:  Nightingale’s theory of environment.  Roper, Logan & Tierney (ADL).  Palau’s (interpersonal communication)  Orem (Self-Care)  Roy (adaptation model)  Carper (personal explanations)  Henderson's theory.  Johnson behavioral systems model Theories and models for community health nursing
  • 14. 1.Florence nightingale ;environmental theory  Major concept:  Ventilation and warming  Light, noise  Cleanliness of room walls  Health of houses  Bed and bedding  Personal cleanliness
  • 15.  Variety  Chattering hope and advices  Taking food, what food ?  Pretty management observation Theory of Florence nightingale Nursing paradigms Nursing: nursing is different from medicine and the goal nursing is to place the patient in the best possible condition for nature to act . Nursing : is the “activities that promote health (as outlined in canons) which occur in any caregiving situation .they can be done by anyone .
  • 16. Person: * People are multidimensional, composed of biological, psychological, social and spiritual component. Health: * Health is” not only to be well ,but to be able to use well every power we have . * Disease is considered as dys-ease or the absence of comfort. Environment: * “poor or difficult environments lead to poor health and disease. * “environment could be altered to improve conditions so that the natural laws would allow healing to occur.
  • 17. 2-Roper Model  Person: A developing maturing individual throughout the life span moving from dependence to independence  Health: meeting a range of needs - health changes with many separate facets
  • 18.  Environment: Anything external to the person and is a framework of the activities of living  Nursing restoring or maintaining activities of daily living when person cannot cope independently
  • 19. 3-Peplau's Interpersonal Relation Model A- person -As an individual that strives to reduce anxiety cost by needs.
  • 20. B- Environment -It implied that nurse must consider culture and values when caring the patient at the hospital environment. C- Health -Consist of interacting physiological and interpersonal conditions promoted through the interpersonal process. D- Nursing - Is a significant therapeutic interpersonal process. - Nursing is organized through building relationships to support communication.
  • 21.  4.Callista Roy's adaptation theory * Focuses on the ability of individual; families; groups; communities or societies to adapt to change. * the role of nurses is to assist the patient to adapt to illness to be able to respond to other stimuli.
  • 22.  Roy's Adaptation Theory A- person: - Is an adaptive system who uses innate and acquired coping mechanism to deal with stress. - can be individual, group , family or society. B- Environment - All conditions, circumstances and influences affect the development and behavior of individual and group it is constantly changing and interacting. - Internal and external systems that impact on equilibrium
  • 23. C- Health -equilibrium resulting from effective coping D- Nursing - Includes assessment, diagnosis, goal setting, intervention and evaluation. -Manipulating environment to enable coping.
  • 25. The four fundamental "patterns of knowing":  Empirical Factual knowledge from science, or other external sources, that can be empirically verified.  Personal Knowledge and attitudes derived from personal self- understanding and empathy, including imagining one's self in the patient's position.
  • 26.  Ethical Attitudes and knowledge derived from an ethical framework, including an awareness of moral questions and choices.  Aesthetic Awareness of the immediate situation, seated in immediate practical action; including awareness of the patient and their circumstances as uniquely individual).
  • 27. 6-Henderson's theory A-Person: - A person must maintain physiological and emotional balance and requires help toward independency.
  • 28. B- Health : - Is basic to human functioning which require independence and interdependence. C- Nursing - The nurse has a unique function to help sick and well individual . -She maintains good nurse physician relationship The 14 components of nursing care encompass all possible function of nursing. D- Environment - Healthy individuals may be able to control their environment but illness may interfere with that abilities .
  • 29.
  • 30.  people routinely consider the consequences of their behaviors before engaging in these behaviors.  Intentions are determined by two factors, attitude toward the behavior and beliefs regarding others people’s support of the behavior.
  • 31.  Explore the relationship between behavior and beliefs, attitudes, and intentions.  The theory emphasized the role of intention and suggested that the likelihood of behavior change is dependent on the amount of control a person has over a given behavior and the strength of their intent to change.
  • 32.  Social cognitive learning theory highlights the idea that much of human learning occurs in a social environment.  By observing others, people acquire knowledge of rules, skills, strategies, beliefs, and attitudes.
  • 33. Key components of the SCT related to individual behavior change include:  Self-efficacy: The belief that an individual has control over and is able to execute a behavior.  Behavioral capability: Understanding and having the skill to perform a behavior.  Expectations: Determining the outcomes of behavior change.
  • 34.  Expectancies: Assigning a value to the outcomes of behavior change.  Self-control: Regulating and monitoring individual behavior.  Observational learning: Watching and observing outcomes of others performing or modeling the desired behavior.  Reinforcements: Promoting incentives and rewards that encourage behavior change.
  • 35.  Tannahill health promotion model consisting of three overlapping spheres of activity: (health education, prevention, and health protection). 1-Health education is designed to change the knowledge, beliefs, attitudes, and behavior in a way that facilitates health
  • 36. 2-Disease prevention aims to decrease risk factors and minimize the consequences of disease; it includes primary, secondary, and tertiary prevention. Primary prevention: Prevention of onset of disease, e.g. immunization; encouraging non smoking. Secondary prevention: Preventing progression of disease, e.g. Screening. Tertiary prevention: Reducing further disability and suffering in those already ill.; e.g . Rehabilitation , patient éducation, palliative
  • 37. 3-Health protection focuses on fiscal or legal controls and policies and voluntary codes of practice aimed at preventing ill health and enhancing well-being
  • 38.  Epidemiology journal.  Global journal of nursing and forensic studies.  Advanced practices in nursing journal.  Journal of nursing and health sciences.  Nursing and care journal .  Health economic and outcome research journal .
  • 39.  Level of prevention of corona virus according Tannahill Model (An Intervention-Based Model)
  • 40.  Primordial prevention  Primary prevention  Secondary prevention  Tertiary prevention
  • 41. Non-modifiable risk factors:  Chronic disease this includes people with lung disease or diabetes, those who have suppressed immune systems  Age(elderly)  Gender-males have been affected more often than females .  Pregnant women
  • 42. Modifiable risk factors  Health workers are recommended to apply infection prevention and control measures while dealing with patients.  Recent travel from or residence in an area with ongoing community spread of COVID-19.  Close contact with someone who has COVID-19 such as when a family member or health care worker takes care of an infected person.
  • 43. Health promotion  Avoid large events and mass gatherings.  Avoid close contact (within about 6 feet, or 2 meters) with anyone who is sick or has symptoms.  Keep distance between yourself and others if COVID-19 is spreading in your community, especially if you have a higher risk of serious illness.  Avoid touching your eyes, nose and mouth.
  • 44.  Wash your hands often with soap and water for at least 20 seconds, or use an alcohol-based hand sanitizer that contains at least 60% alcohol.  Cover your mouth and nose with your elbow or a tissue when you cough or sneeze. Throw away the used tissue.  Avoid sharing dishes, glasses, bedding and other household items if you're sick.  Clean and disinfect high-touch surfaces daily.  Stay home from work, school and public areas if you're sick, unless you're going to get medical care. Avoid taking public transportation if you're sick
  • 45. ⦿Specific protection ⦿Vaccination: ⦿No vaccine ⦿Increase immunity -Making healthy lifestyle choices by consuming nutritious foods -getting enough sleep and exercise are the most important ways to bolster your immune system
  • 46.  Specific protection For people at risk  No direct close contact with person while they are infectious  No close contact with a person with a confirmed infection who coughs or sneezes  No touching objects or surfaces such as door handles or tables contaminated from a cough or sneeze from a person with confirmed infection and then touching your mouth or face.
  • 47. Early diagnosis  WHO recommends that all suspected cases be tested for COVID-19 according to WHO case definitions (see: Global Surveillance for human infection with coronavirus disease (COVID-19))  Prioritization for testing should be given to:
  • 48.  People who are at risk of developing sever disease and vulnerable population who will require hospitalization and advanced care for covid-19.  Health workers including emergency services and non- clinical staff  The first symptomatic individuals in a closed setting( schools, prisons, hospitals)  People traveled from infected areas.
  • 49. Treatment  Management of mild COVID-19: symptomatic treatment and monitoring: 1. Patients with mild disease do not require hospital interventions, but isolation is necessary to contain virus transmission and will depend on national strategy and resources. 2. Provide patients with mild COVID-19 with symptomatic treatment such as antipyretics for fever. 3. Counsel patients with mild COVID-19 about signs and symptoms of complicated disease. If they develop any of these symptoms, they should seek urgent care through national referral systems
  • 50.  Management of severe COVID-19: 1. Give supplemental oxygen therapy immediately to patients with COVID-19 and respiratory distress, hypoxemia or shock and target SpO2 > 94% 2. Closely monitor patients with COVID-19 for signs of clinical deterioration, such as rapidly progressive respiratory failure and sepsis and respond immediately with supportive care interventions. 3. Use conservative fluid management in patients with COVID- 19 when there is no evidence of shock.
  • 51.  All measures available to reduce or limit impairments and disabilities and to promote patients adjustment to irremediable condition.  Intervention that should be accomplished in the stage of tertiary prevention are disability limitation and rehabilitation.  Rehabilitation: after discharge from hospital patient's should be rest at least 2 weeks before they get back to work.
  • 52.  Wills M.Evelyn, McEwen Melanie (2002). Theoretical Basis for Nursing Philadelphia. Lippincott Williams& wilkins.  Meleis Ibrahim Afaf (1997) , Theoretical Nursing : Development & Progress 3rd ed. Philadelphia, Lippincott.  Taylor Carol,Lillis Carol (2001)The Art & Science Of Nursing Care 4th ed. Philadelphia, Lippincott.  Potter A Patricia, Perry G Anne (1992) Fundamentals Of Nursing –Concepts Process & Practice 3rd ed. London Mosby Year Book.  Vandemark L.M. Awareness of self & expanding consciousness: using Nursing theories to prepare nurse –therapists Ment Health Nurs. 2006 Jul; 27(6) : 605-15  Reed PG, The force of nursing theory guided- practice. Nurs Sci Q. 2006 Jul;19(3):22