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Assignment: Identify and discuss the major indicators of menโ€™s health
status
Assignment: Identify and discuss the major indicators of menโ€™s health status ON
Assignment: Identify and discuss the major indicators of menโ€™s health statusRead chapter
18 of the class textbook and review the attached PowerPoint presentation. Once done,
answer the following questions.Identify and discuss the major indicators of menโ€™s health
status.Mention and describe the physiological and psychosocial factors that have an impact
on menโ€™s health status.Mention and discuss barriers to improving menโ€™s health.Mention and
discuss factors that promote menโ€™s health.INSTRUCTIONS:As stated in the syllabus present
your assignment in an APA format word document, Arial 12 font attached to the forum in
the discussion tab of the blackboard titled โ€œWeek 11 discussion questionsโ€ and
the SafeAssign exercise in the assignment tab of the blackboard. It is mandatory to post
your assignment in the SafeAssig exercise. If the assignment it is not posted there I will
grade the assignment as 0. A minimum of 2 evidence-based references besides the class
textbook no older than 5 years must be used and quoted. You must post two replies to any
of your peers sustained with the proper references no older than 5 years in two different
days to verify attendance and as well make sure the references are properly quoted in your
assignment and you mention to whom you are replying to. The reply is a comment to your
peer not an extension of your assignment. A minimum of 800 words is required. Please
make sure to follow the instructions as given and use either spell-check or Grammarly
before you post your assignment. Please review the rubric attached in lecture You must
present the assignment according to how it is posted, answering the questions by number,
essay-style assignments will not be accepted unless otherwise specified. Iโ€™ve been grading a
lot of assignments with quite a few spelling/grammar errors. As a BSN student, you should
be able to present an assignment according to APA and without errors. This reflects our
University.rubric_2_8_.docxchn_chapter_018.pptxescription Rubric Detail Levels of
Achievement Criteria Proficient Competent Novice Introduction and quality of discussionโ€™s
Argument Weight 60.00% 100.00 % It is consistent with application in research related to
its context. Clarity of ideas. Comprehensive, indepth and wide ranging. 70.00 % The topic
has a partially weak association to clarity of ideas and related topic. Relevant but not
comprehensive. 15.00 % Unable to address any part of the question and/or topic. Little
relevance/some accuracy. Objectivity of Tone, overall quality & Review of Literature in APA
6th format within past 7 years Weight 10.00% 100.00 % Tone is consistent, addressed
professionally and objectively. Evidence in literature s arguments. 70.00 % The tone is not
consistently objective. Some observations, some ive evidence used. 15.00 % No objectivity
in tone. No evidence of literature review provided. Lacks evidence of critical analysis, poor
to no use of ive evidence. Grammar / Writing Skills Weight 7.50% 100.00 % Excellent
mechanics, sentence structure and organization with no grammatical mistakes. 70.00 %
Some grammatical lapses , uses emotional responses in lieu of relevant points. 0.00 % Poor
grammar, weak communication, lack of clarity. Peer Reply #1 Weight 7.50% 100.00 %
Assignment: Identify and discuss the major indicators of menโ€™s health statusDemonstrates
an exceptional ability to analyze and synthesize student work, asks meaningful extending
questions. 70.00 % Some ability to meaningfully comment on other students work and ask
meaningful questions. 0.00 % No peer response Peer Reply #2 Weight 7.50% 100.00 %
70.00 % 0.00 % No Peer response Levels of Achievement Criteria Overall APA Use Weight
7.50% Proficient Competent Demonstrates an exceptional ability to analyze and synthesize
student work, asks meaningful extending questions. Some ability to meaningfully comment
on other students work and ask meaningful questions. 100.00 % Demonstrates an
exceptional ability to apply 6th edition APA standards. 70.00 % Some ability to to apply 6th
edition APA standards. i.e. use of in-text citation, reference structure, quoting,etc. Novice
0.00 % No adherence to 6th edition APA standards. Chapter 18 Menโ€™s Health Copyright ยฉ
2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. Longevity and
Mortality in Men ? ? ? ? Rates of longevity are increasing for both men and women. Gender
disparity for life expectancy and mortality has decreased, but mortality rates for men
remain higher than those for women. Factors influencing mortality rates include race or
ethnic origin, socioeconomic status, and education. Males continue to be at risk for death
resulting from unintentional injury and homicide. Copyright ยฉ 2015, 2011, 2007, 2001,
1997, 1993 by Saunders, an imprint of Elsevier Inc. 2 Morbidity in Menโ€™s Health ? ? ? ? Men
tend to perceive themselves to be in better health than do women. Assignment: Identify and
discuss the major indicators of menโ€™s health statusWomen are more likely to be ill, whereas
men are at greater risk for death. Incidence rate for acute and chronic conditions is higher
for women than for men; injuries are higher for men than women. Women have higher
morbidity rates than men, but men have higher morbidity and mortality rates for conditions
that are the leading causes of death. . Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by
Saunders, an imprint of Elsevier Inc. 3 Precursors of Death Frequently NOT Addressed by
the Present Health Care System ? ? ? ? ? ? ? ? ? ? Heart disease and stroke
Hypercholesterolemia Hypertension Diabetes mellitus Obesity Type A personality Family
history Lack of exercise Cigarette smoking Cancer ? ? ? ? ? ? ? ? ? Sunlight Radiation
Occupational hazards Water pollution Air pollution Dietary patterns Alcohol Heredity
Certain medical conditions Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders,
an imprint of Elsevier Inc. 4 Menโ€™s Use of Medical Care ? ? ? Men do not engage in health
protective behaviors at frequently as women. Most men do not have routine check-ups,
including screenings. Men seek ambulatory care less often than women. ? ? Men delay
medical treatment ? are sicker when they do seek health care ? therefore they require more
intensive medical care. Men tend to have longer lengths of stay in the hospital than women.
Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 5
Male-Female Health Paradox Females are sicker, but males die sooner? โ€“ Verbrugge and
Wingard (1987) Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint
of Elsevier Inc. 6 Male-Female Health Paradox (Cont.) ? Biological factors ? ? Genetics,
effects of sex hormones, and physiological differences Influenced by genetics, hormones,
and environment Socialization ? Men enculturate their sons to believe that risking personal
injury demonstrates masculinity. ? Men are more likely to change health behaviors when
ed by female family members. Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by
Saunders, an imprint of Elsevier Inc. 7 Male-Female Health Paradox (Cont.) ? Orientation
toward illness and prevention ? Assignment: Identify and discuss the major indicators of
menโ€™s health statusStereotypical view of men as strong and invulnerable is incongruent
with health promotion. ? Men lack the somatic awareness and are less likely to interpret
symptoms as indicators of illness. ? Men may have a desire to rationalize symptoms and
deny their susceptibility to disease, thus delaying treatment. Copyright ยฉ 2015, 2011, 2007,
2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 8 Male-Female Health Paradox
(Cont.) ? Data collection on health behaviors may not be accurate: ? Males are less likely
than females to participate in the data collection process. ? Social pressure for males to be
less expressive (suppress their emotions) may help explain gender differences in reporting
health behaviors. Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint
of Elsevier Inc. 9 Nurseโ€™s Responsibilities with Menโ€™s Health ? ? ? ? Use gender-specific
interview techniques to obtain the most accurate health history. Be aware of personal
gender bias in data collection. Be aware of the accuracy and interpretation of secondary
sources of information. Help men learn how to provide to the caregiver or to develop a
caregiver role. Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
Elsevier Inc. 10 Nurseโ€™s Responsibilities with Menโ€™s Health (Cont.) ? Acknowledge that
gender-linked behaviors increase risks: ? ? ? Lifestyle factors (e.g., use of tobacco, substance
abuse, poor preventive health habits and stress, lack of emotional channels) Menโ€™s
unwillingness to seek preventive care Menโ€™s unwillingness to seek health care when a
symptom arises Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint
of Elsevier Inc. 11 Barriers to Health Care for Men ? ? Little effort has been made to create a
malespecific health care climate Access to care ? Focused on maintaining an effective
workforce ? Financial for curativeโ€”not preventiveโ€” care ? Assignment: Identify and
discuss the major indicators of menโ€™s health statusReluctance to take time off from work for
care ? Lack of health promotion ? ? Disease prevention and health promotion not often
reflected in a manโ€™s perception of health Focus on disease cure in the present health care
system Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
Elsevier Inc. 12 Menโ€™s Health Care Needs ? ? ? Permission to have concerns about health and
talk openly to others about them for the consideration of gender role and lifestyle
influences on their physical and mental health Attention from professionals regarding
factors that may result in illness or influence a manโ€™s expression of illness, including such
things as occupational factors, leisure patterns, and interpersonal relationships Copyright ยฉ
2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 13 Menโ€™s
Health Care Needs (Cont.) ? ? ? Information about how their bodies function, what is normal,
what is abnormal, what action to take, and the role of proper nutrition and exercise Self-
care: testicular and genital self-exams Physical exam and history-taking that include sexual
and reproductive health and illness across the lifespan Copyright ยฉ 2015, 2011, 2007,
2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 14 Menโ€™s Health Care Needs
(Cont.) ? ? ? Treatment for problems of couples, such as interpersonal problems, infertility,
family planning, sexual concerns, and STDs Help with fathering (i.e., being included as a
parent in child care) Help with fathering as a single parent, particularly with a child of the
opposite sex, in addressing the childโ€™s sexual development and concerns Copyright ยฉ 2015,
2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 15 Menโ€™s Health Care
Needs (Cont.) Assignment: Identify and discuss the major indicators of menโ€™s health status?
? ? Recognition that feelings of confusion and uncertainty in a time of rapid social change
are normal and that they may mark the onset of healthy adaptation to change Adjustment of
the health care system to menโ€™s occupational constraints regarding time and location of
health care sources Financial ways to obtain these goals Copyright ยฉ 2015, 2011, 2007,
2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 16 Primary Prevention Measures
? ? ? ? Provide health education and screening in the workplace Participate in interest
groups and research focused on menโ€™s health Encourage interest in physical fitness and
lifestyle changes Include the male perception of health in policy formation Copyright ยฉ
2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 17 Secondary
Prevention Measures ? ?Tailor health care clinics to menโ€™s needs Provide screening services
for men ? ? ? ? ? ? ? ? Dental examination: Yearly Eye examination: Every 3 to 5 years Blood
pressure check: Every 2 years Blood cholesterol check for men aged 53 years and older
Prostate examination: Every year after age 50; blacks every year after age 40 Colorectal
screening: Every 3 to 5 years Tobacco use and cessation information every year One-time
screening for abdominal aortic aneurysm for men 65 years old if the male has smoked โ€“ The
U.S. Preventive Services Task Force (2004) Copyright ยฉ 2015, 2011, 2007, 2001, 1997,
1993 by Saunders, an imprint of Elsevier Inc. 18 Tertiary Prevention Measures ? Provide
rehabilitation with sex role and lifestyle considerations ? Provide counseling on lifestyle,
role changes, and job retraining. ? Give men permission to express emotions. ? Adapt goal
setting to meet menโ€™s needs. ? Keep time away from work to a minimum. ? Develop new
concepts of community care ? Provide specific services for men; adapt care to meet needs of
male population in the community. Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by
Saunders, an imprint of Elsevier Inc. 19

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Identify and discuss the major indicators of health status.pdf

  • 1. Assignment: Identify and discuss the major indicators of menโ€™s health status Assignment: Identify and discuss the major indicators of menโ€™s health status ON Assignment: Identify and discuss the major indicators of menโ€™s health statusRead chapter 18 of the class textbook and review the attached PowerPoint presentation. Once done, answer the following questions.Identify and discuss the major indicators of menโ€™s health status.Mention and describe the physiological and psychosocial factors that have an impact on menโ€™s health status.Mention and discuss barriers to improving menโ€™s health.Mention and discuss factors that promote menโ€™s health.INSTRUCTIONS:As stated in the syllabus present your assignment in an APA format word document, Arial 12 font attached to the forum in the discussion tab of the blackboard titled โ€œWeek 11 discussion questionsโ€ and the SafeAssign exercise in the assignment tab of the blackboard. It is mandatory to post your assignment in the SafeAssig exercise. If the assignment it is not posted there I will grade the assignment as 0. A minimum of 2 evidence-based references besides the class textbook no older than 5 years must be used and quoted. You must post two replies to any of your peers sustained with the proper references no older than 5 years in two different days to verify attendance and as well make sure the references are properly quoted in your assignment and you mention to whom you are replying to. The reply is a comment to your peer not an extension of your assignment. A minimum of 800 words is required. Please make sure to follow the instructions as given and use either spell-check or Grammarly before you post your assignment. Please review the rubric attached in lecture You must present the assignment according to how it is posted, answering the questions by number, essay-style assignments will not be accepted unless otherwise specified. Iโ€™ve been grading a lot of assignments with quite a few spelling/grammar errors. As a BSN student, you should be able to present an assignment according to APA and without errors. This reflects our University.rubric_2_8_.docxchn_chapter_018.pptxescription Rubric Detail Levels of Achievement Criteria Proficient Competent Novice Introduction and quality of discussionโ€™s Argument Weight 60.00% 100.00 % It is consistent with application in research related to its context. Clarity of ideas. Comprehensive, indepth and wide ranging. 70.00 % The topic has a partially weak association to clarity of ideas and related topic. Relevant but not comprehensive. 15.00 % Unable to address any part of the question and/or topic. Little relevance/some accuracy. Objectivity of Tone, overall quality & Review of Literature in APA 6th format within past 7 years Weight 10.00% 100.00 % Tone is consistent, addressed
  • 2. professionally and objectively. Evidence in literature s arguments. 70.00 % The tone is not consistently objective. Some observations, some ive evidence used. 15.00 % No objectivity in tone. No evidence of literature review provided. Lacks evidence of critical analysis, poor to no use of ive evidence. Grammar / Writing Skills Weight 7.50% 100.00 % Excellent mechanics, sentence structure and organization with no grammatical mistakes. 70.00 % Some grammatical lapses , uses emotional responses in lieu of relevant points. 0.00 % Poor grammar, weak communication, lack of clarity. Peer Reply #1 Weight 7.50% 100.00 % Assignment: Identify and discuss the major indicators of menโ€™s health statusDemonstrates an exceptional ability to analyze and synthesize student work, asks meaningful extending questions. 70.00 % Some ability to meaningfully comment on other students work and ask meaningful questions. 0.00 % No peer response Peer Reply #2 Weight 7.50% 100.00 % 70.00 % 0.00 % No Peer response Levels of Achievement Criteria Overall APA Use Weight 7.50% Proficient Competent Demonstrates an exceptional ability to analyze and synthesize student work, asks meaningful extending questions. Some ability to meaningfully comment on other students work and ask meaningful questions. 100.00 % Demonstrates an exceptional ability to apply 6th edition APA standards. 70.00 % Some ability to to apply 6th edition APA standards. i.e. use of in-text citation, reference structure, quoting,etc. Novice 0.00 % No adherence to 6th edition APA standards. Chapter 18 Menโ€™s Health Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. Longevity and Mortality in Men ? ? ? ? Rates of longevity are increasing for both men and women. Gender disparity for life expectancy and mortality has decreased, but mortality rates for men remain higher than those for women. Factors influencing mortality rates include race or ethnic origin, socioeconomic status, and education. Males continue to be at risk for death resulting from unintentional injury and homicide. Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 2 Morbidity in Menโ€™s Health ? ? ? ? Men tend to perceive themselves to be in better health than do women. Assignment: Identify and discuss the major indicators of menโ€™s health statusWomen are more likely to be ill, whereas men are at greater risk for death. Incidence rate for acute and chronic conditions is higher for women than for men; injuries are higher for men than women. Women have higher morbidity rates than men, but men have higher morbidity and mortality rates for conditions that are the leading causes of death. . Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 3 Precursors of Death Frequently NOT Addressed by the Present Health Care System ? ? ? ? ? ? ? ? ? ? Heart disease and stroke Hypercholesterolemia Hypertension Diabetes mellitus Obesity Type A personality Family history Lack of exercise Cigarette smoking Cancer ? ? ? ? ? ? ? ? ? Sunlight Radiation Occupational hazards Water pollution Air pollution Dietary patterns Alcohol Heredity Certain medical conditions Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 4 Menโ€™s Use of Medical Care ? ? ? Men do not engage in health protective behaviors at frequently as women. Most men do not have routine check-ups, including screenings. Men seek ambulatory care less often than women. ? ? Men delay medical treatment ? are sicker when they do seek health care ? therefore they require more intensive medical care. Men tend to have longer lengths of stay in the hospital than women. Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 5
  • 3. Male-Female Health Paradox Females are sicker, but males die sooner? โ€“ Verbrugge and Wingard (1987) Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 6 Male-Female Health Paradox (Cont.) ? Biological factors ? ? Genetics, effects of sex hormones, and physiological differences Influenced by genetics, hormones, and environment Socialization ? Men enculturate their sons to believe that risking personal injury demonstrates masculinity. ? Men are more likely to change health behaviors when ed by female family members. Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 7 Male-Female Health Paradox (Cont.) ? Orientation toward illness and prevention ? Assignment: Identify and discuss the major indicators of menโ€™s health statusStereotypical view of men as strong and invulnerable is incongruent with health promotion. ? Men lack the somatic awareness and are less likely to interpret symptoms as indicators of illness. ? Men may have a desire to rationalize symptoms and deny their susceptibility to disease, thus delaying treatment. Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 8 Male-Female Health Paradox (Cont.) ? Data collection on health behaviors may not be accurate: ? Males are less likely than females to participate in the data collection process. ? Social pressure for males to be less expressive (suppress their emotions) may help explain gender differences in reporting health behaviors. Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 9 Nurseโ€™s Responsibilities with Menโ€™s Health ? ? ? ? Use gender-specific interview techniques to obtain the most accurate health history. Be aware of personal gender bias in data collection. Be aware of the accuracy and interpretation of secondary sources of information. Help men learn how to provide to the caregiver or to develop a caregiver role. Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 10 Nurseโ€™s Responsibilities with Menโ€™s Health (Cont.) ? Acknowledge that gender-linked behaviors increase risks: ? ? ? Lifestyle factors (e.g., use of tobacco, substance abuse, poor preventive health habits and stress, lack of emotional channels) Menโ€™s unwillingness to seek preventive care Menโ€™s unwillingness to seek health care when a symptom arises Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 11 Barriers to Health Care for Men ? ? Little effort has been made to create a malespecific health care climate Access to care ? Focused on maintaining an effective workforce ? Financial for curativeโ€”not preventiveโ€” care ? Assignment: Identify and discuss the major indicators of menโ€™s health statusReluctance to take time off from work for care ? Lack of health promotion ? ? Disease prevention and health promotion not often reflected in a manโ€™s perception of health Focus on disease cure in the present health care system Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 12 Menโ€™s Health Care Needs ? ? ? Permission to have concerns about health and talk openly to others about them for the consideration of gender role and lifestyle influences on their physical and mental health Attention from professionals regarding factors that may result in illness or influence a manโ€™s expression of illness, including such things as occupational factors, leisure patterns, and interpersonal relationships Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 13 Menโ€™s Health Care Needs (Cont.) ? ? ? Information about how their bodies function, what is normal, what is abnormal, what action to take, and the role of proper nutrition and exercise Self-
  • 4. care: testicular and genital self-exams Physical exam and history-taking that include sexual and reproductive health and illness across the lifespan Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 14 Menโ€™s Health Care Needs (Cont.) ? ? ? Treatment for problems of couples, such as interpersonal problems, infertility, family planning, sexual concerns, and STDs Help with fathering (i.e., being included as a parent in child care) Help with fathering as a single parent, particularly with a child of the opposite sex, in addressing the childโ€™s sexual development and concerns Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 15 Menโ€™s Health Care Needs (Cont.) Assignment: Identify and discuss the major indicators of menโ€™s health status? ? ? Recognition that feelings of confusion and uncertainty in a time of rapid social change are normal and that they may mark the onset of healthy adaptation to change Adjustment of the health care system to menโ€™s occupational constraints regarding time and location of health care sources Financial ways to obtain these goals Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 16 Primary Prevention Measures ? ? ? ? Provide health education and screening in the workplace Participate in interest groups and research focused on menโ€™s health Encourage interest in physical fitness and lifestyle changes Include the male perception of health in policy formation Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 17 Secondary Prevention Measures ? ?Tailor health care clinics to menโ€™s needs Provide screening services for men ? ? ? ? ? ? ? ? Dental examination: Yearly Eye examination: Every 3 to 5 years Blood pressure check: Every 2 years Blood cholesterol check for men aged 53 years and older Prostate examination: Every year after age 50; blacks every year after age 40 Colorectal screening: Every 3 to 5 years Tobacco use and cessation information every year One-time screening for abdominal aortic aneurysm for men 65 years old if the male has smoked โ€“ The U.S. Preventive Services Task Force (2004) Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 18 Tertiary Prevention Measures ? Provide rehabilitation with sex role and lifestyle considerations ? Provide counseling on lifestyle, role changes, and job retraining. ? Give men permission to express emotions. ? Adapt goal setting to meet menโ€™s needs. ? Keep time away from work to a minimum. ? Develop new concepts of community care ? Provide specific services for men; adapt care to meet needs of male population in the community. Copyright ยฉ 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 19