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Evaluation Of The Diabetes Self Management Education Program At Mercy Philadelphia Hospital
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Book Synopsis Evaluation of the Diabetes Self-management Education Program at Mercy Philadelphia Hospital by : Yik Han (Rachel) Chan
Download or read book Evaluation of the Diabetes Self-management Education Program at Mercy Philadelphia Hospital written by Yik Han (Rachel) Chan and published by . This book was released on 2014 with total page 66 pages. Available in PDF, EPUB and Kindle. Book excerpt: The prevalence of diabetes has been on the rise for the past decade and it is projected that this will continue to affect more people worldwide. Diabetes education programs such as the Diabetes Self-Management Education program teach patients to manage their diseases through a healthy diet, physical activity and medications. The evaluation of such a program must be based on a participant's perspective. The objective of this research is to evaluate the effectiveness of the nutrition education component of the diabetes outpatient education program at Mercy Philadelphia Hospital in improving participant self-efficacy regarding nutrition-related aspects of disease management. The study was a quasi-experimental research with a pre- and post-test design, utilizing a convenience population of diabetes education outpatient program participants at Mercy Philadelphia Hospital. Five subjects participated in the nutrition education component of the program and this study. The identical pretests and post-tests include eight statements; subjects were asked to rate their levels of self-efficacy in completing diabetes self-management tasks. Results showed that two subjects increased their self-efficacy scores while others reported no changes in self-efficacy after participating in the nutrition education class. Mean scores increased slightly but there was insufficient data to conclude on the efficacy of the nutrition education component of this program. Future research needs to focus on the ways for individualized nutrition education to be delivered effectively from the perspectives of patients with diabetes.
Book Synopsis An Outcome Evaluation of Taking Control by : Ijeoma Isiadinso
Download or read book An Outcome Evaluation of Taking Control written by Ijeoma Isiadinso and published by . This book was released on 2001 with total page 100 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Educating Your Patient with Diabetes by : Katie Weinger
Download or read book Educating Your Patient with Diabetes written by Katie Weinger and published by Springer Science & Business Media. This book was released on 2008-10-22 with total page 333 pages. Available in PDF, EPUB and Kindle. Book excerpt: Diabetes affects an estimated 20 million people in the United States, with many people remaining unaware that they suffer from the disease. While the number of diabetics continues to rise, the number of caregivers who specialize in diabetes treatment does not. In Educating Your Patient with Diabetes, Katie Weinger and Catherine Carver assemble commentary from a panel of leading diabetes practitioners and researchers and put together a highly readable guide to supplying patients with diabetes with the information and ability to successfully cope with their disease. The authors and editors provide substantive data on successful models of diabetes education and the process of educating diabetes sufferers. Additional chapters discuss diabetes in pregnancy, the challenge of weight and diabetes management in clinical practice, and diabetes education in geriatric populations. Timely and accessible, Educating Your Patient with Diabetes is a must have for all diabetes educators, physician assistants, nurses, and endocrinologists who endeavor to support their patients' diabetes self-care efforts and help them maximize the opportunities for patient learning.
Book Synopsis Evaluation and Validation of a Diabetes Self-Management Education (DSME) Program by : Heather L. Ortiz
Download or read book Evaluation and Validation of a Diabetes Self-Management Education (DSME) Program written by Heather L. Ortiz and published by . This book was released on 2017 with total page 149 pages. Available in PDF, EPUB and Kindle. Book excerpt: This Direct Practice Improvement (DPI) project used a mixed-methods design to evaluate the effectiveness of a Diabetes Self-Management Education (DSME) program as a dietary lifestyle intervention to lower Hemoglobin A1C (HgbA1c), post-prandial blood sugar levels, and weight in individuals with Type II Diabetes over a six-week period of time. This DPI project adds to existing literature, identifying a DSME program effective in improving the health outcomes of individuals with Type II Diabetes. The Johns Hopkins Nursing Evidence-Based Practice Model guided identification of the practice question, evidence collection, and translation to practice. Quantitative data illustrates how understanding metabolic differences in simple and complex carbohydrates, effects of gluconeogenesis on blood sugar, and pairing foods in the right amounts, at the right times of the day allows for the remission of symptoms of Type II Diabetes. The data shows that individuals with Type II Diabetes who followed the DSME program (n=15) reduced their Hemoglobin A1C levels to
Book Synopsis Evaluation of Diabetes Education Classes at Riddle Hospital by : JoAnne DeRobertis
Download or read book Evaluation of Diabetes Education Classes at Riddle Hospital written by JoAnne DeRobertis and published by . This book was released on 2014 with total page 54 pages. Available in PDF, EPUB and Kindle. Book excerpt: Diabetes is afflicting more individuals and at younger ages. Research supports the benefits of education to better control diabetes through improved blood glucose levels. Riddle Hospital offers diabetes education classes for patients, facilitating management through self care. In this study, the effectiveness of the diabetes classes was evaluated to ensure that the individual educational needs of diabetics attending the classes are being addressed. This study used a multiple choice, pretest/posttest questionnaire to determine the effectiveness of the diabetes education classes. The intent was to identify areas where program improvement is needed, contributing to better diabetic management. Subjects were African American and Caucasian. Individuals at each class differed; the first class had 5 individuals, the second and third class had 6 attending. Classes were presented by two certified diabetes educators: a registered nurse, and a registered dietitian. Results revealed a 13.6% increase in mean knowledge score in Class 1, a 7.1% increase in Class 2, and a 17.5% increase in Class 3. Of the 17 tests, 53% (n=9) showed improvement, 12% (n=2) showed decreased scores, and 35% (n=6) showed no improvement. Class #3, (Diabetes Self Management and Education), had the greatest increase in pre to post scores. This is likely due to the overlapping in educational material throughout the three sessions. Class #2, (Eating Behaviors and Food Choices), had the smallest increase from pre to posttest. Emphasis on this area in future classes could contribute to improved blood glucose control and better sustained health for diabetics. Future research could assess the impact of nutrition education as an element of successful self-management for diabetics.
Book Synopsis Self-efficacy and Diabetes Self-management by : Jeannette Liller
Download or read book Self-efficacy and Diabetes Self-management written by Jeannette Liller and published by . This book was released on 2020 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: " A diabetes self-management education (DSME) program was utilized to deliver an educational intervention in a rural area of Colorado. The aim of the program was to increase self-efficacy and diabetes self-management behaviors in people with diabetes aged 18 years or older. The intervention was guided by social cognitive theory (SCT) and consisted of weekly diabetes education classes delivered over three weeks. Each class lasted 1.5 hours and was developed based on the American Academy of Diabetes Educators (AADE) seven essential topics for diabetes education. The program was evaluated using a pretest/posttest design. Self-efficacy was measured using the Stanford Diabetes Self-Efficacy Scale (SDSES) and self-management was evaluated using the Diabetes Self-Management Questionnaire (DSMQ). The program resulted in an increase in both self-efficacy and self-management but did not meet the program benchmark of a 20% increase. This program supports the use of DSME guided by SCT but additional work must be done to tailor the program to the target population and to reach the identified benchmark. Key words: diabetes, diabetes mellitus, type 2 diabetes, T2DM, self-efficacy, self-management, diabetes self-management education, DSME " -- Abstract
Book Synopsis Developing a Diabetes Self-management Education Program by : Loquintha Rex
Download or read book Developing a Diabetes Self-management Education Program written by Loquintha Rex and published by . This book was released on 2007 with total page 73 pages. Available in PDF, EPUB and Kindle. Book excerpt: Problem: Pre-diabetes is an insidious condition that commonly persists for many years while progressing on to diabetes type 2. As many as 39% of patients who present with a new diagnosis of type 2 diabetes already have the presence of diabetes complications at initial diagnosis. Diabetes has become an epidemic that continues to escalate annually. Diabetes can affect multiple organ systems and lead to serious debilitating complications. Ventura County is consumed with many diabetics. There are not any comprehensive diabetes education programs in the county. Purpose/Scope: The purpose of this evidence-based practice intervention was to evaluate the effectiveness of a Diabetes self-management education (DSME) program on patient's health care utilization, medication use, self-efficaacy for diabetes and general disease management and ability to exercise, and glucose testing. A pres-test/post-test design was utilized to survey subjects participating in the program. The participants received education in four sequential sessions delivered at consistent time intervals over an eight week period. Goal: The goal of developing this program was to empower patients to develop the knowledge and skills necessary to improve health outcomes and to provide access to a diabetes self-management education program open to the general public residing in Ventura County in hopes to improve patient's lives by reducing potential long-term diabetes complications following gaining knowledge of preventative care, improving early diabetes diagnosis, and reducing the workload of primary care practices. Objectives: the objectives of this project included: following the completion of the DSME program, the subject will gain improved scores on the Chronic Disease Self-Efficacy Scales: Exercise Regularly, Manage Disease in General, Health Care Utilizations, Glucose Testing, and self-efficacy to perform self-management behaviors comparing pre-course versus post-course scores. Plan: Phase I and II involved developing the proposal draft and submitting the document to the GPD. The proposal was submitted to the IRB and approved on 3/20/2007. The class content slides were finalized. Phase III involved recruiting subjects and advertising. The classes began April 9, 2007 and continued for four separate sessions through 5/14. Pre-test and post-test questionnaires were handed out to subjects on the first day and last day of classes. Following completion, the data was analyzed. Outcomes and Results: The pre-test and post-test mean scores were compared using paired t-test and the differences were statistically significant.
Book Synopsis Evaluation of Attendance, Patient Satisfaction, Knowledge, and Clinical Outcomes Following Participation in a Group Diabetes Self-management Eduction and Support Program in a Primary Care Clinical Setting by : Jordan LeCour Rauh
Download or read book Evaluation of Attendance, Patient Satisfaction, Knowledge, and Clinical Outcomes Following Participation in a Group Diabetes Self-management Eduction and Support Program in a Primary Care Clinical Setting written by Jordan LeCour Rauh and published by . This book was released on 2020 with total page 74 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Introduction: Although group Diabetes Self-Management Education and Support (DSMES) programs have been attempted throughout Community Health Network, no evaluation of the programs had been conducted. Introduction: Although group Diabetes Self-Management Education and Support (DSMES) programs have been attempted throughout Community Health Network, no evaluation of the programs had been conducted. Objectives: The primary objectives of this study were to evaluate attendance, patient satisfaction and change in disease state knowledge following participation in six sessions of a group DSMES program led by a multidisciplinary team. The secondary objective was to evaluate clinical outcomes. Methods: This retrospective, observational study focused on process improvement evaluating a standardized approach to a group DSMES program beginning in August 2017 within Community Health Network. Eleven courses ran six sessions lasting approximately 1.5 hours that occurred weekly or every other week. Patients with a history of Type 2 diabetes who had a primary care provider within Community Health Network were invited to participate. Attendance and clinical outcomes were evaluated by a retrospective chart review of the electronic medical record. Evaluation of the program, both patient satisfaction and knowledge, occurred through the voluntary completion of various paper surveys throughout the program. Results: To date, eleven clinic sites have completed a group DSMES program totaling 89 patient participants. Program attendance was evaluated to determine what topics, days, times, and clinic sites would allow future programs to reach the most patients. 47 patients (52.8%) were able to attend four or more of the six sessions; 14 patients (15.7%) attended all six sessions. Responses from the patient satisfaction surveys indicated that patients approved of the speakers well over 90 percent of the time, patients "Strongly Agree" in favor of the sessions at a rate of 88.5% (3.54/4), and patients favored topics focusing on nutrition. Knowledge-based surveys showed an average score increase of 8.3%. Frequently missed topics included goal fasting and fed blood sugar levels. Patients showed mastery of concepts related to the definition of diabetes as well as frequency of immunizations, eye exams, and hemoglobin A1c monitoring. The average reduction of hemoglobin A1c was 0.58% overall. Patients that attended all six sessions saw an average decrease of 0.96%. Patients lost an average of 0.9 kilograms. Systolic blood pressure average dropped by 2mmHg. Conclusion: Following participation in the group DSMES program patients were satisfied with their care while increasing their disease state knowledge leading to an improvement in hemoglobin A1c. The results observed from the review of this DSMES program supports its continued use and expansion throughout Community Health Network" --Unnumbered leaf 1.
Book Synopsis Evaluating a Diabetes Self-management Education Protocol for Implementation in a Charity Clinic by : Shirley Koshy
Download or read book Evaluating a Diabetes Self-management Education Protocol for Implementation in a Charity Clinic written by Shirley Koshy and published by . This book was released on 2017 with total page 138 pages. Available in PDF, EPUB and Kindle. Book excerpt: The purpose of this quantitative pretest-posttest project was to evaluate the self-care knowledge and intent to change behaviors of adults with type 2 diabetes mellitus (T2DM) after the implementation of an evidence-based educational protocol. Orem's self-care deficit nursing theory (SCDNT) and Bandura's social cognitive theory were used as the conceptual foundation for this Direct Practice Improvement (DPI) project. As there is no structured evidence-based educational program in existence at the charity clinic, the aim of the project was to raise awareness about type 2 diabetes mellitus, importance of receiving care in a timely manner to prevent complications, providing information regarding different resources available in the community, and goal setting for prevention of disease and its complications through a diabetes self-management education (DSME) protocol. However, it was not known to what degree/extent a DSME protocol will enhance the knowledge and intent to change behavior in diabetic patients with T2DM at a charity clinic in Houston, Texas. The Michigan Diabetes Research and Training Center's (MDRTC) Revised Diabetes Knowledge Test was utilized as the survey tool. A convenience sample (n=22) was used and data analysis performed using paired sample t-tests via SPSS database volume 25.0 on the scores rendered from the survey tool. The results of the project showed a significant difference in the pre- and post-test scores (p
Book Synopsis Diabetes Self-management Education Programs at U.S. Army Medical Centers and the National Standards for Diabetes Self-management Education Programs and the American Diabetes Association Review Criteria by : Heather Wheeler Hansen
Download or read book Diabetes Self-management Education Programs at U.S. Army Medical Centers and the National Standards for Diabetes Self-management Education Programs and the American Diabetes Association Review Criteria written by Heather Wheeler Hansen and published by . This book was released on 1996 with total page 180 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis A Core Curriculum for Diabetes Education: Diabetes education and program management by : Marion J. Franz
Download or read book A Core Curriculum for Diabetes Education: Diabetes education and program management written by Marion J. Franz and published by . This book was released on 2003 with total page 284 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Assessment of Factors for Patient Engagement in Diabetes Self-management Education and Support (DSMES) Programs by : Amy Lynn Seither
Download or read book Assessment of Factors for Patient Engagement in Diabetes Self-management Education and Support (DSMES) Programs written by Amy Lynn Seither and published by . This book was released on 2020 with total page 22 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Diabetes self-management education and support (DSMES) programs are recommended for all patients with diabetes at the time of diagnosis and subsequently as needed. Diabetes is becoming increasingly prevalent in the United States, but the estimated percentage of patients receiving DSMES remains low. The purpose of this study was to identify patient-specific factors documented in the electronic medical record (EMR) that are associated with engagement or non-engagement in a DSMES program. The institutional review board approved this retrospective case-controlled chart review of patients who were referred to DSMES classes at Eskenazi Health (EH) by their health care providers. Both demographic and clinical information from the time of patient referral was extracted from the EMR. All patients who were screened for the DSMES classes and enrolled in the program from January 1, 2017-December 31, 2018 were included in the study. The analysis included 414 patients. Age (p = 0.042) and the number of chronic medications that a patient is prescribed (p = 0.002) were found to be statistically significantly higher in engagers compared to non-engagers. Whereas glycated hemoglobin (A1C) (p = 0.002) was found to be statistically significantly lower in engagers compared to non-engagers. This study shows that increased age, decreased A1C, and more prescriptions for chronic medications are associated with engagement in DSMES classes. These results correlate with the findings of similar studies regarding both age and A1C which suggests these findings could be more generalizable. These results may be used to develop a more targeted screening process for recruitment to the DSMES program. However, additional studies are needed to determine how the program could be altered to reach additional patients in the future"--Provided by author.
Book Synopsis Utilization of a Standardized Diabetes Self-management Education Program in the Management of Type 2 Diabetes by : Stephanie Omotayo
Download or read book Utilization of a Standardized Diabetes Self-management Education Program in the Management of Type 2 Diabetes written by Stephanie Omotayo and published by . This book was released on 2020 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: " It is essential that appropriate mental health support is targeted to support people with eating disorders who have anxiety. The purpose of this evidence-based practice (EBP) change project was to implement Purpose: The purpose of this evidence-based change project was to provide diabetes self-management education (DSME) to participants in a federally qualified health clinic (FQHC) to increase patient knowledge of diabetes self-management behaviors and decrease fasting blood glucose levels. Methods: Thirteen adults with uncontrolled Type 2 Diabetes; able to read, write, and speak English; and who had access to a telephone and a computer or tablet with a stable internet connection were voluntarily recruited at a FQHC. Four bi-weekly DSME one-on-one virtual sessions lasting one hour occurred over a nine-week period, with a 30-minute follow-up phone session during weeks when DSME was not scheduled. Using a pretest/posttest approach, participants' diabetes self-management knowledge, using the Revised Michigan Diabetes Knowledge Scale (RMDKS), and fasting blood glucose were measured before and after the educational intervention session. Statistical analysis utilized a paired t-test for comparison. Results: The data showed a statistically significant post-intervention improvement in both patients' diabetes knowledge with a mean pretest knowledge score of 60% and mean posttest score of 77% (p
Book Synopsis Assessment of Self-care and Education in Patients with Type 2 Diabetes Mellitus by : Kristen Mae Monroe
Download or read book Assessment of Self-care and Education in Patients with Type 2 Diabetes Mellitus written by Kristen Mae Monroe and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and Significance: The annual cost of diagnosed type 2 diabetes mellitus (DM2) in the United States is $327 billion, with individuals with DM2 spending 2.3 times more on health care than individuals without DM2. Education, such as Diabetes Self-Management Education and Support (DSMES) programs, and self-care support, utilizing tools such as the Summary of Diabetes Self-Care Activities (SDSCA) Measure, are the cornerstones of improving care and outcomes for patients with DM2. Purpose: The purpose of this quality improvement project was to implement a standardized self-care assessment and educational intervention for a mid-Michigan internal medicine clinic's adult patient population over 18 years of age with DM2 and hemoglobin A1c (HbA1c) greater than 9% and improve patient self-care. Methods: The Plan, Do, Act, Study (PDSA) Cycle and the Chronic Care Model were used as a framework to guide the project. Eligible participants were identified by clinic staff and received self-care education. Evaluation: The validated SDSCA tool was utilized to assess self-care pre- and post- educational intervention. A two-tailed paired t-test was then performed to compare pre- and post-intervention scores. Outcomes: Of 25 eligible patients in the clinic, 13 patients participated in the initial phase with 3 patients lost to follow-up, leaving 10 patients included in data analysis. A statistically significant improvement was seen in DM2 self-care with mean scores increasing from 4.1 days/week to 4.8 days/week (t = -6.5, p
Book Synopsis Comprehensive Diabetes Management Reinforcing Self-management Education to Improve the Diabetes Outcomes by : Elizabeth Parackal
Download or read book Comprehensive Diabetes Management Reinforcing Self-management Education to Improve the Diabetes Outcomes written by Elizabeth Parackal and published by . This book was released on 2018 with total page 136 pages. Available in PDF, EPUB and Kindle. Book excerpt: Diabetes remains a significant health problem in the United States, and related complications are on the rise as evident by the growing prevalence due to care fragmentation and inadequate care coordination. This quantitative quality improvement project evaluated the effect of diabetes self management education (DSME) reinforcement intervention as a primary care solution for prevention and control of diabetes and prediabetes in a small convenient care clinic in Southern California. The purpose of this project was to design and implement a diabetes self-management educational reinforcement program to enhance patients’ knowledge on diabetes self management. Diabetes knowledge improvement was measured by using a reliable and valid pretest and posttest DSMQ questionnaire. The pretest HbA1c mean was 6.51 and the post-test mean was 6.91. There was a paired differences mean of -0.40. Results indicates a significant rise in post-project HbA1c value among the control group (p=
Book Synopsis Diabetes Self-management Education: a Powerful Tool for Diabetes Control in India by : Majumder Anirban
Download or read book Diabetes Self-management Education: a Powerful Tool for Diabetes Control in India written by Majumder Anirban and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Diabetes self-management education: a powerful tool for diabetes control in IndiaDiabetes self-management education (DSME) is a critical element of care for diabetes management and is a powerful tool for reducing glycosylated haemoglobin (HbA1c), risk for complications, hospital admissions and cost of care.1 The purpose of this study was to determine the impact of DSME in improving the outcomes of diabetes care as measured by glycaemic (FPG, PPG & HbA1C), lipid (total cholesterol[TC], triglycerides[TG], low density lipoproteins[LDL] and high density lipoproteins [HDL]) and anthropometric parameters (weight, BMI & waist circumference) in individuals with type 2 diabetes mellitus (T2DM).A retrospective analysis was performed for 160 adult T2DM patients who received DSME training in 2013u20132014 from our center. DSME provided to the study participants was consistent with the requirements from the National Standards for Diabetes Self-Management Education.1 Participants received one time 6 hours intensive group training. All education was provided by a team of diabetologists, certified diabetes educators who in addition are dietician and exercise physiologist. Patients received instruction in: diet/exercise education; self-monitoring of glucose levels; medication management specifically for insulin users; diabetes related problem solving, and lifestyle changes to help reduce the risks and complications of diabetes. Subjects were judged for their acquired knowledge about the disease by using a set of questionnaire and were awarded a score based on their performance. Their socioeconomic status was also ascertained by using Kuppuswammy scoring (KS score)2 which looked at their education, monthly income and occupational status. The subjectsu2019 glycaemic parameters, lipid parameters and anthropometric measurements were checked before the DSME programme and at the end of 6 months and 12 months respectively. The DSME scores were divided into tertiles and lower tertile patients were compared to intermediate and higher tertile patients, to assess, whether differences in acquired knowledge about diabetes had impact on glycaemic, lipid and anthropometric parameters. It was revealed that waist circumference increased in all the three tertiles over the entire year following DSME without any statistically significant change in the weight and BMI over the year. Subjects with DSME score in the lowest tertile had an initial improvement in the FPG values at 6 month but a rebound increase at the end of the year made it lose statistical significance. There was however no statistically significant change in the HbA1C and PPG over the year. The lipid parameters (TC and LDL) showed statistically significant progressive deterioration which perhaps emphasises the need for an intermittent reinforcement of education. Subjects with DSME score in the intermediate tertile had an improvement in the glycaemic parameters (FPG and HbA1C) throughout the year but there was no improvement in the lipid parameters . Subjects with DSME score in the upper most tertile were already having better controls of their glycaemic parameters at the baseline and did not show significant improvements over the year but their lipid parameters (TC and LDL) did show a significant improvements over the year, perhaps secondary to their better understanding of the contribution of lipid control towards prevention of macro vascular complications. Further analysis of the data also revealed that DSME scores were independent of socioeconomic status even when analysed separately for income levels and educational qualification. In India where the large number of diabetic population has a considerable economic implication on the state as well as on the individual, more widespread use of DSME can be a cost-effective option in fighting against the growing menace of the diabetes epidemic. In conclusion, comprehensive diabetes outcomes were correlated with adequacy of baseline diabetes education. Subjects with even minimal diabetes education (lowest tertile) had transient improvement in outcomes whereas those with optimal education had sustained multifactorial benefits. Moreover DSME benefits were independent of socio-economic and educational status indicating its widespread applicability even in resource limited settings. In India where the large number of diabetic population has a considerable economic implication on the state as well as on the individual, more widespread use of DSME can be a cost-effective option in fighting against the growing menace of the diabetes epidemic.References :1. Martha M. Funnell, Tammy L. Brown et al. National Standards for Diabetes Self-Management Education. Diabetes Care. 2010 Jan; 33(Suppl 1): S89u2013S96.2. Kuppuswamy B. Manual of Socioeconomic Status (Urban) 1st ed. Delhi: Manasayan; 1981. pp. 66u201372.
Book Synopsis House Report by : United States. 79th Congress, 2nd session
Download or read book House Report written by United States. 79th Congress, 2nd session and published by Government Printing Office. This book was released on 1998 with total page 1650 pages. Available in PDF, EPUB and Kindle. Book excerpt:
