Professor of Health Policy and Public Policy
|Address:||2021 K St. NW
Washington, DC, 20006
Areas of Expertise
Public health policy
Clinical preventive services
Health reform research
Dr. Paula Lantz, a social epidemiologist, is Professor and Chair of the Department of Health Policy in the Milken Institute School of Public Health. Before joining the GW faculty, she was a faculty member at the University of Michigan School of Public Health and the Gerald R. Ford School of Public Policy, including serving for six years as the chair of the Department of Health Management and Policy. Other prior positions include working as an epidemiologist for the Wisconsin Division of Health, and as a senior researcher for Marshfield Clinic, a 400-physician integrated delivery system in Wisconsin.
Dr. Lantz's main research interests include the role of public health in health care reform, clinical preventive services (such as cancer screening and prenatal care), and social inequalities in health. She is particularly interested in the role of health care versus broad social policy aimed at social determinants of health in reducing social disparities in health status. She has led several research projects related to the National Breast and Cervical Cancer Early Detection Program, and conducted other studies on breast/cervical cancer screening and treatment in low-income populations. In addition, she has served as a lead investigator on the Americans’ Changing Lives Study, which is an ongoing, longitudinal research study of social disparities in health status and aging in the United States. Dr. Lantz has received funding for her research from the National Institutes of Health, the Centers for Disease Control and Prevention, and the Robert Wood Johnson Foundation.
PhD, Sociology, University of Wisconsin
MS, Epidemiology, University of Wisconsin
MA, Sociology, Washington University
BA, Sociology, St. Olaf College
Papers Currently In Progress or Under Peer Review
Lantz PM, Alexander JA, Adolph C, Montgomery JL. State government organization of health related services: Trends and impact on budget allocations for public health and Medicaid. In progress.
Lantz PM and Kindig D. Population medicine: A bridge between public health and medical care. In progress.
Lantz PM, Mendez D, Philbert MA. The role of smoking in radon-induced lung cancer: The need to refocus radon control policy. Under review.
Golberstein E, Lantz PM, Hirth R. The effect of education on health: A cost-utility approach. Under review.
Fowler E, Gollust SE, Dempsey A, Lantz PM, Ubel PA. Headlines, policy, and vaccination: Emergence of controversy in local media coverage of new issues. International Journal of Press/Politics, accepted.
Fleischer N, Diez-Roux A, Lantz PM. Socioeconomic patterning in tobacco use in Argentina. Nicotine and Tobacco Research, accepted.
Clarke PA, Hawthorne V, House JS, Lantz PM. A social structural theory of mental health in later life: Towards the advancement of theory in the sociology of aging. Social Forces, accepted.
Underwood W, Orom H, Poch M, West BT, Lantz PM, Chang SS, Fowke JH. Multiple physician recommendations for prostate cancer treatment: A Pandora’s box for patients? Canadian Journal of Urology, accepted.
Gollust SE, Lantz PM, Ubel PA. Images of illness: How causal claims and racial associations influence public preferences for diabetes research spending. Journal of Health Politics, Policy and Law 2011; 35(6):921-59.
Mendez D, Alshanqeety O, Warner KE, Lantz PM, Courant PN. The impact of declining smoking on radon-related lung cancer in the U.S. American Journal of Public Health. 2011; 101(2): 310-14.
Lantz PM, Pritchard A. Socioeconomic indicators that matter for population health. Preventing Chronic Disease: Public Health Research, Practice and Policy. 2010; 7(4). Online publication: http://www.cdc.gov/pcd/issues/2010/jul/09_0246.htm.
Gollust SE, Fowler EF, Lantz PM, Dempsey A, Ubel PA. Controversy undermines support for state mandates on the human papillomavirus vaccine. Health Affairs. 2010: 29(11): 2041-46.
Ruel E, Reither EN, Robert SA, Lantz PM. Neighborhood effects on BMI trajectories for black and white women. Health and Place. 2010; 16(2):191-98.
Fagerlin A, Zikmund-Fisher BJ, Smith DM, Nair V, Derry HA, McClure JB, Greene S, Stark A, Hensley-Alford S, Lantz P, Ubel PA. Patients’ decisions regarding tamoxifen for breast cancer prevention: Responses to a tailored decision aid. Breast Cancer Research & Treatment. 2010; 119(3):613-20.
Lantz PM, Golberstein E, House JS, Morenoff J. Social and behavioral risk factors for mortality in a national 19-year prospective study of U.S. adults. Social Science & Medicine. 2010; 70:1558-66.
Gold KG, DeMonner SM, Lantz PM, Hayward RA. Prematurity and low birth weight as potential mediators of higher stillbirth risk in mixed black/white race couples. Journal of Women’s Health. 2010; 19(4):767-73.
Clarke PJ, Ailshire J, Lantz P. Urban built environment and trajectories of mobility disability: Findings from a national sample of community-dwelling American adults (1986-2001). Social Science and Medicine. 2009; 69(6):964-70.
Gollust SA, Lantz PM, Ubel PA. The polarizing effects of news media regarding the social determinants of health. American Journal of Public Health. 2009; 99(12): 2160-67.
Mohai P, Lantz PM, House JS, Morenoff J, Mero RP. Racial and socioeconomic disparities in residential proximity to polluting industrial facilities: Evidence from the Americans’ Changing Lives Study. American Journal of Public Health, 2009; 99 (S3): S649-S656.
Clarke PJ, O’Malley PM, Johnston L, Schulenberg J, Lantz P. Differential trends in weight-related health behaviors among American Young Adults by gender, race/ethnicity, and SES: 1984-2006. American Journal of Public Health. 2009; 99:1893-1901.
Gollust SA, Lantz PM. Communicating population health: Print news media coverage of type 2 diabetes. Social Science and Medicine. 2009; 69(7):1091-98.
Lantz PM, Soliman S. An evaluation of a Medicaid expansion for cancer care: The Breast and Cervical Cancer Prevention and Treatment Act of 2000. Women’s Health Issues. 2009; 19(4):221-231. *This article received the Gibbs Leadership Prize for Best Manuscript Published in 2009 in Women’s Health Issues.
McEwen LN, Kim C, Karter AJ, Haan M, Ghosh D, Lantz PM, et al. Are health-related quality-of-life and self-rated health associated with mortality? Insights from Translating Research Into Action for Diabetes (TRIAD). Primary Care Diabetes. 2009; 3(1): 37-42.
Lantz PM. Gender and leadership in health administration: 21st century progress and challenges. Journal of Healthcare Management. 2008; 53(5):291-301.
Shone LP, Lantz PM, Dick AW, Chernew ME, Szilagyi P. Crowd-out in the state children’s health insurance program (SCHIP): Incidence, enrollee characteristics and experiences, and potential impact on New York’s SCHIP. Health Services Research. 2008; 43(1):Part II:419-434.
McEwen LN, Kim C, Karter AJ, Haan M, Ghosh D, Lantz PM, et al. Risk factors for mortality among patients with diabetes: The Translating Research into Action for Diabetes (TRIAD) study, Diabetes Care. 2007;30(7):1736-41.
Rogers JL, Johnson TR, Brown MB, Lantz PM, Green A, Smith YR. Recruitment of women research participants: The Women's Health Registry at the University of Michigan. Journal of Women's Health. 2007; 16(5):721-8.
Hawley ST, Lantz PM, Janz NK, Salem BO, et al. Factors associated with patient involvement in surgical treatment decision making for breast cancer. Patient Education and Counseling. 2007; 65(3):387-95.
Janz NK, Mujahid M, Densen LC, Lantz PM, Hawley ST, et al. Symptom experience and quality of life of women following breast cancer treatment. Journal of Women's Health. 2007; 16(9):1348-61.
Lantz PM, Lichtenstein R, Pollack H. Health policy approaches to vulnerable populations: The limits of medicalization. Health Affairs. 2007; 26(5):1253-57.
Zeber JE, Valenstein M, Blow F, Grazier KL, Lantz PM. The effect of a medication copayment increase on veterans with schizophrenia. American Journal of Managed Care. 2007; 13(part2):335-46.
Katz SJ, Hofer TP, Hawley ST, Lantz PM, Janz NK, et al. Patterns and correlates of patient referral to surgeons for treatment of breast cancer. Journal of Clinical Oncology. 2007;25:271-76.
Fagerlin A, Lakhani I, Lantz PM, Janz NK, Morrow M, et al. An informed decision? Breast cancer patients and their knowledge about treatment. Patient Education and Counseling. 2006; 64:303-312.
Lantz PM, Mujahid M, Schwartz K, Janz NK, et al. The influence of race, ethnicity and individual socioeconomic factors on breast cancer stage at diagnosis. American Journal of Public Health. 2006; 96(12):2173-2178.
McEwen LN, Kim C, Haan M, Ghosh D, Lantz PM, et al. Recording of diabetes as a cause of death in Translating Research into Action for Diabetes (TRIAD) study. Diabetes Care. 2006; 29(2):247-53.
Morrow M, Mujahid M, Lantz PM, Janz NK, et al. Correlates of breast reconstruction: Results from a population-based study. Cancer. 2005; 104(11):2340-2346.
Katz SJ, Lantz PM, Paredes-Alexander Y, Janz NK, et al. Breast cancer treatment experiences of Latinas in Los Angeles County. American Journal of Public Health. 2005; 95(12):2225-30.
Katz SJ, Lantz PM, Janz NK, et al. Surgeon perspectives on local therapy for breast cancer. Cancer. 2005; 104(9):1854-1861.
House JS, Herd P, Lantz PM. Continuity and change in the social stratification of aging and health over the life course: Evidence from a nationally representative longitudinal study from 1988 to 2001/2. Journal of Gerontology: Social Sciences. 2005; 60:S15-S26.
Lantz PM, House JS, Mero R, Williams DA. Stress, life events and socioeconomic disparities in health: Results from the Americans’ Changing Lives study. Journal of Health and Social Behavior. 2005; 46(3):274-288.
Janz NK, Mujahid M, Lantz PM, Fagerlin A, Salem BO, Katz SJ. Population-based study of the relationship of treatment and sociodemographics on quality of life for early stage breast cancer. Quality of Life Research. 2005; 14(6): 1467-1480.
Katz SJ, Lantz PM, Janz NK, et al. Patient involvement in surgical treatment decisions for breast cancer. Journal of Clinical Oncology. 2005; 23(24):5526-5533.
Lantz PM, Janz NK, Fagerlin A, Lakhani I, et al. Satisfaction with surgery outcomes and the decision process in a population-based sample of women with breast cancer. Health Services Research. 2005; 40(3): 745-767.
Lantz PM, Kane Low L, Varkey S, Watson RL. Doulas as childbirth paraprofessionals: Results from a national survey. Women’s Health Issues. 2005; 15(3):109-116.
Katz SJ, Lantz PM, Janz NK, Fagerlin A, Schwartz K, et al. Patterns and correlates of local therapy for women with ductal carcinoma in situ. Journal of Clinical Oncology. 2005: 23(14):3001-3007.
Richardson CR, Kriska AM, Lantz PM, Hayward RA. Mortality attributable to a sedentary lifestyle in pre-retirement aged Americans. Medicine and Science of Sports and Exercise. 2004; 36(11):1923-1929.
Lantz PM, Keeton K, Romano L, Degroff A. Case management in public health screening programs: The experience of the National Breast and Cervical Cancer Early Detection Program. Journal of Public Health Management and Practice. 2004; 10(6):545-555.
Martin EG, Warner KE, Lantz PM. Tobacco harm reduction: What do the experts think? Tobacco Control. 2004; 13:123-128.
Dombkowski KD, Lantz PM, Freed GL. The role of health insurance and usual source of medical care in age-appropriate vaccination. American Journal of Public Health. 2004; 94:960-966.
Dombkowski KD, Lantz PM, Freed GL. Risk factors for delay in age-appropriate vaccination. Public Health Reports. 2004;119(2):144-155.
Orians CE, Erb J, Kenyon KL, Lantz PM, Liebow EB, Joe JR, Burhansstipanov L. Public education strategies for delivering breast and cervical cancer screening in American Indian/Alaska Native populations. Journal of Public Health Management and Practice. 2004; 10(1):46-53.
Lantz PM, Orians C, Liebow E, Joe J, Burhansstipanov L, Erb J. Implementing breast and cervical cancer screening programs in American Indian and Alaska Native populations. Health Care for Women International. 2003; 24(8):674-96.
Schulz AJ, Israel BA, Lantz PM. Instrument for evaluating dimensions of group dynamics within community-based participatory research partnerships. Evaluation and Program Planning. 2003;26(3):249-262.
Lantz PM, Weisman CS, Itani Z. A disease-specific expansion of Medicaid for women: The Breast and Cervical Cancer Prevention and Treatment Act of 2000. Women’s Health Issues. 2003, 13(3):79-92.
Lantz PM. Smoking on the rise among young adults: Implications for research and policy. Tobacco Control. 2003;12(Supplement 1):60-70.
Metzler MM, Higgins DL, Beeker CG, Freudenberg N, Lantz PM, Senturia KD, et al. Addressing urban health in Detroit, New York, and Seattle through community-based participatory research partnerships. American Journal of Public Health. 2003; 93(5):803-811.
Orians CE, Erb J, Lantz PM, Joe JR, Burhansstipanov L, Liebow E. Successful strategies for increasing breast and cervical cancer screening: Lessons learned from tribal programs. Indian Health Service Provider. 2003:28(3):53-57.
Steyer T, Freed GL, Lantz PM. Medicaid reimbursement for alternative therapies. Alternative Therapies in Health and Medicine. 2002;8(6): 84-88.
Dombkowski KD, Lantz PM, Freed GL. The need for surveillance of delay in age-appropriate immunization. American Journal of Preventive Medicine. 2002; 23(1):36-42.
Lantz PM, Zemencuk JK, Katz SJ. Is mastectomy over-utilized?: A call for an expanded research agenda. Health Services Research. 2002;37(2):417-431.
Lantz PM, Viruell-Fuentes E, Israel BA, Softley D, Guzman R. Can communities and academia work together to improve public health? Results from an evaluation of a community-based participatory research partnership in Detroit. Journal of Urban Health. 2001;78(3):495-507.
Katz SJ, Lantz PM, Zemencuk JK. Correlates of surgical treatment type for women with non-invasive and invasive breast cancer. Journal of Women’s Health and Gender-Based Medicine. 2001;10(7):659-670.
Eaker ED, Jaros L, Vierkant RA, Lantz PM, Remington PL. Women's Health Alliance intervention study: Increasing breast and cervical cancer screening. Journal of Public Health Management and Practice. 2001; 7(5):20-30.
Israel BA, Lichtenstein R, Lantz PM, McGranaghan R, et al. The Detroit Community-Academic Urban Research Center: Development, implementation and evaluation. Journal of Public Health Management and Practice. 2001;7(5):1-19.
Lantz PM, Lynch JW, House JS, Lepkowski JM, Mero RP, Musick M, Williams DR. Socioeconomic disparities in health change in a longitudinal study of U.S. adults: the role of health-risk behaviors. Social Science and Medicine. 2001;53:29-40.
House JS, Lepkowski JM, Williams DR, Mero RP, Lantz PM, Robert SA, Chen J. Excess mortality among urban residents. American Journal of Public Health. 2000; 90(12):1898-1904.
Lantz PM, Richardson LC, Sever LE, et al. Mass screening in low-income populations: Challenges in securing diagnostic and treatment services in a national cancer screening program. Journal of Health Politics, Policy and Law. 2000; 25(3):451-471.
Penrod JR, Lantz PM. Measurement error in prenatal care utilization: Evidence of attenuation bias in the estimation of impact on birth weight. Maternal/Child Health Journal. 2000; 4(1):39-52.
Lantz PM, Jacobson PD, Warner KE, Wasserman J, Pollack H, Berson J, Ahlstrom A. Investing in youth tobacco control: A review of smoking prevention and control strategies. Tobacco Control. 2000;9:47-63.
Pollack HA, Lantz PM, Frohna J. Maternal smoking and adverse birth outcomes among twins. American Journal of Public Health. 2000;90(3):395-400.
Frohna J, Lantz PM, Pollack HA. Maternal substance abuse and infant health: Policy options over the life course. Milbank Memorial Quarterly. 1999;77(4):531-570.
Frick KD, Lantz PM. How well do we understand the relationship between prenatal care and birth weight? Health Services Research. 1999;34(5):1063-1073.
Lantz PM, Richardson LC, Macklem DJ, et al. Strategies for follow-up and treatment services in state breast and cervical cancer screening programs. Women’s Health Issues. 1999;9(1):42-49.
Lantz PM, House JS, Lepkowski JM, Williams DR, et al. Socioeconomic factors, health behaviors, and mortality: Results from a nationally representative prospective study of U.S. adults. JAMA. 1998;279:1703-1708.
Lantz PM and Booth KM. The social construction of the breast cancer epidemic. Social Science and Medicine. 1998; 46:907-918.
Lantz PM, Weigers ME, House JS. Education and income differentials in breast and cervical cancer screening: Policy implications for rural women. Medical Care. 1997;35:219-236.
Frick K and Lantz PM. Selection bias in prenatal care utilization: linking economic and health services research. Medical Care Research and Review. 1996;53(4):371-396.
Lantz PM, Stencil D, Lippert MT, Jaros L, Eaker ED. Implementation issues and costs associated with a proven strategy for increasing breast and cervical cancer screening among low-income women. Journal of Public Health Management and Practice. 1996;2(3):54-59.
National Cancer Institute Cancer Screening Consortium for Underserved Women. Breast and cervical cancer screening among underserved women: Baseline survey results from six states. Archives of Family Medicine. 1995; 4:617-624.
Lantz PM, Stencil D, Lippert MT, et al. Breast and cervical cancer screening in a low-income manage care sample: the efficacy of physician letters and phone calls. American Journal of Public Health. 1995; 85(6):834-836.
Lantz PM, Dupuis LJ, Reding D, Krauska M, Lappe K. Peer discussions of cancer among Hispanic migrant farm workers. Public Health Reports. 1994; 109(4):512-520.
Newcomb PA and Lantz PM. Recent trends in breast cancer incidence, mortality and mammography. Breast Cancer Research and Treatment. 1993; 28(2):97-106.
Pezzino G, Remington PL, Anderson H, Lantz PL, Peterson DE. The impact of a smoke-free policy on jail inmates in Wisconsin. Tobacco Control--An International Journal. 1992;1(3):180-184.
Remington PL and Lantz PM. Using a population-based cancer reporting system to evaluate a breast cancer detection and awareness program. CA--A Cancer Journal for Clinicians. 1992; 42(6):367-371.
Lantz PM, Partin M, Palloni A. Using retrospective surveys for estimating the effects of breastfeeding and child spacing on infant and child mortality. Population Studies. 1992; 46(1):121-139.
Lantz PM, Remington PL, and Newcomb PA. Mammography screening and increased incidence of breast cancer in Wisconsin. Journal of the National Cancer Institute. 1991; 83(21):1540-1546.
Jacobson PD, Lantz PM, Warner KE, et al. Combating Youth Smoking: Research and Policy Strategies. Ann Arbor, Michigan: University of Michigan Press, 2001.
Peer-Reviewed Book Chapters
Lantz PM and Griggs JJ. Chapter 56: Cancer Epidemiology and Cancer Prevention. In Cecil Essentials of Medicine, 8th Edition. Editor-in-chief Andreoli TE; Editors Carpenter CJ, Griggs RC, Benjamin IJ. Philadelphia: Saunder, 2010; pages 598-602.
Lantz PM, Israel BA, Schultz AJ, Reyes A. Community-based participatory research: Rationale and relevance for social epidemiology. In J. Michael Oakes and Jay Turner, Editors, Methods for Social Epidemiology. San Francisco, CA.: Jossey-Bass Press, 2006, pages 239-266.
Israel BA, Lantz PM, McGranaghan R, Kerr D, and Guzman JR. Documentation and evaluation of community-based participatory research partnerships: The use of in-depth interviews and closed-ended questionnaires. In B. A. Israel, E. Eng, A. J. Schulz and E. Parker, Editors, Methods in Community-Based Participatory Research for Health. San Francisco, CA: Jossey-Bass, 2005, pages 255-277.
Lantz PM. Youth smoking prevention policy: Lessons learned and continuing challenges. In RL Bonnie and ME O’Connell, Editors, Reducing Underage Drinking: A Collective Responsibility. Washington, DC: Institute of Medicine of the National Academies, 2004, page 716-742.
Schulz AJ, Israel BA, Lantz PM. Assessing and strengthening characteristics of effective groups in community-based participatory research partnerships. In Handbook of Social Work with Groups, edited by CD Garvin, MJ Galinsky, and LM Gutuierrez. New York: Guildford Publications, 2004, pages 309-325.
Lantz PM. Socioeconomic status and health care. In the International Encyclopedia of the Social and Behavioral Sciences, edited by NJ Smelser and PB Baltes. Oxford, England: Elsevier Science Ltd., 2002.
Lantz PM and Partin M. Population indicators of prenatal and infant health. In Indicators of Children’s Well-Being, edited by Robert Hauser, Brett Brown and William Prosser. New York: Russell Sage Foundation, 1997, pp. 47-75.
Lantz PM, Alexander JA, Adolph C, Montgomery JL. State government organization of health related services: Trends and impact on budget allocations for public health and Medicaid. In progress.
Lantz PM, Soliman S. The impact of two policy changes on diagnosis and treatment in the National Breast and Cervical Cancer Early Detection Program. Submitted to the Centers for Disease Prevention and Control, Division of Cancer Prevention and Control, April, 2007.
Ford BC, Dalton VK, Lantz PM, Lori J., et al. Racial disparities in birth outcomes: Poverty, discrimination and the life course of African American women. African American Research Perspectives. 2005;11(1):48-64.
Lantz PM, Ubel PA. The use of life expectancy in cancer screening guidelines: Moving with caution from model-based evidence to evidence-based guidelines. Invited editorial. Journal of General Internal Medicine. 2005; 20:552-3.
Lantz PM, Kane Low L, Watson R. Doulas’ views on the rewards and challenges of their work. International Journal of Childbrith Education. 2004; 19(4):31-34.
Lantz PM, Jacobson PD, Warner KE. Youth smoking prevention: What works? The Prevention Researcher. 2001; 8(2):1-6.
Lantz PM, Sever LE, et al. Strategies for providing follow-up and treatment services in the National Breast and Cervical Cancer Early Detection Program--US, 1997. Morbidity and Mortality Weekly Report. 1998; 47:215-218. Reprinted in JAMA, 1998:279:1941-42.
Lantz PM, Bunge M, Cautley E, Phillips JL, Remington PR. Mammography use--Wisconsin, 1980-1993. Morbidity and Mortality Weekly Report. 1995;44:754-757.
Lantz PM and Reding D. Cancer: beliefs and attitudes of migrant Latinos (peer-reviewed letter). JAMA. 1994; 272(1):31-32.
Kvale K, Remington PL, Lantz PM. Self-reporting of Papanicolaou smear tests among women after hysterectomy. Wisconsin Medical Journal. 1994; 93(6):275-276.
Lantz PM, Weier A, Remington PL. Mammography utilization in Wisconsin: 1987-1992. Wisconsin Medical Journal. 1993; 92(10):580-582.
Latton SK, Remington PL, Bunge M, Kaufman N, Lantz PM et al. Inappropriate use of transillumination for breast cancer screening--Wisconsin, 1990. Morbidity and Mortality Weekly Report.1991; 40(18):293-296.
Lantz PM, Remington PL, Kuate Defo B. Breast cancer survival in Wisconsin. Wisconsin Medical Journal. 1992; 91(10):597-598.
Lantz PM, Remington PL, Cautley E. Identifying women who have never had a mammogram. Wisconsin Medical Journal. 1991; 90(10):591-592.
Lantz PM, Remington PL. Breast cancer in Wisconsin: assessing the potential for primary prevention. Wisconsin Medical Journal. 1991; 90(9):538-539.
Byers RL, Lantz PM, Remington PL and Phillips JL. Malignant melanoma: trends in Wisconsin, 1980-1989. Wisconsin Medical Journal. 1991; 90(6):306-307.
Lantz PM, Remington PL and Soref M. Self-reported barriers to mammography: implications for physicians. Wisconsin Medical Journal. 1990;89(10):602-606.
Lantz PM, Bunge M, and Remington PL. Trends in mammography in Wisconsin. Wisconsin Medical Journal. 1990;89(5):82-83.
Lantz PM, Remington PL. Obesity in Wisconsin. Wisconsin Medical Journal. 1990;89(4):172-176.
Remington PL, Lantz PM, and Phillips JL. Cervical cancer deaths among older women: implications for prevention. Wisconsin Medical Journal. 1990;89(1):30-34.
Remington PL, Lantz PM. Routine check-ups among Wisconsin adults. Wisconsin Medical Journal. 1989;88(10):39-42.
Remington PL, Lantz PM. Mammography guidelines and practices in Wisconsin. Wisconsin Medical Journal. 1989;88(9):38-42.