English  |  正體中文  |  简体中文  |  Post-Print筆數 : 11 |  Items with full text/Total items : 89327/119107 (75%)
Visitors : 23826135      Online Users : 144
RC Version 6.0 © Powered By DSPACE, MIT. Enhanced by NTU Library IR team.
Scope Tips:
  • please add "double quotation mark" for query phrases to get precise results
  • please goto advance search for comprehansive author search
  • Adv. Search
    HomeLoginUploadHelpAboutAdminister Goto mobile version
    政大機構典藏 > 理學院 > 心理學系 > 學位論文 >  Item 140.119/58971
    Please use this identifier to cite or link to this item: http://nccur.lib.nccu.edu.tw/handle/140.119/58971


    Title: 失眠脆弱特質、壓力因應及睡眠的不當認知在失眠發展歷程所扮演的角色
    The Roles of Sleep Vulnerability to Stress, Coping and Maladaptive Sleep Belief in the Development of Insomnia
    Authors: 洪智盈
    Hung, Chih Ying
    Contributors: 楊建銘
    Yang, Chien Ming
    洪智盈
    Hung, Chih Ying
    Keywords: 失眠
    失眠脆弱特質
    因應方式
    睡前激發狀態
    不良睡眠信念
    insomnia
    sleep-related vulnerability
    coping strategies
    pre-sleep arousal
    dysfunctional belief
    Date: 2012
    Issue Date: 2013-07-22 17:17:02 (UTC+8)
    Abstract: 研究目的:失眠病因理論指出失眠可能受到壓力誘發,進而提高激發程度,干擾睡眠;壓力下的睡眠脆弱特質可能為一危險因子,而伴隨有不當的睡眠信念與壓力因應者可能讓失眠症狀更易延續。過去研究也支持了上述因子與失眠的關聯性,但由於過去研究多為橫斷相關研究,對於了解這些因素如何交互影響造成失眠的發生仍相當有限。本研究透過追蹤2006年針對大學生睡眠調查的研究受試者以更進一步了解此一問題,欲探討兩研究目的:一為了解壓力下睡眠脆弱特質是否可預測失眠症狀的發生;其次為探討壓力因應風格及睡眠的不適當認知在負向生活經驗對身心激發程度及失眠的影響是否扮演調節變項的角色。
    研究方法:本研究以問卷調查法進行,以2006年10月由政治大學睡眠實驗室於政治大學進行睡眠調查研究之受試者為研究對象,該研究中有330位受試者簽名表示同意接受後續追蹤調查。本研究透過電話可聯絡到192位受試者,一共回收126份(66%)有效問卷。問卷內容包含失眠嚴重度指標(Insomnia Severity Index; ISI)、匹茲堡睡眠品質量表(Pittsburgh Sleep Quality Index; PSQI)、福特壓力下失眠反應量表( Ford Insomnia Response to Stress Test; FIRST)、睡眠失功能信念及態度量表(Dysfunctional Beliefs and Attitudes about Sleep; DBAS)、睡前激發程度量表(Pre-Sleep Arousal Scale; PSAS)、生活經驗調查(Life Experiences Survey; LES)以及因應量表(COPE)。統計方式則分別以邏輯斯迴歸分析探討失眠脆弱特質對失眠症狀發生的預測力,以階層迴歸分析探討睡前身心激發程度在負向生活經驗預測失眠嚴重度的中介效果,以及壓力因應方式和睡眠的不適當認知對負向生活經驗預測睡前激發程度的調節效果。
    研究結果:研究結果發現失眠脆弱特質對失眠症狀之發生有接近顯著的預測效果,呈現失眠脆弱特質越高,未來失眠風險就越高的趨勢。負向生活經驗會透過睡前身心激發程度的完全中介效果之作用,來影響失眠的嚴重程度;且失眠脆弱特質對負向生活經驗與生理激發程度的關聯性有調節效果,而情緒因應方式對負向生活經驗與認知激發程度的關聯性有調節效果,進而影響失眠嚴重程度。然而對睡眠的不當認知並無顯著調節效果,而是會直接影響睡前身心激發程度,進而影響失眠的嚴重度。
    研究結論:研究結果基本上支持失眠病因理論的預測,壓力會透過提高激發程度進而干擾睡眠,然而不同的調節因子可能有不同的作用路徑。在失眠脆弱特質的預測性上,呈現出特質越高未來失眠風險就越高的趨勢,但其預測力並未達到顯著,且此特質較高者在面對壓力時會引發較高的生理激發;而面對壓力時若採情緒風格因應者則易引發較高的認知激發程度,進而提高失眠嚴重程度。此外,不當之睡眠信念則不需與生活壓力形成交互作用,直接就對睡眠形成影響,推論這些信念會使得睡眠本身成為壓力的來源。這些結果有其臨床意涵,建議壓力下睡眠脆弱特質可作為篩選失眠的高危險族群的指標,針對此族群提供衛教,教導適當有效的因應壓力方式及放鬆技巧訓練,以降低其生理或認知激發狀態,以降低失眠的發生率。
    OBJECTIVE: Various etiological models of insomnia suggest that stress might interfere with sleep by increasing level of arousal. Sleep vulnerability to stress might precipitate an individual to this effect, and maladaptive belief and coping skills could perpetuate the transient sleep disturbance into more long term insomnia symptoms. Previous studies have supported the associations between these factors and insomnia. However, past studies were mostly cross-sectional in nature, how these factors interact to contribute to the development of insomnia is still limited. Thus, the goals of present study are to examine (1) whether normal sleepers who are vulnerable to stress-related sleep disturbance are at higher risk for subsequent development of insomnia symptoms at a long-term follow-up, and (2) whether pre-sleep arousal serves as a mediator, and coping and maladaptive sleep belief serve as moderators of the association between stress and insomnia severity.
    METHOD: The sample was from the participants of a sleep survey at National Chengchi University in 2006. There were 330 participants agreed to be contacted for follow-up sleep surveys. They were invited to participate in the study through telephone in 2012. Participants who agreed to take part in the study were asked to complete a battery of questionnaires online, including the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), the Ford Insomnia Response to Stress Test (FIRST), the Dysfunctional beliefs and attitudes about sleep questionnaire (DBAS), the Pre-sleep arousal scale (PSAS), the Perceived Stress Scale (PSS), the Life Experiences Survey (LES) and the COPE. Logistic regression analysis was used to examine whether sleep vulnerability to stress predicts insomnia symptoms, and linear regression analysis was used to explore whether pre-sleep arousal serves as a mediator and coping and maladaptive sleep belief as moderators for the association between stress and the development of insomnia.
    RESULTS: Sleep vulnerability to stress showed a near significant trend in predicting insomnia symptoms. Pre-sleep arousal plays a mediating role between negative life experiences and insomnia severity. On the other hand, sleep vulnerability to stress moderates the association between negative life experiences and pre-sleep somatic arousal; emotional coping strategies serve as a moderator for the association between negative life experiences and pre-sleep cognitive arousal affecting insomnia severity. Although maladaptive sleep belief does not play a moderating role, it predicts pre-sleep arousal directly.
    CONCLUSIONS: The findings basically support the prediction of insomnia etiological models that stress interferes with sleep by increased arousal; however, different psychological factors play different roles in the process. It showed a tendency that participants have more sleep vulnerability to stress are at high risk to develop insomnia symptoms. However, the predictability of sleep vulnerability does not reach significant level. Individuals with high vulnerability might have increased somatic arousal when facing stressful situations and those who use more emotional coping strategies might increase cognitive arousal. Maladaptive sleep belief predicts pre-sleep arousal directly instead of interacting with negative events. It is possible that the maladaptive sleep belief can increase sleep-related stress directly. The results imply that sleep vulnerability to stress can serve as an indicator to identify individuals with higher risk for insomnia. A preventive program with sleep education and relaxation training to reduce pre-sleep arousal can be provided to prevent occurrence of insomnia.
    Reference: 孔繁鐘 (1999)。精神疾病的診斷與統計。台北市:合計圖書出版社。
    林詩淳 (2008)。慢性失眠者與情境性失眠高危險族群之壓力因應與失眠的關
    係。國立政治大學心理所碩士論文,未出版,台北市。
    邱兆宏 (2004)。壓力與健康:整合分析與模式驗證之研究。高學醫學大學行為科學研究所碩士論文,未出版,高雄市。
    初麗娟、高尚仁 (2005)。壓力知覺對負面心理健康影響:靜坐經驗、情緒智能調節效果之探討。中華心理學刊,47(2),157-179。
    陳昌偉、詹雅雯、楊建銘、林詩淳 (2009)。中文版睡眠失功能信念及態度量表之信、效度探討。臨床心理學刊,4(1),59-67。
    蕭仁釗、林耀盛、鄭逸如 (譯) (1997)。健康心理學 (原作者:E. P. Sarafino)。台北市:桂冠圖書。(原著出版年:1994)。
    許文耀 (2003)。資源流失、因應、社會支持與九二一地震災民的心理症狀之關係。中華心理學刊,45(3),263-277。
    楊建銘、許世杰、林詩淳、周映妤、陳瑩明 (2009)。失眠嚴重度量表中文版
    的信、效度探討。臨床心理學刊,4(2),95-104。
    詹雅雯、陳昌偉、楊建銘、林詩淳 (2009)。中文版睡前激發狀態量表之信效、度探討。臨床心理學刊,4(1),51-58。


    American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th edition). Washington, DC: American Psychiatric Publishing.
    American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th edition). Washington, DC: American Psychiatric Publishing.
    Ardelt, M. (2000). Still stable after all these years? Personality stability theory revisited. Social Psychology Quarterly, 63(4), 392–405.
    Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. Journal of Personality and social psychology, 51(6), 1173-1182.
    Bastien, C. H., & Bonnet, M. H. (2001). Do increases in beta EEG activity uniquely reflect insomnia? A commentary on "Beta EEG activity and insomnia" (M. L. Perlis et al.). Sleep Medicine Reviews, 5(5), 375-377.
    Bastien, C. H., St-Jean, G., Morin, C. M., Turcotte, I., & Carrier, J. (2008). Chronic psychophysiological insomnia: hyperarousal and/or inhibition deficits? An ERPs investigation. Sleep, 31(6), 887-898.
    Bastien, C. H., Vallieres, A., & Morin, C. M. (2004). Precipitating factors of insomnia. Behavioral Sleep Medicine, 2(1), 50-62.
    Baum, A., & Grunberg, N. E. (1991). Gender, stress, and health. Health Psychology, 10(2), 80-85.
    Bélanger, L., Morin, C. M., Gendron, L., & Blais, F. C. (2005). Presleep Cognitive Activity and Thought Control Strategies in Insomnia. Journal of Cognitive Psychotherapy, 19, 19-28.
    Billings, A. G., & Moos, R. H. (1981). The role of coping responses and social resources in attenuating the stress of life events. Journal of Behavioral Medicine, 4(2), 139-157.
    Billings, A. G., & Moos, R. H. (1984). Coping, stress, and social resources among adults with unipolar depression. Journal of Personality and Social Psychology, 46(4), 877-891.
    Bonnet, M. H., & Arand, D. L. (1995). 24-Hour metabolic rate in insomniacs and matched normal sleepers. Sleep, 18(7), 581-588.
    Bonnet, M. H., & Arand, D. L. (1997). Hyperarousal and insomnia. Sleep Medicine Reviews, 1(2), 97-108.
    Bonnet, M. H., & Arand, D. L. (2003). Situational insomnia: consistency, predictors, and outcomes. Sleep, 26(8), 1029-1036.
    Borkovec, T. D. (1982). Insomnia. Journal of Consulting and Clinical Psychology, 50(6), 880-895.
    Breslau, N., Roth, T., Rosenthal, L., & Andreski, P. (1996). Sleep disturbance and psychiatric disorders: a longitudinal epidemiological study of young adults. Biological Psychiatry, 39(6), 411-418.
    Buysse, D. J., Angst, J., Gamma, A., Ajdacic, V., Eich, D., & Rossler, W. (2008). Prevalence, course, and comorbidity of insomnia and depression in young adults. Sleep, 31(4), 473-480.
    Buysse, D. J., Reynolds, C. F., 3rd, Monk, T. H., Berman, S. R., & Kupfer, D. J.
    (1989). The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193-213.
    Carney, C. E., & Edinger, J. D. (2006). Identifying critical beliefs about sleep in primary insomnia. Sleep, 29(4), 444-453.
    Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: a theoretically based approach. Journal of Personality and Social Psychology, 56(2), 267-283.
    Chou, C., Yang, C.M., & Chen, J. (2007). Dyscunctional sleep cognition and vulnerability to stress related sleep disturbances. Sleep, 30 (suppl S), A380
    Cohen, J. (1988). Statistical power analysis for the behavioral sciences. (pp79-80). Hillsdale, NJ: Lawenerce Erlbaum
    Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385-396.
    Collins, A., & Frankenhaeuser, M. (1978). Stress responses in male and female engineering students. Journal of Human Stress, 4(2), 43-48.
    Coren, S. (1988). Prediction of insomnia from arousability predisposition scores: scale development and cross-validation. Behaviour Research and Therapy, 26(5), 415-420.
    Costa, P. T., Jr., & McCrae, R. R. (1988). Personality in adulthood: a six-year longitudinal study of self-reports and spouse ratings on the NEO Personality Inventory. Journal of Personality and social psychology, 54(5), 853-863.
    Doghramji, K. (2006). The epidemiology and diagnosis of insomnia.The American Journal of Managed Care, 12(8 Suppl), S214-220.
    Drake, C. L., Friedman, N. P., Wright, K. P., Jr., & Roth, T. (2011). Sleep reactivity and insomnia: genetic and environmental influences. Sleep, 34(9), 1179-1188.
    Drake, C., Jefferson, C., Roehrs, T., Richardson, G., & Roth, T. (2004). Vulnerability to chronic insomnia: A logitunal population based prospective study. Sleep, 27(suppl S), A270
    Drake, C. L., Jefferson, C., Roehrs, T., & Roth, T. (2006). Stress-related sleep disturbance and polysomnographic response to caffeine. Sleep Medicine, 7(7), 567-572.
    Drake, C., Richardson, G., Roehrs, T., Scofield, H., & Roth, T. (2004). Vulnerability to stress-related sleep disturbance and hyperarousal. Sleep, 27(2), 285-291.
    Drake, C. L., Scofield, H., & Roth, T. (2008). Vulnerability to insomnia: the role of familial aggregation. Sleep Medicine, 9(3), 297-302.
    Edinger, J. D., Carney, C. E., & Wohlgemuth, W. K. (2008). Pretherapy cognitive dispositions and treatment outcome in cognitive behavior therapy for insomnia. insomnia. Behavior Therapy, 39(4), 406-416.
    Espie, C. A., Inglis, S. J., Harvey, L., & Tessier, S. (2000). Insomniacs' attributions. psychometric properties of the Dysfunctional Beliefs and Attitudes about Sleep Scale and the Sleep Disturbance Questionnaire. Journal of Psychosomatic Research , 48(2), 141-148.
    Fernandez-Mendoza, J., Vela-Bueno, A., Vgontzas, A. N., Ramos-Platon, M. J., Olavarrieta-Bernardino, S., Bixler, E. O., et al. (2010). Cognitive-emotional hyperarousal as a premorbid characteristic of individuals vulnerable to insomnia. Psychosomatic Medicine, 72(4), 397-403.
    Freedman, R. R. (1986). EEG power spectra in sleep-onset insomnia. Electroencephalography and Clinical Neurophysiology, 63(5), 408-413.
    Freedman, R. R., & Sattler, H. L. (1982). Physiological and psychological factors in sleep-onset insomnia. Journal of Abnormal Psychology, 91(5), 380-389.
    Hamilton, S., & Fagot, B. I. (1988). Chronic stress and coping styles: a comparison of male and female undergraduates. Journal of Personality and Social Psychology, 55(5), 819-823.
    Harvey, A. G. (2002). A cognitive model of insomnia. Behaviour research and therapy, 40(8), 869-893.
    Healey, E. S., Kales, A., Monroe, L. J., Bixler, E. O., Chamberlin, K., & Soldatos, C. R. (1981). Onset of insomnia: role of life-stress events. Psychosomatic Medicine, 43(5), 439-451.
    Hicks, R. A., Marical, C. M., & Conti, P. A. (1991). Coping with a major stressor: differences between habitual short- and longer-sleepers. Perceptual and Motor Skills, 72(2), 631-636.
    Kuisk, L. A., Bertelson, A. D., & Walsh, J. K. (1989). Presleep cognitive hyperarousal and affect as factors in objective and subjective insomnia. Perceptual and Motor Skills, 69(3 Pt 2), 1219-1225.
    Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Spinger.
    LeBlanc, M., Beaulieu-Bonneau, S., Merette, C., Savard, J., Ivers, H., & Morin, C. M. (2007). Psychological and health-related quality of life factors associated with insomnia in a population-based sample. Journal of Psychosomatic Research, 63(2), 157-166.
    LeBlanc, M., Merette, C., Savard, J., Ivers, H., Baillargeon, L., & Morin, C. M. (2009). Incidence and risk factors of insomnia in a population-based sample. Sleep, 32(8), 1027-1037.
    Leger, D., Guilleminault, C., Bader, G., Levy, E., & Paillard, M. (2002). Medical and socio-professional impact of insomnia. Sleep, 25(6), 625-629.
    Lichstein, K. L., & Rosenthal, T. L. (1980). Insomniacs' perceptions of cognitive versus somatic determinants of sleep disturbance. Journal of Abnormal Psychology, 89(1), 105-107.
    Monroe, L. J. (1967). Psychological and physiological differences between good and poor sleepers. Journal of Abnormal Psychology, 72(3), 255-264.
    Morin, C. M. (1993). Chapter 4. Insomnia: psychological assessment and management. New York: The Guilford Press.
    Morin, C. M., Belanger, L., LeBlanc, M., Ivers, H., Savard, J., Espie, C. A., et al. (2009). The natural history of insomnia: a population-based 3-year longitudinal study. Archives of Internal Medicine,169(5), 447-453.
    Morin, C. M., Blais, F., & Savard, J. (2002). Are changes in beliefs and attitudes about sleep related to sleep improvements in the treatment of insomnia? Behavioral Research and Theraphy, 40(7), 741-752.
    Morin, C. M., & Espie, C. A. (2003). Chapter 6. Insomnia : a clinical guide to assessment and treatment. New York: Plenum Publishers.
    Morin, C. M., Rodrigue, S., & Ivers, H. (2003). Role of stress, arousal, and coping skills in primary insomnia. Psychosomatic Medicine, 65(2), 259-267.
    Morin, C. M., Stone, J., Trinkle, D., Mercer, J., & Remsberg, S. (1993). Dysfunctional beliefs and attitudes about sleep among older adults with and without insomnia complaints. Psychology and Aging, 8(3), 463-467.
    Morphy, H., Dunn, K. M., Lewis, M., Boardman, H. F., & Croft, P. R. (2007). Epidemiology of insomnia: a longitudinal study in a UK population. Sleep, 30(3), 274-280.
    Nicassio, P. M., Mendlowitz, D. R., Fussell, J. J., & Petras, L. (1985). The phenomenology of the pre-sleep state: the development of the pre-sleep arousal scale. Behaviour Research and Therapy, 23(3), 263-271.
    Nofzinger, E. A., Buysse, D. J., Germain, A., Price, J. C., Miewald, J. M., & Kupfer, D. J. (2004). Functional neuroimaging evidence for hyperarousal in insomnia. The American Journal of Psychiatry, 161(11), 2126-2128.
    Nomura, K., Yamaoka, K., Nakao, M., & Yano, E. (2005). Impact of insomnia on individual health dissatisfaction in Japan, South Korea, and Taiwan. Sleep, 28(10), 1328-1332.
    Ohayon, M. M. (2002). Epidemiology of insomnia: what we know and what we still need to learn. Sleep Medicine Reviews, 6(2), 97-111.
    Perlis, M. L., Smith, M. T., Andrews, P. J., Orff, H., & Giles, D. E. (2001). Beta/Gamma EEG activity in patients with primary and secondary insomnia and good sleeper controls. Sleep, 24(1), 110-117.
    Ree, M. J., & Harvey, A. G. (2004). Investigating safety behaviours in insomnia: The development of the sleep-related behaviours questionnaire (SRBQ). Behaviour Change, 21(1), 26-36.
    Sadeh, A., Keinan, G., & Daon, K. (2004). Effects of stress on sleep: the moderating role of coping style. Health Psychology, 23(5), 542-545.
    Sarason, I. G., Johnson, J. H., & Siegel, J. M. (1978). Assessing the impact of life changes: development of the Life Experiences Survey. Journal of Consulting and Clinical Psychology, 46(5), 932-946.
    Schmidt, R. E., Harvey, A. G., & Van der Linden, M. (2011). Cognitive and affective control in insomnia. Frontiers in Psychology, 2, 349.
    Semler, C. N., & Harvey, A. G. (2004). An investigation of monitoring for sleep-related threat in primary insomnia. Behavioral Research & Therapy, 42(12), 1403-1420.
    Stepanski, E., Zorick, F., Roehrs, T., Young, D., & Roth, T. (1988). Daytime alertness in patients with chronic insomnia compared with asymptomatic control subjects. Sleep, 11(1), 54-60.
    Spielman, A., J. (1986). Assessment of insomnia. Assessment of insomnia. Clinical Psychology Review, 6(1), 11-25.
    Spielman, A., J. & Glovinsky, P. (1991). The varied nature of insomnia. In PJ Hauri (Ed.). Case studies in insomnia. New York, Plenum Press.
    Tang, N. K., & Harvey, A. G. (2004). Effects of cognitive arousal and physiological arousal on sleep perception. Sleep, 27(1), 69-78.
    Tsai, P. S., Wang, S. Y., Wang, M. Y., Su, C. T., Yang, T. T., Huang, C. J., et al. (2005). Psychometric evaluation of the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) in primary insomnia and control subjects. Quality of Life Research, 14(8), 1943-1952.
    van de Laar, M., Verbeek, I., Pevernagie, D., Aldenkamp, A., & Overeem, S. (2010). The role of personality traits in insomnia. Sleep Medicine Reviews, 14(1), 61-68.
    Van Egeren, L., Haynes, S. N., Franzen, M., & Hamilton, J. (1983). Presleep cognitions and attributions in sleep-onset insomnia. Journal of Behavioral Medicine, 6(2), 217-232.
    Yang, C. M., Chou, C. P., & Hsiao, F. C. (2011). The association of dysfunctional beliefs about sleep with vulnerability to stress-related sleep disturbance in young adults. Behavioral Sleep Medicine, 9(2), 86-91.
    Yang, C. M., Lin, S.C. & Cheng, C.P. (2013). Transient Insomnia Versus Chronic Insomnia: A Comparison oStudy of Sleep-Related Psychological/ Behavioral Characteristics. Journal of Clinical Psychology.
    Yang, C. M., & Lo, H. S. (2007). ERP evidence of enhanced excitatory and reduced inhibitory processes of auditory stimuli during sleep in patients with primary insomnia. Sleep, 30(5), 585-592.
    Description: 碩士
    國立政治大學
    心理學研究所
    97752018
    101
    Source URI: http://thesis.lib.nccu.edu.tw/record/#G0097752018
    Data Type: thesis
    Appears in Collections:[心理學系] 學位論文

    Files in This Item:

    File SizeFormat
    201801.pdf1298KbAdobe PDF879View/Open


    All items in 政大典藏 are protected by copyright, with all rights reserved.


    社群 sharing

    著作權政策宣告
    1.本網站之數位內容為國立政治大學所收錄之機構典藏,無償提供學術研究與公眾教育等公益性使用,惟仍請適度,合理使用本網站之內容,以尊重著作權人之權益。商業上之利用,則請先取得著作權人之授權。
    2.本網站之製作,已盡力防止侵害著作權人之權益,如仍發現本網站之數位內容有侵害著作權人權益情事者,請權利人通知本網站維護人員(nccur@nccu.edu.tw),維護人員將立即採取移除該數位著作等補救措施。
    DSpace Software Copyright © 2002-2004  MIT &  Hewlett-Packard  /   Enhanced by   NTU Library IR team Copyright ©   - Feedback