OUR VOICES EMPLOYEE & COMMUNITY MAGAZINE
\
Alisha Bronne, MBA, CPXP Care Experience Officer
Donna Geiss, RN, NNP, MSN Care Experience Officer
PATIENT EXPERIENCE
Person-Centered Care Expo Celebrating Our Volunteers
Pathway to Planetree Good Catch Program
APRIL 2023 D I G I T A L M A G A Z I N E
TOP FEATURES 01
CELEBRATING CARE EXPERIENCE WEEK The Beryl Institute defines the patient experience as "the sum of all interactions, shaped by an organization's culture, that influence patient perceptions across the continuum of care."
02
CEO MESSAGE
PATHWAY TO PLANETREE Embracing a Culture of Person-Centered Care. Caring for our patients, employees, families and community. Every day our amazing staff at both facilities provide exceptional person- centered care for our patients. During Patient Experience week we place a spotlight on all of you who make a positive in the lives of our patients and their families.
03
04
CENTRAL STERILE EQUIPMENT UPGRADE
Ribbon Cutting Ceremony to celebrate the New Steam Sterilize Equipment for Central Sterile Department.
GOOD CATCH PROGRAM "Good Catches" Improve patient care by providing the opportunity to investigate and rectify problems before they occur and cause harm.
05
NYC Health + Hospitals/Jacobi | April 2023
Our Voices
is a monthly digital publication designed to communicate, inspire, engage, and connect employees at NYC Health + Hospitals/Jacobi|North Central Bronx, patients, and Bronx residents to valuable wellness content, plus relevant hospital information, updates, and events.
NYC Health + Hospitals/Jacobi | North Central Bronx A Great Place to Work | A Great Place to Receive Care
Editor-In-Chief & Graphic Design Keisha Gilles Director, Communications, Public Affairs & Community Relations
COMMUNICATIONS & PUBLIC AFFAIRS TEAM
John Doyle Associate Director, Communications & Media Liaison
Rawle Titus Assistant Director, Communications
Diane Arroya Assistant Director, Public Affairs & Community Relations
Martin Johnson Digital Marketing, Graphic Design & Social Media Manager
Dominique Maddox Digital Marketing & Social Media Manager
Yris Caban Community Associate
NYC Health + Hospitals/Jacobi | April 2023
Chris Mastromano Chief Executive Officer
Healthcare is about people who selflessly and heroically deliver it in the face of adversity with compassion.
Message from Chris
It's officially spring! The weather is becoming warmer. We are planning our vacations and looking forward to traveling and spending time with our loved ones. It's a great time of year. As the season changes, one thing remains the same: my gratitude towards all of you for your continued commitment to providing high-quality care to our patients and serving our communities in the Bronx. You are making a positive impact daily, and we are advancing healthcare together. This month we celebrated the Patient Experience, the pinnacle of our daily work. Whether you are a clinician providing direct care, a housekeeper cleaning a room, a representative helping someone with billing questions, assisting a family by giving directions or keeping our environment clean and safe, you are all part of making our patient experience a positive one at every point of contact. Thank you for your contribution. Special thanks to Care Experience Officers Donna Geiss and Alisha Bronne for the work you and your teams do to expand the person-centered care we offer our patients. Thank you all for supporting the various activities planned at both facilities to engage staff. We are all the Patient Experience! We also celebrated our Medical Laboratory Professionals, Administrative Professionals, and Volunteers. Notably, we are anticipating our Planetree survey at the Jacobi campus. We are optimistic about a positive outcome. Thank you all for your steadfast commitment to health care. Remember, face masks are required in patient care areas. Continue to keep yourselves, our patients, colleagues, and loved ones safe and healthy.
Chris Mastromano
Celebrating Patient Experience Week
We are proud to share that our Person-Centered Expo was a great success on Wednesday, April 26, with close to 1,000 visitors!
Many thanks to our Patient-Centered Care Expo planning team, who worked tirelessly to create this highly engaging event! Excitement can be seen on their faces as they enthusiastically jump into our fun activities. Staff indulged with neck and back massages from our lavender-scented Zen tent, sampled our latest plant- based eggplant crostini bites, and pitched in to color our hand-crafted posters with original animation characters who embraced the words "Better Together." Many learned our most advanced application in safety called "SOS," which can be activated from any computer in an emergency. Stand Up Against Violence Resources were made available for anyone interested in learning about their robust program. Others enjoyed visiting our Patient Relations table, where they were able to learn to speak to patients in sign language. Visitors were also invited to learn about our latest projects co-designed by patients and staff, such as our new and improved whiteboards and how to join our Patient Family Partnership Council. The JEDI (Jacobi Equity, Diversity, and Inclusion) and ERG (Employee Resource Group) table also offered resources for staff to explore their interest in building a more inclusive culture at Jacobi. The Planetree Academy of Person-Centered Care housed a variety of experiential training that included a communication tool method called the "Heart Head Heart" sandwich, Teach Back and Six Word Story project, which asked staff why they chose to work in healthcare, thus connecting what we do with purpose and meaning. Patient-Centered Care means caring for our patients, staff, and community. We wanted to share many of the resources Jacobi offers while engaging in activities with music, dancing, arts, and experiential learning. We were able to establish this, with more to come!
Please look for our Happy Kart on Wheels, as our Planetree Academy of Person-Centered Care training will expand throughout the hospital!
Those who complete their training from the Academy will receive a special gift for their participation! For more information, please get in touch with Donna at donna.geiss@nyhchhc.org or Barbara at footeb@nychhc.org .
Please note our Planetree on-site visit will be on June 6, June 7, and June 8. Please join us in delivering our best services at Jacobi! More to come soon!
NYC Health + Hospitals/Jacobi | April 2023
Meet the Care Experience Team Jacobi Campus
Meet the Care Experience Team NCB Campus
Celebrating Patient Experience Week
Patient Experience Week, also known as Care Experience Week, is an annual event to celebrate and highlight healthcare staff of all disciplines that impact the patient experience daily. This week, we show our staff appreciation for their hard work and continued efforts on behalf of our patients and the community. We also take the opportunity to thank our patients for trusting us with their care. We honored the week by partaking in virtual and in-person events coordinated by our Central Office Care Experience Team and local NCB events. NCB presented to our system on our ICARE Recognition Program and our Hospital Police Team achievements. The staff participated in Tai Chi, Jewelry Making, Soca Fitness, and Dance Cardio, to name a few. Our leadership team participated in day and night rounds, which included a sweet treat for our staff. ICARE In Action Our Electrician Team is being recognized for embodying our ICARE Values. The Electrician Team prioritized replacing lights with even brighter ones at our entrance to ensure patients and staff have increased visibility during the dark hours. This truly embodies Integrity, Compassion, Accountability, Respect, and Excellence .
“The electrical shop staff put into practice the ICARE Standards daily. We are honored to be of service.”- Doug Fulton, Supervisor Electrician.
CARE EXPERIENCE
The Care Experience Team focuses on providing person-centered- care by modeling and upholding the ICARE values through strategic planning of patient experience/satisfaction recognition and employee engagement initiatives. The Team collaborates with stakeholders to share data measurement and interpretation, executes service excellence and recovery efforts, and serves as a partner in driving performance improvement initiatives at all levels. The Care Experience team continuously evaluates the needs of patients, visitors, employees, and the community to ensure a satisfactory experience.
Our Team comprises Patient Relations, Workforce Wellness, Guest Services, and Spiritual Care.
PATIENT RELATIONS The Patient Relations team partners with patients, their loved ones, and employees to uphold the Patient Bill of Rights. The Team provides support in resolving issues and concerns that patients and guests may encounter during their visit in real-time and through the grievance process. The Team provides language access services for the Limited English Proficiency (LEP) patient population through medical interpretation and translation. The Team coordinates Spiritual Care and services such as requested visits, Mass, and last rights. WORKFORCE WELLNESS The Workforce Wellness team focuses on supporting employees through Helping Healers Heal by successfully integrating programs and activities aligning with the eight well-being dimensions. The Team provides crisis support on an individual and group basis. The Workforce Wellness team partners with departmental leadership to ensure employees have the resources to be engaged and well at work. GUEST SERVICES The Guest Services team is the initial point of contact for patients and visitors entering the facility. The Team supports way-finding, appointment verification, transportation, and all guest-related activities and requests.
NYC Health + Hospitals/Jacobi | April 2023
Patient Relations Team: Marycruz Jimenez, Community Associate Anneris Corporan, Director of Patient Relations Patria Mbadinga, Patient Representative
Guest Services Team: Jasmin Graham, Client Navigator Catherine Dillon, Client Navigator Luthfunnessa “Happy” Begum, Client Navigator Hollis Reid, Client Navigator
Father Duru Hippolytus Duru, Chaplain
Dhesiay Tiburcio, LCSW Wellness Program Director
Imam Noman Noman V. Mohammed, Chaplain
"Good Catches" are events that might have resulted in harm to the patient, but did not result in harm due to identification and correction of error. The Good Catch Program
NYC Health + Hospitals/Jacobi | April 2023
We recognized two Radiology Technicians, the latest beneficiaries of our Good Catch Program. We applaud Sharon Fullerton and Michael Fernandez for their diligence in duty and for prioritizing patient safety.
NYC Health + Hospitals/Jacobi | April 2023
NUTRITION CORNER
BEST FOODS FOR HEALTHY LIVING
Why You'll Want to Eat Your Veggies
These are just a few benefits of following a plant-based diet.
Can eating a plant-based diet keep you healthier?
Diets made up mostly of vegetables, fruits, whole grains, beans and nuts offer a number of advantages. They have relatively low levels of saturated fat and cholesterol and include many foods rich in fiber and other powerful disease-fighting vitamins and minerals.
Here are 3 good reasons to follow a vegetarian diet:
Heart Disease
Fewer vegetarians die from heart disease than non-vegetarians.
Plant foods tend to be extremely low in artery-clogging saturated fat, the worst culprit in heart disease. Whole grains, fruits and vegetables are rich in vitamins, such as C and E, which may provide a heart- protective bonus.
Hypertension
Vegetarians tend to have a lower incidence of hypertension (high blood pressure) than non-vegetarians.
Lower blood pressure in vegetarians appears to be independent of body weight, sodium intake, exercise habits and dietary fat intake. A higher intake of whole grains, nuts/seeds, fruits and vegetables seems to play a role.
Diabetes
High-fiber, plant-based diets have been shown to reduce the risk of type 2 diabetes.
A plant-based diet, rich in beans and slowly digested grains, seems to improve blood sugar control. Studies have shown that eating more red and processed meats may increase the risk of type 2 diabetes without factoring in body weight. You don’t have to strictly follow a vegetarian or vegan diet to reap the benefits of a plant-based diet. Cutting back on animal foods and increasing the amount of vegetables and plant-based foods you eat is a solid step in the right direction. You may even lose a few pounds and gain a healthier lease on life in the process.
NYC Health + Hospitals/Jacobi | April 2023
We celebrated the culmination of an almost three-year ordeal to purchase and acquire our new Steris Amsco 400 Series Steam Sterilizer to replace are 45-year-old Amsco 300 Series Sterilizers. The engaging Ribbon Cutting event was a success, and we appreciate all who played a vital role in accomplishing this! Thanks to NCB's Deputy Executive Director Alfredo Jones, CNO Dr. Neena Philip, Director of Nursing Carmen Holt, Director of Peri-Op Tonia Belfrom, Assistant Directors of Nursing Infection Prevention Marianne Luchetta, and Sony George. Also, thanks to Director of Sterile Processing Mr. Kyeremateng Asiama, Sterile Processing Manager Clive Inniss, and Assistant Director of Sterile Processing Darryl Henderson. “What is a steam sterilizer”? A steam sterilizer is a machine that uses steam under pressure to kill harmful bacteria, viruses, fungi, and spores on the instruments that are placed inside of the pressurized steel chamber for a certain amount of time and under a certain amount of pressure. Most instrument manufacturers recommend that steam sterilizers reach a minimum temperature of 270° and a minimum 30 pounds of atmospheric pressure. The Sterilizer was designed and built for this purpose and when operated by properly trained Sterile Processing Professionals this machine is our most cost effective and efficient means of sterilization. S t e r i s Am s co 400 Se r ie s S t eam S t e r ili z e r
NYC Health + Hospitals/Jacobi | April 2023
NYC Health + Hospitals/Jacobi | April 2023
MEDIA
Veronica Ades, MD, MPH, FACOG Vice Chair, Department of Ob/Gyn
BronxTalk features Bronx Borough President Vanessa Gibson talking about how to tackle maternal health disparities that show that Black women are more than three times likely to die of a pregnancy-related cause. Vice Chair of the Department of Obstetrics and Gynecology Dr. Veronica Ades, discusses how these issues might be addressed. Gary Axelbank is the host.
NYC Health + Hospitals/Jacobi | April 2023
Abortion and Reproductive Care Veronica Ades, MD, MPH, FACOG Vice Chair, Department of Ob/Gyn
What services do we provide at Jacobi when it comes to Abortion and Reproductive Care? How many patients do we see and treat in a year? NYC Health + Hospitals/Jacobi gynecologists provide comprehensive preventive and treatment services to patients throughout their lifespans. Our services include preventative gynecology such as pap smears, HPV vaccinations, and STI screening; adolescent gynecology; management of gynecologic conditions including uterine fibroids, ovarian cysts, endometriosis, and much more; comprehensive family planning services including contraception (i.e., birth control), abortion care, and miscarriage management; reproductive endocrinology and fertility; urogynecology (female pelvic medicine and reconstructive surgery); gynecologic surgery; and gynecologic oncology. All 11 of NYC Health + Hospitals acute care facilities – including NYC Health + Hospitals / Jacobi – provide abortion care with the option of both medication abortion and abortion procedures. In 2022 alone, Jacobi provided abortion care to just under 800 patients. People are seeing the headlines about abortion bans and the potential banning of Mifepristone; where do things stand within New York City and at Jacobi? NYC Health + Hospitals acute care facilities – including Jacobi – still offer medication abortion using Mifepristone. Regardless of the legal status of Mifepristone, we will continue to offer safe and effective medication abortion using alternative, well-studied medication regimens as necessary. Misoprostol-only regimens for medication abortion have been well-researched and endorsed by national and international organizations, including NAF and the WHO. While such regimens are generally not quite as highly effective as mifepristone-misoprostol regimens for medication abortion, efficacy and patient satisfaction are overall still relatively high. As a safety net hospital, we often see patients who are vulnerable and may not have family or social support for their abortion care. What are we doing to support these patients? in the summer of 2022, NYC Health + Hospitals hired a Reproductive Health Navigator to support patients in need of accompaniment with coordination of appointment scheduling; logistics related to transportation, lodging, childcare, and escort to the; and financial support for those patients who are traveling from outside of the five boroughs. In addition to this systemwide resource, Jacobi hired an Abortion Care Coordinator to support patients and providers. Many Jacobi employees work outside the field of abortion and family planning; what can they do to help? What is accurate information they can relate to their family, friends, and neighbors who could require these services? They can maintain community education and awareness of the comprehensive services offered at Jacobi/NCB, including abortion care. They can emphasize that people can get the full spectrum of reproductive health needs met at our facility. They can give our H+H phone number out widely so people can contact us: 1-888-NYC-4NYC.
NYC Health + Hospitals/Jacobi | April 2023
ANNOUNCEMENT Ambulatory Care Internal Referrals Guide ANNOUNCING
ACCESS THE REFERRALS GUIDE BY VISITING THE INTRANET. CLICK THE THIRD CAROUSEL SLIDE
AMBULATORY CARE INTERNAL REFERRALS GUIDE
Overview
Identifying which services are offered on-site and providing any applicable pre-requisites for The purpose of the Ambulatory Care Internal Referrals Guide is to clarify the referral process at NYC Health + Hospitals/North Central Bronx, by:
referring patients.
In particular, this guide will clarify which services are offered at North Central Bronx vs. which are provided at NYC Health + Hospitals/Jacobi. The intended audience of this resource are providers (physicians, residents, PAs, NPs, etc).
Contact Information Anyone with questions or concerns should contact: Erica Cruz Assistant Director of Ambulatory Care Erica.cruz@nychhc.org Use the “department” and “subspecialty” columns to find the service you are interested in referring to. Scroll to the right to find useful information such as points of contact, hours of operation, referral pre- requisites, and more. Services offered only at Jacobi are highlighted in yellow. How to Navigate the Spreadsheet 1. 2. 3.
ACCESS THE REFERRALS GUIDE BY VISITING THE INTRANET. CLICK THE THIRD CAROUSEL SLIDE
50%
Ansamma MoonJely, RN, BSN-BC, HNB-BC Clinical Ladder Symposium
O F F
NYC Health + Hospitals/Jacobi | April 2023
Nurse Moonjely Impresses at Clinical Ladder Symposium Registered Nurse Ansamma MoonJely is exceptionally passionate about holistic practice in nursing. In April, Nurse MoonJely brought that passion to the Clinician Ladder Symposium at Central. "Holistic Nursing practice is different from traditional Nursing as it focuses on well-being and multifaceted healing," said Nurse Moonjely during her presentation. "Traditional Nursing concentrates on treating symptoms. Holistic nurses incorporate those skills with attention to a patient's spiritual, emotional, psychological, and social well-being". Her presentation- The Benefits of Holistic Nursing- received an overwhelming response from a broad cross- section of health professionals across the Health + Hospitals system. "You did a great job explaining the purpose, background, and outcome of your project on the "Benefits of Holistic Nursing" and the application to practice for the neonate in the NICU," said Paula Brown, a Director of Nursing here at NCB. Senior Vice President of NYC Health + Hospitals, Dr. Natalia Cineas, was among the observers who recommended that the presentation be published on the AACN platform. "They were so impressed," Nurse Moonjely declared in an interview with the Public Affairs Department. "Holistic practice is enriching." Her presentation also focused on the modalities of holistic nursing, such as Acupressure, Touch, Reflexology, massage, aromatherapy, and meditation. Nurse Moonjely, RN, BSN-BC, HNB-BC, works with the Neonatal Intensive Care Unit, NICU, at NCB. "I have been a NICU IC nurse for more than 33 years. I am very passionate about the alternative modalities", said Nurse Moonjely, a certified holistic nurse. She advocates holistic intervention as a safer alternative than pharmacological interventions for babies in pain management. According to studies, all procedural, repeated, and sustained pain can cause Neurological and psychological consequences, hypersensitivity to pain, also decreased immune function. It is also not just for babies. It's also for adults for Healthcare workers. Holistic practice reduces burnout.
NYC Health + Hospitals/Jacobi | April 2023
A study of emergency care involving victims of severe brain trauma is to be performed in this area. NYC Health + Hospitals/Jacobi is conducting a research study to learn if either of two strategies for monitoring and treating patients with severe traumatic brain injury in the intensive care unit (ICU) is more likely to help them get better. Both of these alternative strategies are used in standard care. It is unknown if one is more effective than the other. In one strategy doctors concentrate on preventing high intracranial pressure caused by a swollen brain. In the other strategy, doctors try to prevent high intracranial pressure and also try to prevent low brain oxygen levels. This study will discover if either strategy is safer and more effective. Because the head injury is a life-threatening condition requiring immediate treatment, some patients will be enrolled without consent if a family member or representative cannot be rapidly available. Before the study starts, we will consult with the community. We welcome your feedback and questions. For more information or to decline participation in this study, please visit boost3trial.org or contact our study staff at (646) 816-3333.
Primary Investigator: Nrupen Baxi, MD Study Coordinator: Hussain Syed
NYC Health + Hospitals/Jacobi | April 2023
PATHWAY TO PLANETREE
Founded by a single patient in 1978, Planetree has empowered over 9 million patients and healthcare providers to look at the care journey in a whole new way. Harnessing Evidence and Experience to Change Culture It places patients and caregivers at the center of the care experience and unites communities around health and wellness. It places patients and caregivers at the center of the care experience and unites communities around health and wellness. Person-centered care creates workplaces that energize and inspire joy.
NYC Health + Hospitals/Jacobi | April 2023
NATIONAL VOLUNTEER WEEK Thank you!
NYC Health + Hospitals/Jacobi | April 2023
IT’S NOT FUNNY CAMPAIGN Derogatory comments and jokes which attempt to “poke fun” at people based on their religion, ethnic group, race, ability status, sexual/gender identification, or any perceived differences have one thing in common – they are NOT FUNNY. These comments can be said casually, but perpetuate harmful stereotypes and create an unsafe working environment.
Words hurt. Be an upstander. Help call people up by pointing out how their words can have lasting and negative impact on others. Redirect those making inappropriate comments to focus on shared values and empathy. Interrupt early. Be a role model.
Learn more about how you can be an “Ally to All” . Join the Employee Resource Group that focuses on how we can support all our colleagues and keep moving forward towards an equitable and inclusive environment for staff and patients alike.
For more information, kindly reach out to Marni Confino Marni.Confino@nychhc.org | (718) 918-5832 or Leora Botnick | Leora.Botnick@nychhc.org | (718) 918-6706
PHYSICIANS Your Voice Matters An Invitation from Dr. Steven R. Hahn and Dr. Yogangi Malhotra, Co-Chairs, FBCC The FBCC partnership is designed to enhance patient experience by improving physician engagement. The mission of the Facility-Based Collaboration Council is to enhance NYC Health + Hospitals/Jacobi’s patient experience, clinical outcome, physician satisfaction, and fiscal health by engaging and empowering front-line physicians and senior leadership in direct communication in a safe and collaborative setting.
Joseph M. Seldin, MD
Yogangi Malhotra, MD
The council meets monthly; the meetings include one Doctors Council member from each department, along with CEO Chris Mastromano, COO Jordana Bailey, CMO Michael Zinaman, CNO Suzanne Pennacchio and other Senior Leaders. 01. Collaboration and Communication: Each service presents 1-2 "Service Reports" (frontline issues that we have attempted to fix locally and need facilitation/intervention of the group). The members of the group discuss possible solutions to resolve the 'pebbles in our shoes' together. 02. Culture and Engagement: "What matters to you?" The meeting provides a safe space that fosters active engagement of clinicians and administrators to co-create our shared purpose. 03. Leadership: The FBCC is an ideal forum for leadership development. Frontline physicians get first- hand access to the important initiatives and happenings across the hospital. 04. Quality & Performance Improvement: FBCC provides experiential education in quality improvement science to front-line physicians. Please reach out to either Dr. Hahn or Dr. Malhotra if you would like more information on FBCC, participate in the forum as a representative of your group or if you have an idea for improvement that may need support. Steven R. Hahn, MD, FACP
Yogangi Malhotra, MD, FAAP Director of Pediatric Quality and Safety Associate Professor, AECOM Department of Pediatrics | Office: Room 8S04, B1 Phone: (718) 918-4039|Cell: 734-904-6569 Malhotry@nychhc.org
Professor of Medicine, Albert Einstein College of Medicine Director, Internal Medicine Residency Primary Care Track Director, Clinical Ethics Consultation Service NYC Health + Hospitals/Jacobi | Office: 4W5B, B1 Phone: 718-978-4996 | Cell: 914-441-6628 Steven.Hahn@nychhc.org
EMPLOYEE RESOURCE GROUPS
2023 SCHEDULE
ALLIES FOR ALL Group Lead: Marni Confino 1PM - 2PM | Building 1 - Room# 2N24
LGBTQIA+ Group Lead: Jordana A. Bailey 12PM - 1PM | Building 1 - Room# 2N24
February 23 March 23
February 23 Mar ch 2 3 | April 27 May 25 June 22 July 27 August 24 September 28 October 26 November 30* December 28
CANCELED
April 27 May 25 June 22 July 27 August 24 September 28 October 26 November 23 - (day after Thanksgiving) December 28
WOMEN Group Lead: Joanne Sampson 12PM - 1PM | Building 1 - Room# 2N24 February 8 - Conference Center March 8
BLACK/AFRICAN AMERICAN Group Lead: Kara Simpson 12PM - 1PM | Building 1 - Room# 2N24 February 9 March 9 April 13
April 12 May 10 June 14 July 12 August 9 September 13 October 11 November 8 December 13
May 11 June 8 July 13 August 10 September 14 October 12 November 9 December 14
LATIN X Group Lead: Nancy Ruffin 12PM - 1PM | Building 1 - Room# 2N24
EMPLOYEES WITH DISABILITIES Group Leads: Maria Dimeglio & Ralph Liebling 12PM - 1PM | Building 1 8E20
May 22 June 26 July 24 August 28 September 25 October 23 November 27 December 18
April 11
For Inquiries, email: JacobiEDI@nychhc.org
NYC Health + Hospitals/Jacobi | April 2023
Our Voices Digital Magazine
Submit Your News Stories! Communications & Public Affairs Building 4 | 7N1 Phone: (718) 918-3827 Email: JacobiNCBPublicAffairs@nychhc.org
@JacobiHosp
@NorthCentralBronxHosp
Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12 Page 13 Page 14 Page 15 Page 16 Page 17 Page 18 Page 19 Page 20 Page 21 Page 22 Page 23 Page 24 Page 25 Page 26 Page 27 Page 28 Page 29 Page 30 Page 31 Page 32 Page 33 Page 34Made with FlippingBook - Share PDF online