. 9 Q ~ o O I a - o t . .— I 4 .'-II‘_ . 4 . - , . I .— vv, . '- ~. ~ , . fi‘ ‘0 - a“ ...-. - ._ . - -- - ' ' ' ‘ -- '.- .c. . . . _ .- . o I g . I _ . . ; , ‘ ~ - C . I I I- . C I l .. ’ I . .l ‘ g I I. g I . ‘ . ‘ I . I . o I ‘ I ' _ ' ‘. g ' . ‘ 0 C _ , I . ' . o. . - II 0 'Q: I O . ‘ . o . . a I I . ~ .- I _ . - g . I . . . ' . , ~1 . , . v 4 o . - o . _ ~, - .. I - I - o . . . ~ ~ . _ - ' . . . - . _ .. ‘ - ~ I l _ o _ ‘ " . I I ~ 0 . - - - . . ,- - -. . . . . . u 4 - . ~ - v o . I c o -‘ . _ . .c .. I . - . . . I . u a n I - . o . I I . I 4 . 4 A .' ~ I . Q _ v . . . . . . o u I . . _ . I 'II. _ , a .- . ' . .. . 4 . . - , -. . ‘ I o . - - . _ . II I I . ‘- g . O _ . . . n -- .. .. . . _. II I . . .- - - . o ’ ' I : ' . ' - ' "..“' ’ . .- ’. _ ‘. I ' ‘. . . : .. . . . 4 ~ g . I ~ . . . . ' ‘ . . , ., . . ... I - o v ‘ |« _~ - . u 4 Q ~ I A I. ‘ 4 ‘ - ' . .' o . I - u ‘ ' Q I .g n n -l I. . I I I ' ‘ - . , o - . . «c - l - - . ~' ' -. ' ~ .'. I I - a ‘ I . . -. . 0‘ ‘ - 4 - ‘ . . . . . . n . 4 n . . . 4 - - o . n _ .. . . o‘ . . ‘."-. ..' "I'. ‘ . n _ . . 4 _ . . .. I- - ' ~ a - . 4 .n) , - ' v I . . . , . o r _. ' ' _ . ca - . ' '. ‘ . - . ... - ' . . - - ' . ' Q . I . .I ... . I . .‘ u . ' ‘ ‘ .. . I -I . . . o - .~ . ~ - . I. . , . .. . . . Q 4 .. . y- -- . . _ . . _ . I ~ . _ . . . . . , . . . I . _ u . u 1‘ . . 4 n . . . . . I I . p ' .u . . _ . . . - . . .. 'u‘ I o . I ~ . . ‘ . o ' ' . u n I_ w ‘ . _ I I " » v 4 . ~> O o ' n - , . I - - - Io _ . , - ~ . 4 ‘ » . ' - - - . o “ . . '. II - I I . I - 4 . - - . . . . .0 . _ _ Q . - . . .‘ _.I - . ~ 2 . ,- . . - - .. .- . - . - - v - \ - _ . I IN . .I > f . . t -- ' ' I I ‘ . . n-‘. .‘ ' I I - .; I ‘ .- x . _\o_ I ' - . . .. . . . -- . ‘ . . - . ‘ , I '- _ . . _ - ~ .- . I ‘ . ' . .,- . . ’ \' 4 .. .I . - ‘ ., , o ‘ .I I . I . u . a . ‘ ... ~ I I - . § \ v - I . _ . " .. . . _ _ ‘ ~‘. ' . . . . ' . . . ~, - x ‘ I . . . .I . II . I , . . . o 5 ,‘ I ‘ ' ‘ . 0.." . ' ° ‘ 0 . . I . 4. - t . '. -. ‘ . ' - . -' - I ‘ ' ‘ n. . A < I .~ _, ._ . ~ ‘ . o . . _ j. ..I - ' ~ ... - 4 I . I I I . . , - In , - I. - . . . 0 ‘ . _ I I . . . ' I.- - . . . u . . . 4 I. I. . o .' . . . ~. I. . I. .IIII .I . I k . 4 I . . - . -. g I ‘ . II- Y 4 III I , . . 4 ’. ' . . _ I ‘ - I Q . I ' - ‘0 4 , . . . .. . - ‘ . ~_ 0 ' - ‘ I I ' A I , n O I . I I I . '; . a I s . . ‘ . . I A -I ' . . . , . . . ~ . - v . _ . .' n V' ‘ o . . g . . - _ . . , ' ' . o ' .'. 3.. . Z . Q i ' - . ' . . . ~ _ - . 4 _ ’. ‘- - I I . ‘ I .\... . n _ ' ‘ . . I . . . ... . . ' - ‘ . ; - . - _ - - . ‘ ‘ I — I 1 ‘ ' - . . . -: - ' ‘ . - . . . ~ . - - 4 . .. 4 - - I - - I. ' o .‘« . ' ‘ ‘ ‘ o v . ’ , . . ' ' .I. - I . u " . . -... u : ' .. ‘ . II . .~ .I ‘_ . .I ‘. . 0.. . . I . . . . . . ~ ~ ‘ . o I . I, . . . . ~ v o -‘ ' ' ‘ ' ' ‘ ' . ‘ o . ‘ - . I v - O I - Q I q . . -\ . . . ‘ .. " . s .‘ ‘. -o ‘ ‘ - I . . _ o . ' . r... . . - ' ... ' I . . . . ... ' 1 I ‘ ' - ‘_°“' . I. . . . . . I. » , -. g ‘ . , .1 I ~ . ~ . .. -. I... I a I ' ’ ‘ I ‘ ' ' ‘ . - I u . ' O r - ‘ I‘ ‘ E - .'_ ' . ‘ - o " ' .4 . . ... ..-... . . ..". . . 9 ... .. o o . v - - ‘- ‘ '- -. : o- ‘-' :\ ‘ . -. .. . ‘- -» . g . I I ' 4 .4 . . ‘-° '. .. 4: -. . ‘ . ' t I u I .4- . I l I . I ..I V I II ' I I ‘ I' I ‘ 4 . ' I 4 .. . . , - -.. '." ‘ . ~ 0. ° ‘ . . . .I . I . _I ., - . ... co -- . . -- - . .‘ . ... ‘ . u. . . .. . '." ~ . , ° ~ . ‘ 'u . . .-‘- - . . .~, . o . . I I A . . . ‘ - . 4 s . - o-‘. I , . . .- g, ' <~ - ~ v I , ~ . .. ' ‘ qI- I ‘ "v . ¢~. - 4» -I .o - ,0“ . n ,I .‘ vI I- .0 t ' - I . . . ‘ ‘ I h 0 ~‘ ‘ ' ' 0' ' ‘ ' I . - . ' . .- . .. . . -. .~ - - . . . " 4 - . ' , .. _ ~ I ' - ' c - ... . . . .. - .-. .. .I . v . . . . 4 , .. . . Is . . ' - ' . . . . - ...‘ II .I . . I.I - I I I I I . I I II I‘l- . v . . O .- ~ , I V ‘I . - ~ . ‘4 ' ..‘.o . I ‘ . r .' 4 u . . .- ' . ‘ . I ' 0 - .. I ." a . - I a ' 4 - _ . .'. -., . . . . . I g- .. I I I I I“ '- ..' .\ . . .. .. ,I . . , . 4 ' - . . . ‘. o - _ . .u ‘ . ... . u ‘ ' ' . 0 ~ . .. - _ >0 - I I -I . o . ‘., . . - ,, . - I I O o I ' - p I o . . - .O' .' . I . . I . . 4 a v -‘ - . . . . 4 n' c .' . -. ~ . v -. —- --' - to '0. - I o - , -.. . .I . . . . . o 7 .. I I I.I - . o . . -, . 0 o .. ' ‘ .' ’ ‘ . - - < .. o I . a I . ~ . ‘ ' . _ . . . - - - - .. c . . . a - .‘ , , f . . . . . ~ ‘ - . v I v - u 0 ~ . 4 . o . . .. . , . I . . . . . . - .. ‘, o M - ' . .- . '. o a a o '4' - . .‘ . , .a ' ' . . _' ' . . .. - I I I I I . 'I; .0 I . . I . .. . . .' . . - - ' ' 4 . . . I u . o ' o ‘ Q ' O 1 ~ . . -- - - . . . .. . . o-A -. 4 , I 0 I v - . o .. - . I . u . ... I . . o v a. . '. . . ¢ . . I o -‘ . - . , . . , c . ‘ _ .. . . .I u .. . . c . . - _ . . . . . ‘ o. . - o. - o- . . o g . ' 4 - o t ' n C - I . ' - O .o - ~ . . . ‘ . 4 I , -. o -- - ‘ ‘ ‘I' I . _ . I . . , . . ' ‘ V ' I I 4. I 0 . I . . ,4 . - . I I I - . . f a . . - n . o u . I , bo- . . . o D - ' ‘ n . . . . v» ‘ . I . .I - . _ . ‘I D .I I I I I I ... . . , ... -. . . » . . . . . ." , . . .. , . . I . b I 1 o 0 ~ - . . ' O . .- . o . - . - ‘ . - . ~ - - . . . - ~o . . I, o I. . I J . . . . ’ . ' - 0 . A - o - - . - c ' . ,I . 0 .. _ I . -- . - . . . . . . ~_. I I I I I Q 0 A I ' ' I - . I , . . . .. . . o . . . - , . . . , . . . . . . . . . . - . . . 4. - - ‘ . . I u ' ' I r ' v . . . . . ' . - . _ . . . ~ . . - a . . .. . . . - . .. . I . 4. o - 4 ' ' - I I. O ' ‘ v . . . - .. I 4 , g . . . . . I u . . .. . . . 0 g ‘ — ~ - . . I . I I ' ~ . . . o . I - . . . . o - - , - c . ~. .I. , . . I v ' I 0 ~ .. ' o . . -. . .. - . _ _ . . , . . o . ‘ - ‘0 o -. . . . , .. , . ~ . . . I a- I . . . - . I 9' .. . II I I v . I . . . ' l D .. ~ . - ' ' ¢ I . u - n I 4 ' . . . " o -. . n c o . - . _ A . . ‘ A . . . I ' -' - . - o o 0 ~‘. . l . . . . 4 . . 4 . 0 ' v 1 . o- - ' . ' - - . I . i ' . . I I O ’ ‘ I . I . ’ . . . 4 I I . . I I " I b” 3 - d . ‘ , - - 4 . . -' . a . n g ‘ ’ '_' . . I I ‘ 4 I ' ' y 0 .- I .D o l s n I I ' I I c . . ‘ - ‘ I n o 4 . .. n . I I . I . . o I ' . , . . . . . - c 4 ‘ _ > . . . . . . . . . , . I I I - . n— ‘I . . - - . . . I I I I I I I I II o . I I I ’ - ' v d I u, _. . . . , . I I . . . . . .7 I . ‘. . _ . . . .— . . '. , - . . I ' ‘ " , I 4 . I ' DI . I _ . . .. . ' ' ' . - . . , .. I . , g . - I . ’ . v . . ‘ , _ I I . o - . . . , . - ‘ . . o ‘ _ . .4 . a . 4 . I. . ‘ . I . . 4 , - . - , . l - . I . - o , ~ 5 I u 1" . I . c I ’ V n 0 I Q . . v ' ' ' u n " - I ‘ I - ' .. .- I - 45 o n O - ., ‘ ‘ . 1 . . .. . . . . . . u.-. ,. . . I u 4. ._ .‘ . . . . I . . . , . . . - . . .' . . ..,. 4 - . _ . . - . . . . . . . I. . . u . ~ . . . o . ‘ I I .— v. . . - -' . ~ I . . . . . . - . . . I ~ . , . , » - . I I -I '| . ‘ . ' ’ '. - > . - I~ . . . , . . . , . . -- o . . , . . . ' O O 4 O . .. - . - . 1 .- . 1 " ' , t 1 1 u ' ' . . Q . u 0 ~ . I- ~ . . . I . . . . - . . . . . . - I ' . . - l . v . -- . .- .... - . . ,. . . 4 . . ‘ - .. ‘ . . . 4. . , . .. ' I . . I ,9 I I . I I I I u . I .4 v I O . ' ' ~ ' . n - . . . - . , ‘. ‘ -A.o "‘ ‘ ' ' ‘ ‘ I - ! ‘ . . ,, o a v . , « . . .. «r .. .. ~ . l p -. . ‘ c v. " ‘ . . . . . . - ,- o a. , A I ' f ‘ ‘ ..- . . ’ o ‘ I U v Q . . I q o - ‘u I . . ’. .- . f" ‘ .. . ‘ . I. ._.. ‘ . . . ‘ o 4 . - 4- - . . - . ~x 0: . . .. I .0.- .. ~ , . - , . . - . o , . - . v ‘ . 4 - o . , . a . .. u - . 4- ~. . ' 'I‘ I I. l O u - . ' . .— n o . I ' . . ,. o . . I. v . ..~. . I. -- w. ‘ -- . . - . . . -» . u .. ‘. - . - . u n - <.,.- ,o , 4 n . ~ . , . 1 ... -. .. . .. -. - 4 . .. ‘ - , - — . o .- . o - I 4 . . . . . ' n 0 . . . .. . . - .c LIBRARY Michigan State University PLACE IN RETURN BOX to remove this checkout from your record. TO AVOID FINES return on or before date due. MAY BE RECALLED with earlier due date if requested. DATE DUE DATE DUE DATE DUE 6/01 c~JCIFIClDateDue.p65-p.15 AN ADOLESCENT PRENATAL EDUCATION CURRICULUM By Linda A. Dalman A SCHOLARLY PROJECT Submitted to Michigan State University in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE IN NURSING College of Nursing I998 ABSTRACT AN ADOLESCENT PRENATAL EDUCATION CURRICULUM By Linda A Dalman Adolescent pregnancy is at a very high rate in the United States, contributing to the high incidence of low birth weight babies and premature births. Literature reveals effective prenatal education to pregnant adolescents can have an impact on lowering the number of premature births and low birth weight babies . For this project a prenatal education curriculum from the Oakland County Health Department was adapted to the adolescent population, using Leininger‘s Cultural Care Diversity and Universality Theory and Kolb's Learning Theory. The adolescent is seen as part of a specific culture who has various Ieaming styles. This study addresses the unique adolescent culture and Ieaming styles, to create an effective adolescent prenatal education curriculum. Implications for the APN are presented, focusing on education, research, advanced practice, and product development. ACKNOWLEDGMENTS I am grateful for the wonderful support of my chairperson, Dr. MaryJo Amdt. Her unceasing advice, support, and encouragement were instrumental in the successful completion of my project. With her gift of organization, expertise, and ability to keep me on a focused schedule, I was able to complete my project within the desired time frame. Thanks also to Kathie Dontje and Jackie Wright for their willingness to offer their expertise and assistance. I also thank the Ottawa County Health Department and the Prenatal Education Committee for their input in this curriculum. 1 especially thank Connie Kross and Lisa Stefanovky who helped write and rewrite the curriculum. 1 especially thank Shirley Rogers for retyping the curriculum so many times. Much thanks to Linda Bender and Oakland County Health Department for sharing their curriculum for our revision. I would also like to express my gratitude to my husband George, and children, Ryan, Ben, Kurt, and Anne for their patience and support during these months in which this project over shadowed our family time. I could not have done this project without'your encouragement. iii TABLE OF CONTENTS LIST OF FIGURES .............................................................................................................. v TNTRODUCTION ............................................................................................................... 1 BACKGROUND AND SIGNIFICANCEZ PURPOSE .............................................................................. - .............................................. 3 DEFINITION OF TERMS ................................................................................................... 4 PROJECT DESIGN ............................................................................................................. 4 THIEORIES AND FRAMEWORK ...................................................................................... 4 Leininger's Theory ............................................................................................................ 5 Kolb's Theory ................................................................................................................. 10 LITERATURE REVIEW ........................................................................................ » ........... l4 Adolescent Culture ....................................................................................................... l4 Adolescent Pregnancy ................................................................................................... 15 Prenatal Education ........................................................................................................ l7 Kolb's Learning Theory Application ............................................................................. 18 SUMMARY 2] PROJECT DEVELOPMENT ............................................................................................ 22 IMPLICATIONS.............; ................................................................................................. 26 Education ...................................................................................................................... 26 Research ........................................................................................................................ 27 Advanced Practice ........................................................................................................ 28 Product Development ................................................................................................... 29 SUMMARY ....................................................................................................................... 29 LIST OF REFERENCES ................................................................................................... 31 APPENDIX A ........................................................................................................................ First Class Delivery Curriculum iv LIST OF FIGURES Figure l - Leininger's Sunrise Model (Leininger, I991) ...................................................... 6 Figure 2 - Dalman's Adapted Sunrise Model ....................................................................... 9 Figure 3 - Kolb's Concepts ................................................................................................. I I Introduction More than 1 million teen age girls in the United States become pregnant each year (Bachman, I993). The high rate of adolescent pregnancies is of serious concern to many citizens but especially perinatal health professionals because of the increased risks to both mother and baby (SIager-Eamest, Hoffman, & Beckmann, 1987). Approximately 6% of all infants born in the United States in I980 were born to girls who were less than l8 years old. Studies from the 19605, 19705, and 19805 have shown that births to such young mothers are associated with high rates of infant mortality, morbidity, and subsequent psychosocial and developmental problems among surviving offspring (Piechnik & Corbett, I985). The United States ranks 19th among 25 industrialized countries in the rate of infant mortality; many wonder how this can be. One major subgroup which contributes to these numbers is the adolescent population who deliver 13% of the low birth weight infants. Low birth weight infants make up 0.3% of all births in the United States and account for 25% of infant deaths the first year of life (Opuni, Smith, Arvey, & Solomon, 1994). These statistics have prompted health professionals to try to reduce these numbers, looking for innovative ways to improve perinatal outcomes. 2 Background and Significance Adolescent pregnancy is a major health problem in the United States. Ottawa County of Michigan had 272 live births to teens between 15 and 19 years of age, representing 8.4% of the live births in the county, according to 1995 Ottawa County statistics. There were 4 births to mothers below age 15, the largest portion coming from Holland Township and Holland City. A survey conducted by the Ottawa County Health Department in 1996, identified that the adolescent population was either not attending a prenatal class or that the education was not meeting their needs because of class structure and/or the information format was not sensitive to the adolescent population. The existing prenatal education class curriculums that are currently provided in the county are not specifically targeted for the adolescent population. In order to provide effective prenatal care to this population, class curriculums must be designed to address the specific needs and Ieaming characteristics of the adolescent population. In order to address the lack of prenatal education targeted for teens, a group of 3 RNs and 3 health educators representing Ottawa County, Holland Hospital , Zeeland Hospital, and one of the local physicians offices formed a committee to begin an adolescent prenatal education class in Ottawa County of Michigan. A pilot program was created and information from a focus group of adolescent parents was assimilated to help design a program to fit the adolescent‘s needs. A pilot class of 13 adolescents was conducted in January of 1998. Another adolescent prenatal class was held in April and again in June of 1998. Presently a prenatal class, consisting of 9 pregnant adolescents and their coaches, is being conducted at the Ottawa County Health Department. Nurses have a responsibility to provide appropriate prenatal education to pregnant adolescent girls. The education needs to be inviting and include specific content which fulfills adolescent's desires and needs for parenting skills as well as the labor and delivery process. Since research has shown the positive effects of early prenatal education and the reduced risk of poor pregnancy outcomes, it should be an essential part of pregnant 3 adolescent prenatal care (Dieterich, I997). Fewer preterm deliveries and higher birth weight infants were the result of the Northeast Adolescent Project done in 1990. This project involved a collaborative effort of community services including nurse educators, clinic services, public school staff, case managers, counselors and public transportation personnel (Opuni et al, I994). The relationship between a lack of prenatal education and the number of preterm deliveries was also studied, and a positive correlation was observed (Libbus & Sable, 1991). In order to significantly improve the outcomes of adolescent pregnancies, it is necessary to reduce the incidence of low birth weight by addressing the social, psychological, and nutritional needs as well as specific health problems of young pregnant girls (Piechnik, 1985). Prenatal education can help address pregnant adolescent health issues. The APN can use the adolescent prenatal education class as an opportunity to encourage improvement in women and children's health by addressing pregnant adolescents high risk needs. The education can help cut the cost of primary care by reducing the number of low birth weight babies and premature deliveries. The APN role as assessor, health educator, and advocate can be utilized in the pregnant adolescent health concern. The APN involved in primary care can help organize these classes and teach the pregnant adolescent population. Purpose The purpose of this scholarly project is to create a theoretically based prenatal education curriculum for adolescents and their support person. This prenatal education curriculum incorporates the Kolb's Learning Style Theory as well as Leininger's Culture Care Diversity and Universality Theory. The goal of the adolescent prenatal education course is to help adolescents deal more effectively with the labor and delivery process and also develop needed parenting skills. The project is a theory based curriculum which could be used by health care professionals in most any setting to teach pregnant adolescents. Definition of Terms Wu is defined here as the provision of information about pregnancy, labor and delivery, and parenting skills, taught in a small group session, applying various Ieaming style techniques (Lindell, 1988). This free prenatal education class will last six weeks followed by a series of parenting support sessions. W is defined as a woman between 13-19 years of age. W1: refers to the way individuals generate the concepts, rules, and principles that guide their behavior in new situations they encounter (Kolb, 1984). Wu refers to anyone the pregnant adolescent chooses to help her through the labor and delivery process; this may be father of the baby, her mother, sister, or friend. Project Design A specific adolescent prenatal education curriculum was designed incorporating a variety of teaching methods. Kolb's Learning Theory was used to create a curriculum which meets the adolescent's various Ieaming styles. Leininger's Cultural Care Diversity and Universality Theory was applied to this study as a framework to assess the adolescent culture. Adolescents were asked to suggest ways to improve the class through an evaluation process. The end product is a packet which includes a short explanation of the theories used and a condensed review of the adolescent culture, helping educators sensitively apply the curriculum of 6 lesson plans. Theories and Framework The framework for this project is Leininger's Cultural Care Diversity and Universality Theory as well as Kolb's Learning Style Theory. Leininger's Theory is used in this project to visualize the adolescent as a culture. Concrete ways to assess and understand the adolescent culture are described using Leininger's Theory. The Kolb's Learning Style 5 Theory is used to help design a prenatal curriculum which can be understood by a variety of learners, no matter what their Ieaming style. I . . , II Leininger stresses careful assessment of the client before quality care can be given. Technological factors, religious and philosophical factors, kinship and social factors, cultural values and lifeways, political and legal factors, economic factors, and educational factors all need to be determined (Leininger, I979).This theory focuses on the health system that encompasses the values, norms and structural features of a specific family or community (see Figure I ). Madeleine Leininger experienced a culture shock during the mid 19505 while she worked with children in a child guidance home in midwestem United States. Specifically she functioned as a clinical nurse specialist working with disturbed children and their parents. She observed in these children concurrent behavior differences and concluded these were culturally based. She decided that a lack of knowledge in different cultural bases was a missing link in nursing care. Leininger built her theory on the premise that the peoples of each culture not only can know and define the ways in which they experience and perceive their nursing care world but also can relate these experiences and perceptions to their general health beliefs and practices (George, 1990). Leininger's definition of transcultural nursing is: "a learned subfield or branch of nursing which focuses upon the comparative study and analysis of cultures with respect to nursing and health illness caring practices, beliefs, and values with the goal to provide meaningful and efficacious nursing care to people according to their cultural values and health-illness context" (Leininger, 1979, p.15). cULTUHE CARE WORLD VIEW m°i°aisflmfis otfi‘g"; #300: / Cultural values I \ ‘/ o‘flggb \ ":32" [I ‘90! %\ >\ / 6b \ m4 mama”, / \ o / i \\ $9 \ \ I ”0’ ’I \ / $9 WW: K\\ 0;, a ”‘3: \f 45%;. 3/ x’ \ I \ I Lg: -.. .....I: .. :.":3".'.‘.l‘:!"_b°.'9°.l. .. .1]: ._ _ E. .. .i at lndvldrals. tamlllos. group: and lnsllnrtlona l Dlvorsc health systems I ' .L I Folk \ 1 Professional I Worm ‘, Nursing \I Mom: I ‘T \ Nursing cm doddons and actions \ ._ / Cultural can prounmlonlmalntcnanco Cultural can acoommodadomnogotlatlon Cultural can romantic/restructuring I cum congruent cm \ / \Q—I/ Figure 1. Leiniger's Sunrise Model depicts dimensions of Cultural Care Diversity and Universality. 1101:, From Culture Care Diversity and Universality: a theory of nursing (p. 43) by M.L. Leininger, 1991, New York: National League for Nursing. 7 Leininger looks at both the cultural differences and commonalities. She refers to commonalities as universality and differences as diversity. Culture is defined as the Ieamed, shared and transmitted values, beliefs, norms, and life practices of a particular group that guides thinking, decisions, and actions in patterned ways. Cultural values are derived from the culture and identify desirable ways of acting or knowing. These values guide decision making for members of the culture. Culture care is defined as the cognitively known values, beliefs, and patterned expressions that assist, support, or enable another individual or group to maintain well-being, improve a human condition or . lifeways or face death and disabilities. (George, 1990) Leininger most often refers to ethnic cultures in her theory but age groups also present specific learned values, beliefs and patterned expressions. Adolescents present with a specific set of norms which they and their peers have developed over the years. This very specific culture has been present as long as there have been adolescents. The adolescent culture is part of the developmental process, a part of becoming a man or a woman. The changes which occur may cause the adolescent to experiment and be different from children or adults. The need to be different is an effort to be unlike the children adolescents once were and different from the adult world adolescents are to become. In order to find out what you can do and who you are, you have to find out what you can do on your own (Hamachek, 1990). In adolescence, a metamorphosis occurs and with this change, a set of values, dress, language, music and outlooks are produced. Understanding an adolescent's definition of health is important to developing a plan of care or educational curriculum. Awareness of an adolescent's feeling of invulnerability and in some cases awareness of the adolescent's naivete is imperative. Culturally congruent care will help the client learn how to improve or maintain their health, be satisfied with their care, and follow through with care plans. Nursingto Leininger involves providing human care to people in a way that is meaningful, congruent, and respectful of cultural values and life styles. A model depicting the 8 adolescent culture and prenatal care was developed by Dalman (See Figure 2). Adolescents are a culture of their own and assessing their cultural and social structure dimensions; their needs, values, education level, economic status, and social support systems is important when providing prenatal care to adolescents. Prenatal health of adolescents as seen in the Dalman model involves many influences and care patterns. There are diverse health systems which also play a large role in adolescent prenatal health. Community prenatal education is only one part of the diverse health systems which interact with the pregnant adolescent. School and social services are interacting also and serve a very significant part of adolescent development and health care. Prenatal clinic care also is very important and articulates with the community prenatal education programs. Prenatal education, school and social services, and prenatal clinic care need to interact with each other and the adolescent to produce the finest outcomes, that of a healthy mom and baby as well as effective parenting skills. (George, 1990) AdoleSLenjL (a were C “rt ll F inf-”Ivan.” f ”3’9 I .- and S h ,-. o -H-<.r'n - in eh::30en;l (are. [7% £V 'nd &"s¢,0-3L W 51/ Prcvud'ul he“ ”'4‘ 0? Acre lescen‘TS Dill-[:rsc Hcal‘H-x Sgskms ‘- \ - \ f-‘L. / / \ \ / A? \ / .\ / SCkooi Pmd“ c°"‘"“’"‘+5\ I + I (Jinic pnm‘hJ . sodg\ l ’ cart. (Gucci-ion I \ StNicLS \ / V PWJMMS / \ ,‘x\ /\ / \\\ I/ \‘t.” \\~a’/ HQOJ‘HVJ mam '4' Babrj EFFecfive Par-en'lrnj Skills finial. Dalman's Adapted Sunrise Model depicts dimensions of Cultural Care Diversity and Universality, adolescent culture, and the concept of adolescent prenatal education. Note. From Culture Care Diversity and Universality. A theory of nursing (p.43) by ML. Leininger, 1991, New York: National League for Nursing. 10 Kolblslheoni Kolb's Learning Style Theory is used as a framework in this project to underpin specific Ieaming styles adolescents may have. Kolb identified four Ieaming styles; Converger, Diverger, Accommodator, and Assimilator (Reed, Ayersman, & Kraus, I997). Awareness of these different Ieaming styles and using curriculum which relates to a variety of Ieaming styles can help a greater number of students learn more effectively. Individuals will gravitate to a particular style of learning based on past experiences, heredity, and environmental demands. There is no best Ieaming style, all are of equal value and merely represent different ways of gaining knowledge (Amdt, 1994). The project does not assess each adolescent's Ieaming style individually but incorporates a variety of teaching methods to reach a variety of different Ieaming styles, consistent with the application of Kolb's Ieaming theory. Kolb (1984) developed a Ieaming cycle which starts with concrete experiences, followed by observation and reflection, leading toformation of abstract concepts and genera/i:ation, evolving to testing implications of concepts in new situations, and again back to concrete experiences (See Figure 3). Concrete experience Ieaming involves leadership, relationship, and help skills. Reflective observation Ieaming includes sense making, information gathering, and information analysis. Abstract conceptualization Ieaming includes theory, quantitative, and technological skills. Active experimentation Ieaming involves goal setting, action, and initiation skills. 11 concrete experience Accommodator Diverger testing implications observation and of concepts in new reflection situations \ C onverger Assimilator formation of abstract concepts L and generalizations Eiguril, Kolb's concepts. 12 Kolb has 3 concepts to explain the aspects of Ieaming. First, this Ieaming process is continually reoccurring. Concepts are tested in experience and modified as a result of a person's observation of the experience. All Ieaming is releaming and all education is reeducation. Second, the direction Ieaming takes is governed by one's felt needs and goals. Learning experiences are sought which are related to individual goals. The process of Ieaming is erratic and inefficient when personal objectives are not clear. Third, since the Ieaming process is directed by individual needs and goals, Ieaming styles become highly individual in both direction and process. In some areas, specific objectives and needs may be clear guides to Ieaming, in other areas individuals wander aimlessly. (Kolb, 1984) Individuals have preferences for Ieaming and Ieaming is affected by several factors such as abilities, traits, or intelligence. Learning Styles have been proposed by many authors, 21 styles have been identified. Many believe Ieaming is based on experiences people bring to a situation. Kolb (1984) thought Ieaming could be based on 3 modes. Mode one includes the Performance Mode where learning is focused on an immediate task of limited time. Mode two is a Learning Mode where knowledge is extended in time and space to encompass similar situations. Mode three is the Developmental Mode which has the longest time perspective with the strategic control of adaptation. Kolbs formed a Ieaming style inventory based on these concepts. Studies have been done to evaluate the validity of this inventory, some support and others have found contradictions. Studies have found the 4 factors of the Ieaming cycle present but there is intercorrelation among them. Many have decided Kolb's theory has merit (Kaskowitz, 1995). Kolb (1984) identified four specific Ieaming styles. Individual learners can possess one or more styles of Ieaming. The 4 styles identified include: converger, diverger, assimilator, and accommodator. The converger learning style relies on dominant Ieaming abilities of abstract conceptualization and active experimentation. The greatest strength lies in problem solving, decision making, and the practical application of ideas. It is titled l3 converger since a person with this style seems to do best in a testing situation where there is a single correct answer. Convergent people are controlled in their expression of emotion. They rather like to deal with technical tasks and problems rather than social or interpersonal issues. They often specialize in the physical sciences such as engineering and technical specialties. The divergent learning style emphasizes concrete experiences and reflective observation. Their strength lies in imaginative ability and awareness of meaning and values. They view concrete situations from many perspectives. The emphasis of this style is on adaption by observation rather than by action. It is named diverger since a person of this type performs better in situations that need main ideas or brain storming. Divergers are more interested in people and tend to be imaginative and feeling oriented. They have broad cultural interests and specialize in the arts. Counselors, personnel managers and organization development specialists are often divergers.(Kolb, I984) Assimilation learning style abilities involve abstract conceptualization and reflection observation. Inductive reasoning is a strength in this style with the ability to create theoretical models and assimilation of desperate observations into an integrated explanation. This style is less focused on people and more concerned with ideas and abstract concepts. It is important to this leamer that the theory developed is logically sound and precise. This Ieaming style is more characteristic in individuals in the basic sciences and math, research, and planning departments. (Kolb,1984) A ccommodator learning style strength lies in doing things, carrying out plans and tasks and getting involved in new experiences. The emphasis of this style is on risk, action, and Opportunity seeking. It is termed accommodation because it is suited for situations where one must adapt to changing circumstances. People who are accommodators most often solve problems in an intuitive trial and error manner, relying on other people for information rather than their own analytic ability. These learners are at ease with people but may be seen as impatient or pushy. Accommodators are often in l4 technical or practical fields, as well as action oriented jobs like marketing and sales. (Kolb, 1984) Combining some of the concepts of Leininger's Cultural Diversity and Universality Theory, Kolb's Learning Style Theory, and an adolescent prenatal education curriculum is the framework for this project. Assessing the adolescent culture and applying a variety of Ieaming styles to the prenatal curriculum helps the learner grasp the concepts presented by the educator. This unique combination proved to be an effective teaching method and useful tool. Literature Review Adolcmmiulture The adolescent is in the stage at which it is vitally important to learn how to exist in society independent of parents. The adolescent transfers independence to peers and strives to learn from them the secrets of entrance into the adult world. The adolescent often rejects traditional norms and values. Adolescence is a time of maturation, a time of role transformation from that of a child to an adult. During this time many changes occur: such as hormonal changes, physical growth, self concept formation, and gender/role development. (Montemayor, Adams, & Gullot, 1993) According to Bernard (1961), the adolescent culture includes material symbols such as certain kinds of cars, clothes, along with paraphernalia of sports and recreation. A nonmaterial symbol includes the adolescent language. Adolescent culture emphasizes fun and popularity, popular songs reflect adolescent preoccupation with love. Political concern is not characteristic of the adolescent culture but when asked their opinion, adolescents reflect those of their class backgrounds. A substantial portion of the adolescent society is alienated and rejected by the majority of society. In recent years it appears children enter into the adolescent culture at a younger age. The adolescent culture is essentially the culture of a leisure class with no job requirement in order to be self supportive. The adolescent culture has tribal customs such as dating. Today more and 15 more adolescents date in groups rather than as couples. Adolescents often feel invincible to disease or even death and will enter into risky behaviors such as driving fast, having unprotected sex with more than one partner, and engaging in sports activities which are dangerous. Adolescents have hangouts or gathering places of their own. Even their jobs are different than the older population as they are employed as baby sitters, carry cuts at the groceries, counselors at camps, or waiters and waitresses in restaurants. (Bernard) According to Dieterich (I997), interviews with adolescents have uncovered adolescent's health belief perceptions and self efficacy expectations which specifically relate to pregnancy. Many adolescents stated they had little support from other persons, they felt isolated and needed help. Adolescents described medical caregivers as insensitive and poor communicators. Often there is inadequate prenatal education provided to pregnant adolescents possibly related to a lack of knowledge about how adolescents learn, coupled with the thought that adolescents do not value education. Adolescents state the fact that external barriers of transportation and cost do exist in their world since many cannot drive or cannot afford a car. System barriers of long waiting times and short visits in the delivery of prenatal care are also observed by the adolescent population. Cognitive and emotional factors including negative attitudes, fear of pregnancy, as well as birth and parenting, low self esteem, and difficulty with problem solving and decision making skills may contribute to negative adolescent health outcomes (Dieterich). If both educators and care givers can recognize these barriers, strategies could be designed to help improve adolescent health behaviors. AdolescenLEtegnancies Adolescent pregnancy is a very complex issue which involves social values, economic status, and cultural influences which have been passed on to the adolescent through family, peers, and the norms of the community. Each adolescent's sense of self, aspirations and expectations for the future, and ability to utilize prior experience to address current and future decisions play a part in adolescent pregnancy (Zabin & 16 Hayward, 1993). Developmental events will determine the young person's libidinal drives and also his/her ability to resist these biological forces. Because the influences on the adolescent are powerful and pervasive, educators must recognize how extensive an intervention must be whether teaching sex education. birth control, or prenatal education. A pregnancy causes a more profound disruption on the life cycle of the mother, the younger she is. The youngest sexually active adolescents are at highest risk for accidental pregnancy leading to a unintended birth. Those at highest risk are the early adolescents who live in the poorest areas of the community, where they are subjected to the combined stresses of social, economic, and environmental deprivation. (Zabin & Hayward) Scholl, Hediger, and Belsky (1994) found pregnant adolescents younger than age 18 are at a high risk both medically and socially. They are still groWing and in competition with the fetus for nutrients. Physically, pregnant adolescents are at risk for such things as pregnancy induced hypertension, anemia, and preterm labor leading to preterm delivery. These health risks are more often untreated among adolescents since many do not seek prenatal care (Scholl et al.). Premature termination of schooling, single parenthood, repeated and unintended pregnancy, difficulties in obtaining employment , and economic dependency are common place among mothers who start child bearing as adolescents (Zabin & Hayward, 1993). Approximately 73% of births to adolescents in 1988 were unintended. Of the births to women under age 20 years, 38% are to mothers 17 years of age or younger. The impact of environmental, economic and cultural conditions are a part of the equation in adolescent pregnancy rates (Zabin & Hayward). Adolescent pregnancy and childbirth are associated with many negative outcomes such as a higher risk of pregnancy and neonatal complications, acquiring a sexually transmitted disease, lower educational and occupational achievement, welfare dependence, marital problems, difficulty completing the developmental tasks of adolescence, and increased risk of suicide. Pregnant adolescents can have long term 17 physical and psychological problems. Annually 500,000 adolescent pregnancies terminate in miscarriage or induced abortion. Today 96% of pregnant adolescents who give birth keep their babies, placing these children at risk for abuse, neglect, and poverty. (Dieterich, 1997) EmnmLEduQaIiQn One way to address the rate of low birth weight babies born to adolescents and also infant deaths is to develop a comprehensive prenatal educational program targeted at the adolescent population. A study done by Slager-Earnest, Hoffman, and Anderson- Beckmann (1987), found attenders of an adolescent prenatal educational program demonstrated fewer perinatal complications and fewer obstetric and postnatal complications than nonattenders (Slager—Earnest et al.). Another program in Texas called the Northeast Adolescent Project (NEAP) done in 1990, produced similar results with fewer premature deliveries and higher birth weight infants (Opuni et a1. 1994). Libbus and Sable (1991 ) explored the relationship between specific prenatal care education content and birth outcomes. It was noted that the lack of prenatal education and the number of preterm deliveries showed a positive correlation. It was tentatively suggested that prenatal education may lessen the risk of preterm, low birth weight infants (Libbus & Sable). A study done by Jones and Mondy (1990) showed a significantly greater proportion of the high-treatment participants (those attending eight or more sessions) in a prenatal program for adolescents, returned for an annual family planning evaluation. A greater proportion of these adolescents also returned for post partum care (Jones & Mondy).Virtually every young mother who returned for postpartum care accepted a method of contraception. In addition to preventing low birth weight babies, prenatal classes can potentially prevent future pregnancies in this age group through use of contraceptives. 18 Effective prenatal education for pregnant adolescents differs in class structure, content, and teaching methods from traditional prenatal classes (Lindell, 1988). A prenatal class targeted at more educated, older pregnant women who have a significant other and or husband may not meet the educational needs of a pregnant adolescent. A pregnant adolescent has different concerns and fears as well as different issues which affect their lives and indirectly their pregnancy. It is important the education provided is geared to the adolescent's needs and addresses Ieaming styles. The educator must be sensitive to pertinent problems and issues the pregnant adolescent may have in order to effectively teach and prepare this client for labor and delivery as well as parenting. Teaching parenting skills should begin well before the birth of a baby and can be easily tied into the child birth education program (Corwin, 1998). A A Learning Needs Assessment for Pregnant Adolescents was administered in a study by Bachman (1993), indicating that adolescents wanted to learn most about infant illness and complications during labor and delivery. Teaching strategies adolescents chose included hospital visits, parties, video tapes, films, records, and games (Bachman). Strategies that actively involve adolescents help give them a sense of control in the direction of Ieaming and thus increase their desire to participate. Encouraging class cohesiveness, sharing feelings and nurturing should play a part in the class dynamics. Activities should be designed to increase the adolescents understanding of pregnancy, birth, postpartum, and personal care. Class goals also include increasing decision and coping skills; encouraging self esteem, confidence and communication skills (Dieterich, 1997). Materials should be sensitive to cultural diversity, socioeconomic conditions, and literacy skills. I; ll , I . I] l 1' . Learning is primarily concerned with abstract ideas and concepts. Traditionally, Ieaming is said to occur when there is a change in behavior and the outcomes or product are emphasized rather than the process (Amdt, 1994). Learning is the process of l9 acquiring and remembering ideas and concepts. The more you remember, the more you learn; in other words concepts come before experience. The concepts of Ieaming and problem solving have not been treated in separate zones. Learning is considered a passive process where a teacher conducts the process while problem solving is an active process where the person with the problem tries to resolve it. The problem solver must take risks and experiment in order to come to grips with a problem. By combining these concepts of Ieaming and problem solving, conceiving of them as a single process, we can come closer to understanding how it is that people generate from their experience the concepts, rules, and principles that guide their behavior in new situations (Kolb, 1984). Learning style is not a new concept and educators tried in the 1970's to incorporate various new Ieaming styles in the grade school through college classroom. Beginning in the 1960‘s, educators looked at various methods of Ieaming. aware that many students were not reaching their potential skill level. Many schools changed curriculums and reformed their teaching methods. The mode of lecture only became a style of the past. According to Samples and Hammond (1985), educators found students learn by various modes, some need to read the concept in a book, others need to do an experiment to understand. Some students learn by writing a song or poem, some by visualization or sound. Many students are good at writing thoughts down while others can verbalize much easier than write. Not any one method is better than another and any one person learns from more than one style. At any given time, one half to three quarters of students in most classrooms are not Ieaming at all near their optimum. Only one quarter of students gain the most from a single approach to instruction. Educators must try to more effectively reach all students by using a variety of teaching methods which incorporate many Ieaming styles. (Samples & Hammond) One person who was intrigued by Ieaming styles and the work of David Kolb was Bernice McCarthy. She too believes "people learn first by perceiving; how we are in and take in experience and then how we process; how we react, confront, and resolve and 2O become the creators we are meant to be" ( McCarthy, 1996, p.13). David Kolb's Learning Style Theory was utilized by Mo C arthy and her ideas help explain the theory further. McCarthy uses the 4-MAT approach: active experimentation, reflective observation, concrete experience, and abstract conceptualization. She applies them just as Kolbs did but describes quadrants 1-4. Quadrant One learners prefer concrete observation and reflective observation. This learner needs to know what the material they are to learn means to them personally. They like small group discussion and are very interested in people. This learner likes consensus and unity. Quadrant Two learners love facts, certainty, and order. They need rules and reality is described in terms of these rules. Authorities and experts are important to them but otherwise this type learner is not interested in people. Quadrant Three learners are interested in action, they take abstract ideas and experiment with them. They especially like laboratory science and practical applications. Quadrant Four learners are self discovery learners. They make decisions with ease and are very flexible. They often come to accurate conclusions with little or no logical justification. They are risk takers and often seen as inconsiderate. They are driven to apply to the outside world what they learn in the classroom. (McCarthy, 1996) Kolb's Learning Theory has also been applied to the computer science industry. Computer experts too are looking at various Ieaming styles and how people learn. Hypermedia is believed to accommodate different Ieaming styles and different entry levels of skill because of its flexibility and high level of learner control. Bridging the gap between instruction, computers, and Ieaming styles may be possible by presenting materials to be learned in a way that encompasses differences in learning style (Ayersman & Minden, 1995). Kolbs Learning Style Inventory was used by Ayersman to help examine Ieaming in a hypermedia-assisted instruction environment. Ayersman examined possible differences in hypermedia knowledge among Kolb's four Ieaming style groups before and after a 15 week computer course. The study posits Ieaming style as the independent variable to find if various style types differentially apply the mental 71 b models. Learning styles did affect certain mental model frequencies, especially the citation-frequencies of schemata. Learning style did not have a significant effect on the citation-frequencies of semantic network, concept map, or frames/scripts (Reed, Ayersman, & Kraus, 1997). Summary Prenatal education programs for pregnant adolescents must try to focus on a piece of the adolescent pregnancy issue, working together with other diverse programs since many avenues are needed to make an impact. If the adolescent culture can be identified, utilizing Leininger's Cultural Care Theory, programs can be created specifically to adolescent needs and problem issues. Adolescent prenatal education programs need to assess the education level of learners and create curriculums which utilize a variety of Ieaming styles as suggested by Kolb's Learning Theory. Applying Leininger's Cultural Care Diversity and Universality Theory as well as Kolb's Learning Theory will create a curriculum which is effective for a larger number of learners. The adolescent prenatal education program will be more appealing and more adolescents will want to listen and learn. Prenatal education programs for adolescents that build trust and offer acceptable, accessible, and appropriate services can make a difference in adolescents lives. Education which shares parenting skills as well as birth control can help prevent a second pregnancy to an adolescent mother and minimize the stresses on several generations. 22 Project Development For this project, a prenatal education curriculum specifically targeted at the adolescent population was created. A prenatal education curriculum from the Oakland County Health Department which they created around 1990 is used and adapted to the adolescent's needs. Permission to use the curriculum base was granted by the author, Linda Bender, RN, ICBLC and the Oakland County Health Division of Personal and Preventive Health Services. The adolescent prenatal education curriculum includes activities which hold students attention as well as group discussion to encourage involvement. More detailed information about specific nutrients and physiology was deleted with information about health, diet, and child care emphasized. Since the risk of preterm labor and birth weight is greater in the adolescent age group, these issues are discussed as well as single parenting, relationships, schooling, and day care. When prenatal education classes for adolescents are not meeting their needs or even appealing, they probably will not attend. Teaching strategies which involve participants are more successful with the adolescent population than didactic methods. Relevant material presented clearly, in the adolescent's language, is important. Humor helps maintain interest and can reduce adolescent's stress level when dealing with uncomfortable material (Timberlake, Fox, Baisch, & Goldberg, 1987). This curriculum incorporates these concepts. The curriculum is based on Leininger's Cultural Care Diversity and Universality Theory( Leininger, 1991) as well as Kolb's Learning Styles Theory( Kolb, 1984). Adolescent culture is incorporated in the curriculum through music selections, vocabulary, and social issues discussed. For the adolescent pregnant population, efforts should be directed toward discussions of depression, assessment of self worth, and the value of appropriate health-care seeking (Giblin, Poland, & Sachs, 1986). The educator 23 must devise teaching techniques that conform to the student's cognitive level, psychological needs and social patterns (Catrone & Sadler, 1984). Some suggest Ieaming is more difficult for adolescents as they have more stressors and also encounter school transition from elementary to middle school. Motivation to learn and attend prenatal classes may dim due to all these changes (Montemayor, Adams, & Gullotta, 1993). At the beginning of Appendix A (see Introduction to Prenatal Education Course), the adolescent culture is described with their social and physical needs explained. By educating the instructors regarding the adolescent culture and their specific unique needs, the instructors will be able to teach more effectively. A variety of Ieaming styles and methods are incorporated into the curriculum to encourage Ieaming. At the beginning of the curriculum, Kolb's theory is explained and several teaching techniques suggested (see Appendix A, Introduction to Adolescent Prenatal Education Course). Each lesson should address all of the Ieaming styles which Kolb's suggests. Lesson one will be used as an example to show how all the Ieaming styles are expressed. The (‘onverger learner comprehends best by doing and performs best in a testing situation where there is only one correct answer. Practicing the Kegel exercises (p. 6) and the breathing techniques (p. 14) in lesson one is helpful to the Converger learner. Taking the pretest test is also another helpful method of Ieaming for the Converger. For the Diverger learner, group situations and discussion is important. The Diverger likes to work in small groups. In lesson one the class is involved in a get acquainted activity where students share in small groups (p.3). This small group activity allows the Diverger to share personal experiences also, another concept they enjoy. Asking the students to help list various tests or symptoms they may have in pregnancy encourages the Divergent learner in lesson one (p. 4&7). The Accommodator learner loves new experiences and is a good problem solver. They gather information from other people , make their decisions, and then act on it. The breathing experience is important to the Accomodator learner. This learner can hear the lecture, decide what will be helpful 24 for them in labor and then try out the breathing mechanisms. The Assimilator likes the lecture format and learns best from this teaching technique. This learner values the experts knowledge 50 charts, videos, and handouts are useful (p.4,7,8,9,l l,&12). Lesson one also contains the lecture format in many areas. The Assimilator leamer also needs time to reflect on the information shared so a break half way through the evening provides time for these learners to talk about the concepts discussed. The "Parenting in Pregnancy" curriculum created by Dr.Ann Corwin, Ph.D., 1998, is also incorporated in this project with the permission of the author. At the end of each weeks curriculum, one or more of the sixteen parenting concepts is inserted with detailed information for the educator which explains the concept and how this parenting skill can be incorporated into the session. The class size is suggested to be around 12 adolescents not counting their coach. Small group sessions of 10-14 participants can be more conducive to Ieaming and discussion (Lindell, I988). Coaches are invited to all sessions since many students may not like to attend by themselves or do not have transportation. It was discussed whether or not to invite coaches since some may not have a coach. This will be considered for future classes but for now coaches are invited. Those stating they are without a coach are offered one if they would like. The class coordinator works with the Positive Parenting Program in the community to provide coaches. Since the Oakland County curriculum is a six week series and to help keep costs down, the class is six weeks in length with a follow up reunion and parent support group which begins at the conclusion of the prenatal class. The support group is on going, may be attended before delivery, and is available as long as the student wishes. Parenting skills are emphasized along with discussion time for the adolescent's concerns. At the present time the prenatal classes are held at the Ottawa County Health Department with possible classes offered through local high schools. To maintain a high level of credibility, the class is taught by an APN who has an interest in the adolescent 25 population, has experience in labor and delivery and/or is a certified prenatal educator. The course is free, with funding from an Ottawa County adolescent support program called COPE. Other state and local grants are possible funding sources. Currently the prenatal program is collaborating with the Early On program, applying for a Michigan grant. Wednesday evenings from 7pm to 9pm is class time with possible after school or noon hour sessions in the future. There is a 15 minute break at about 8pm or half way through the session to serve refreshments, socialize, and use restrooms. Adolescents are invited to join the class through their physicians office, school, and various hospital literature available in the community. Transportation needs are assessed when the student calls for registration, taxi money is available if needed. Included with the six week curriculum is information about the theories applied, general instructions, a pre and post questionnaire, and post survey questions. The pre and post questionnaire is helpful in tailoring the curriculum to the student's needs, areas which are weak can be identified and more emphasis on the student's deficient areas. The post test can help evaluate student comprehension and whether further teaching or another teaching method in a certain area could have been helpful. A list of handouts is included in the curriculum with weekly agendas which are placed in a folder for each student. Childbirth Graphics is a great source for education tools such as charts, videos, slides, and handouts. The local health department health educator is another source for handouts at low or no cost. The curriculum evaluation could include comparing it to another prenatal class. Does this specific curriculum attract adolescents? It is important to note whether the curriculum is meeting the objectives stated. Are adolescents attending the clasS? Are students stating they are better prepared for labor and delivery in the post evaluation? A review of outcomes would be helpful as the birth weights and weeks of gestation at time of birth are noted. Talking with the educators and getting their opinion of the curriculum 26 would be helpful. Did they find the packet was complete? Was the information easy to follow? What was their sense of how the adolescents responded to the materials? Implications Education In education, Ieaming styles need to be addressed as APNs instruct clients. Kolb's Ieaming theory can be used not only in prenatal education but other areas of nursing education such as diabetic teaching or stop smoking techniques. Nursing needs to continue applying these teaching theories to their curriculums. Schools of nursing must remember the Ieaming needs of students and develop curriculums which offer a variety of Ieaming techniques. Providing lectures, hands on experience, work in groups, problem solving, as well as visual teaching tools in a given lesson plan can help a larger number of students grasp concepts. The APN can play a large role in the development of prenatal education for pregnant adolescents. The skills as an educator and health expert can be utilized in this area. The APN can plan, coordinate, as well as teach this curriculum to pregnant adolescents. Prenatal education may help decrease adolescent's knowledge deficit and the number of preterm, low birth weight babies. Parenting skills can be taught by the APN and modeled in the class and support systems. The APN's knowledge regarding growth and development as well as family theory can encourage healthier relationships and families. Teaching preventative care to mothers as well as their children may have a great impact on the future health of this country. Teaching parenting skills may help increase health and decrease dysfunctional families. Primary health care settings provide a perfect environment for the APN to care for the adolescent in pregnancy and encourage enrollment in a prenatal education course. The APN as an educator or clinician would better understand the adolescent needs, wellness could be emphasized to help prevent illness as well as complications in pregnancy and or labor and delivery. 27 The APN can educate other health professionals, encouraging coordinated, cost effective care for pregnant adolescents. The adolescent prenatal education curriculum can be shared with other qualified APN educators who have had experience in women's health and specifically labor and delivery. Holding a seminar which explains the adolescent prenatal curriculum, will help equip others to teach pregnant adolescents. Sharing this particular curriculum may provide others with needed tools to educate pregnant adolescents. This specific adolescent prenatal curriculum is very unique as it incorporates Kolb's Learning Theory and Leininger's Culture Care Theory. The curriculum itself needs evaluation by a group of prenatal educators every 6 months to year. As classes are taught, evaluation from the students will help improve the content and evaluate teaching techniques. This curriculum should never be considered complete and perfect but rather should continually be updated and reevaluated. As research uncovers better teaching methods and more effective ways to conduct prenatal classes, APNs can incorporated this information into the curriculum. Research Further research which reviews methods and styles of Ieaming could impact future teaching methods and help create more effective prenatal education programs. Research could compare a group of students who were taught using Ieaming style theories versus a group taught without Ieaming style theories. Specific studies looking at the efficacy of having each student bring a coach to the adolescent prenatal classes could be researched. Do some students not attend because they do not have a coach? A group of students who have a coach could be compared to a group who did not have a coach , does one group tolerate labor and delivery better than the other? Working in collaboration with the community health department and private providers, the APN could continue to look at the affect prenatal education may have on the adolescent population and specific labor and delivery outcomes. The study done in Chicago by Slager-Eamest et al. (1987) could be expanded and updated with a larger sample over a prolonged amount of time. More 28 studies need to be done which attempt to show actual outcomes of these prenatal classes, collecting data on birth weights and preterm deliveries of those attending prenatal classes versus those not attending classes. Factors that motivate students to change their behavior could be studied, what causes a student to act or not act on the information she has gained. How can nurses and other health providers support the pregnant adolescent in this process? As more adolescent prenatal classes arise, a study which looks at the pregnant adolescent class attendance record would be interesting, evaluating why some do attend classes while others who are offered classes do not attend. Looking at specific issues which may affect attendance such as transportation, location of class, time of class and other variables in relation to class attendance would be beneficial in program development and future research. Admcedfiracrice The APN who is knowledgeable about the adolescent culture can be an advocate for the adolescent. The APN can help health care providers in private and clinic settings understand the individual needs adolescents have and help providers better care for these clients. Often health providers do not know how to relate to the adolescent age group and there is much misunderstanding between the two groups(Caterone,1984). Adolescents may not keep appointments or follow through with important testing because of misunderstandings. The APN can work through the prenatal classes, communicating with care providers and adolescents trying to heal these misunderstandings. Providing awareness of prenatal classes, writing journal articles, or offering seminars to health care providers regarding pregnant adolescents may help increase cultural awareness and encourage effective teaching methods. The adolescent prenatal curriculum could be implemented in local health departments or school based programs, such as health class or noon hour pregnant adolescent support groups. Hospitals could target the adolescent population by having a class separate from the older pregnant couples. Incorporating the curriculum in primary health care offices 29 could make the class time more convenient, providing more comprehensive services under one roof. The lessons could be taught on a one to one basis in the student's home by a maternal support or home health nurse. Offering a variety of times and places may help increase the number of students available to participate in the class. The APN in the practice setting can encourage the pregnant adolescent to attend the prenatal class. Pieces of the class content can be reinforced at the visits also. It is important to provide information regarding the classes to all area health care providers so proper referrals can be made. Given the evolving health care system with increased emphasis on cost containment, adolescent prenatal education can help . 1f adolescents know the signs of preterm labor, understand how to care for themselves in pregnancy, fewer babies will need expensive neonatal care. Insurance providers including Medicaid will see the value of the class and provide funding for the classes, enabling an ongoing adolescent prenatal program. Brodumflexelonmem Many different avenues could be taken with product development. The materials could be copy righted by the author or the materials could be given to the local health department and copy righted by their agency. The author could hold seminars for APNs qualified to teach the curriculum and disperse the curriculum at the seminar. Some regulation would be appropriate to help keep the materials of high quality and at least trying to ensure proper educators are teaching the class. Materials could be updated more efficiently if we know who has them. For now the Ottawa County Health department will have the rights to the materials, giving proper credit to the author. The class presently is being taught through the Ottawa County Health Department and has personnel who can help apply for funds to help get the program up and running. Summary The implications for education, research, and advanced practice are important to visualize and apply to the prenatal education curriculum for adolescents to help decrease 30 the number of preterm deliveries and low birth weight babies born to the pregnant adolescent population. APNs can make a difference by analyzing the pregnant adolescent situation, understanding their culture, knowing their various Ieaming styles, and creating prenatal education programs to help alleviate the risks of adolescent pregnancy. 31 LIST OF REFERENCES Amdt, M.J. & Underwood, 8., (1990) Learning style theory and patient education. lonrnaLoflContinuinaEdncationnflNursinaZlU ). 28-31. Ayersman, DJ. & Minden, A.V., (1995). Individual differences, computers, and instruction. ComputersinflumanBchaxioLm3-4), 371-390. Bachman, J .A., (1993). Self described Ieaming needs of pregnant teen participants in an innovative university/community partnership. MatemalfihfldflmsingloumaLZlQ), 65-71. Bernard,J. (1961). Teenage culture. W W 338 (2), 24. Catrone, C. & Sadler, S. (1984). A developmental model for teenage parent education. laumaLQLSthlfliallthQ), 63-67. Corwin, A. (1998). W. Program inserts presented at a Pro Ed Services Seminar approved by the Michigan Nurses Association, Grand Rapids, Mi. Dieterich, L. (1997). Assessment and development of adolescent childbirth education to improve health behaviors. WW 6(1), 25-31. George, J .B. (1990). WWW Practice. East Norwalk, Conn: Appleton & Lange. Giblin, P.T., Poland, M.L., & Sachs, BA. (1986). Pregnant adolescents' health information needs. mumaLQflAdQlescemflealthJO), 168-172. Hamachek. D- (1990). W. Needham Heights, Ma: Allyn & Bacon. Jones, M.E., & Mondy, L.W. (1990). Prenatal outcomesfor pregnant adolescents and their infants using trained volunteers. .LQumamflAdglescem HcaIIILLMS), 437-443. 32 Kaskowitz, G. (1995). Factor analysis of the model constructs suggested by Kolb's Ieaming skills profile. W0), 479-486. Kolb, D.(l984). WWW Lsaminaand Moment. New Jersey: Prentice-Hall. Leininger, MM. (1979). Iranseuhnralfinrsing. New York: Mason Publishing. Leininger, MM. (1991). W New York: National League for Nursing. Libbus, M.K.& Sable, MR. (1991). Prenatal education in a high risk population: the effect on birth outcomes. BlRIIiJfiQ), 78-82. Lindell, S.G. (1988). Education for childbirth: a time for change. Jeurnal m We), 108-112. McCarthy, B. (1996). Win. Barrington, Illinois: Excel. Montemayor, R., Adams, G.R., & Gullot, TR (1993,). AdeleseenLSexnality. Newberry Park, Ca: Sage. Opuni, K.A., Smith, P.B., Arvey, H., 8; Solomon, C. (1994). The northeast adolescent project: A collaborative effort to address teen-age pregnancy in Houston, Texas. Journal QESchQQLHealthfifiw), 212-214. Ottawa County Health Department ( 1998). W. Unpublished manuscript, Holland. Michigan. Piechnik, S.L., & Corbett, MA, (1985). Reducing low birth weight among socioeconomically high-risk adolescent pregnancieslenrnaLeflNurse W0), 88-98. Reed, W.M., Ayersman, D.J., & Kraus, LA. (1997). The effects of learning style and task type on hypermedia based mental models. .IQurnaLef Edneatienaanltimediaand Hypennedjefl3/4), 285-304. Samples, B. & Hammond, B. (1985). Holistic Ieaming. IheSeienee Ieaeher (29), 28- 34. 33 Scholl, T.O., Hediger, M, & Belsky, D. (1994). Prenatal care and maternal health during adolescent pregnancy: a review and meta-analysis. JeurnnLandelejeemfienhh 15(6), 444-456. Slager-Eamest, S.E., Hoffman, S.J., & Anderson-Beckmann, C.J. (1987). Effects of a specialized prenatal adolescent program on maternal and infant outcomes. leumaLQf Wm), 422429. Timberlake, 8., Fox, R.A., Baisch, M., & Goldberg, B.(1987). Prenatal education for pregnant adolescents. JQnrnnLeflSehQQLHeahhfl(3), 105-108. Zabin, L.S. & Hayward, SC. (1993). WWW Childbmring. Ca.: Sage. Appendix A ' D . . - rs‘W’.‘ I dram WWV‘0& First Class Delivery Adolescent Prenatal Education Curriculum Scholarly Project for the degree of Master of Science in Nursing fionr Michigan State University College of Nursing Linda Dalman 1998 The following curriculum contains the parenting education inserts from Parentig in Pregnancy: Begin at the Beginning which is a program designed by Ann S. B. Corwin, Ph.D., M.Ed. It also contains adaptations of the prenatal class curriculum which was developed by the Oakland County Health Department. No parts of this curriculum may be reproduced without permission by the Ottawa County Health Department Ill IE IlEl I' C 'l GeneraLlnsmrctions Thank you for helping teach the prenatal education class. With the help of educators like you we can make a difference in adolescent's lives. This project is a cooperative effort of Holland Community Hospital, Zeeland Hospital, and Ottawa County Health Department. Linda Dalman RNC, SNP at Michigan State University has put this curriculum package together for her Masters Project. The project is research based, applying Kolb's Learning Theory, Leininger's Cultural Diversity and Universality Theory, and Parenting in Pregnancy by Dr. Ann Corwin (see Introduction to Adolescent Prenatal Education Curriculum). The wide variety of learning styles students may have is acknowledged and applied in this curriculum, the adolescent culture is identified. It is important all the materials in this packet are read before attempting to teach the prenatal class to understand some important teaching concepts. It is not necessary to limit the teaching methods to ones presented but rather to encourage creativity within the class room. It is important to assess how the class is responding to the teaching methods used and if the methods are not productive, different methods are encouraged. The class list is gathered by the receptionist at the Ottawa County Health Department and the Center for Good Health at Holland Hospital. The class is free at this point so you will not have to collect money from the students. Erica Wojcik is the coordinator for the program and she will be your contact person if you have any questions. Her phone number is 393-5 793. The class is held at the Ottawa County Health Department from 7-9pm each week except for week 3 which is at the local hospital. The coordinator will take care of scheduling your room at both sites. Only invited certified child birth educators and or an APN will be teaching the courses. Your supplies will be in the room where you are presenting. Each week there is a 15 minute break at about 8pm and a snack is offered, the coordinator will supply this for you. We try to keep the snack simple and nutritious for the students. It is important beginning the first week that name tags are provided for instructors and students. Time for socialization in the group is beneficial since part of the goal of the class is to provide a support system for these teens. Time at the beginning, break, and at the end may help encourage socialization and support. Try to get to know the students and any specific concerns they may have. Music at the beginning and during break may also provide a more relaxing atmosphere. Folders for each student with class highlights and specific brochures will be provided for students by the coordinator. Childbirth Graphics is an excellent resource for most of the flip charts and other supplies. Also the health educator in the local health department was able to provide at minimal cost, other pamphlets for the class. It may be most helpful to have students keep their folder at the class site for the entire 6 weeks and take them home after the last class. Also "What to Expect When Expecting" is a book you may offer to the students. Many receive this book from their health care provider but if students did not, they may have one at no charge. Each weeks curriculum is a different color and at the end of each weeks session are "Parenting in Pregnancy" forms. Please read these and try to ii incorporate the concepts discussed within the curriculum where noted. An asterisk will help identify appropriate areas in the curriculum. Please hand in the pre and post tests and evaluation forms at the end of the session. Use the pre and post tests to help determine class needs and help structure the class objectives. It is important to include information tailored to the students needs. Give completed tests to the coordinator. Thank you again for assisting with this important program. Adolescent Prenatal Education Board iii O . I... .' .é...‘ " 'Ir'. ..il' U. This prenatal class was created to target the adolescent population, helping them cope with pregnancy, labor and delivery, as well as expand their parenting skills. The class was developed to incorporate parenting skills along with the labor and delivery concepts, utilizing ideas and techniques used in labor and delivery to assist them later in making crucial parenting decisions. The curriculum combines Ieaming styles with the adolescent culture, developing a plan which adolescents understand and is attractive. As instructors it is important we first of all understand the clients we are teaching in order to be effective educators. Second, we must develop a curriculum which is taught so the students can grasp the concepts presented. Third, the curriculum must present material which the students need and desire to learn, addressing the most pressing issues at hand as in this case, parenting as well as labor and delivery. The adolescent culture is often thought of as a culture within itself, so very different from the child or adult in our society. Utilizing Leininger's Cultural Care and Universality Theory, the adolescent culture can be understood. If we do not understand or educate ourselves about the culture we are addressing, we will not be effective educators. We must understand their concerns, what is important to them. The adolescent is at the stage where it is vitally important to learn how to exist in society independent of his/her parents. The adolescent often rejects the traditional norms and values, looking to peers for these norms and values. Adolescents have their own iv language, values, clothing style, music, and goals in life. Adolescence is a time of maturation, transformation from child to adult. Many hormonal changes occur, physical growth, self concept formation, and gender/ role development. As educators we need to try to communicate in ways adolescents will listen and can understand, sometimes using their language or music. It is important we acknowledge adolescents values and goals, helping channel them into productive lifestyles and good outcomes. Recognizing emotional factors and fears, helping them problem solve in their world and making decisions from their perspective is important. This program combines adolescent culture or Leininger's Theory with specific Ieaming styles, as described by David Kolb's Learning Theory. People learn in different ways, not all are able to learn from a lecture format, where tests are given with only one right answer, but some do. Some need visual helps such as pictures or diagrams to understand concepts. Some learn by trial and error so problem solving works best or hands on manipulation and experimentation. Others learn best in a group setting, discussing the issue at hand. Some sit back and listen, observing what is going on, absorbing the concepts and is later able to put the whole picture together for everyone. David Kolb felt this was Very true and developed a theory regarding Ieaming styles. No one person will have only one style but rather a combination of more than one. He described some learners as Convergers, who learn by doing. These learners will want to try to feed a doll in the class room, perform the baby bath demonstration and practice the breathing techniques. The Diverger has a great imagination and looks at the meaning and values of things. These learners work well in groups, developing ideas and V brainstorming so it is important to divide the class in small groups on occasion and allow brain storming. Involving the students with creating a list of symptoms they have had in pregnancy or tests they have had helps this learner grasp concepts. The Diverger also likes to share their experiences as they relate to topics discussed. The Assimilator looks at concrete concepts, everything must be logical and without deviation. A lecture format is best for the Assimilator learner. Graphs, videos, and charts may be helpful as well as a tour of the hospital or health department. During a break this learner can discuss topics discussed with peers and feel even better about the process. The Accommodator loves new experiences and is a good problem solver. They gather information from other people, make their decisions, then act on it right away. The Accommodator likes to experiment so letting them hold a doll and try various feeding positions and techniques will be helpful. Having this student pack a diaper bag for the baby or a suitcase to bring to the hospital would be a great learning experience. Besides identifying Ieaming styles and adolescent culture concepts, parenting is also presented in this prenatal curriculum. Dr. Ann Corwin has developed "The Parenting in Pregnancy" curriculum and this has been incorporated into the adolescent prenatal education. The tools given will help include these sixteen parenting skills into the lessons. The skills of parenting and the development of a family is often overlooked in prenatal education. Adolescents have an especially challenging parental role since they are often single parents with multiple social concerns. "Parenting in Pregnancy" introduces an enlightening set of parallels between labor and delivery concepts with those of being a parent. vi This adolescent prenatal education curriculum, utilizes the concepts suggested and hopefirlly can help adolescents learn and understand the labor and delivery process as well as parenting skills they will need in the future. Educators can make a difference in adolescents lives, helping them deliver full term healthy babies and become effective parents. vii s on . 0000. :0. 00:25.02 055005 0. 5.0000000. 55:00:: :. 05... >08 3:33.000 2:00:00 0500:» 3:005 0000. 0:..50 50006.0: :0 00:0:00E. 0.: 0000.. 0:0 00:00.00”. madam 0.... £030.20 .0 00000.0 05 0. 5.80002: .300 0:0 55:00:: >530: 0 :0: 00:0:00E. 0.. 0:0 :0..an .020. 05 5:0: :00 .05 3.001 50:032.. :0 05:08 .00. 05 0:..50 .:0E00.0>00 .50“. .E05 5.? .000 0. 26: 0:0 5:052: ..0 :060EE .00. 05 .0 .0033 0000:6000 0:0 000:0:0 0E 2:905 050000.50: 0.080: 3030". 00.5:00. 050.0...» toaqam b..0..:00::00 :0 00:0:00E. 000005 00.2 0:005 00:00.0 0:0 8.0300... -. a 0:95.00. :0..0x0.0.. 000 .32 05:05:00 .N.. 2000000 0:00: 0.0:.0 0:00:00 2300.000 0.0.0000 00:00.0 .3 000.05 00 :00 0.0.6 0.5 30: 0:0 0.00.0 :.0n..:0.m:0....:00... 05 00:00.00 0.. .0000. 9:080; 0 .0000 2020.60 :00 00:300. 0005.. 05 30: £0.96 .0 .020: 05 0. 32:0: 00 :00 .05 3.00: 00.5000 .0 .0.E0._>n. 00.00 000“. 05 050: 30:00.00 0001.500: >550. N 50:030.: .0 .2008... .00. 0.... 0:.50 .300 0:0 .0506 .0. .0820 m. 0.0 000:0.00 0 E? 50.03 .0 ..0.§0.E 00.5: 00.000. .0032: 0:00 30.00:. 05 0:302:00 00.000: :03; 3:059: 0:50 0629:? 5:09.050 50: 5:00. .m 50:050.... :0 0.008.: .00. 0:. 0:50 000 0.:0603 0 :_ 5000 :0...) 000:0:0 00:5 00:00.00 .v ...Eoficm 05000030.. 0.050: 0.000 30:00. .0 005500. 050.0»... 00005 .N .0305 05 :0. 00.2 0:005 00:5 .0... .F 00500 a . 000.0 00> 0:0 .53 50> >¢m>...mo mmfio hmmr. 00.. 00000.0 .0200 .:0.000 ..m .0 2.0.22.0 0:00:07. 00E0.00.0 :0..0..000:0... .0>...0 0.:00 0.0 0.2.... 0:303 0.00.2... 00.00 000 ....3. 000. 0.:02 .200. 000.0 .020 00:00:0..< 003-000 0.00: :0 .00E0: 05:00.0... 0.000 :0 0E0z wmamfl Dcm 00000—0 50 05 ...O ...—6.50 ._. 00050.2 0:.:000h 0:0 000.0 .m .0.:0E:00..0. .0 >....00..0>0. - 0.020 .N ......0000 00:00.0 050:0: :0 0:.00.0:. 0:205». 0: .00:0:0 .0E00..00m-0:.0_.0m .. ”0:...00 d .00:0..00x0 .:0..0000w. 00.02.05 .0 :0..0000..:. .0 30.000 00.0033 £000.50. 00000021 0.. 00.3201 :00... 000.. 0.000 .0:00.00 0:50:00. :. E0... ..00< .m 2.00:. 050.0..0 ..00000 000. 0E0.0>0 ..00000 .0 :0..00....:00. .0.000 0... .0 $000 ..0:. .0. 0:..00 0:0 0:..:0.00 >0.:0 0. 000: >05 0:00 0:. E00_ 0. £000 >05 00 0.:200 .:0.000x0 .0.000 0 .. .m .0_.:0 ..0:. .0 :...0 0:. .0. 0.:200 .:0.000x0 0.0020 ....s :0.:>> :0_.0E.0.:_ 0030.0 0 .r N 0800000 050.030. 0:0 0>...000 0 5:00.30 ..0:. 0:.x0E :. 0.:200 .:0.000x0 .:0000.000 .0.000 0 .. .. ”00000.0 E200 .:0.000xw .0 0.000 .m .0000: .00.. .00.: 0. E03 _ .00.. :0 0. 000.0 0.... .0 0000. 0: .r ...000 .00.. .0 :...0 0:. .0. 2000.0 00.. 00 00.. .0. 00:0..00x0 0:.:.00_ 0>..0E.0.:. 0:0 0.00.380 :0 00 ...3 000.0 0.:. .0:. 0:.00: E0 _ ”0800.02. .0.0:00 .< 20:02.0”:2. mw_t>_.ro< ..zwhzoo 020.0350 «an ..0E0.0>m 000000.. 30050.1 0.. 00:00.91 000.... 009 9.2.0000 30.20:: 0000 00.0 0.0 00.00000 0000.0 :9: 62.020000 0.0 >9: 09:9. :9? >000 9: 5.3 9:00 0. 0.03.0. 9.0.00. 0.0 >9: .023 ...050. 0 .0. 9.9.00.0 9:00 5000 09:5 02:08. 002000. 0>9._ >9: 00300 00... 09.00900 000000000 020:0 000.50 :0 0. 29.009. .900 0:0. 30050.0 9: 5000 00:05.80. 00.00. “000030 :00 5.00:9: 9: .0 600.00 .050 9: 5000 000...: 00...: 50 020:: 00 p.000 00.30200: 00 :00 30.20:: 9. ... .305. :0: 00 >9: 0:09:00 0: 0:0. 30.0300 :9: .050: 0.002202 0>9. 0: 0:00 2.000: 0. = 000.0 9: 0: .050 2000 00:00.0: :9: 000 £03.02: ...0 :00 0.0000 0>0I ”030.20.... 00:00 ”000.9: a0.00.005 00... 0.0.0000 0.09.2800 0.0:. .00: 0. E9: 0.0... ...3 0:.... 000.600 2 0>0c >9: 09...: 9:00 3:002 000 80.9.: 0.0059: 000.0 9: 029. 000.0 9: 5000 00:00:82 5.9.00 9: 0:0 200.9. 0000009: 5.03:0... 9: .93. ”2.2.2 00.8.0 8: 30.00000 0. 002002020 .0050 .000: 0:20.500 0: 000 000.0 :0 c0:0._00:00 .0 350.0000 c0:000.. 2.80. 50> 0:0 30> .0. 0.0000300 0.0 :9: 000.020 029: :00 00> .9: 00 00000. 002.9, 00000.0 :00 0>> 0.003 5000 050009. 000 002.0 .0002) 0.300. 0.9000 000:0:000800 60.000020 000.0 05:09:. 9:00 9.2000. .0 09:0... .952... .Ed 090 .. .Ed 00.» .05.... Nm’ ww...._>_._.o< HZMPZOO mzo.._.wm30 .00000..00x0 0>00 >00. 0000000 .003 90000.0 x0< .>000000.0 .0 0000.0 00.00000.0 0:03 0000000 32.... - 8.0.0.0 0002.00 .200 5...? >000 0.900. .0 >E0.000 30.> 0. 000 .. ..000 0:... >0.0.00< 000.0: .00..-0.0 .0.000.0 000.0 9000.0 .0. >950 E000000 00> 00.00 .000000000 .00> 0.0. 200 0000.0.0 0000 000 00.03 0000.90 .00> 030.0 000 00.90 0230.0 .00> .00. .00. 000 E00000: 0.0090 .00> 0. 00 ...3 >000000.0 00000 0.00 00> .00.03 00. .0 000000 0 0. F 0200000090 .0. 02.0.0090 0. >000000.0 00000 00.0.00 9000.0 .00> ..IIH0.00|0.0|.0.- .00I.m .0000. 00. 00.0320 0.00.0020 00. 00.000 0000 0.0090 00.0.0 000.0.00 .00> ”0.00.0 .0 00000000 ”0.0 >000000.0 .0 00.000. .00. 00. 00000 000.03 >000. >0 000000098 0000000 .0000: 00. .0 00.00 ..00000.0 0. 000 0:03 >000 0.00503 0 0. 000000 0000000 >005. €0.80... .00.... 05:9: 8.5 0:.. 9.. 0:0 00.000. 00.0. 000 00.00.: 00.0. .0 70.9006... 0.0. 000.20 0. >000000.0 02.00 .00..0:9: .00. .00> .0 00.0 00. .00.. 0:003 00 .0 00.00:. .0000.00 00.: .0. 0.00. >..0.0000 >000000.0 >000 .080. .0 >0.0.00< 3030”. 0>000 .00> .0 0:000 00. 000 5.000 0000 0000.05. .00> 0.00.0.0 0. 00 00> 000 .00>> .m 909000.900 .900. 000.00.0>00 >000 .00> 0. 30... .N 0>000 0..00.00. 00. 0. 00.000000 0. .00>> .. ..0000 0.0. 0. 00.00 0.0 0>> 02.0000..0. .< >oz<20mmm “.0 «0.10.205. ._.w<.. NI... 00.0.60 00 ...3 .00. 0.00.000 00009.0. 0. .00. 00.0000. 0 00 0000 00 000.. 000.0 00000 .0 0200 0.0000 00 .00 000000 00 000 .. .0:0000..0000 000.0 .0900 090005. 00000000 >000000.0 003 0000 0. 0000 00> 0>00 .00>> 00000000008 00> 0>00 000.0.000.0 .0 0:0. .00>> wm_.:>_.ro< ..zmhzoo mZOr—MMDO m 0.. .0..32E 090000.000 .00> >0 00000020 00 0.0000 .00 >000000.0 00000 000900 0.0 0000... 000.0 :00 >00... .5300. 00. .0 00.0> 000000.. 0.0 0000 ... 00.0.0.0... .|00..0I 0.200 .0300 030.0 00.0 00.0.0 00. .0 0.00090 00 ... .00..00..0000 00000 000 000 ..0300 00. .0 00.0000. 00. 00.00.00. 00.0000. 00. .09 >000 .00> 0. 00000000 00... ”02.0 ..0000 00.0> 00. 0. 0000.. 0.0000. 00. x0.0. .00. 0000000 0000000 00.29 000.0 000000x0 .00.0> 00. 00 0.00090 0.00. 0. 000 >000000.0 02.00 ..03 0003 .00 >00. 00>.0> 0000 ... 000.0 .0 30.. 0.000 .00>0.0 .00. 00>.0> .0 00000 0 0>00 00.0> 00 >..>0.0 .00.000 .003 >00 0. .0000 00. 0. 000.0908 00. 0.0.. 000.0 >..00 00.0> >0._000 .00002 00.0> 0000..|0|> .00.0000. .00.:.0000 000 ..000 0290 0900000 00.390 .00> I.000|0|..00..m| .>.0>..00 .0. 02.0.0090 0. 0000 .0990 00. .0 00.0000. x.>.00 00. 00 0000. ...030 000 09.00 0. 0.00. 00.0000 .000: 00. .0 0000.00.00. 000000. 00. 0.30.. 000.0 00. 0000.00. >000000.0 00000 .>000 00. 0. 00..0.00:0 009900090 000 0009.00 00000000 00. .0 0_0>0_ 00.... ”0000.0 0000 000 0000.030. 02.000000 .9004... .00.000 :00. 0.0.00.0 0 0.00.00. :00 0:...030 0.00. 000 0900.2 .00.00>0 00. 0. >__0.00000 .>0000090 0. 00.0.. >000 0. 0000.00. >.0000000 00. 0. 000 .0000: 0. 0:...030 0...). ”.00“. 000 0000... 00. .0 05030 .>.0>..00 .000 000. 00 >00. .00 0.00. 0.0.>0..0 .0 .00>0.0 ...3 ..0 .0 0.090 02 0009000 00.00 00.0 00. >0 000000 90 >00 .. 000.0000 .2000 00.0 0.0090 :00. 00 0009.0 00.0000. >..00..0 .00.000. 00.0>00 09003 E00090 >002 30.9% mm.._._>.._.o< 0.2wa00 mZOFwwDO 00.. .020 0000.0 000.0 02.00 0.0002 00 0. 0.00020 0090005. .000000. 0.000091 0.. 02.0900 - 0000.. 00m. -oszmme wm< 30> 5.0020020 >Z< ...:Om< $20....mm30 >z< w> zmI>> mwosomm mm ¥w< O... mmDm mm .00.0000.0 .0209. .000000 >00 .0 .2200 .0 ..00.0.0000 0.000. 200 >0 020000.080 .0 C000 .00 v 000. 0.00.. E0009. >.0> 0.0 >00... 20.0.0020: 000009.000 00. 0000”. .E00. .0000 9.320. 090000.000 .00> :0... ..000. 0.0.9090 0.0.. 90:00.0...0 0. :00....0 00 :00 >00. .00 ..000. 00.. .00 0.0 000009.000 00.21-000.90 00009090 >000000.0 00 E0009. 0.00. 00.0000 .00. 00.0.0 00> .0 002.09.000 .00..090.. 0.0 0000.: 330% >000 .00> .0 .0200 00.0.0000 00. .0000 00.003 000 >000000.0 .0 9.0.0.0020 0. 000 :00....0 00 000.00.: .0 02000.0 000 0003 0.00 0. .00000.0 00.00 000.050 0.0 .0002 00.0 000 00 :0“. .> 00 0 000.... 00. .000. .0 000009.000 00800.0. 02 .0 0.00 0.. 00.0.0.8 0...: 00 0. >.... .000.... 0.00. .00. .000. .0 0...: .00000. 00.0. 000 00.000... 00. 0000.0. 230.0 0000000 0. 0. 0 0. 00 02.003 .000 00> 00 000. 00 E00. 0.00 2.0 .0000 000 0200.. .09. 05.90 00.00:... 9. 00.00. :9... ..00009. 00 0.. 301 >000 .00> 02>00 .000 20.0.00 99: .0>000. 0. 00> 0.00 00.0 000 000.996 0000 .. .>.0>..00 000 .000. 02.00.09.000: 0.0 00.03 00.0 .000..00 000 .00.00> 00. 0. 00.0002 00. 000.000..0 000.0.0x0 .000v. 0.0. 00000. 0.00 000 ”000.998 .0 v. 00000 .0 0000. >00. 0003 00x00. 2.00.00 0. 02.0 0.003 .00002.0000. 009.0= 0000000x0 00.0 09:03 00.0.".v .0000 0.00. 902.0 0. 00> 00.0000 00000.0 .00> :0 0.00090 .00 00.0.0 00.000 >000 .00> ”00:02.0 .000 wm=t>_._.0< PZMPZOU wZO_._.wwDO .0.. 000.0 .0 .0.. 0 0.090 0.00 0.00020 ..0.00200 .000. 90.00.90 .0 000.0 ..00. 2 000.0 30:0. 0. 0.00020 x0< 30.00200 .0 00000. 0.... 302 0 02>..0o .0.00200 .000.. 90.0290 .0 000.0 .809 .02.... 0 0. 0.0... .0~.0 000 .00200 0.00 0. >.0.00. 00.00900. 0.0 0:00 0.>000 05 00.002... .00. 00. 2 >.0.00. >.0> 030.0 00.0. 00 .r “>0000090 .0 .9002... .00. 00. 02.00 .< 20202960 000 0.30.0 .90.. .. 00230.0 >000 .00> 0. 30: .... .200 .0220000 290.900 .0. ...0.200 00 .00 >02 .0 >02. .000 00 .0. 0000000 .00. 0.0000 .0.009 5.3 000.90 .0 000009.000 02.0.: . 2 000.003 >0 0.0.00 0200000 .000. - .000. 0.0.0290 0.0.0000. 000.0. .0 .0020000 .0000 .030. 00. 2 0.00 .0 90000.0 ..00 290.900 .0. 002.00. 0. 202 0:03 .000 00 2 ..0. 0.002052 0. 000. 000. 00.00.0000 00 0.003 0.0. >0000090 0.0. 0.. ..0020>02 >000 0. 0009000 000002 0 .0 9002032 .90.... 2020.62 >000 02 02.20. .0.000 0002.30 .00.0.> 09.0.0 .0 0.0000 .2000 .0600 00.000. 00>0 00. 0.0.00 0600. 0:20 .9000 .0>0u. ..00. .9000 00000 00. .0 0:...030 00000.2 .00000000 290.900 .9900 .02..20> 000 000000 .00.0.0.00 .9300. ...0.0>> .0 00m.. .. 000 2.202.... .000 0 0.... .00. >02 .. .0 ..0000 000000.. 0 00 >02 .. - 00.00> 00. 20.. 0.0.“. .N .200 505.3 .0 2.3 - 00.00> 00. 20.. 000.0 .0 000.000 .0 02000.0 .. cn'oi co'v'm'co'rx' .><>>< 210.”. 0.2.0 .0 0.30.2 00.00 00.000 .00> 0. 000009 00 0.0000 020.02>0 0000 .r 629.2325 >ozwwmm2m m..m.mw00 .w 00.0 00.90 00.9 00 .00.00 0.. 00.00 -..0>0 >..000 .0020: 00000 0.0. 0.9.30.2 0900.220 ..0.000 .00> 0>00 00> 0n. ww..:>.._.0< ..zwhzoo m20_._.wm30 an: 9:855. 53 .252 .98 02m 533 voom - :20 2: - 8285 5.5220 9.3265 .8 E9529 .3 .92 co 9.08 So 6w $28 2: Eu: :3 can Ema? v.33 2: 25 .8 new $583 9: much :8 336 new v.82; £250 Socmcooa m5 toga...» 65 35:5: 30:35 35 = .33 E0: 326 29.29: 233 9.9 new .33 2 559: E0: 59x0 can 3:053: 53cm: 2 55:35 9.50 30.9% $5 :33 m5 2 2583 an... «958?. on... m. “95> 5.5 a 3.58 : 2 m new $55 om 2 2 8923 2a $53 322 9:2: 05 8650 92293:.2 2 523 2 BB 2: 22 a; as 8.68% 38. 2 a. he in. < 2.28 EOE Eon mo Eng 9: So: 2 236: new to» :5 9m mmcon ms... .xom; 5a 258 X Sam o. $55.50 3.3 9? 30's. 5:05 5m 9: .0 0cm 05 .3 v.22: 9: E Esou ummz we :5, Em .05 3an $22 .>.E:EE_ meaEm. m3. 3:25 :8 0:633»..me 5.5 Stu 25:06 39 m 98. 3E3E§ mf... 28.5083 {53 m5 BE 9583 9: .3325 0533 En mmfionzcm 9598a p.659: 3:83 95:0th Eat 3_c:EE_ 253m 2 mcamn Ema 9; .55 5cm aEmamzoo Ea: E9: E965 Em: 2 23...... m 3305 2 Emma ucm 9:29: 95 3:3. on... dEaa new 5095 0683 32 new mctm on... .239: new 265 2 03:50 3ch van EmB och «.33 5a 253 «\. .356 9.5% 2 new .95. 35:. 9 new $58. m 52m 2 39 as .m 555 .0 98 m5 6 a 22%. @5255 m. :65 of. .505... 2 :63 «mean 2: .9535 m: xoam van :95 5m: :8 map. as... Emu ucm Em: mom new .8? m: Sam ocm :80 :3 = 5.27. 95 x8. :8 = s 58:. m5 6 new as E 95. 86:. m. 285 can 858. m 2 x m 53m m. 25 2: 438$. mm.._..>_._.0< ...ZMPZOO mZO.._.wm30 000 >00000000 0. ..0..000.. .0.. 0.0... 0. 050000.000 0.00. 0020 000 >00000000 .000< 00.000000 .00.>0. 0003 0. .. 50 00.0 0. 0.00 0. .. 00.0.0000 0.30.0 .000..00.0. 00.00.0000 .00.0.00 ..0Eo..00>w £000 .00.:. 8280. 00.0 .o 0.0.. .20... - EB 0. >000 00. .000 00>0 005.08 .0000000 0:03 000.900 .0 0.00000 00... .0000. 0.003 0...; >000 .00.0.> 00.0 30. 0 00300 .0 0.0.. 00. 000 00.0 000 ..000. 05.05000 5 0.0.. 0.... 00000.00. 00.0.0Em .00000 00.0. 00. .0.... 0.00050 000 .000>x0 .000.0 .0 30.. 00. 00.000.000 .0000 .00...005 00. .0 0.0002. 000.0 00. 0. 0000.00 000 00.60.0000 000000 000.050 “00.0000 ..000 .: >000 50> 000... 000 .0... 0. 0:00: - 0.000 00... .< >000 0.>000 50> 000 - >000 50> 0.0. .00 00> .002, .0000 000.000 >0..000 00.00. 0. 00> 000... 0000000 >000 50> 050000000 .6 00.000. .00. 0000. 00.50 :03 30.0 >000 50> 0.00 0. 00 000 00> 000.0. 00.00 0.0 .00>> 2.0.000 50> ..00 0. 0000 00> .0000000... 000 0.0. 0.0.0. 00> ... ..000000E0E .0 05.02 05.0.0000. 00:00 0. 0.0... 0000. 0.0.00 0000000 0.... 00E..0E00 .00 .0000. 00.50 0000 00.0000 >..000: 000 000.080 000. .00....0000000 >00 .0. 0:00 .0.0. 00. 00.0.0.8 0. 05.. 0.0. .0 .5900 :00.0 0 0050.0. .00. .00. 0 0. 0.00.0000.0E0 0< .05: 00. 0.0. 0000.0 0:00 .0.0. 000 >.000 .. 032.030 00.0. 00.. .>..00 0. 0.0.. 0.5.0.00 0...... 00.0. 00. 0.00.0.0 000 000.0000 .0.... 30.0.0.... .0 000.. 00. 0. .. 000w 0..0.0E< 00. 0. .00>> .10.... v .380 .0 ._ .08.... 00.30.. 08... 5.; .03.. 8.200 ..e 0 Q... .50 0. ._ so) .0255: 000 000 000000 .00...005 N 00.0.000 00.03 .0000 .00...0E: 00. 00.2... 020. o... o. 03 20 0.080... m... o. 0.0.0.. .80... 0.0... $50 .8005: 9.. 0. .00>> .>. mm.._..>_._.o< 0.25.200 mZOFwwDO 0>00 .Eo.0>0 005000000500 00. 5 00.5.0.0 00. 000 .00E00.0>00 ..00 0.000 00. 0. .000005. >..0.0000m .0~.0 000 000050 0.00 0. >558 00.000000. 000 0:00 0.>000 00. 0000000 0.0.20 000 >..0.00000 00.00000. .00. 00. 0. 0.000 00000 500.02 ...02. 00000 000.0E 00. 00 0:00. 0. .0.0000 0. >00000000 00 00.00000. .00. 00 0. ”0000“. 0000 .0m 0. 0. >00000000 .0 00.005. .00.. 0000 .r 0. ..0>> 2,000 0. >000 50> 0.0... :00 00> >0>> 000.00< 0000.02 0000 .0 ..0000000 000 00> 0:02, 00> 0.00.0 000 >000 50> 0. .00—0000 00 000 000000.000. 0050 00.0.0000 >00 00.0. 00> 000.00 20.0. 00 00.000 50> 0.00 0. 050 00 00.000 50> >0 00>0000< 000000.005. ..< .00 0.0000000 00.00000. 0>00 00.002, 0000. 00 0000.0. 0E0w 0.0.0 00.00 .000- ....0.>0000 >..000. - 030.00.? 00 000.0 2,000 002, 00.000 0>00 >000 00.0000 .0 .0. 0 .0000. 002. 0000.000 .00. 0000030 00000 0. 0000 .0 .00.000 0000 000 00.0.0. 00.0000 00.0 0. 2.000. ..000 0>> .>00 000 000000050 00.0000 00. 00000 00 0000 N 00 .. 000. 0000. 0>00 0. .00 >0 .r .200 0.0.0005. .0.0.00000 .00.00 .00. .00.000 ”00.0000 00 00.0.0. 50> .00.... 000.000 000 >000 0.00 00. 00.0.0000 0:000 000.000 >000. 00000 00000 .000... 000.0 000 0000:0000 6.0000. 00.800 .0005 .000... 00: ..000 .>00000000 00.50 .0000.0 000.000 00.00. 0. 000 0. .00. 0.00000 5.0 0o 52.00 < - 0.0.2200 .28?~ .200 - 05 .390 >000 000 0.000 0.>000 50> >02, 00. .0000 000 000.000 ..0000000 000 00> 0002. ..0 .0 0.0.00 0. .00 .000 0... 00 .00.000 .0 000050 0.00 0 0. 0000. 0.. 02,000. 000 02 20.0.00 >000 00. 0000000 .0000.< ”000000.60 0..0000.< 0.0.00 ..000 0.0000000 000 00> 0:02, 000000.000. 00.00 .0000 Z0< 00 00.000 50> .m 0. 00:0. 00> .0 >00 0>0I wm_._._>_._.o< 0.2th00 mZOmeDC 0.000 0.0 5.2. .0.000.00 2.00.0”. .0.000.00 0.>> 0.0.0.>0 000... 00.. 02.... .0... 0000M 0.00000... 00.002. 2.0. .x00 00. 0. .0. 0.000.0 0. 00 000 00> .002. 000 - >.0>..00 000 .000. - 00.0 2.00 .0 00000.0 0.002. 00. .0000 0.00. 0.00. 0. 0000000 ...2. 0.5 ..000. 00000 .00000 .00>.._00.00> 0.00 0. 00 000 00> .002. .0. .. .002. - .000. .0000 .00.00. ...0. 0. 00.0 0. 00.00 0.0 02. .000 2.00 .0000 0.00. 0. .002. 00> 0000000 0.00 ..0 0.0 00> 0.000.. 0. .00>> .0000. 0 000. 0. 2.0... 09.0.02. 00000000 0.. 00.50.01 0000.. >000000.0 >0..00_.. < .0”. 000“. 00.000.00 .00000.0 0.0 00> 0..02. 0.0.0.>0 00.00 000“. 00m - 00000 .00.”. 00... .0 0.0000 000 0.00.0 .0300. .0w .0E.. ......0E 00. .0 .0m. .0002. 0.00 o. .o 0.0.850 0.0;. 0... .00. 00000 ......0.m 00. .00.. ”>000000.0 00000 0000m. 0.0.00: .0. 0.0 00.0. 00 0. .00. .2.00 0.0000. .00 0. 00000 >000 .00> 0.00 0. 00 .000 00.000. 0.>000 .00> 00.0 .00 0.002. 00> >000 .00> ..00 000 .00.02. 000. 0. 0000.0 000.0; 08. o. 0.0 002 00 0.208 00.00 500 000.02. .005. .>000000.0 00000 .00.02. 0.00 0. >0..000 0. ._ .5508; 0. .000; .o .0800 .00.. 00. 00.0.00 .0 00.0 000 0.000. 00.0 0. 00... 0 .00 0. 0.0... 00.0.. 00.0.0E0000 >000 .00> 000 .00.000. 00.0. .00. 00. 0. 000000 «x. n 0. 000000 .\. N .0000 0.0.. 02.0.0 >000 .00> 0000.00.01 02000.... .00. 00. 00000 0.00 .00.02. ..00. 000 >00. 00 .0000 0.0 000.02. 00.00 .3000 00.00.0>00 0 .0 0.0.0>0 000>.00 00. 0. 008. 0. 00.02. 000.000 0000020 >0.000 .0. .0. 00.0.0 .0 02.00 0.00.0. 0.000.000.00 00.0000. >0.0.00 >0 .00E00.0>00 0.0.0 ..00E. 2.00.00 >00. 0.000. 00.00.00 0000001 .N ww....>.._.0< ..ZMPZOO 020....wm30 «0 an ..0000> 00 00000305 000 00.5 00.3.5 0000 0>00 000003 000003 .0000: 0 0.. 0.5 .00.00 0 0388 3.930: 0. >08 59. 5...; 5.32.5 0 00805 05 5.; {o3 2 30> 0.0.. :8 .05 0032.5 0:30 >53 30> on .055 00030 00 000 00500. 00. .30> .00. 000.0. 000 0.000. .0 030.03 0. 0000. 0.000003 >00>0 00000098 0.000 30> 00 300 00000030 00300.0 0.00000; >..0>m .0050; .0000 ..0. 5.0.00 0. 0000.. .v ...000. 5000 0.0.5 30> 0003 080.. ..o 000.0 000. >000 0.005000 00. 00 .30 000030 00 000 .52 9.. 3:802 0.5 :22. 08.0.. 0 000.0 .0 0 ...00.0..0.. 00 .000000 0. 00.000 0.300. 0.... 000. 000 .022: 05 ..o .68 05 2c. .0800». a .0855. a: $90 .0.... 0. £530 05 .022: 05 ..o 05:08 0.: .0 .00.. 00.0000>0E 0 0x... 00.. 0000 000.300. 00.3 0 0.0. 83.. 00:00 0300 00.003 00 00.... x000 30000 .000. 0 5.3 00. 0030.. .90 0 00 .00. 0.00 0300.3 00. ..0 00000 0.... 000000 000.000.3000 0000b 0.0030. 00.005 0.... 8 300.5005. 0000000000 ..0 00000 0 003000. 0000000000 0000.. .N A0000030> 0.0000. 00.03 0x... ._ .3000 0.0.0. 0. 00300 30> 0305.3 .>__00..0E0.30 .0000000 0000. 2003000000 0x003 ._ 00000. 00.03 .0090 .00.0030. £00000. 0 8:8 0. .2; .... 020.: 0,: .25; 05 2:. so .32 2. .0005. 3005000.. 000030 .0_003E 0.0 0 0. 00.03 .030033 05 .3000 0. 05.. ..w 000 02.0.0.5 00.200 00. 000>> .00.000. 00.0 00. 0305 000 00>: >000 .30> 00003 .0205 00. 0. 00000000000 0. 0000. .0 0003 00 0. e 90000.0 000 020.3 3.5. 5.; .00 520 08.0.. 00.50 28%: .23 .0 .0000000x0 00.30.00 000 000.008 >.0E00x0 00 00 00.0 000 0. .0... .30> 0. 00 .05 ...3 000.000 00. .30> 0.33 .822 o... 2 >05 5.3 83.0 .25; 05 2c. .32 .9. 0000 0. 00000 0. 0000 000.00.. 0 .00. 0003 0000 0.... 0. 0000.. .< wm_t>_._.0< ...ZMFZOO wZOmeDO 2 00 ....>0>> 00.8.0. 0.0 30> 000>> .0000 0.003 03.0.3 .30> >..0.00000 .>000 .30> .030 ...3 .000. .30> 000. 00. ..000. 00030 00 000 30> 090.0. 0.00. 00... 0000x001 9.000.020. - .300000 >0000000n. 00000.00 00m. 0000. 00030 0.0000008 30> 00.0000 .0. 030.0000... >.00.00 00... 0. 00006.00 0%. 8...... 02.8.8.2 0 0030.050. 00.5005 .0 0.0.0 00.0.30 000 .00.000. 0.00000 .000... 000030 .0 30.00 .000. .0000000 000.000 6000005.. 00.30002 00.0.00 .0 02.0.0090 000 0000.305. .N .3058. 0. 8.0.0.00 .. ”003.00. 0030.0000. 0000 .. .580 0:00. 00 ....s 0.5 .00. 0030.0000. 00.000 00.03 >0 .000. 00030 .02. :8 8.05. 29.0 0.5 02.2... o. 00; 02. 05030900....8 0. 0.96 0.5 2.00 200000600 0. .0000 . .000 o. .0. 00.000 ..00. 0000. 0_0>0 .000I00.000..u.|0.00 0.000.0...00 000.0 0>0... .x.>.00 00. 03 00.0000 0.0.. 000009.000 .30> .00>0.0 00.000. .0 0_0>0_ 00.0 0030000 0.000 000 0000. 0.0 30> 000>> .0000. 0.00. .. 00000.90 00 000 .000.. 02.0000 000. 00.0000 0000000000 0000.3 .30> ...0; 00 0003 .00000 .. .000>x0 . 000 000.0 003000 000.00 .00 0. 03.0.3 .30> 0030000 03.0.3 .30> 0. 000.00 0. 000>x0 000. .00. 00000. ._ ..000. 00030 0000.00 0. 9080.0 000 03.0.3 .30> 0. 30.. 000.0 000.. >000 0000. .30> 0. 03.0.3 .30> 0.0.. >030 30.. 0. 000.0 .30> 000300 .. 000000 000.0. 0000. 000>> 0.000 000 .0000. 000 030.x00 00.0000 >00. 0000 .0.00 .00. 0.0000 000>> .w .< .000.. 000 00000000 000.6 00k «>000 .30> .0 ..00 0 .0 .>000 .30> 0000. 30> 0003 .00. .. 0000 30: ._> ww..:>_.r0< ...Zm...ZOo mZO....wwDO V. c: 0.30> .. 30> 00... 000 0.00000. 00.30.... .00 0500.0 0.. 0. 0 .3000 00 >.0000.0 ...3 30> 500.0 >..00000 30> 00 .00. 00 ..00 .3000 .0320 500.0 0. >.. 0. 0. 0000.30 .30> 0000005000 ..0. 00030 0.0.. 0. 30> 0.00 0. 00.5000 00 205000000 02.00. 5.3 000500. 0000. 0. 0000 30> 0003 0.0000 00.5000 0.0. >.. 000 30> 00000.0 9000.00.00 0>0... ”00.5005 000003000 0.300. .30> 0030.5 0300 0.050. .58... .30> 0030.5 .30 000 0. 500.0 0. 000 0... .0000 >020 0 0>00 30> ... .0000 .30> 0030.0. >.0000 000 >320 0.000.- 000005000 0000 .0 000 05 000 00.00.000 05.0 500.0 30.0 0000 0 00.0...- ”.500... 80:00.0. 9.. 00:8 8.0 - 58.0 05.0.00. 0.: .< 000.0 0..3 00000.0 .000.. .0... 0030.0000k 00.5005 0... 000030050. .x0.0. 0. 000.03 0.00 000 0030.0000. 00.5005 0008.0. 0.00. 00.0000 0. 30> 0.00 000 00.5005 .30> 00.320 >.0.0.00._00 .0000. 0.0 30> 0002. 00.300. 000 8.00 00 0. 0000. 00.5005 .30> .00x0_0. >.0> 0.0 30> 000>> 00000.0. 0..3 0000-0.-0000 v..03 .000. .0. mungzzom... 02.000000 >003 000 00.000. >.000000003 0. .. 0.003 005.050. >0.000 .30> 0200000 30> 200.000 0.00. 00.0000 0000005000 .30> 000 .0000 003 000 03.0.3 00 ... .>000 .30> 0.00.0 000 90000.0 000 03.0.3 .30> 0. 0000 000>x0 000000 0..3 030.. 000.0 030.0 0.0. .00..0..000.. 00.5000 .30>0 0.030. 0.30000 000.0 .30>... 030.0 0.0. 0000 .30>. 0.0.. 30> 000>> -waO0mw0 zo...:.o< 0.sz200 wZOFwwDO 2. an .>.0>..00 9.0 .80.. :80. ..80. .o .300, mcozoflmm Enamel u 82> ._=> .30> m0“. w..m<...m00_200 DZ< 02. -xSwm ...wOs. .01... wgwwu. ...(I... 02.1.2me 00 ..w>m; th mmOOIo 0030.0000. 05500.0 00. ..0 .0 05200083000 000 0000.0. .000. 00. 0. 0.0.. 00.... wm_._..>_.ro< hzwbzoo wZOFwMDO First Class Delivery Pre and Post Questionnaire I. What is the cervix? a. an opening to the uterus b. the cut that the doctor makes to allow the baby to be born c. fluid that surrounds the baby d. the way the baby cats inside the mom 2. It is OK to drink 1 beer a week during your pregnancy. T F 3. Fetal monitoring would measure: a. number of hours until delivery b. mother's heart rate c. size of babies head (1. spacing and timing of contractions 4. How can your coach help you decrease the pain during your labor? a. let the nurse know when you need something b. do not criticize her c. help you time contractions d. all of the above 5. What is a sign of labor? a. vomiting b. contractions that are irregular and short c. pressure in the pelvic area d. contractions that are regular and closer together 6. Why is a caesarean section done? a. abnormal position of baby b. fetal distress c. baby's head is too large d. ineffective contractions c. all of the above 7. How often do you feed a newborn? a. whenever the baby is hungry b. every 4 hours c. only during the day d. when you eat your meals 8. How do you stop your baby from crying? a. spanking b. cuddling your baby c. holding the baby while taking a ride in the car d. play loud music 9. What is a normal characteristic of a newborn? a. having a cone shaped head after birth b. enlarged genitals c. yellow skin d. a and b only 10. It is OK to have sex without using birth control during the 1st six weeks after delivery. T F ll. When is it not safe to have sex during your pregnancy? a. the last three months b. after the water breaks c. all during pregnancy (1. if there is a risk your partner has an STD e. b and d 12. What services are provided at the Ottawa County Health Department for you and your baby? a. birth control supplies b. well baby check ups c. free immunizations d. parenting education c. all of the above 13. I am most fearful of in this pregnancy and on a scale of HO (1 means afraid; 10 means most afraid) I would rate my level of fear at a flitting In Pregnancy been] (ll ”)0 begin/mug: CHILDBIRTH EDUCATION GOALS [mmmwwmmmarmgmmformwmmmmmgbmm ofalltbeaomieca'ortsm botbprocaswesJOB WING/orpaspafiumparmbzg Wbmmpart aftbeirgoal in laboranddeliuay. PURPOSE: To help new parents understand why Childbirth Education is so important to their future parenting endeavors. GOAL: To outline the purpose of Childbirth Education using the five “KEY TERMS" to describe how the logical birthing process occurs and how each is paralleled in posrpartum. DISCUSSION: Introduction of Instructor— Focus should be on family experience rather than qualifications. lnscrucror may say, “The mos: profound qualification I have is that I’ve had a child myself and experienced the joys and hardships of becoming a family”. Introduction of the five “Key Terms”— . SUPPORT Labor: Finding resources to fulfill mom's need to cope with pain. Posrpartum: Finding resources to help cope with the baby's needs. I DISTRACTION Labor: Keeping mom occupied with something else rather than focus on the pain. Posrpartum: Keeping baby occupied with techniques to calm them or prorect them from oversrimulation. I COMFORT Labor: Finding ways to help mom cope with .her discomfort and somhe herself.(i.e. changing positions. urinating. etc. ). Postpartum: Providing objecrs for the dependent baby to soothe itself (i. e. fingers. pacifier, security blanket or object. etc. ). I RELAXATION Labor: Mom must release her working muscles aside from the uterus to conserve energy. Posrpartum: Parents must use the techniques learned in Childbirth Education to help combat sleep deprivation. Focus on getting back to sleep rather than on how much sleep they have lost. I DISCIPLINE Labor: Teaching mom to react differently than she normally would when she feels pain; using coping skills to manage her behavior. POStpartum: Recognizing that babies are not born with the ability to manipulate parents with their behavior (They do nor cry to make parents angry). After six months of age. baby can be taught to change by replacing unwanted behaviors with appropriate behaviors. GOAL SETTING: Parents are given the opportunity to establish their own goals for Childbirth Education (a birth plan) and their role as new parents (a parenting plan). © 19‘)" Ann Cumin. l’li.l).. 28.241 (Emmi \zille} l’urlmu). Suiti- F-ll-i. Ltigunu Xiguel. (L-U).Z(i“-l-lllllTe|: ('Hl (HS-9978 arenting in Pregnancy . . .begin (I! ”Jt’ beginning SUPPORT SYSTEMS An insert designed to enhance the “Introductions” phase of your Childbirth Education curriculum. Wehlbbmomwfllbmdrflmbaficdb'mmmagemm, Mbeadaidbtglbemmexboob andsaeingtbemedoctrsmnde ”MWforthmwmmmawammmy Waumodosmforwwfannbnouatmc mbanmettolatad, resultingmttfedhgquaplemess. M,Mgmt¢mbeminpamummofmmmdmdalw. PURPOSE: To begin the bonding process among new groups of families and introduce the support system concept. COAL: To encourage participants to meet and get to know as many new couples as possible at the firsr class. DISCUSSION: Couples Interaction— Each couple introduces themselves to Other parents, asking these quesa'ons: Where do you live? Who is your physician? When is your due date? Have you chosen a pediatrician? (How did you come to that decision?) What jobs do you hold outside the home? Facilitated Discussion- The following questions are graphically displayed without the answers: “What does a m0ther need to learn about her body in labor that her child needs to learn in the first year of life ?” (Answer: TRUST) “What does a coach need to provide for a mom in labor that a baby needs from its primary caregivers in the firsr year of life ?" (Answer: DEPENDABILITY) OTHER RESOURCES: Labor and delivery support staff (nurse. doula, midwife. etc.) Obstetrical and pediatric support Postpartum groups Family and friends Religious groups Childcare providers © l‘l‘)" Ann (lurwin. Hill. .3834! (Imu'n\':ille}'l’:irk\\':1)'.SuiteF-lh. lagimzi \iguel. (Lt UHF-Hill) ’l'elf ("l-H (HS-99??? arenting in Pregnancy . .bqqin (ll [be beginning CHANGE The Key to Progress in Labor and Postpartum Papleareirtberardyrasnmmdnnge. butabangeisnecessaryinprqnanty;changeisnmyinbrrtb, andcbangeisnmy thwarting. ifpraratalpurenhcananbraamdwlmmelbeabmge, Murilbtgmwfmyudtbapaufiwjbra. PURPOSE: To parallel the changes a pregnant and laboring woman's body must undergo. with the changing roles couples must undergo in order to become parents. GOAL: To help parents identify and more readily accept these necessary changes. DISCUSSION: Physiological Change UTERUS—the involuntary muscle with the“ m‘ind of its own” . Some of you will have children that remind you of the uterus»! They don‘ t seem to listen to your directions. CERVIX—the opening to the uterus tlun changes through a slow, deliberate, Stretching process. Your job as a parent is like the cervix. It takes slow. deliberate time to raise children and everyone stretches and grows through the experience. CONTRACTIONS—no two are alike, they always come, they have a powerful presence, and eventually calm down. No two children are alike, they have a profoundly powerful influence in your life. and no matter how much they “act up” they eventually calm down. KEGEL—the voluntary muscle crucial to control in labor and posrpartum. A mother's awareness of her kegel muscle helps her control her delivery and recovery. Reminder notes to exercise the kegel gives good practice for using notes to remind parents of what needs to be done for their children and how they need to take care of their parental relationship. UMBILICAL CORD—the physical attachment the baby has with its morher for survival. The psychological and physical reattachment in posrpartum is also vital for baby‘s survival. PLACENTA—the nutritional source for baby and the vehicle for wasre material. After the baby is born. all these functions are transferred to the parent. Parents need to consciously nourish. change wasre. and attach to your newborn. Necessary Change: The Parallels for Prenatal & Postpartum A change in a morher’s body requires movement. Everything in a mother‘s body shifts and moves to adjusr to the baby. ln pregnancy, movement means health (unless contraindicated by their physician). Movement allows for pain reduction and the reassurance that the baby is healthy through kicking. In labor, movemenr means progress. A woman may need to change positions to adjusr to her perception of pain. In parenting, movemem means change. Everything in new parent‘s lives has to shift and move to adjusr to a new baby. When a parent is stuck in a painful situation with their child. one of them needs to change their behavior or make a “move” in order to alleviate the problem at hand. © 19‘)" Annhmiin. Phi). 283” ( .munlzille} P'irlm u Suilel- 134 l. :lullll:l\lf’llt’l (. \‘L’h‘i l-lllllltl l 14) 6-H 99"8 flnting in Pregnancy . . .begin a! {be beginning NUTRITION... HOW TO FEED A FAMILY! Youmwbatwuaatsaycfiallllnpregnancy literallywbatammpuhmberboaybaswyflrmgbdowr'lbdrebealtbandwdfa’eofber unbornduldandberseyfInpaspartum,gaodaza'ngbabitsutiquxtwebaaltboftbeenarefamdyforalifetime. PURPOSE: To understand that good nutrition is important borh before and after the birth of the child. GOAL: To introduce the concept of “modeling"—allowing parents to see how their eating habits affect and form the eating patterns of their children. DISCUSSION: Ask parents: “WHAT ARE YOUR FAVORITE FOODS?" Point out the differences in likes and dislikes and how texture. smell. and tasre contribute to individual preferences in food. “WHAT DID YOUR MOTHER SERVE YOU TO EAT THAT YOU LIKED THE MOST? (LEAST?)" Ask also when mom or dad served this food, identifying memories associated with eating. “HAVE EATING HABlTS CHANGED WITH PREGNANCY?" Did you think more about what you could or should eat or nor eat? “WHAT DO YOU WANT YOUR KIDS TO EAT? AND WHY?" AWARENESS The conscious eating habits in pregnancy should transfer to posrpartum. so parents can become more aware of the nutritional needs of their children. OBSERVATION Help parents understand that eating will be paramount to their postpartum experience with their child. How much they eat. how they eat. when they eat, how they digesr. and how their bodies respond to food (weight gain) are part of the daily routine. PREPARATION Prepare parents for the changing patterns of eating that are “normal". Modeling allows good nutritional habits to become part of your children's eating pattems—behavior that will carry with them throughout their lifetime and can affecr generations to come. © W)“ Ann (Zuni-in. PM). .3324] (Irmm Valle} l’1ll‘l\\\‘:l_\.Silllt‘F-ll-l. LugunziNigucl.(2.\t).‘(i“~l+llllTel; ("l-H (HS-99‘s arenting in Pregnancy . . .begin (I/ ”re beginning PROGRESSIVE RELAXATION hmdwmwmsofwm. mmeofbobmbefdimibebodyaswdlastbemindRmfion mummmwgmformuemmwmmwbymmmm. PURPOSE: To introduce the concept of relaxation as a tool for lifelong comfort. GOAL: To teach parents specific relaxation techniques as a means of conneCting with their infant. DISCUSSION: Breathing for relaxation— By changing the automatic process of breathing into a conscious effort, it is possible to take the focus of your mind away from the pain or Stress you are experiencing, thus resulting in relaxation and Stress relief. Breath 1: Allow your mind to direct the oxygen to the top of your head as you inhale, then release the tension in your forehead. cheeks and jaw as you exhale. JuSt like your infant will do with those firsr reassuring breaths at birth. Breath 2: Repeat, but this time release nor only the forehead, cheeks and jaw. but the shoulders and arms as well. Allow the tension to run out your fingertips and “let go” of the Stress. Iusr like new parents need to “la go" and realize that the Stress they feel with their infant will not last forever. Breath 3: Repeat, but this time move the visualization further down the body into the torso, the legs, and eventually out the bortom of the feet. As parents learn to “take in” what they need, and “let go” of what they don't need. they have discovered a valuable method for meeting needs and reducing Stress. borh in labor and as a technique for coping with their child's needs for comfort. The parents who teach their children this valuable relaxation technique will be giving their children the gift of knowing how to comfort themselves. These are the children who will feel less pain—giving parents the ultimate pleasure of sharing the ability to case some of the pain their children will experience as they go through life. © lflll‘AiiiiComin,[41.11.3314] (Emmi \tille} Parkway. Suite 13-131. l.;lf.'llll;l Nigiicl. (l.-\‘).‘h"-l-lll0 Tel: (.‘l-n (HS-9978 200 0030.050. 05500.0 0300000- ..000. .0. 00.3000E 00.0.00- .0000000000 0E. .. 2 30:- 00.0 000 .000.. .0 00000.0 00...- ..000000 00000.0.- ..000. 00030 0002.000. .0.00- .>000000.0 00030 0.00. .00.000..- 0..0.0 00000.00- H>..m_>~_m>0 was“. 0000000000 .000. 00.02300 0.0.0xw d. ..000. .0. 003.0000. 00.5020 0.000 200000500 .0 000.020 .000. 0000.03 0 0000000 000 .00. 0000.000 000 00.0. .000. .0 200000500 .0 ...00E00000. 000 0000:? 0000. 00. 00000 . 0 ..000. .0 0000.0 .30. 00. 3.0000. .0 0003000 000 0.0. 00.0.0. 00E03 0 .. 00.0.0000... 0..30.0. 00.35.2000 00. .00.000 0. .00000E. 0. .. 303 000 .0. .0000.00.00. .0 0.3.03... 05 .003 0.0.0xw .m .0000 00.0 >00. .000. .00. 0.00.00. 0. 3000 .00. >000 0.00.003 0 .00. 000.0 0000000 ... 000.020 0. 0. 0002.000. .20. 0:03 0000 2 0303 000 .000. 00030 0002.000. .20. .0 0000.30 05 0.0.0xm. .0 ..00. 0000 .0. 0000.30 00. 0.0.0.8 000 0.00. .0.000.0 00.0. 0000000 .0 .3000 0 .0. 00000 0. 0003 0.....0 00000.00 0 3.0000. .. .mmEomamo ._ 000.0 .000.. 000 00000... .0.000.0 >..—mafia 0050 0.0.0.0 0n 0.. .0003. .20. 00. .0 3.03.00. 00. 000000 0.0000 00 30.0 0.00.0000.00.0 02000.... .00. 00. 00030 .00....0000000 00.000.00.00 .0 0000020 00. .0. 3:030: 00.00000 00 2 3.0.0.000. 0 0. .000 000 6000.00.00. 00 ...3 0.3.. .0 .0300.0 ..050 0.0. 0.300 cm 0.5.0. 09030 0 30 000.05.; 0. 0.2. m... 0.2. 2.0.0:... .0 .0300.0 ..00.0 0 30.0003 0. 03.0.3 00. 0.0. 000000. 0. 0.0000 0.0. 0 00.03 0. 0.300020 00. .0 0E0: 00. 0. 0.0... 0.00.0000.00.< .320 2 000 000 0000 0. ..00 00. 0. .. 0>00. 000 .2.0000 00. 2 0002.30 .00 00.2 0.3000 000 00 ..000. 0.0. 00 2.00.00. 0 00300 3:03.00 000 .00. 0.0.. 03.03.00. .000 0..3 .0 0.00.00.00.20 02000.0 000 .00.00. 0003 000... .0 000.... 00000.0 .000. 00. 0.0000 2 003000 3.0.000 0. 3000 00. .. 00.0..200 0.00.30 0. .2000 00 .P 0000000000 .0 00000 00. 000200..3 03.0. 00. 300 000 2 003.0000 000. 0. 0.0. 0000 00 ... 00.030. .00 .0 0000.30.00 ..00. 00.00.: 0..00.0E 00. 0000.30.00 30 .0 002.000.50.00 0300030000 2 00 0030.0. 0.00.3x0 0000000 00. .00.0E 00. 00.3.0 30 020.30.00 00 30E 0000000000 0000000000 00300 0. 000 0:03 .2005 .220 0.03 000000 0. .00.00. 00 .r ..00... 00000002 00. 000. .02 0202.00.00 0.00. 0 0. 0.0... ”Coo. .000 0009000 0.00.3.5 .0 .00... 00000 000000000 00 h .0003x0 003000 000.00 .00 0. 03.0. 00. .00. 0000. 300... 000000. .00 0000 0.0. .. 00300. 000.00 0003 00.. ...3 0.0. 0000 00. 0.0303 000 300000020. 0>00 ...3 03.0. 35.000 0 .00.< 0230.0. .00 0.000 00.. 0. cm: 0000. .0000: 00. 0. 0.0. 0000 0 0>00 ...3 0.0.030 0.. 0. 0003.8 .0 3.00.0 0..3 03.0. 35.000 < 003.0000 0. 0.0080300. .20. 0. 0000 .2200. .0 0000000. 00 ... 000.0 0 0.00 0.0. 0000 0.3000 00. 00.000. .2.000. .20. 000 00230.0. .0 0.0300 0 0. 00.0000. 0.0. .3000 v..0. ...3 03>. 02.000. .20. 0.000090 00 2 03 02.000 0. .00.0E 00 h 0th. .000 00000002 mm.._..>.._.0< 0.23.200 wZOmeDO E 00 00000 2005 :0 005002 50 30:0 000 30.006 50.23 .000 05 02000 00:00.: 0 0. 00.000000 0.0 000300 0005 3 500 22.8080 0:55 3 £65: c2050 .80 £00053 @0020. 05 005000.: 000 0205 05 .0>0 0000.0 0_ $5 00000 9500000500000 0 0_ 00300 .050 0.: 0009.00: .900 05 00 x20 0. 0053 00000050 000: :02; 000000000 00000050 05 m_ 000 000.0000 0.0505 05 0. 0000000 0.0 3.00 :0 000300 02 5:00:00... 0005 0000 6:00:09: 00 00.: £5 0. 00:00.2 .0E0§m .300 50> 00 £5 05 0:0 00:0. Saw 00 00:0. 02 0.0 0.0,: .222 .90“... - .2858 5 9:05 0% 9280 2 .92". «9.3 0.03 .2522 .90“. 28820 :< $00 .2; 0000. 8 00050 05 2 05000000. 0_ >000 50> 30: 000000 B 2:50 05 0005: 000 .2000 50> 0020 00:05.25 02... 0000. 00:00 000300000 00:05 .0 002050 000 500030 05 000 “009.00: 0.300 05 0.000.. 000 050008 2 00m: 0. 3mm: 00:00:. .900 20050.0 c< 000 5:002 .90“. 0_00:00_w 0< 0000 .053 .< .Aco 0:0 to 00x03 >..:0=_E.0E_ 00m: 00 :00 5200:. 05 .0 ..0300: 05 c. 0.0 00> 0.33 .600. 50> 50200005 2000002000 00.02008 00 >0E 00> .0000 @500 m. z >..? 000 m. z .023 305. 30> “05 «00:00:... 2 g 00 .3000. 200500 0032000 :0 00:00 00.0 50 c. 20:08: :0 5 200.50. 0000 2.00.000 m. 00:200.: .000.. 2000003 30.00000 «0.2. - xocmcufil E mEEEmQ 00m. H6239.20.)— ._<._.wu_ 0.20mhom4m .0... 53> 050000 05 .05 0x0... 05 000006 0.0050 000.03 < .0000 0_ 0500502050 0003 0.90000 0. ~05 0200 05 2 >5? 0:0 00:002.: 00000000.... .0 x0: ..00.» 0 m_ 0.02... A0555 .00 2000 09 2 our 5023 221:3 00.0. ..00: .28 ...0E -000.. 0 00.02.0000 0_ .053 .>_ ww_._._>_._.o< ...zmhzoo mZO_._.wwDG «a 00 . 0.000 .00.. 00.0.. 00.2 0.03.. 0.0.0000 00 000.0 00 30.0 ..0. 00. 2.0.00000. 000.0 .00 00 0.. 0. >.. 0.0000 000 ..000. .0 0.00 00. 0..3 00000 000.03 0 300 .0000 000 >....00E 0. 00009.5... .000 0. 0000000 2.0000 0. 000 0000000 2.0.00000 .......00E 0.00803 00. ..E.. 000 00 000 00.000080. 000 0200000006 2.0200000 00.00000 .0..00E 0.0.. - .00 0000..0 0. 000..00.0 00 >000 0. 000000 0.00 .0 .00050 0305.0: - 000.00. .0 .0.000 00. 0.0.00 009.020 00. 0.003. >000 0. 00:00.0. .0 2.000. 0.0.. 0.00. 0. 0.00.00 0.000 00. 0.0.00. 0.000090 0>.00>0. 00 0. 0.0.7 00.0.0 00. 0.0. 000000. .000.. .0.00.00 00:00.2. 0 0..3 .0 000.0000 0..00.0E 00. 0. 00000.0 00:00 05000.0 00. 0..3 .00..0 00.00000. 00 000 000..00..000 0000.0 00 .. ..00 N .0 r .000. .0 0. 00.0..0 8 .02.. 5:8 9.. 0:0 2.0.8.... .0080 0 5.; 0.... 8 000 .0.000 00.. 00.0.0 00 >000..0 .000. 3.0.03 .0 000. 000 2.0.00.0 00 h .00..00.E0x0 .00.00> 0 00.50 0.000 0.300 00. 0. 0000000 0. 00.03 009.020 .0..00 .0.0000 0 00.00 000.000. 0. 0.0. ..000 0.300 00 .. .000: 00 >00. .0..000. .00.0.0. 00 002000000 0. 000..0.0 .0.0. 0003 00 0000. 00.500. 0.0 0.300. 0.0.0000 0.0.0 000>> 09.00.). .00.0.0. 0.0000 0000. .000. .0 0.00 00. 0.0000 0. 000.03 >000. 00.00 .000...03 0 0. .00 .0 .03000 0 0.0. .0.03 0 00.0. .000...000 000000 0.0.00 00.00. ..0000 0>00. 000 0:03 000 000.03 000000. 00. .00. 00 00>0E0. 00 000 .. ..0>.00>0.000. 0. .0..000. 0.0... mug—20.0.4 ..zwhzoo wZO.._.meO MN 0% ¥00 ...3 00.. 000 .. ..000. 0. 000.0 .0 ..00E.00.. .00.00000.0 0. 00>..00.0..0 50> .0000 3000005 00.50 0.00.. .00 00 0.0.00 00 0.0000 00.. .00000 .00.: 0. .00 .000.0.000 0x00. 0. 0.0000 00 ...3 00.. 0.003 000..00..0 3000.005 00 ..00. 0.00. 2000.30 0.000 .00E.00..000. 00. 0000 0000. 30.... 0.0000000000. 00. 0>00 .00 0.0 _ .. 000000 0.003 .00>>. 00.00 ..E 00.0.5.0.00 0. .00000E. 0.500. .00. 00. 02... 00.00000 000 00.0.. ..00. 000 0000020 .000..00....00. 00. 0. 00>..00.0..0 0.0.0000 0.0 .002... 0300 3. 000 0... .0. .000..00: .0 .00. 00. .0 00.0.. 00. 0.0 .003. 0.0000000 .0 .00. 00. .0 0.00000 00. 0.0 .00>>. 0.00. 00. .0 0.500. 00. 0.0 0.00:0. 301.. 0.8 0025... .00. 9.. :0, 8.05.2... .00>>. 000.0 .0 .00. 0 .0000 .020 0.00 ..00 0. 00000000 0.0 009000 .0.. 0. 00 0.0 000. m 5.000 00.2000. 0.0000 00.03 3 00000.0 00. 0. .000000 00000.0. hzwwzoo 0920.002. ..00.00>0 0.0. .0.0_ .000. 00000 0000.000 .0000 0.0... 0:0. ...3 0>>. 0.0000000 20.0.0000 000.00 .00.0..000. 00.00 0:03 0.000 50.. 00 .0.. 0.. .00 00 .m 02.00...E.0.0. 00.0..000. 0.0 00.. .. v.0 00 .. 0.00.5 ..0000 0>00. 000 00.. .00. 00 00.6.00. 00 .0..000. 000.008. 00. .00. ..00 ..00000 0. ..0 ._ .N ..000. 0. .000 0..30.0. 005000.000 .00.. 0..3 .2 0w .0 000 00. 00000.0 .0 00.2.8.2 0.0. 5.3 00.80 .0 ..000. 00.50 000.0000 0.300 00. 000000 0.0.00 20.0.0000 000 000 0.0.0000 >.0> 0. .0..00E .00.0.0. 00... - 00030.0 0.00 0:000 .00.. ..00 .0000 0. .00E.00.. .0 0.000090 ..00. 30 0.0.00 .0.00 ..00. .0000 000.0.000 00.00. 0.00 .> ww..:>_._.o< hzmhzoo m20....wm30 00.200 0.... 00. .0 00.0 0000 00 00.0.0000. >000. 000.00 .0.000. 00. .0 .96. 00. 0. 000000000 000 0000 00... 02.0.0 .0.. 20.. .0 8 o. 0.00 0. .32 .8009... 00.. <. ..000. 5.00.0000 0 0000. .000..0.0.. 0. 0.0. 005000.... 000 0.200 00. 0000.0. 00000.00.0 000 .0000 00. 2.0000. ..00 00000005 00. .0. 300 0.00.000 000 .0006... .00.000. 50> .0000 0.00. 0.00.5 0. 00000 000 00 000 .0000.0 .00 00 05000.0 0.0.0 0>00 00.0 ..00. 000 .00 0500000 000. 0. 0.00. .0000.0.0 .00 00 05000.0 000. 0. 0.00. 0000000 000 0500.0 0. .0.000 000.0000 ._ 0.03.0. .0000. 00.... 000 .030. 00 0.00.000 2.00 .00 .00. 00000 >00. 000.03 00H .>.0>..00 0.0.00 00.003 0 0. N. 0.00.00. 00...-.0.0 .0. .00000 0000000 0000 0.0h ... 0300 .0 000.00. 00.0000 0.200 00. 0.5.; 02.00.. 25.. 0. 000.. 0.: .. .8 0.0... .o .000. .560 0000 2.0000 >..>00 0.200 00. 0.0. 00000000 300 00 h 0.000000 0.0..000800 0. 0.00.0005. 0.5... 0.20.. 2.0 ...3 80 02.8 8.0. 502000.020 02... 02.2050... .. . . .305. 0.00.00 0Q 30... . . .300000.n. 0.. 00000.01 00%.. ...080 05.0.0 00 .0.... .30.. 28...... .0.: 39.0 ..00 .80 0.00053 < .0..» 0.0.0 0.80 o... .00>> .0 .253 0... 2... .30.. 9.. 0...... o. .00... ... o... 0.00.. 9.0. .050... o... 5...; ...o; 0.0.. m... 0. .. 0.80.. 0. .00>> 0.003 .00. .8... .< 3.90.. ..0000.. .0. 000.00 2.0 .80.... 80> HIE... 02< 0005 .0 000000.. 0.: ._> mm_.:>.._.o< ..th200 $20....me0 000 x.>.00 00. 00.00.0000 0. .< 0.0.0.0008 o. 0. F 0.0... 00000.00.0 000 .0000.0. .0 00.000 .. .0.0.00...000 0. 00.00005. ..000. 00000 00.0.0 .00.. .0 000000000 00. 0.0.. 000.000. x.>.00 00. .0 00.0000 00. 0. .. .00.0.0.... 00:00 00.0. «00.0.0 0. .002. 000000 20.0.0500 000 0.0.00.0000 0.000000 0.0..000 o. 0. 00.0..0 0. .0200 .00.. ...00 .000. .0 00.00.000 -50... o. ..05 a... - 8.0000 0... 0.0.. 02.00 0... 0. 0...» - .30.. .o 000.0 .0... .. 5.00.00 5.; 08.0 02.0.0. .5 000 .000.00000 .000..00 .000. .0 0000.0 .00. 0.0 0.00.. .0000. 000 .000.. .0 000000. .0 0000346000090. 0.. 00000.00. 00m. ”.000.. .0 0000.0 00... .o ..0..0000 00. 0. 0... .00.. .0. 000 080. 0 .00.... 000 00> .00000000 00 0. 000 0.0. 0. 0.00 00 000 ... 00.0.00. 0>00 0000.00.00. 00.0.00 00.00. 0. .0..0000 00. 0. 00 0. 00.00.00. 00 20000.0 ...3 00> 00.000 00. ..0. 00< 300.0320 .0 .00.000.0 00.0 .. 0.. 0.0.. 00. .0 .0.00 00. 0.02 20.0.0088. 0..30.0. 00.05.2000 .00.. .00.000 ..000. 0.0. 00 00.. 0.0.00 000000 000 .. .00 ..000. 00000 0000000 2.0000 0.0.. 00.00> .00.. 0.0.. 0.0.. .0 0.0000 .0 0000 < .. 09.00... 0.0.03.0 000... 0025.920... .0 00000.00 .<0Imm<_o mo 105205 #000... z< ..000. .0. 0. ._ .00.000 0.0. 0200000 000 .00. 0. 0.00 00 ..00..00. ..00..00.... 0.: 0.00020 ...0 .0000 200000 < .0 .000..00..000 ..00..00.0.. 020....o<......zoo 9.00.20.09.00 2. 000.0002. .0 v’m’ 00.0 0.0.00 .00.. 00.0000 .00.00> 00. .0 0000 0. 0000 00. 000.5 0. 00.0; .0.. 0. 00 000 .0+ 4+: 0. .0.. .000 0.200 00. 0000.0. 00000000 0000 00. .>.0>..00 00000- mm.._._>.._.o< 0.25.200 $29me.00 83 ..oo -m. ho 38%. 996.55% 2 2:2: =5. 55, ..oo 520 £3 mco_m 8:8 9: Eo: 328:2 cam :96 9: 8:3 cosmooom 5.5220 now: .3850 E9509 .3 mmaomfi ocm 53m or. 9.29: x86 2.38:9. .EoE -oomtw ocm cozmzo 2m: -3... o. - co x03 2 .98 -9: m comooo zoom 95 Son 2 Ban 9.: con; cor: macaw moo. cone 2m >9: Sn mcozomzcoo 2m 29¢ .55 .0..an o5 ..ocm moSEE cm 55.3 338 2.93 = .9583 9: S :23:me HBoom; S mama BE... on... .23: on o. moSEE 3 So: Socicm «mm. :8 new {o3 Em; m. £5. .233 9.: BE So now «53> 9: 50:2,: Son 9: $53 3.2: @5505 9: .ooSm being... 9: m_ £5. anon on. S 5.5 on. o. 356 So 0.. com ooomto §85 2.2 2 528 Macs... 9: m5: 9: soc gong .o mama ocoomw och BEG Eu 2-» ..motofi 9.: Sn ommfi .322 9.: - 5229... .m 3.26 .5 we :82 9:2 .m 36.6 50 Yo 3%. 2.8 .F ”..mommamooma 2:. 82%. m_ boom. ho woman um? min Av ommfi - @982 on. cmc. . .559 .083 $095. 05 m_ .oom. ho 009m “3 on..- .80 or o. 36.6 new ooomto oxooor mmEoooo 528 9: Bow. ho mama fir o5 @550. .5532 Sooo cozmzo ocm EoEoomtm .35 boa ooomto $09 2 mmoomooo o. mozczcoo now #8 mm 3530.: m_ £5 $92.2 Soom So me; x coc>> .ona 55 oco Soon. um mcaoo 528 of. .mcozomofioo 952: o. can 528 9: B So ocEEE or: m_ of... $558th w. SES .228 5.3V 269 ms 25 Esoo o>oE coo Ema So» on 223950 oocooo wm_._._>_._.0< PZMPZOO wZOmeDO Ron Soc oo »coE 3o: 80... 9: -coooom o 96: »coE 3o: ooocom -oco mcoZmozo mmaoma .Acozo moEoc ocv .o>oc »oE »o£ mcommozm .»ococooco c_ 3.850 :05 9c; 2 ocoo $536 $5 coco. c. was: 52.8 95% 85:2 3 2 “co; Sc on 5:53 2.6% of. $53 on» mo mco. mo coEoB mccSo. o5 £5, cooou oco .ooEoo o»o c_oE_o2 .m .cooooh o om_o m_ .8332 o. oEoc Ea: oocoEQ ._o._omoc o5 co. 962 2 no» macoz, ocfioc cos; So oc... o. 2.328 omSctooooo on. 5;) 5o“ 9 com: coctoo So» oco So> .oEoc “o .con m_ ..ooo. »_._oo .o 52: »=o:m: .cooo moSEE m Sooo oco mcozooccoo con; Eamon 05 co. mcSoo. ocoEEoooc acofioo “mos. ..ogomoc on. o. mc_om ocoooo ocozooccoo co: 3 65:8 c. Sm oco o. .mafio coEoz, 9: 9o; oco E_oo »o«m ..ooo. »_coo c. .N Em: mN_oEmo .52 on .5353 mccooo. o5 omoSooco oco coooow e moo coccom cooo._ o5 coo coc>> .oo. .99: on :3» room .869: oco ocfiSc och .oco_o on “co; :9» “oz“ oco .Eotooé om m_ .2 coo oco£ 953 23% .2. Sacco—co. So .22 So» Sooo mSoZoc on »oE oo> to...” _o=omoc 9: 2 co: .2 o.ooo>oo co mo So om_o coo oo> .coEoB occooo. 05 2 »:Soom co oocom o 96 oco omoSooco 2 9oz coo oocomoco So> scocooc: bo> m_ 29 So> ”Amocoooov mcoccon. coco; ”$2.52.“. mOmS ....O moom .»_cooo._o mc__ooc m_ »ooo So» 2?... oon 0. 96.85 o co“— cooooo So» o. 539 no» Ecfi cocov Eacooomoo mxoocs w 2 v 3. .mxoo; _oco>om oxo. coo £5. .53 m_ Son 9: coco mum _occoc 2 9:2: 9: ho E39 och - co_S_o>c_ .mEoS on. S co_S_o>c_ oco »..o>ooom mono.— 3 moouw £50“— 05. .v .__> «coooo coccoo coco. o mo 22 So» c. Sooo ooccoocoo Soc. no» So .oc>> Hmcocton. «So» .2 oo 53 coctoo So» ocfioc so» So .oc) So» 5;, Eom8v coctoo coco. o o>oc 2 mc_c -co_o So :o» S »coE 3o: mm_._._>_._.0< Pzwkzoo wZOEbwDO no on 3:65» .__o£ EoE -aooo oco cocooccoo o5: »=o:So 2 238 o omooco .mcozooc -coo S cozoSo oco »oco:o -o: oc. oEE: ooozmo. .= o. manoxo ..oE? ozw .888 So» :2 6.2336 :63 $5 .. .322 on. c. :53 28:... 82.8.28- cases >55.“ :3 Bo 52.8.38 o5 S oEoo o5 .o mmocococ c. xooo o 9553. .omoocos =3, =8 »=mco.c_ och- .358: 05 one: :2 8 =3, Eo_mco: oSmmoS .mcaoc cozoozcoo o o< - .mooca o5 co »=com moEoocc oooE- .coco o ooox oco .oco »oc. coca oco coo» mcozooccoo o5 Aocooom o5 o: coc3 »=ooxo Esoo 2c; 2 coccoo o5 S. .232 on »oE = .DZ> 20040 KO IOh<>> < ommz 30> .cozoozcoo o accoo mooca SooE Sccoo mcomcE Aococ cov ”ococw- »=co__m ooocé .coos mcomcE ”ooocoooE- omoc ocu S c: 05 9.: 203 $22: no 8: 822 9: 5:2- .oco mcozooccoo o5 Eoc 26c moSmoos. nmcozoococoo o5 S >h_m2m_hz_ och .mcmo_ cocooccoo o5 95. 25: ”226928 9: co zo_h._o~c_ och nococooccoo oc. S >ozw30mmo och 2.wa MI... “.0 02.225 -mm th Oh wZO “.0 02.22.0mm MIh .201“. w20_ho m. of h Em... Ih_>> wzo_ho_h0< hzthOU wZQthDO $3 .2335 coccooo mc_»_ooo ocozmcoEoo oooSoEw $935.50 56336 S. oE: ozm - o_ooco_Eoo ocoE Eoc. oon o. oo »oE coooo Sc ..o. .65 Sc; Ecooam xm< coooo oSoocoqu ooccog - »oco=oocl E uccocol cows. .2 oooc :o» m ocozmooo xmo oco mocoz, co moooc oco Sc? :65. Eoc. coo .toom mcfiSc oco _oo_ooE oco cg; ooooo>oo coc om coco. c_ moagccoo. omoc. mom: oco coca, coc cg; ocuoocc coo oco Eoc. 26cc :o» coco om moogccoQ co_.oxo_o.. oco ocESoS o5 Sc 5.3 oEoc .o oozooca .CSoc »._o>ov coco ooocc: o. coc oc_Eom .xooc coc co S: a5». o_o>o oSocm ocm coco coEmoo ..oc oococo o. coc omoSoocm .c_oo xooc coo moagccofl o>=ooto cooE oco S oco m_ of h .mcozooccoo oco mESo xooo .626. oco 2 2335 »_ooo 2 wococ cocEc moo: ..occoo och .mcozoobcoo occoo Axooo cosos cScoom oc. o. oSmmoS coocaoo »_oo< .c_oc coc cmEc ”cS_o 68 o 5? ..oc co. oooc coc oo_>> .coEoB 2.8 2 05.6.9 on coo coEoooo co3o_ oco mco_o oxozm ..o__Eo.. cco. ocoiooo o ..o .moEomcc oco mcfi: moxobm coSo.._o tow .cim ococ oc. co 2826 S mcESS co>o ocoo on coo coEooco m.coEo>> oc. co>o mciobm Ea: 265%: of h .omoSoEw oo=oo om_o .omommoE _oc_Eooco Em: o oo .mc_xo_o._ of. 3:: ocm g S8 co .mococ .xooc .mcooSocm coc omommos. .8395 g 82 29. 3 89:2 o .2 ago do: Sc co“— oc__omo>>c_oc 9. Sc 95 .»S on: coc o>oo. coo vow: moagccoo. mc_£oocm .moEo oo_ S SS: S moi coEoB accoco. o5 coho ...3 .3 .9. .NF .5 .oh Kai wm_h_>.h0< hZMhZOO szrhwwDO anon ...xoom o_>_on_.. o5 oco mcoEmoo mciooc .585». b. mocooSEoo o>oc .ng -coo oooom : .ooococoEoo ...occoo So» co .ooo .coocaoo o .253 oc_coo_ .ocofi .h HmcoEooo omoc. S 2.8 ».= coo :o» .»__occoc mcfimocooco m_ Sco. So» mo oco. m< .933. cc; mc_x_o>> o.oEo=o coo 3o» coco. mco. o cg; »=o_ooomm .ocooco 83oz, coco. oSco coco ocoom Sccoo coEoB So: coco; mESD ocoEmom mcacoco .m_>_oo o5 cmaocco »o3 m: oon »coo So» 3.2 3380- .o: ococm no» coca, .coaooc ocoE oco coSmoc ocoE .comcobm oEoooc mcocooccoo- omco_o coco. So» 92 mc_x_o>, moon 3o: .oSfimoo mo oco. mo .6 coco. So cmoocc. coEmoo So» omcoco oco .mc_>o..c ooox do So 2 53 .Eoo moo. 5.3 oco »_xoSo ocoE »coc So» o>oc 9 So; So» 2. coco; co“. mcoEmom .So »ooc o5 cmoo 2 oooc :o» coccs oE: oco S. 355 So» motomcoo of h .3895 oco Em: Sc oco cooooc coco. S. 2 So; oo> .ooxo_oc oco so» coca, »__moo oSE »coc So» co>__oo »_cooo._o ___3 3o» oco {o3 Soc o: oo ...3 »ooo So> .xo_oc 2 Eoo. o. m_ coco. o_oot£Eoo 93. o o. »ox och .c_oo oSE So. o3 .EocS oco omcoo oco o3 coc>> .oo»o Sol - ceocoh - coon». - »ococuoi E acccocol ..Soococ oom. o_o»o c_oa-co_mco..coon_ goo; 6o. so: 2633. .< H>mm_>:wn_ oz< «09) mo... wmmzw> mm. o_o»0 co_mcoh-coou_-c_oa oc. Sc; c_o_oxo oco»co coo mm_h_>.h0< hzwhzoo wthwwDO 2.. an .ococxooc So» S to oEoS So» .... o. of oco Soc: .oxcoS S SS. o co 3o...o o o>oc oco 932.3 5.3 oo.o>o.o m. oooc So» Sc. 28 oon .xooc So» co o__ o. 3826:. oco So» a .mEoS So» o. co..oSo...o oooS moococco oco .co_oEo ocoE mco_.oo._.coo $on 8.. 5 22m :2 5o» 5 2363mm .oz_>._-mo_m .Soco. on ow.o coo coco. So> .ooS o. 29. cooc 933 So» omaoo coo oco oSooo... oco mocoS oc. o. cozoSocS oooS So» 5.? mocotoE. of h .»ooc oc. S too 526. oc. c.oS oco »_ooom .oc. .o>oo oco> ScoS. oco ocoo mcScoomoo oc: m.ommo> oooS ..o..oE oommocoEoo mzcoS oc. S Ego; och .c. coco. o. coEmoo hwm0>> oc. m. xooo So» co 9.». Sc. .3895. .Soo. occao non c. »o.o SSE :o» o. .ofiocfioco .oSoSo o>oc :o» 2. non c. »o.m o. o>oc ...3 oo> .mocoSEoE S oSSE oS.oEo._o oco .wmocfiS .o.o. .mcSooS S omooooc ooo c. »o.m .35 So» .2. v.2 on »oE 30> .»o3 ...cmc, oc m. ococ h coco. accoo :o» S. 9:95 .ocz, om: .c_oco 0:28. o c. xoom .m coco oc. S xooo oc. co 26:5 o co ocho. ...oco o oSoozm co ooo c. .coco: ..w .v ..oocoSoco So» o: 2.3 o. .cocmoco oco So» 2E; Boc 0:293 oozoocn: coccoo So» .mc_omo coo. coo So> .ooo .6 So: oc. co Snow .m .v.m.~... -o_ocxo .xo_om .de; -ocaoo ....oo ooE. o ox: xooc mc_coco .mxooSc oco coEoooo S mo.om:E co.cm_. .mc__occ_ o_.c>> .mSo. ..o co .oocv. goo”. 229. ..S 228. 28m 2209. 2. Q :8 8» co...moo 338 __o oc. c. coco co ooo o co 252.... 8.8 .mc_oao oooc oco occo So» 5.? co mSo. ..o co .35. .N mm_h.>.ho< ...ZMhZOO wZO.hwwDO «no... .mmo_o mkoo; :8: co mmoS of. S. .cSo .oo -o. o no om: o. SoEo co c. acts ocooEoE mmo_o o>oI .cSoE So» cooocc. ».3o_m o.ocxm- ..omoc »SS o o>oc So» o. .539: ..o. omoc So» caoocc. »_oooo oco 232.» 225. .co_.oo=coo cooo S oco oc. oco mc.cc_aoc oc. .o 58.5 oooo 567. o oxo h ..cooocm mc_xo_om.. ..o .585 ©5335. ... ..oooooou. 3:89 - »ococuocn. c. acccocoo. oom. .Eooc oc. c. mcESEom .coctoo So» 68:. co .oo ooco>oo o S oSSS o .coocc o - «co; :9» mc.c.»co oc coo ESQ _oooo och .co_.ooc.coo o mESo mc.c.oocc oco »oc. o__c>> coocoo o co .oSSS ..oo..co co co oooooo. oco oocooo mo»o c_oc. ooov. 9 .292 .. oc: coEo3 »coS. “ESQ .ooou. .»coc So» oco :o» coo ooom m. So So» com»xo S omoo »c..ooc och .c.oo co 38. o. ».___co So» S 2.8 »o3o moxo. So no» xo_oc »_co Sc coo oc.c.oo..c So» co mcfiaoon. coococ cooo. 3on .oc. omcoomoc mmocfi o .co>oco oco ooxo_oc oSE oEoooc o. :o» o_coco coo mc_c.oocc So» c3oo @5267. »_ocococ_.oo .omco. oco no» :23 coSmoc oco E_oo oEoooc o. moco. oc_c.oo..o So» .ooxo_oc oco so» coc>> cocoooo. {o3 co_.oxo_oc oco mc_c.oocm Hmongccooh ac.c.oocm . .mco_._moo .cocoEo »coE c. tohEoo :o» 3o=o oco »ooc So» toooom o. o.oc m3o=E ..o._omoc oc. .o .3585 26...»... o m. 955 omoo c. $32.3 .o._omoc oc. 5.3 o: 855 Eoc. achm o.o>o o. momoo;o___o Sto.oo cc oEoc Eot mozxo oEom occc o. oooo m. ._ - 96...“. coco. occao mco_._moo ocacoco Soco goo. ocmSc 26c Soco coco. 2:. on So» 923 SEES 28 ESE So» o. x.o h «cocooccoo cooo S oco oco mcEcBoo oc. .o ocoo on coo Sc; .3635. oco»co moon. mw.h_>.._.0< hzwhzoo w20.hww30 83 smoco cozoozcoo= moooom 582% .5 Eco ofiooco £536: -coo - ..mcSoQ cocoobcoo: mouoom SSocmc. - ..mcoz -oozcoo 8:35.. 96: So .2 So mcoEmoo EoSEo c_ 233 om oo :55 o>oc .96. ...o 8on c. .2859: $05 oozooS mucooSEoo 26: .535 oc_mcoo_o ammo .3o_m o 5? co=oo=coo cooo oco oco caoo m»o>>_< »_Bo.» oEooS no» mo :59: oco omoc So» S>o moo Soon o oooS oco ochooS So» 32m cooo. c. 293523»: no» a .oczoEcoZooE on »oE oo> .29. mcESoS So» :63 .ooooocEQ. S »NNS SQ :o» a. .mcozoohcoo o5 mESo 9:85 no» mo Soc“ oamco. So» ooov. .cSB So» ocho 75.— cSoE So» S Soc 9: o. »_Eg oaoco. So» S a: or: cooo. .»S m_ cSoE So» or »_co>o o_ocxo oco o_occ_- o~o__.co>coo»c »oE Moo; co o_occ_ ..coo- oEs co Eocxov So :65. Soon 823 £35 oc_mcoo_o- oc>> mm: 3: mo... .So o£oo5 9: mo ocoom 0557. o oon 9 9... coEoB 9:8 .2263 225 .225 no» mo o>oE =5, xooo 53o. So> .539: So» c9325 c. 2.35 »th m_ omoc So» 3 So So o. mcfioa E9» 532: So» 39. o. 3.9.. 93: So» c925 c_ 05.:on .»_3o_m oco »_oooo o_occ_ - 35585 _oc_EooooEoo so» 2o... 2 9.585 S mob £5 8: ”8.585 80mm 32.0. ww_._._>:.0< ...thzoo mZOFwMDO PRENATAL PARENTING SCALE gnéwev She—Ur Please answer the following questions. circling a 'T' for true and 'F' for false. 1. 2. Ln 0‘; (0 13. After my baby is born I will need support. (3) F If the coach is the only support. that will be enough. T (E) There will be changes in my life after the ‘ child is born that I cannot anticipate. (E! F There are coping techniques that I can learn in the prenatal period that will help me » after the baby is born. (5) F The stages and phases of labor and delivery are different for every woman. CE) F There are stages and phases that my child will go through after birth that I must be able to identify in order to be an (:> T effective parent. F My child must separate from me in order to - grow and develop. Ci) F The first separation from my child at birth is just as necessary as the separation from the infant at around three months. . F The pregnancy and labor process is painful for bOth parents and infants. but it is pain with a purpose. (E) F There are things I can do to learn about and recognize the ”cues" my baby gives to me about\ what he/she wants. (3/ F If my baby gives me the "cue" of crying during the first six months and I pick him/her up. I am taking the risk of spoiling the child. T (E) If my child needs to be comforted during the first few months of life. the only appropriate . way is through my own individual efforts. T Q5} Not every child needs to have an object (other tha a person) to comfort him/herself. T (E? o 1997 Ann Corwin, 9111)., 23241 Crown Valley Parkway, Suite 5.124, Laguna N1gue1, 01 92677-1400 Tel: (714) 643.9978 14. 15. 16. 17. It is important for every child to grow from being dependent to being independent and eventually interdependent. T F I should begin disciplining my baby from the time of birth. T F My baby will be born with a certain personality and there is nothing I can do to change that. T F After my baby is born. my sex life with my partner will remain basically the same as it was before the pregnancy. T F After the baby is born it is normal to be depressed. T F I will know on my own how to recognize whether I need help in coping with my new baby. T F Continuing education will be needed in order to become an effective parent. -a n1 «9 1997 Ann Corwin, Ph.D., 23241 Crown Valley Parkway, Suite 5-124, Laguna Niguel, CA 92677-1400 Tel: (714) 643-9978 arenting in Pregnancy . . begin a! ”)0 beginning “KICK COUNTING” Effleurage for Bonding Begin a! the beginning by mmmum‘calmg wilb war baby wrougb touch—the may! gem/e tool Menu have to bondwilb tbeir infant PURPOSE: To stress the importance and power of touch as a vehicle for unborn and newborn speech. To help parents feel less anxious about counting kicks by explaining benefits beyond measuring the number of kicks. GOAL To teach parents the effleurage (finger massage) technique for communicating with their unborn baby. This “handSeon bonding” is the perfect practice ground for non-verbal communication. DISCUSSION: The “how-to” of effleurage— 1) Z) 3) 4) to communicate and identify “cues” from your baby to check on the health of your baby through “kick counting” Choose one hour each day to “attach” to your baby through touch Quietly listen to what your baby is saying through the touch-kicks. Their movement is a “cue” for you to pay attention! As you count the number of kicks. become aware of your baby’s rhythms. Help your baby to identify your touch and begin a reciprocal relationship with your unborn baby. Your baby will remember this and return the favor or reciprocal responses at three months postpartum. Touch-identification can also be pracrice for the touch relaxation coping techniques needed during labor. THE IMPORTANCE OF TOUCH In pregnancy: touch can indicate the health of your baby In labor: touch can be used between contractions for relaxation Postpartum: touch can release tension in your newborn and reattach parent and child © 199" Ann Corwin. Ph.l).. 383—1] (Zrmi'n Valle) l’:1rl\\\':1}'.811i1e F-lZ—i. Laguna Niguel. (1A 9311","4400 Tel: (714)643-9978 arenting in Pregnancy . . begin n/ ”.76 bqginning HOW DO PARENTS KNOW... when labor begins? when parenting begins? Permearetaugblbowbrqufiio'gmoflabormdmbwetbesbflklawnadianimEdumabn,ywnoone WmmmbmelemnbegmMuwprgswk PURPOSE: To parallel the ability to identify possible signs of labor with the ability to identify how and when to parent. Each requires learning to succeed! GOAL: To give parents an undersranding of the difference between true/false labor and true/false parenting. As parents long to know how the process of labor begins. the process of identifying and preparing for parenting can happen at the same time. DISCUSSION: Ask parents— I What signs will you look for that signal the beginning of labor? I What signs will you look for that signal the beginning of parenting? Signs of Labor: Signs of Parenting: Water, water everywhere . when mom‘s Wet diapers everywhere water breaks Coming to the realization that the ' Coming to the realization that babies contractions won’t srop, no matter what require non-Stop caretaking, no matter position mom’s in how tired parents get Mom’s emorional state changes in order to Parents’ emorions change in order to respond to labor respond to baby’s needs There is a “rush” or urgency that take care of Reorganization of life to adjust to this business/get things done (nesting insrinct) “lifetime” guest Weight-loss Loss of physical attachment to baby Flu-like symptoms Tired and achy all over from sleepless nights Once the signs of labor and parenting are recognized. the odds of responding appropriately are increased tremendously and the confidence level goes up for parents. © 19‘)"A1111(20m'in. Ph.D-lSHl (Irmm Vallei Parkway. Suite 13-134. Laguna Niguel. (2A93(1'-"-1~i()() Tel: (71+) 6-15-9978 arenting in Pregnancy . .begin n/ [be beginning STAGES AND PHASES OF LABOR Contradomanddflémarebodih’bewm. Ibeyalwyr wme, tbeyoona'nuetobtaldandgrowandas they fadeaway orsqiaratefi’om a mother: they laowa lifelong impression. PURPOSE: To parallel the Stages of labor with the stages and phases of child development. GOAL: To teach parents to recognize the characreristics of each phase and stage in order to reduce stress and see labor and delivery as a training ground for parenting education. DISCUSSION: LABOR, STAGE ONE The firSt stage of labor has three phases or parts just like the firsr year of baby’s life. Phase One: Early labor—parallels immediate postpartum Both are filled with anticipation and the need to resr. The coach's role is to take care of mom and provide support. Phase Two: Active labor—parallels the first few weeks postpartum The mom experiences profound fatigue and physical pain from labor and the new 24 hour a day job of taking care of the newborn. Phase Three: Transition (the toughesr part of labor) parallels first three months postpartum A time of movement or change from one place to another. It is a time marked by confusion and is when the pressure really begins. Mom may get discouraged with her progress, jusr like parents get discouraged waiting for their child to respond. LABOR. STAGE TWO (THE SHIFT) Parallels pOStpartum by the third month. Mom’s contraCtions are now further apart, seemingly easier, allowing her to work with her pain; in posrpartum, baby is sleeping better, responding to parents, making fussy times easier to handle. LABOR, STAGE THREE Separation of the placenta, your child's “physical guardian angel”.* This Stage seems insignificant since the focus is on the newborn... just like those stages in your child’s life that seem to pass without consequences and/or confliCt. As parents automatically focus on their newborn, parental prioritizing begins to ensure their- child’s health and safety needs. LABOR. STAGE FOUR Parallels the firs: year. This stage mirrors all the subsequent stages of development your child will go through in his/her lifetime. COPING TECHNIQUES. Each Stage of labor is as unique as the Stages of child development. If parents recognize these Stages, they are prepared to choose techniques to cope. Ask: What Stage or trimester of your pregnancy did you have the most trouble dealing with? How did you cope? Instructor parallels parental responses with this learned technique that can be transferred to postpartum. Examples of coping techniques: The nausea often encountered in the first trimester requires problem solving for the physical ailments in pregnancy. This is the training ground for coping with potential child illness. I“As described by Balinese mothers in the journal of Perinatal Education, Vol. 6, No. l, ‘97. © l‘)9."A1111(20n1'i11. Ph.D., 38241 (Zrmm Valley Purlmuy. Suite F-lli. Lugunu Xiguel. (2A WWII-100 Tel: (71-1) (145-9978 arenting in Pregnancy . . .begin (ll the beginning HELP WANTED: DEPENDABLE COACH jwtasawacb'smle muslbedearlydqhalforstmbt labor, somwllhalrolebedqinedforsuacesy‘idpospaflumparenfing. Wigner such as wmmmicaabn, touch reassurance, mm, and [aware tbecoacbls keys to sucaass. PURPOSE: To identify the role of the coach in labor and parallel it with the posrpartum coaching required in parenting. GOAL: To teach coaches how to transfer the skills used in their supportive role during labor to develop a concise plan for supporting each other in their new role as parents. DISCUSSION: Identification of the roles of the dependable coach. ROLE IN LABOR ROLE IN PARENTING Watch and observe mom to assess her needs... Lisren to what mom needs... COMMUNICATE COMMUNICATE by offering positive feedback on how she by talking about how she is coping with is progressing in labor. the new baby and reinforce her efforts for success. TOUCH TOUCH either physically or mentally, and recognize to 500the stressors. Recognize what type what type of touch she needs for comfort of touch is needed for comfort, intimacy. and control. or j usr reassurance. ASSIST ASSIST by offering alternatives when she is discour- by helping with the transition to this aged by her progress and help her get into new job of parenting. Rem ind her of a relaxing position to relieve the pain. relaxation techniques learned in prenatal classes. LOVE LOVE provides reassurance and support, providing and respect each other’s newly developing mom with greater confidence and feelings of parenting styles, recognizing that each of accomplishment. you must define your own role as parent. Just as a mom has the distincrive role of delivering her baby. the coach has a disrinctive role of supporting that delivery. In postpartum. mom continues to depend upon the supportive role of the coach. This role can be modified and switched, depending upon the needs of the family. © l997.-\1111C0rwi11. Ph.D., 3824] Crown Valley Parkway. Suite F-lZ-l. Laguna Niguel. (IA 936711400 Tel: (Tl-'1) (145-9978 arenting in Pregnancy . . . begin all/1e beginning THE “FEAR-TENSION-PAIN” CYCLE juslasamotberrqummudadgeabawlbecbangababoayuapmafingmymamforbiw, parmbrquiebwwldgeabowwecbongolbdrmwwwwemndaawd PURPOSE: To discuss each parent's perception of pain and understand it as a necessary tool for survival. GOAL: To help parents recognize their current Style of dealing with fears associated with pain, then teach them how to subStitute their Fear-Tension-Pain Cycle with an Education-Relaxation-Distraction Cycle in labor and postpartum parenting. DISCUSSION: A cycle is a wheel of continuous motion. The wheel, if left alone, will run until it hits a bump. Bumps are painful and whoever experiences the bump mu5t then decide how to cope with the consequences. Fear-Tension—Pain is one of the “Cycles of Life.” In the process of childbirth and parenting, it must be replaced by: EDUCATION I of the labor process in order to ease fear of the unknown I of infant development to help parents undersrand why children behave the way they do RELAXATION I to allow parents to release tension in labor and ease the perception of pain I to give parents patience to deal with the stress of a newborn DISTRACTION I to give parents the tools to change behaviors when faced with pain I to give parents the tools to change their child's behavior when inappropriate The lifelong process of parenting demands continuing education. Parents must recognize what needs to change and deliberately train themselves to do the job of parenting better than the previous generation. © 19*)7A1111 Corwin. Pl1.I).. 383-11 Crown Valley Parkway. Suite F-ll-i. Laguna Niguel. CA 93677-1400 Tel: (7141) (HS-9978 arenting in Pregnancy . . .begin (I/ [be beginning STAYING IN FOCUS Focal Points and Cleansing Breaths Foaesbzgt'rtlabor—arr‘nparenfing—labespracfice, bemwelberearermmaowdwacaonsmlabonjuslasmw. PURPOSE: To demonstrate the need for focus in both labor and posrpartum parenting. GOAL: To practice the labor skills of focusing and communication through signals (Le. cleansing breaths) in order to help parents feel “in control” for the demands of parenting. DISCUSSION: Focal Points— Focusing allows goals to be accomplished through planning. In Labor: When a mom focuses in labor, her perception of pain is less. The focal point helps mom get a sense of control. In Parenting: When a parent focuses on parenting, the job becomes easier. It allows for more control in the family, rewiring in greater confidence. Cleansing Breaths— Each cleansing breath signals the onset of a contraction. In Labor: The cleansing breath is used as a signal. it is important for her partner to recognize this signal and respond accordingly. Each breath gives oxygen to working muscles for strength. In Parenting: Each deliberate breath in postpartum allows parents to get control before acring. giving them time to draw strength to owe. Facilitated Discussion— As each parent brings an eXtemal focus to class, ask, “How did you choose your focal point? Why is it significant to you?” Children who learn to focus from their parents feel more secure. They know when to stop and when to go. eliminating confusion and allowing them to eventually rely on themselves for comfort and security. © 1997‘ Ann (20min. Ph.D., 3831 Crown Valley Parkway. Suite F-lla. Laguna Niguel. (IA 92(1""-l-100 Tel: (”l-1) 6-15-9978 3.6a =5 8.55 co so». 5.3220 coocomooo- .53 59. ca 5.3 9: - .83 8 Sam 28% 2:. »S>_.oo oco cooo. acSo SS. ES .5. neocooSoE. »._o>..oo oco cooo. occoo ocoo on »oE S5 ooSooooS .8622. Eamon 9.. 2 Eco. tooo. of. m... .338: Ease—coo 2.23: 3 €28~ on 22. $23 lnzml.>..._c.-m.>...otmm. . <.___1 o. .958: on. S.— xooo 2:95 .5» ES: mot. S... .9 .So. co cooo 35c. o2... »Ecoo. .m .»S>._oo oco Sam. 5. mosgccoo. ocESoS SobmcoEoo .m .momcoco one... 5.3 oooo o. 26: oco cocoa Eatoofioo 9... ocean coEEoo mcoSSomS oco moococo oncomoo N cocoom coocomooo o S oocoEStoo 9... c8 mco_.oo_oc_ 03.38 c.o.oxm .m cooo. mc.So oSocSoco .oSoSo ocean S 93: oco mEocoo 9.. oNcoEEsw .m .»co>._oo oco cooo. mc.So ow: Se mcoSo cocooSoE Eon ootomoo .v .»._o>_.oo cocoobxo cSooo> oco .»..o>_.oo moooco. .»EoS.m.oo cooo. S cocoooc. .o.o_...to .»Eo.o_ch ”oco moSooooS _oo_ooE 9.32.8 on. SE.» c.o.oxm. .m .moSooooS co_mm_Eoo .ogomoc mezzo. oocomon. .N cooo. 32o... oco .25.. comics 85.2% o... :2 o. om: coo coEoz, o mEoSE»m oco chm .oo_m»_..o o... S 068 5996 .F awaken—.00 :— 330 35:85 »S>_.oa oco Soon on... >¢m>.._mo mmfio .51.“. on 2. SS no» ac... So. 2.. no.» coc>>. «SS. S 39.... ScS ..o .m.coc.o>oc. .oBoo omoo. ....socm »ooo.o.. »co no: no» o>oI- ...coxoS mo... SocoSEoc. o..o.cc.o. SSS; S won. on. mcE. no» on- ....wcoSoecoo oc.>oc coon no» o>oc oco. 3oz- ono» o. :53 Sco_So..c8 o... oo ocoS so..- memo. oco cooo moon mco. 3o..- mmco..oo..coo So» So SS .8261- ”coco. o. So.» ...3 oco .o o: .zn.<..o.ooo. .9598 So» ..oo no» coc>> .co mcSo m. Sc? ».._.o.o oco 8.26.8 omSccoSoo So» ..oo o. oSSoc Sc Enocw no» .ooEoocoo .o oomnSoo oc._oo. So no» .. . .ooScooxo ono_cn o S. SS. m.coc.o.s ».o>o - .ooEoEomv .mcoS .ooo. »o? o... c. 5.53 ncoEo co.S..o> S S. o m. 29.... ..oS. ooS o. »_co ..ooo. c. m. .. .. So So coo »ooo So> ....ooo. SS... S Boo... o>oc »oc. no> ...momommoc. ooxE... ocom coo »ooo So> cooo. c. »..oo. So no» .. oc_ccoSo o. moE_.oEom Eoc on coo .. .< $.09} QT; w. ... .cc_oo..co Eo... occo>ooo. - cocoa .EncooSoo. oc. .nooo ..o. ...3 oz. .»__oc_n. .m. ._ .. 83.8 o. Sc; oco »Smwoooc on »oc. SE. »....s - 5.52.5 coocomooo omnomS ...; o>> .cc.oo._co c. SS. £3 .o. no»: on »oE Sc. oco.So.ooc. oco .moSooooS oco moccno. Seomoc coEEoo .238... 9.. o. ocSm ..ooo. c. »__oo. So no» .. ..o. 3.289... coo no» Soc Sooo 5o. ...3 o>> .».o>__oo oco .ooo. Sooo coSmnomS So oSSEoo o. ocSm So oz, :5th ZOFODDOmhz. ._ $.33 So. E9. oco.Sono »c< mm.._..>_...o< bzm—FZOO wZO_._.wm30 Son .833: o5 o. on o. 8» 25; Bee. :2; 8» :2 :5 2.3.22... at .ooccoS 65883 .m .539. o.oE oco ..oocoS ..omco. mco_.oo..coo .v ..mnE Soon—2 - S58»... 885.28., Ewan 803.39.... Soon. .m .233... o.>.oo .mom .ocooxooo .ooEoco ox..-.on.Scoc. So ..ot oco_.oo..coo SSS... .o .o.nmom .N ..oc_mo> o5 Soc En: S conm o .o So. ..ocS. ScoSEoE o... S 9231 .F Sooo 8.26:2 o5 S cozocSEoo o ..o .oco »co coca. zn.<..o.ooo So» ..oo .m .25 9.er €3.28... 528 2.. ... 89.20 oz. :9: on oco Soc. o5 c. 252. go. »_.onm..r .»o>>o on Soc. oon »oc. ciao m5»... ..omcoS Eoc. oxoc. Sc mooo uc.x.o>>. ..ocSmo. .omo_o .o .oocoS So Sc oo ScoSoccoo. .cocm oco SSmo... »_.onmn oS oco..oo=cooe 10mg ww._oE .xooo o... c. mc_cc_ooo ..oo »__onm:.. »oBo on Eoc. oxoc. Sc moon cBoo o5»... .omcoS So... Soon oc.x.o>>. ..ocSno. .omo.o oco ..omco. ..omcoS Sm oco .o.nmo. o.oc. oEoooo So .SE S SSS... on SE ScoSoccooe «.093 m3”: “oS .ooo. SSS... oco .on... cooéoo ooco.ot_o oc. ..o. coo no» m»o.s oEow Bogoooc oc. o. on 23:» 8» con; 58... 2.3.0.8.. So» 2 .552 no» o>o... ozn.> ww..:>.._.o< ...thzoo mZOEMMDO .»..conoo.. o.oc..n o. .onEoEom .mco..oo..coo o8... .xo.o. o. no» ago... .96 SE» - 23... o. con... 5... coS>> ..oo. o. ».. oco xo_om .o.n.on. moco.nEoE ooco Eon on. oz dn 26:93 .no» ooox go; o. .3... »..oo occno ASS; £20.38 6...... ...... .85... .85.. .5... .85.... .8... 82...... oco .oSono .2 63323... .82 6.9.8.8 »..cm._ oc..oo omoSooco m.o.ooo »._mnm: ..mom... 2 Bo: on coo .. 3 ..oo... c. o.o no» .5... no» .. .ooc. »co. .o »>moc o So ..coo ..oo.o.wooo O-..o.. .85. ..n.. .59... mo.no.. .oo.o ..c..o oco mxoocm Em: .oo o. »oxo .. .. 859.; .38.. 2.2.8.8.. 5..» o. ...... ... ”ocaon .ooo. coc>> .o.o .c. om o. .339. on. o. ooco..co ...o.c.s 26$. 6:... S oooco ooxooo own .no» o>oc - oo.ooo.o oc.om .88....8. 8.8.8.9 8: .oz.x<._mm .938... . oc. o. on no» o.o..on oo.o.smco oco..mono So» mc.>o_.. .omooco no» ocom.oo cooonm »co oco .occmo So... So» 5.? ooco..ooxo oc. accocw common 0. mc.om w. Sc; oco .mc.cooooc m. Sc; @5265. with .N .w »o .o.moo oooE on coo .83 .28.. 9.. .... ...: .88 .8... ...... 8.8.5 co.mcoco.oo< 8...... .coEo..oxm. 8.88.8.2 0 n .v .m N _. on... ..5 ... 85.8. 29.88.. 9.. ... no» 8.... .59... .22. ...8... ..5 ... .8. no» .29... so... toga 93 .oo -.ooc. So» S .onEnc ococo .o.o. o... ooox no» oo o.oc>> me>zb< ...ZMHZOU szFwMDO 2.. an ..oo; So. So... oco: .oo..coo oc... o. 26.. 3o.>om oEom ..oSmmoS ..oo... So» 5255.. o. 3.9.. 2n: )— oco oSmmoS oco... .ozo. coo £82.33 .2 co o>oc 62.. no» .o.mo£mocm .oSoSo o>oc no» = .mco.So.ooE o>.m o. »o? o om.o m. oco 3.2.. no» o>.o ...3 of... $22. 3399...: Soto... on »oE 2 co moc...o...om .mc.ooto oco 05.0.6 m. 528 So» .. oo... o. ono So.>.oo..oc.mo> o o>oc ...3 no> .82. on »oc. ocnomo...n c< .369... on. ...3 oS. ..oo; m.»non So> .oSS.ooEo. .oSmmoS oooS .om.no So» ..ooco ...3 ocw .o.oEom oc..n o .825. ....s omSc och c263 .938... ..oo. So no» 2o cock .oo.n.on. o>oc mocmSEoc. So» .ocScB .o.o »o... cooo .o. 26: .oocofi oco..oo..coo So» con; .mo.m.o__o .mcm... .ono. »_So .oSo ono .co..oc..o.c. mc.»...coo. - ».ofi... .....mo... ... .oon.oc. moSooooS co.om.c.oo oc..nom. .oozESm on o. ..oo: ..co .8... c. »_So. o.o no» .. oc.c..o.oo o. 35888 on ...3 no» o.oc.s Eoo. Soot... m o. ...mno... on ».nonoa ...3 no> ...mco_ooc>> m m.> mo... ».o>..oo oco .3... o... o. EmnoS »._onmn o.o m.o£os. .< ..(tmmOI MT; .2 .... ..o..omoc on. o. oo o. no» 2cm; ocmSc cocz. no» ..o. ...3 3.26.... omSctoSoo och .»m.oco So» o>.owcoo oco 2938 mm conc. mo xo.om SEQ. S .coom coco m. .ono. »..oo S Sos— .nn<.o>>ocm on. S So oco c. oc.=om 9oz o>oc no» 23 oon ..oo... oc..no Eoc. ...oc oco mc.....oom ».o> o.o 28.2%. Sc o>oc mocoSEo... ... 5.3 on. m .o 296...... S5 Sc... coEoz, »co—2 cone... ...o. o. 92% oo. oEooon ....co..oo..coo con; »_co mono.c...oo. 9.53.9 So» own o. ..ofi ....ono. c. o>...o no» coca. om Enocm no» .238... on. c. o.oc..> ooxmo no» o>o... mw_.:>..ro< PZMPZOO wZOFwwDO 2.2. ...... .85... ... 5.... .o ».cmnoSc. ooco..onm m. »oon o... om £92 ...»..on o... 2:. flow .. .. o.coEnoco omnoo coo 52:89.. on... .ooSoo mno.oucoo o o. 389.. .ooo. o... »n oomwo..m uc.on m. »oon on. .o... coo... oSoo .. .cS.coooc. m. o.oc. .. ..co..o>..ooo com»xo mo conm. mambo o. oocoomo. c. En... 26.ch o... 2c. 5258... moon ...2. »ooo och ..coEo>oc. .o26n S... 932 o... m. S... $5.33 cooS »xo..o o m. cS.cooo.2 SS: 2.2ch o... c. 52:89.. »co m. o.o... .. oom o. .oEEE mBo..o om.o .. .».o.o.nooo 29.. «In. on. o.8o. o. ..oo: 933 on. co .o..coE .o.o.. o.co.So.o .oc.o.c. co ooo... o. 3.26.5. omSctoSoo o... 26..o ...3 mocoSEo... o... mc..n.onm .ooSoomnm m. moonmfi .o.o.. .. ocoo on coco 8S ...3 .. .cconooc o.oc. oco .ouco..m oEooon coco oco..oo..coo. .ono. on noon» 0. ocoo coco m. .. .oSooooS 3253 o o. ._ .mocoSEoc. o... S oootno o... $22.28 co...) ....oococ.c.o.. o... 5.2, ono .oc.mo> o occno ocoo oSooooS o.oE... ».o> o m. .. ...ooc .ocoo.o ozmoS oco. o o... 9.8. .o... .coEn..mc. co mc.mn »_.o.o....co 88 2.2ch oc. mo.n.on.. ..m.o.o2, S moo. So» 9.35 .28.. o... coc2, w. 2:... .»Eo.o.cE< .ozowoc oc. o. ooc.Eoo o.o no» .oco ocoo on. »oE Sc. mo.noooo.n. .nmaoc. .coco ».o> ocoo S: m. 25. S269 526. o... 8:38 o. 955 co co>.a on »oc. coEo2. o »..oco.moooo .mn.o.oooo 2 2:5 So 5.2. Sono o>oc. o. .o.mom cooo c.o> So» ..oo. o. 2 co S ooo.mc. ...oo. 5.39... o :96 o.o coEo2. moc... ww_.:>_._.o< hzmhzoo wzo...mm30 9‘3 .28.... ...... 5...... .8... 8.8.... coc. .oc.o.. oooooc m. .oc. ..o m. ».mnoocoSoom ..o.o ...2. .oco. .. oo» o. »oo o .o. oc...o2. oco .co..oo oc.on coco om .mSoc vm c.c..2. :26 .2. co .oco. o.c. om 30”.... 2.03 .oco. o.oSc o.n.on. mocoSEoc. oooc2, 5:82. .3... oc. S Sm. »._onm: ..oco. o>..oo..o omnoo o. ».ommoooc on »o... 58.... ..oo. .c.oo.... c..2, co..ocn..coo c. noon m. .om c.ocoSoSoS .. o.o..o 0. .....8 .. ...... ...... .. coco. ... ......8 9.. ... 2.8.... oo._ooo co..oo...oc. o o. .oo c.oco.mo.oo.n. .omoo oc. on o. 3.3.. .....c. .. ..o.mn._oo on coo ooomoo co..oo.oo... oc. canoc..o .co..oo.ooc. Soc .35.? o.oco... 2 SEE... oc. .o. .So....o oco ..conoo.. ».o> oco .mco..m ».o> oEoooc o. oco..oo..coo oc..o.n oonoo coo c.oo...._ foo; ..oo. oommnom... o2. ..o. 95:58 .o.o. o.co..oo.o ononc..coo oc.mn ».omo_o oo.o..coE o.o »coc .oc oco coEQs och .oc._ mnoco>o..c. o.> coEo; oc. o. ».26... 520 oco En: >. S moo om.o_ o c. no.2... m. c.oo..n. S .cnoEo ..oEm < ..oco. oonoc. o. noon on... oc. .. ..c.oo.»xo o..oc.c»m.. m. :62... .c..>oo 2.2m .. ..Socm .oco. .83 o. .0 Sam. :53 o. 556 .52. o 882... .oS.oc m.c. o>.m o. ».ommoooc m. .. moE..oc.ow .mco..oo..coo oc..o.n momnoo .oc. ococcoc o .c.oo.»xo momoo_o. .oco_m ».o..n..o. »ooc .no» oc... .oc. .< o.oo ono So» ocno.o ocSoc »..onmn Sam. .88. ... 8:88. 3.8.3.. - 58.... ».ommoooc 53.... S own oc. oxoc. »oE »Eo.o.cc.o .9829. h ..oo..oo.o _o.ooc. .onon m. m.ch. .co..oo..c. .55... o. .o...o c. .oSoc on SE...» oooS o.o. .mnc. ».o>..oo .coxoS m. o.o.os S moo So» ooco .om.< .cmE m. ..ooc m.»coc oc. coc2, ocoo m. »Eo.o.cc.o .. ooomoS Eoo on. oco omooSS »oc. o.oo .oo...cc.n och ..oco. occno oooc m.»coc oc. co.cmno mo.oc ooo o..o.c...o oc. c. ...n... oc. .oc. o>o..oc »Eo.o.cc.o S 8....0 ww.h.>_h0< ...ZMhZOD wZOFwwDO «V2 ...o.Eoom.o oco ac..ooc c..2, o.oc coo Somoo...Eoo ES). .ooc coc. mommanoo oo. oco co..oo.oo.2 .oo..ooo. on coo oo....oSSSo oco ...3. ..< .22 8S coo 9....an .o. co...moo futon. uc.ococco - »..>o.m ooom o 2:. mc...om oco 3.8:... So: o.>.oo So» mc.xo.om ...o .oSco mommoSEoo c..o2, c...» 8.8.2 o. Enoc..oo oc. .. »Eo.oS.oo .o accoo. o.o>o on..oEom coo coEo>> .cS.oo. .o wnco oc. ouoEoo o. ».o..._ So. .9. So .mc._ooc o_.c..> 5.58m... o.oE omnoo coo .. So... oc. co moSco co.S.oc. m.c h - .o.o.o.o.oo.2 .c .Aco..o.ooo. ooSoo o.o. onco oc. o.c. oco.xo o. »_o..._ 99.. om.o S. SS .»...o.no o.o... o.ooc ..n.c.oo moo. m. .35 oc. o.o26. c260 .cm.o.S moon .no of h - oc..o..2 .o .»c.o.o.m.oo S moo». o2). o.o o.oc h ...oco. 2:. on no» o.o.oc. onmm. oc. .nooo 2.2.2:. om.nc..o.ooo So» 5.2. ...o h .»m.o>o..coo SS. o w. 29... - m.oo. SnoocoSoom coc. oooEoo o.oc. ownoo mo.Eo.oS.oo .2. 3.3.3. o>oc mo.onS oEom ..ooSSEoo m. oc._ooc o..c2. o>.omm.o .oc. ooco..S mcSn ..o..ooo. o.o o.oo. oco »Eo.o.m.oo c.om. .»c.o.o.m.oo oc. coc. ..ooo. o. .oo.oc o.o .oo. co.S o.o.ooo co.c.s o.oo. SnoocoSoom .co>o.o coo .. 535.2. .cm.. o cano.c. »coc o o.oc coo ._ .moo.S.o c. m. »coc oc. .. .cocooc... on coo 5...; £23.... 3o. o on ».o>..oo ooooo coo .no och .c...c o.o..oc Sn. @5ch .oc.mo> oc. moo.o_co .oc. oSooooS .ooSSm coEEoo o S. SE h »EoSSSm .v .bomwoooc .. 26.5.. ..oo; So. oommnom... 2 8.8.8.... .2... 0.8.83 ..o. ww.h.>.ho< ...ZMHZOO sz.hmeO «.52 .coEoSoo ».o>: on 8.8.5. Ennoo> .».o ->..oo 3oo.o.. o.o.ScoEoo 8...... .. ooo .o.oo..xo Ennoo> oc. o.oc2. o.oom oc. co 9....o26 ».o.3...o. 5.2. 52. on »oc. 333 38.8 coc. »coc oco .oc.o... o. »S..c. omnoo o. ».o.... ..oo. »..on.oo m. .o.oo..xo Ennoo> och .c266 oooc ...»..oc oc. oo>oE co.c.s ...3 oc. co 2S3 .o.ooo oc. .co..oo..coo o mc..n6 35:3 552.. oc. o< 6.333 5.8:... oo....ono .oc. ocSo Ennoo> o o. 3.358 oco oooc m.»coc oc. S oo. oc. o. oo....oo m. 38 < .3oo.o. o. o>..oc.o..o co S. SE... .o.oo..xm Ennoo> .»EoSSSo co oooc o. ».o..._ o.oc. o.o o.ocSc. och .ooo. oc. co momSS o>oc »oc. 38.2 »c 6o.o>..o6 o.o oc2. wo.com .oSocm .. mo o.o.o. .oc moon oooc 933 So» .oc. con... o.... 3.8:... .oo.. o.>.oo So» xo.o. »oc. oco cmno o. ooS oc. moonoo. ..oo... .oSoSo och .».o>._o6 33.8 o ..oo: o. »_o.... 22. o.o oSocSoco .o.n6.oo o>.ooo. oc2, coEo>> ..oooc 933 So» oco oc.mo> So» 2 E.o..coo o. 333 5.3 oocmSoo o.o oco o.ocm .oc o.o »oc h .35. 8.3 So... o.... ..oo. 3oo.o. och .oocoSSmo .35.; ER. on o. co...moo oco...» oc. c. .o o.o ».o> m. oooc m.»coc oc. .mc.cmno onc..coo o. o.oocn m. .268 .Smo..m.o .o.o.. ».xoSo cooooc o. moooc cc... oc. .. .oco. S oooS 3:333. 38$ 9... occno ».o>..oo .oc.oo> o occno noon o.o 3552.3. .93. oooc h 38.6... .m ..no »coc oc. @552. SB o..n.. o.o »oc h .»Eo.o.m.oo oc. S mc...no oc. .oc oSocSoco oc. S co..oo..c. oc. .oc..oc oo..o.. coc.?» Sos. .89.. m. »Eo.o.m.oo oc. 222. 3%.. oc. ccSc o. o..ocSoco .ooo. o own o. ..oo: »oc. 8.26.... omSctoSoo och ”whoz ww..:>_._.o< hzthOO wZOFwwDO ...qu ..coSooSoo ».o.o..omo. mo con... mEoSoS 32.3 o. .oco. 293:. So. .3332. 3.28... 2.9:... on coo o.och .c...c .oco »coc So» .ooto »_cSooo coo .oco. accno co>.a oco..oo.6oc. »co—2 .h ......88 ...... ...... o... 8.6.25 .....o..8..8.2 ..oco. o.c. on So» o.o.oc oco..o6coc.c.ooo. oco mooco..3xo ..oc. oco mooco.oS.o So» zn.<..o.oo.o So» c...» Snow... oSocm no> _ 82.8.8... .... 68.9. »..on.oo o.o o.oco. 3.8 .2 .o. 2933 oco o.co..oo6 m. .. .. co..oo...oc. Soc...» c...c ooco..ooxo o. oomoSooco on oSoco coc.?» o canoc..< .».oco. oco m6.ocmo.c. c.oo ..oc. oo 0.... oco .canoc. ..oc.“. 85.598 5.... ..oc. .o. o.oom o.coEo>> .oooc »oc. ..o on 0. 33.58. .cc.c6..co .o.n.oc.. oc. 6:: 5:62. »cos. .mmoooS .oco. oc. S c266 9.26.... o: oco .oco..oo.6oc. 53 ...o... o.ooto ooS S oocomco oc. S omo.co>oo oc. o>oc .mono.ccoo. mc.c.oo.c oco co..oxo.o. ac.6n.oc. .moocSE omoc... .mco..oo.ooE own .oc o6 co.c2. o.o»o .c.on.-co.mcoh..oon... oc. ..oo... o. m»o2, Soco mc.c.oo. coon o>oc no> c.oo m.c. 5.2, 38 o. SEQ... S. ....»o2, »co... o.o o.oc. oco ..n.c.oo »..onmn m. cc.co..co .< >mw>..._wo DZ< mOmS 02:50 “EDMm 2?... m0“. wZO_._.<0.0w—2 .oSocSoco S co..o.S.c.c6o oc. o. ono o.oc.S o. 235 m. oco .. oc.S c.oS o. .ooooS oco o.c.o.n o.coEo2. oc. o.c. oocomc. m. ocn. o...oS < .88... 2.. ... 8.8582928 .. o».o>._o6 oco .oco. mc..n.. oco..oo.ooE S own on. .38.. 2.2228... .8» .>_ 5.2. oo...o. no» S »co o>o... wm_h.>.._.0< hzthOO wzozbmao .2853 .82... .....zfl 85.33.... 5.832 .2825 .oon.oc. 6.250 S ooo... c. noon on »oc. co.c2. 3.623 93:32.. .oc.o ..noc oco .noco So. oco 3.3.... o. o. m c. 9.52. co.c2.. .2 co c. co>.m on om.o coo .. .mSoc v o. m .noco .o. ...3. S..o. c.on. .».S. ...o2. o. 3.3.... cm o. ov moxo. oco 3E oc. c. »..onmn. co..oo._c. co mo co>.m oc coo .. ..oco. c. noon o..oo.oc coEEoo So... oc. .... - .o.oc.oo .mo..oo.oc o.o oco..oo.ooc. omoc h .6.ocoo.c. c.oo .oc mcSooSc. »c .523 32938 oc. o. S._o. .o...oo .oto co.c2. oco..oo.6oc. omoc h SoSoro< .o .00 30> u: 5.4.30 ..wwu. ....200 ...:m .h. ommz 30> n: >..ZO 29.5.0522 mm: ..no »coc So» cono o. ..oo: no» »m.oco oc. c.omo. o. no» o.oc coo 53 ...o.. S..o. oEoo mc...o0 .9383 Sam. ..no.t.o o 5:25 5:62. o o.oc coo oco..oo.ooc. .ococ .oc.o oc. co .omco..oco ..noE... o 3.23:. Soc oco canoc. mo 23.. oco »_xoSo c.oo .oc o.ooS. »..onmn co..oo.ooc. oc .o .oc..c.E 3282 E2. coEo2. < .omoE....om .oc Soto coo cc... ooco coEoB o »o2, och .m .8. .»coc oc. co .oooE. co o>oc coo o.ooto oo.... omoc h .»EoSSSo .».o>..o.. 38.2 no con... oco..co>.o.c. .oc.o .o. ..oo: oc. ..oco. S :32. 8.26.» .333 62833 6.333 coo... c. 30.6 o mo conm ...o2, So .oc.oE oc. c. o.ooto oo.... omnoo coo oco..oo.6o_2 N ww_h.>_ho< hzwhzcol w20.hww30 .6o.oS.c.c.oo o. 32.8 30...: co.S. mom o..ocSoco co oco .oo.c. o..ocS... oc. c. oooo... m. ocn. o onc h dooS 0. Soon com.oo oc. oco coca m. .oc.o.c3 EnSom - >. .Smcn. o.c. o.co.coo cooEoS oc._occ.. co..o..ooo m. Eo.co..o .o. .o..co.oo SSS. .ocoo on 653 oSocSoco .ocoSo. comoo. 3.3 .o. .. .o »ocoo.oc.o co ».co 26c ocoo 2.33 S. SE h .ono.omcoocn »..oS. - oooS o. .oc.oc. mSn. oSocSoc< .3396 .h .cocoocoo .o mc..o3 S 30. o.o.oEoo .o .o...oo o moonoo... - o.oocSoc< .».o.xco o..ocSc. .o26. o.oc oco ooonoc .56... o. .com.ococm .o ...oS.> mo conm ..oN._.noco.. o c..2. oox.c. o.o oo..oo.oc oo....SEow ..coSooSoo ».o.o..omo. .338: 3.93 o. ».ommoooc .. »..oo o. coca on coo coo.oz - co..o..omo. 683.33.. on... oc. S Soto oc. Soc: 222. cc... .oco :26 3. co 9.53... o..... ...oc o Soc .. .oc. 633.3 on oEoooc coo »coc oc. mo .89 c. o.o. ..o...o>o om_o o.o »och ..oco. S 3823 oc. 26S coo »oc. mo »co..o_.6 .Eo v o.o.o... .oco. c. »..oo oo. co>.m .oc o.o mo..oo.oc »..onm: ......ooto ooS oco .mmoco>..oo...o 62.8 S c.oco. .... Soco ..m< ..o S23. ...2. So» .o..omoc oc. .o oomn 2.3.3». S. SE... 3.26.... 3.32286 :26 So» .S< ww.h_>_ho< ...thzoo $20...me0 3...... .2965 ..oco. S ouoS 6cm oc. .o. ..ooooS on coo co.. -o.S.c.c6o co..oo.6oc. och. .».o>..o6 33.3 .o. ..oo: oc. oco »EoSSSo .om.o_ o S ...... ooooobc. co m. o.och ..no »coc oc. 6:33.. 3.35... o>oc »o... m.o.no.oo o>oc oc2. coEo>> .o .53.... .3 ..oo: oc. omoo.oc.. ..oco. c266 26S o. ».o.... m. .. »..oo oo. co>.0 .o.o.o.....coo m .o ... o. 6o.o_.6 Soc coEo2. o ...cn coco oc .occoo .oSUSo c< .6 ....8. 6.... 8 ...2. 5.... ...... .58 ...... .88... .o. 3235.. on coo co.c2. oSmmo... oco... c. ..o... o m. Soto o6... coEEoo So... oc. omnoo on 2.5.38 3.3.5:. on ...2. 3:33.. ..oo... .o... .....o2. .o oco.» Sccoo. ooN..ocSoco o.o moo. .oc omnoooc ooc S .no So o. o.co on .o: ...2. ocw .oc..o..coc. .33 o.co..oo_o mnonc..coo oco >. co o>oc om.o Snc. oco ..o.no.oo co o>oc o. 3:9... 3... mo6.oo6 coEo2. o ._ .o »..oo .o26. So» S 38. o>.oc oc. moc.oc o..ocSoco S 26: mnonc..coo o oco ooo... c. .333 m. .o.oc.oo och .28 .33.. oc. S mc..o>oo oc. ooSSo .2. 6.8 .oc.oo oc. .ooc oooom .o.no.oo oc. o.c. ..ooc o..ocSE oc. c. 2.33 ocSn oooo... m. .32. .o.oc.oo »c.. < .».ommoooc m.....m .o.ooom oc. Soc oc2. ......moSSocSoco .353. o »c oo.oS.c.Eoo on .3... .oSEQo och ... .coEo2. Soc. .3 .23 £3 .co._ooxo - .. SS3 »_6.oc ocm .nc monc..coo .oco. o..ocSE oc. ..oSo...o .3383... o c..>> SS2. oc. 26.3. co..oocom .o: .o 2.... £3. oco Sc .o.o2.o oco o..o2.o «c.oEo. .oc.oc. oc. ..oSEQo co c..>> .o oSocSoc< .3263". < - o.oocSoc< .oSBQm. .N mm.h.>.ho< hZMhZOO mZOFwwDO ..oo: .0 E96... 2 52¢ o.o 3.3.. >— - 9:32.. 303 c. 86 o omzoo coo o.ocaw .2832 293 o5 26.6. o. 28 8 c8 5.3 Ba... 3523. ..ofimommz .oc.o». o So ..oc. coca; S .xb >.o.oE_xo.&< .oEoooE o5 omobo o.oScoc cacooSoc. oc. S moo. cocoofioc. moo. 5.3 $35.35 85.5 o>.m oco .2328 co coc. o>.m o. .o_moo o.o o.ocSm .oo..o>_.ou 33.0. oco 2283-0 .0. o.oE vow: >..oam: o.o o.ociw .o.oBo oco oxoBo mc.oEo. .oc.o—2 .oc.o...a. oco 3235:. m. x050 o.o $.38. och .oooa c. to. m. .o.oc.oo oc oco ooco oE...oco o oozooo. coEoz, oc. Sc .9223 co mo >95 oEom oc. c. uo.o.m_c.c.uo m. c .o.oo .och oc. ocSczocao ooon oc. 2:. 282.0 o..ocSoco oc. S co.SoE. oc. 8.53. 98535 .oc.o.w .m o..oc.ooc< .ocoaom < - o_moc.ooc< Scam 52.3 2 5.83 coo.omooo o moooc coc.?) o .. vow... co.S o.o o.o.zgam .o.oc mc.c.oo.c o.coEo; oc. c..>> o.otoE. oco oooao .2:an oc. c. cmE o. oo.. mossocSm coo o.moc.moco och ...ocoooooc .ocaos 293 o mcfiaoo .23.. .ocao oc. mcfiooco ocoSEoc. oc. oo.:Scaa >..oSouSoo .8:on oc. 8. o.oooc oc. gm 53o. »..ocofioooo .Sc o.o ocoa .oc.o oco uou: -occmoco o.o coEouco o5 S otoa 2.8 SE ac..oo. o acfiaoo _o_moc.moco ..Eofia. o>.ooo. coEoB oEow 2.03 oxozo Sc on £8:an mm_h_>_ho< hzwhzoo m20.hmw30 :3 E30... fin ”o.o ..oc.... 0c00ow o.30c 3.2. ”.003 6.... 6c.oo.o>o .o30.>.0c. o. .oco. S 83 och .ooofi of. c. E3» on ...3 .oco. c. oc... .30.. S .35. .x.>.oo oc. S .coEoooto oco 5.6.... ..3. 0. .oco. S .och - w0 .. 0c.c. .30> oococo coo 30> .336 .30.. «.0333... coo ..oc. .oc. 0o .00o. 0E. 03 .30> o.o.oc 3055.93 .30.. 35.33:: .oc..oc .oco. oco 233.9000 .30> o.3m om ..ooaxo 30> coc. - .o.moo .0 - 80.2 on ..oc. .00o.. .33 528.09.. .300... 0c.c. :30 co aoov. .>mw>_..wo oz< ”.09... 02:50 wzo_h Ih_>> v...> ooco.o..o.c. .oom. oc. o.o..o o..oc.ooc< .ooo. .ooc..on. .m ..30 Eon .oc cm33 0. >....co o..ocSc. oc. c..>> o.otoE. Sc ooco >..o3m3 o.omc.moco of h .o ..ocS oc. c0 coc. oo.o oco co .m... o>.oc .ooco033 oc. 0E. o..ocSoco .80. o 98?. 208: o... S 3.. och .oc.mo> oc. c3305. 203: 3:0. o 5.) 32m 03. c. coco a. x00... .3502. < .c .c0..oo..xo c.33oo> .0 bo>..o0 38.0. o .0. .0 Eco >Eo.0.m.ao co .0. oo.o .ooc..3 oco oc.oo> oc. 053: 0. .oco. S oaofi 0cooom oc. 35.30 com: >.c0 w. 23535 .3062 .0 5.0. m... h .o 0.005 .3502. .v ww_h_>.h0< hZMhZOO w20_hww30 3.33 32.5... .58. .8 ..oc.. 828 c0..oo..c00 o 3 533 0. coc.; 305. .oc .o. 0. .3533 .03. .0 3.35 30058 :0 »_o. 0. 03: ...3 ocm 30.333 Q35 .3. .oc ..oE oco .o.3c.3co .o.30.3o 0oc 3c 5503 o ._ $000 .oc c..>> >.o>..oo..o 35.00; o. 3503 .oc. c3.o o m. c053 .o3o.m 3.5 35.30 .co0.3 0co .c3.3.. 350.5 ..cos. .5o3 ..oc. c330.c. c333 0. 350.... o30=o c0..o>..05 of. 0co ..o>0 .35_o m. .03.. 3300 3>05 Eon oc. 3 .35....39. 0co ..35co.o..m.. ...o.3o3.3.. ...35E30. 3 03.530 co.S .omco.5 o.o 35.3. och 3.3. 35... .0: 300 35cw33 .3503 .oc.o .0 ... ..o..o. 30.>0.3 0co 0003 23. 35533 .3503 9:3 .0 H. .oc0..oo..c00 35.30 .3533. 3505 oc. 03 .3355 03. .33 .303 .oo..coo 0. 335.c0o 33.3 och ..30 >03 .oc cm33 0. 9:03 >_o>..oo .oc.05 oc. .33. S 39.... 0:3 oc. 35.30 E03380 o 00 0. 3.93 35533 ..coE. c035 .3 80233 N c300 03... .. coco 3.. H. .33 35.3.3.3 933 oc. .0 ..o3 >000 03 8:3 52.838 55.32.50 52.8. 9.. ... 85.5.28 8. 38 o... .o 8.8.88... 9: .mc0..oo..c0o 3.3.3 03 .3835 .oc.500co 03 535350 .oc c..>> 35:33 3505 .0 3.353500 o 5.3 83000 .5330 3.380 350.05. .0ooc o.>coc oc. S 33550 .333. oc. 0. £23 @505 .0 .o.o5o.0 .33.o_ . oc. 3.3055003 03 33030 Soc 9... ..00o. 35.30 ...53..o3.33.. - ...... 8.32.2 8.8.. 09,83. - 353 15.30”. ..V .855... cm 2 m .88. 988.. o... .o 582.8 9.. - 35m 9...: .m .239. m o. 85...... m. . .58 9.. .o 5.... 2 x58 2.. .o 8.8.... .3. 59. - 353 02003 .N wm=h_>_h0< hZMhZOO szmeac ..co5o3o.300co S o.o. .oc o>.3 03 93.30% 03 03c o..oc.05 00333.». coo 35.3 .03. och 096.2 533.33 03 032 03 ..30 3603 ..3co .oc c0 55 .oc .33 o.o o.o0_30cm 0co 03c m..oc.05 9.. .9385 9.. ... ......88... 88 m. ....85. .9. ..o 88.. .oc 0co 33 03c 9.3.05 oc. ....) c0...33 ..o. 33 00:30 < .303 35533 .30.. 5.3 5.03 0. >..>o.3 950.3 65.3302 30.533 3:533 5303... ”cc... 0cm .3553. .0. 302.33 .c.0c m. Eon. oc. 3 2.33 c333 .0 .30... .053... 0. 32.350 92.2.0.5 3.35.2000 .30.. 30:0. .c0..o3oo 35E3c oc. .oo. 30.. 03 o53o> .30.. 03.90 0. 3.33 03c 9.33 .30.. o< .oc.ooS 3533.0 0003 .933 5..., ..oo .30.. xo.o. 0. 0.3 on .33 c0..0o..c00 oc. m< .2830 3:533 3003 o .0 3 oc. c3330 5 >..c3.. 3.3.3 .....3303 .. .53... o oxo. 0. 3505 055o. 0. 3.3 coo 23.33 .03... 30:000.. 3 0. m coc. 33:0. 0: .0. .30 .53.. £3. .oc. .. 53.0 .30.. 0.3 35533 2.55 .0. 30> 33.3 >000 .30.. 3 533 5.3303 m. >50.0.o.3o co .oc.ocz. 35550.0 m. 03c o..ooc 3. 3 3.30 ...3 o......0.5 o835.2000 och .30.; 30> ... £3000 .. 3 >.0>..o0 oc. 3m coo 30> .oc. on .055 .533 o .0. .34. .236. 0.00.». 5.3 0390 0co 033333 5.3 0333 w. 533.33 o.co502. och .33... 500. .>.o>0oo.->.o>..o0..0co.... - 500. 33 oc. 5 .o..33c 3. 5 00.33 .03. o...co .30.. 0333 ..oE 30.. .0 ...500. bo>..o0.. .5003... o 0. 0o>05 on ...3 30> .2001 >mw>_.._mo ww_h_>_h0< hzwhzoo wZO_hmmDO $33 .m...c0 2.. 33 3.3 ...3 co.c3 22.3.0 533 33.3 o0 ...3 30> .o5.. :05. o 35.30 33coc0 300352. 083.333 3c >000 .30> ..o5.0c >.o> m. o.c h .>.0>..o0 .23 >.o.o.0oEE. 03 .03. .0 32.... 053.... 05 35.30 >000 ..o5 .0 353cm :26 03 3:50 30.333 3503 >cos. 33.23 .30> 3.3. o.oo3> 000.0 o5 ..o 33.0 03 23.300 33.23 .30> 3 m>o0 3.33 .0. .0. o 2.30 >..o53o> 03.0 ...3 30> 02.030 o0 ...3 233.3 000.0 .30> 33.3 35x2 m. c0..3.0>5 233 235 0. 003335 o0 ...3 3.23 .30> .353 3.93 .0. >.o3.0 0oco.o3 o.o >30 .30> 03 30> .>.0>..o0 .2.< .>.o>..o0 .23 20.303 3 c00m 3 >30 .30> 035320 30> .oc. 035503. 2333 35035323 .33 2 5300 03 .3550 2 33.23 .30> 33.3 83 3c.0oo..3o.m .ooco..o3xo 35035320 .3. ..oc. 2 2533. >.o> 0co >.o>..o0 .2.o m.30c 3.93 .0. .33 >.0> >..o3o3 o.o 3.33 .30. .co..o0xo co m. 500. >.o>..o0 3. c. 0..... 3500 .c0...0c00 0003 5 o.o >30 .30> 03 30> 03 >30 .30> 035320 0. 33 30> .. .0o.o>..o0 3. 233.3 3. 3 .3000 ...3 30..3..c00 35.23 0:5 03 .550 .0 3.355 >55 55.3 2333 33.23 .30> 50.. 523 ...3 233.3 .30> .255 3500 c. .333 .30> .350 .0. 0.00 35:05: 3. .30 ...3 2.30.5 3.35.2000 3. .500 m. >30 .30> .23 5.05 .500 3. >30 .30> .>..30 .30 33.7. >30 o5 .0 .3. och .o3.o5o 0.305.. m.>0o0 o5 .c0..3..c00 .xoc 9.. 5.3 .83 50> 9.8. m. .53 9.. .. .83 ... >2. 3.23 05 35.23 o.o 23.303 0c. 3330 3. .oc h .o0.m oco 0. 23.33: 3.3. ..00.. o5 353. 33 3c >333 553 .33 och 0.3.. 2.5ch 03 3035 .0. 035.033 o0 30 30: 03 5305 o.>0o0 3. .oc. 0» 35333 32... 2 30> 0.3 ...3 2.30.5 3.35.2000 o5 .0o.o>..o0 m. 33 o.>0o0 o5 m< mw.h_>.ho< hzwhzoo wZO.hmm:O «a 3 2:3 29.32 .2 339:8 .65. .8 - 52$me .55 55 35mg - .95? 86:85 en 822%“. .65 was 5:53 22: >58 2965.3 5.83-0 «.3255 .m $5305 303 :9: .390: .San .3896. 6386 two: @2833 mcozficoo .mofioE 9.059: 9:. mcozumbcoo ozuomtmc. - 82905 2 9.2%“. 6:633 993 @538 522955 982: 9: Eo: 8.233 5:806 mcb 2522 358.1 .o :3 MES 9: 9,83 25h .mEmS m5 .0 tag 83: on. E .0 32m... 528 Q: 83 8280. m. 9583 05.5 m_>m..n_ .25va .m Boo 33205 .v 35:30 223 9: 29:95 33 2 5:53 0:23 05 E 5 69m. 8. 2 82 aka anv coEogoama 2282280 m 3266 .Eou .N $2939. 5 5328 5:63 .mctocn< a Kai ”80:85:. .38 on. .o .552: 9: 598cm EQE bo>=mu .269 5:3 950 m_ = «0:00 cozomw 59330 a m_ >c>> .m .55 .865» m .0 $338 on. .2 Samoa 2 Batons: m_ z 8 65: B vmocm vaccma .oc 2m mcozomwé $22 682590 5.5qu 33883 new 9:63 m mm 53 .3 2:05 .- .w.: on. 5 3283.0 96; c0503 9: 5 mac 20657052 .Agcozoom -0; «:69 9: 8395 can“ .652 60883 05 c. 56.05 cm 5395 8.52.3 m_ Bun m 533 5 5:8on as. m. “cozumw 599.30 .< 15.15.0430 z ww...._>_._.0< PZMPZOO w20_._.wm30 an at 9.9.... >330... ...3 E9. 9.... 69956 new 3590 m. ._ ooco 39. 9.. v.0... coo .9.th .59. oco .83 m. .. 3cm >.9mfioEE. .59. 50.. wow 2 man 9. ...3 30> .NP .Eon m. .59. 9.. 3 20.523 @532. m .09 >9: 30> .8555 we - mm Scam 8.3. 5.... 5cm 95.90:. 9....9: new .mc.Eounm 9.. mc.co...w .3558 :9 o. 9: >.co mmxm. .539. 52308 < .2 .58 988.8: m 350.. .mmficomBEm mEmio .8 69.0.3 m. 9.3 052. 9.. m>onm .8. o. .92 m5 25.8 .3. so... 828. - 28.33 8:22 SEER. .moE - 9... ...9. 0.9.5 9.. 30.9... .9... 5.90:. .9535: m ......xfi... 3.65:9... ”39.... N. ova 5.90:. .9 .39. .30.. .888 «62. 90...; 50> .m>o amen... ...3 mmamfi .mo.9:w .m Ema .869: 9.. 2 £9 £2. :8 30> .89. .50.. 59. ..m .6 95$ ...3 9.99.. .bm>..mu 9.. .m .535 9. ucw 350.0 .355... co .2. :8 55.9. Sam. .30.. ....mam: Socmmasm 293 m m. .. 39:... .m .695 9.. 26.9. 9E3: ucm 3......9. .2. 9.9.6 9. ...3 30.. .932va .o .mCEm m5 c..>> 9.9.695 .Emcmm .o .9523 cm ..mcam ..9....m 9. ...3 3m: 93535. .n .mom... c. 9. .9: 5:58 .99 < .303 59. .0 69:00 59.6 6.3395 803 .99 .59. 50> BEBE 2 Eco. 9599.0 9.. c. 82.60 85:55 .0 59.5: m cowsm ...3 6.8.0.3535. .0 E9950 3% .m .383 base 0. .9928 East: ..V >. .m cmxm. 9m moEEmm 9...: van .505 .N 99.8; new 85...... 9m ..9. 052. new 5503.4 4 .2332... .933 2 .22. ww_._._>_._.0< ...Zm...ZOO wZO...wwDO 3:29:95 Ecemm a 38: .88qu .83on - xemcuen‘ s gfiemm 08. 35.59:. E 95:.ng 2639. van moagccom. @5585 3033". .2ch 5.5 9563 ..o 8.50 5.5 :93 .o .52 93... :33 new .659: 5:32 a 5 9.532 5:5 33 m m. .359: .o ozgccoo. m5 .0 «3.939 .mmocmtoaxo 5.5 ..o he flow 295:: 9...? .m_nm__m>m 3:05 toaaaw 2m 99:. .33: g Scam 26ch... £2 2 29m 9.6m .5536 m 9.3m; Eta 33053 new 3.50336 .3. :oEQs mEow .m .33 50> 95:352. £5, 99. ~00 .uommEoocm new 0.933 m_ 0539635 N .333 33 .2: an. E >8 .3 we: 95 2 “Ema :38 can a: 3:. at: .m6m_no >23... E. .0: on .5302 9 «mm. com: 30> .220: .2 5w... mo“. z<._n_ .m 22.62 - c8 - 235 3922 mm - 55 .m 22 ...; 83m; - ES 80 .v a. on - sea a. 92 53 b2:% 5cm :08 in; van a: 6m 2 38585 on :5, 30> .m E 9.9 - m3m=m>m cozmofimE Ema. .N Q65 >3 3...: »_mfiéxoan? .F .5509 9 50:2 9.9 :5 a new >593 fiEEoBm BEE um: 96: 30> 65 89589 .38 30> Sn HEB .269 m o. .m__E_m >..? 2m mmmcmco Estuaumoa cmmhmmmmo .o E 2 a: 2m Ema 50> new 30> mm :08 mm 892385 259.8 m_ 9.502335 .3 .gc: bm>=ou new Sam. 05 co Eco. 50> 2 “Eton—mam: on 53 30> .mr .cozomwé 3 nemzfiu :03 96; on? 353 .2 3.0395 @5535 3 xm: 33205 :m m_ 905 $38 on cozmtomno .8 rows: 28 .90QO m c. 9:: 9:8 wm_._._>_._.0< PZMPZOO wZOFwwDO arenting in Pregnancy . . .begm all/1c bqqinm‘ng DECISIONS, DECISIONS. . . MEDICAL AND PARENTAL INTERVENTION jmtaslaborisanmmm, wispamzfing. Cbokasandrflsmpaflofbotbmdbereisnome ‘hgbt"waybdodlbat PURPOSE: To diScuss the necessity of making choices in labor (such as medication intervention in pain management) and making choices in parenting (such as feeding on a schedule versus feeding on demand) and how those choices affect the outcome of the delivery and the family. GOAL: To help parents weigh the intervention or action againSt the risks involved when making decisions in b0th labor and parenting. DISCUSSION: There are risks involved in both the birth process and in parenting, but with preparation and education, informed decisions can be made. THE CHOICES... THE RISKS During Labor: In Parenting: Medical interventions are necessary under Parenting interventions are necessary under some circumStances for the health of the some circumstances for the health of the mOther or child. There are possible compliv family. They range from Ieaming “when” cations with every type of medication. If the to intervene with your newborn by answering decision is made to use this intervention, it their cues and crying, to Ieaming “when” to is extremely important that the partner or begin disciplining your baby. Again, support coach supports the mom in that decision. of the decision by both parents is vital. When medication is administered, it is Each time parents make a decision regarding unique to that particular mother. How she their child, it is unique because children have responds physically and emotionally has unique personalities. Parenting techniques everything to do with whether the outcome must be diversified in order to be successful. is successful. ’ Unexpected complications in the birth process Parenting always brings unexpected compliv are the norm rather than the exception. CCS' cations. The skills used to cope with the unv arean birth can be one of those unexpected expected in labor are the same skills used for complications and is a choice that can save a life. survival of a healthy family. Recognize when intervention is necessary. Welcome the opportunity to support your unique family. © 199’ Ann Corwin. Ph.D., 3831] Crown Valley Purlnm}; Suite F-IB. Lzlgunzl Niguel. (IA (LIFT-1400 Tel: (71+) (HS-9978 $3 833502 @5585 263mm- 302 2.0m..- @588 2:8- 9..qu 585. mp8: .mcozEac E35. 9.68.— m:Em .m> 9603 535. 8:08.... fiEoanEiO- .80.. 2.8 m.EmE_ cm oatmama con; 5me on 2:05. .9: mcozamoma ANV 9.3 3:800 .m .56 MESS m5 2:. 3039.5 mum $02 2.8 26: new dog; .33 Emaxw .m .58 .2 5.5.0.0. 2938 E oco ucm $.zonbmmenv 9:an EmE_ mEEmmm: onto >mE 52:3 9.5an .3 3.5 33:02 .v .2258 9:305 E Eo>m 2 9833:: c9550 Amy 92 a: oco oomcmflo m. EmEaSUo 05an 2:3 26: oco E? Emaxm .m or. E mchE Any 925 “we: 9: Eco now: .68 E35 9.: E5 E053: .mEoEmEaam A5 oco bacon. .N .como c0223 mocmemEu .mcoESc E oco new .mchE AN 5 mam} Eu: MEEE 9.: 8:3 vow: on >9: 5:: 938 5.309 oco .52th .335 cm...) Emaxw .F ”o. Ban on ___3 33:93 mcficozm 9: $20 $5 ..o oco o5 >m wm>F0m30 >_ 320 Sum 258“. >mm>3wo mmfio ...mmr. one tam >9: 0:2th £22: E xoma 2 ounce. E E9: EB. poo. $55. 958 c_ 392:. mc§o=m3m 65265 .955 E m=§m 3:3 33 N. 5:03 2mm... .82 .35”. m 53: :83 05 @520: :0 mafia. 253 868. 2% a; a mama.” 2.35 can 385 m 5%: .23 an min 868“. t 58: mp8. Baa: 26.326 2 25mm .6: so... 88. 595 >26 82 £2 :8 59.: 53> poo.— E mmxom 0:68» 8592.5 chE 2 coon» mm>os_ 2 £203 £39: 2 mucus 3:83. .636 one: 9.5% new a3 no.0: .88 mum w 5:03 :88 m 5:, 9:89 :8 m 58: >.. 25.9, a 380 ... E 8on 390 2.55.9, 33.3% m £82 302 9:12 Emcotfi 952.mb 3m. 55 pooh 3:85 .33 m £202 m5: new 93c... 9303.0. m 5:03. . 9.85 o. 22 $558 on 2 a: 3952 9.365 263 EaE E 596.. so; 505$, 35 \. 5:02 2:0: m - «x. _. Ego 3mm h 5.63 m2... mic. 4mo _ B a: 2.539: .mEo: :cm 3365: .539 o>oc 338 9.3:: @550: - 92950 «cues: E: 3:93: 2.8:an Ban E 5.3: 3.389998 335:: €58.28 3: Ba 58. 5. Boo 3:929: 363:2 .230 «do. £995 :o::_o>:_ w9m.:E:w .33 :_ 333: $3 :o:9m:9: oz 23:9: 3952 9290:an Ems”. 2.5% «5:369: 929 can; _8_Eo:oow .E: 9:90 :6: £525 3:: 5228 2 96: :58: .5522 3.5.2.: 98.. :09 :8 99:0 .39: 2 83mm .Emo: :o mommEm> E38: 9339: :m0 qumam -82: new 88:98 “a... HHS: :58». 2:8. 5:63: o:Em:mm9m E 80953:. .0 ucm .39: ..o 332:; .um 05 E :88 9: E55 89:8 23:9 E0: 5:95.85 9938: :o 53.8: 3.8. 5:939: 99 39:9: 50: mm 32:: 3mg 9: 929. 328: on 230% 89 2:0: .6 39 .89: 9 ..9:o:>>. 550 new: 5.3 3559 92m... :oEEoo 9m magma: nose—2.. éEmm m boom 93:: . . . :oEEZ - Eobcm: xocmcumi E 3:299: mom. 9%: 8.28: can 832 .m 9:: £5 :55: Em: on 2327. Sn: 9:. .Emcac 35m: 50> >E:mm 2 mm .63 mm ...3: :cm 5.5:; .3832». 8:39: = $an 50> E: >9: E 9:: E932: Em Em:o:E_ :m m_ 0:68”. .< 2.39: 29.530052. ._ 3:03:50 :9: 8th Ban m @539 moo: 26: ww_._._>_._.o< Pzwhzoo wZOFmMDG 8 a: :E mud :coEEaao: .9399 :oo: a. >::9 »_co :59. h._ :a 69.53: 59:8 :53: 9:3 :o:>>- :a_E.:oEo.:::m .9o5E 5E9.> a: :oo: :.:::a: :o:::9 :9. @5289 9:95- .:9. :oo: 9::aE 5a: E :_:::a: 35:9 5592 @5289 9:95- :93 :9: :.:E:a: 5.3 mo::> :a::EoEo_:::w H:.:::au. .N .0.—2 Ea: :a:::om9: E0 .9::aE m om: >0 .:oEo.:::m o::a:_u. .:_Eo:: 9:o>9: ._:9oa :o:a::o :9. :a m:9: 5E9.> :59. .9::aE 0.: on: E 3.6:?» on :39: :9. .o::a:: ::: :9. o 5E9S E :a::oaxo 95:8: 9: 5.3 9::aE o :9: 9: 5:9 E :9 9:95 E «:3: .::a:.::: 9: EoE ::a :9:aE 35:3: :95 : Ea: x..E ::E:: E m::::::: 9::uo:< 68.5 .v ”3:: so» .89 2 :8: :2 E o9:- :O :ommm :o::oEanom :a::::oEo_:::w ::o_::z .m .motaEa 5 :9am:oE 9:: ::: 39:39:: .599: Ea: 803:9: m. >9::m 53:0: ::: £39: :9 m:::: 9: 9ooE ::: mca:o:2 >:an m59:_:E 3.65 965:: 852:9 E9» .9: 93:: 9: :55: 539: E 99 :_:9 9....- 88892 .< H$0wa 49oco m. 26: ww_._._>_._.o< ...zw-PZOO wZOFmMDG an an :::: :::}: E: 9: 9.:o3 .9: 9: m: :o:oo: 9: .559an : ::: oa:o.E: .oo:o.:o>:aa 9. 5.3 co>m «3:: .6.— US: .mou. 9.: 8:029:00 m. x=E Emma ao:.> o:.:oo:m:9m 5:03:95 .< 02.0mm... hmfimm .... on: E 9::aE o ::39: 33:95 :56: 5.3 5. :: o: ...3 mm:.:oo: :9 3:9: ... .v :3: :.E: :98 :2: >:: 5:36 .m::.:oo: Na 9: - m5:aE ~73 :aa: :..a: . oEam :2: .:3o 9: Ea: :.39. oEam ::: >8 .9 9:8: Y: 5.; 8582 No 0: - 9.8.: m-: :8? 2:9: 9: 3:2: 2 3:2: Ea: :o:obo: 35:8: E ..o:E3: :5 :5: :59.“ 9: .< :oo: :32: >::: m: 35:8: ~a m: a. 3:905 :::): «9:8: .8 9: 5.3 :9: - 9.8: o; ”:9 9399 :. >:: :o: 3539 E :o:E3: ::: ::3aE: m:.:oon. .m :5. 9903: 98:: - o.o: o.::.: 595 .N :88 m5xo3m- m:oo: m:._::3o- ..o-935E ow 6:9 E 9.9 939.: m:.:oo: :a:w .- 83:90: 96$“. .o 3:: :::: oE: 93:9 : E .a 5:: a: 5:: 9.0 .>::: a: v.0 9:9 >95 :9: xooca 9:. 96. :.E9.> 530w .5o9 o.:aE ::E 3.83: E 9.9:. :::-:3wa ..o>o. 8.63: 9:33: :5 3:. 8:39: .a 99:3 ..o3 m. >.::3m 99:3 5 m5:aE m E - .96 3.53....- :9m 9 :o:>> om.>:< __.>> 8an .o.::_.:>< 9:oEo.::3w :.E9.> E :::... E9950 .m .m5:aE m 3: 9:oEo.::3m :::oo: :::: Ea: m:.E9.> :93 :::.oo: a:>> mm.._..>_._.o< ...zmb-ZOO wZOFwNDC .m:.::9 :::: E 30> 9 :8: 99:3 E :::.m : :::v. 59.5 :>:3_: 9: :2. :: 9.9:. :.3: ::::E:. :::E: .:9 ::::E:. .N ... m:.:::u. .::9m E“. :::.331 ::::::o :::E ::E: - 8.3.: m...” - :::E: m - .x..E .::9: E 9399 E ::E: 5.3 .::Emaaa: 9 .5950: .:E.:.s_ :::::EEoo9 2.9:: Ez - ::.:.:: :::9m :::...93: E E9 :9 :_::_.:>< .0509: E :o.:::Ex: :::..- aEaa .::9m .:E:: :::3 ::::co - :::E. ::::E :2 .::9: E992: :::: @5932 .:~.: 9 :2. :EE- :x::3 mm .:m :::2:: Em .05 :::z .:_::_.:>: :::E E935 :::9: 9 :::oo: E909: ::: >::: :3:..: - 9: @5932 V'ui ... 65:3... E:9m .9 :::::2 «55:55 .0558 E55: 5:95 E55: :39: ::99 2.94:9: 5.:3 93:9: ::o::.Eoo .::>: ::x: 9.9:: 9:92 :::: .::9: 2.98303: ::: 3.3.: ::::>:_ Omozwzfioowm ...Oz :. E39850 m:_:::Exw b.::::o:: :::E. E :E:9o oz .m:.5o.o E:.:m: :9 ::: ::_aa.: 0: 3.8.3.9: ::: 9: :::o .b: 9 9.: EE3 9 ::oaxm. ..ocooE ::: :::: :: :::: 9::o: DEE: :.o>< .:_.o ESE: :5 :>oE9 9 E: :: o: 3:: 99:3 5.3 :::E. .m .m .v .m .N ... ::::EE: 0: :::EE 9. >:: :Eow .:::::: :. 5599.9: 9%.: E23 9 ::.E:5 :::.E> 9: 9:5 :o.E::n.9m «@593: :::3 E.: 59. :. :::E o: 9 :::: ::::::o .::3 :E:E:E9 c..>> mm.._._>.._.0< ...zwhzoo mZO.._.wwDO wWI—Ir->-L-Io< llll“|1ll I 3:: ... .903: 9 x99 :>.E:..::. ::: 3:: .50: .9: :.5.3 .::9: 9 S: = .:.:.::0: :: :00: :: 9:969 ..9.::0: E. .N .::o. E:.:3 ::: 86:39 82:9 9 9:: >92 .0.::5:o : :: 93. .::5E.: ::: ::.00 ::::o 5.:3 20.69:. .:.EE:: ::: .9.> :.9Eo 9 8:9:.:9 .:EE: E90:E9 ::>.0 9...: EE. :: :99:>:0:E0 :5 2:: ::: :_:E:.E ::: :.99: 90E :E: m: ::: .::E. :>:: Ya. :. :Eoo x..E 9:EE 99:: $289 3:: $5.? 5.9: «.25. 8:993: .9“. E95900 e .::.:::n. .::9: E 30.0.93: :::..9 ::: :0..::::x: ::.:::o ::0.E9.: :.0>< .v :0:::.E0: E: :20 .m ::::3: .::0.EE: ::: .9::E ..:0.:>:: .N E:.:9..0:E ::.::9:E::D .P S: ::.:::n. .::9: :::30 E592 t0:::: ::0 >..E:n. 2-: 59: .1: 29209; .1: =2“. v 5.5. .:::.>E: N0 9:: .99 .N0 o ::09 :.99: 2:202. 02.255 950:: :00“. E9995: >: ::::mEE009 :: E:E9:::: 53.0.:0 ::: ::: 99:: .x..E 9 :>...:::: >::: E EOE :. .E:E9:::: :9. .E3.0_:o .9 x..E E :::: .EE3 E ::::9: :.o .>:: .::>: 3.9:: .::0...::: com .x..E .::9: 9:38: E :0.E::9: ::: 5.::... :00: :30 50> ..9 5.9.5:: :00: - E5 .v .>::: ::: E50E E ::::c .::0:...E: :5 .::E :: ._:3 m: 99 :::83: 2.. 8:98. ...; :.fi ::: 9.98. 59 32.8. .: ww:..>.._.0< ...ZMHZOO mZO.._.wwDO .:E3.: 9 :3: ::.EoE :5 :. E:::3:: :EE :. 5.5. .3: 5 n - :5 :. ::Eoo x...)— :3000 9 :93:.E 5.: :::.9 :3: 3:: :. .E9E: :::.03: :.3:: :. :::::o 99.5 .E::..: E05 9.39:: ..o ::.::...: .::::..9 :::E: E :0.E:::m .::0.EE: .::.xo3: E: :.3:: 3 ::E.3E.E - x99 :30: E: :::EE :5 E ::x9EK :8: :33 .o 8...:8. x85 .585 “.o 3:: a 8.83 9.32:3: .93: :EE .::.::: :.09: :5 E3 :0.E: ::.~::3:w ”:::.03w .9::E 9:39 E3: ...3 :::: ::: :.::E 9 ::::9: :.:::o :30... .::.Eom. :::E. E ::x9Em 50.93.03. :::0E9: .::.:: Ex: ::..:0 .::.::3E :::93 :5 E ::0.E9E00 :::E: 0:.: c.0930. ... E: ::: 3:: 9::3 ...02::9 9E3: x..E E0: :::::: x..E - :::9: E .30 «:5 :.::9 :30: E; :~::3a: ::: E9E00 9 9E: .:.3::3E :::3:o c.0936 - :.0936 :::99 9 39.9.: :.:::.: :::.03: .:o.E3:9: 9.5 :::3:0 5:99: Eu: :93:.E m -N - 5.63:9: :.::: 9 ::::.: x..E :.:::.: :.E:_9: - :.E:_9: ::0EE: ::EE:: 39.9.: 59.9.: 9 :::: 9::.: :. :::.::: :29: E05 ::::::E - 9.03: 3:: .:0.E3:9: x_.E ::3:0 ::::EE: 5...: Ec< .39: 9 9::9: ::3:0 :::0EE: ::.::::0 .3::::9: :::30 u...E 83:9: E5 .:~.: .::9: E E::::::::.. :29: 8-9 E 99:2: ::: 9::9: :0:m. .::9: 3.2. 5.; 889.8 :: :::. 5::9: :0 :99 9 :.:::3 :E00:: ...3 ::: .::.::.: .9::E: ::>.: z .:::3E00 :.::.:.. :Eooo: 0:.: ::: 3:: :3: 39 E5 ::.::3.: 3:: 33 :.:_:x: 3.2 .EE. 930: ow :599 ::: ::::.:.E.: x:=9 .E: s «9.89 :::E. :. :.9 : 3.: ::x:=9 E:>> mw_._..>_._.0< ...thzoo wZO.._.wwDO 8 3: 3:: :::x 9 ::::o: :: ::.E :: ::.so..3: :3:..:0o .:::.: :9.3: ::: 3:: :::E: .:3 9: ::.3:.9 o. .9: 99:: 3:2: 9:: 3:: = .::.: ::00:: :0 :9.. ::..9..:3 ::: ::.: .9: :0 ::.3:.9 or :932 .90: b9, ::.::.: :::.:3 :9.. ::.93: .::.:9 9 :::: oz .9: E: :9.. :::: 5.3 :.::: 30> .::9: :5 :.:9:._< .::.::9 :0:: .: :.::9: 50: ::: .9::E: .:30. 5.3 :3 .::9: 9.9: ::.::.. .0 .33 :5 E .30 .. :::x 9 .::9: :5 .::.::: :::E. : ::.0:.: 3 ::0: :.3:: .::.::: ::.::9: 99. .::9: :::v. .:0 ::.29:. 99:: :::0 ::.3 :. 5309 93: :m .5309 :::0 9 9.: ::3:o 9 ::.. 9.9.: 2:59 ::..09 ::3:0 9 :.::.: 5.3 x:::o :..::.:. 9.9.: :::: __:3 .:::0 :0. :.09: 99. 50:: ::3 :.:::.: :::v. .20....0 ::.:3 .::9: :5 ::.::90 ::0...:0: ::.3. ::.: 5:509 .:_:90 ::: .::9: 9 .::0.0 :::: ::: .::9. t0::3: 9 30...: ::: ...: .0 m: 3.2 .::.:9 ::: .:::..:0o 393.9 :.:::990: .:509 - :0...:0: ::.:0.. ::::c :::.S -.:o: ::.9.::09:: .::ommh .::.:09 o .::.:09 m .:x::3 w .:x::3 m .::.::9: E ::.::.E: 5.3 ::0.:. :3: or - ::9.. :.::.0.:9: .: 93:00 3.33:3 .:0..03:9: 5.9 :::90:. 9 353:9. 909 ::93: >..:o.:0..:: 3:: - :3: 3::309: .>.::3: 5.9 ::::90:. 3:: 9::3: : 0m .:0..03:9: 5.9 :. :::90:. ::.:.39..: .::9: .::9: c: :0 :::.03: - ::::9:: :.::9 >.::3: 5.5. .::.::.: 90: 9 :::. .0: ...3 .::9: .: :9.. 309.0: ::.xo3: ::: :::0...:0: 330:: 3:: .. .::.: ::: :9.. :039 :.5 0.3:: ..9._ 230:: .0 9 :::: 30> :::E ..:::0: :.E. :9.. ::.30..:3: .::.x03: ::.3:.:. :7: c. .::9: .::9: 0. :3: :. 3:: :95: «iv; .N ... “33:95:... .9 .NF .2. ww...._>_...o< ...ZMPZOO m20§ww30 ..0: : :::.>0.: :. 9::9: :0:m ...0: 5.3 99:59:: 50:: :.: .:: .0 :3. :.::w .::. .:50 .30.. .:>0 :::: m... 5.3 :2 ::0 :0 .::. 5:99: :.: .:.. .::. .30> :0 :30: .09 3:: 3: :::: .::.0 :5 5.3 :::: :.3:: .:: .0 :3. 3.9:: :::: ::0 5.3 9.09.3: :5 98:3: ..::_30:: .30> .::.::: 3.9... 3:: :.0... .F .0... 30... :039 :.3: ..:0: ::: ..: :039 30..:3: ..:0: ::.::: :9 .::9: 3:9- :.3: 0. ::::c :: :::3 ::.:::: :9: 39 3::- ::.: :0:: .::: :.3: ..:... E. 50.0 :.3: : .::.9 ..:0:. :0:99: :.3:: 90.. ..: ::30..:3: 969:. 0.- U:::: .::..:9: 9: :.03: ..: 0: ::9: :5 E :0...:0: :5 :.:.0. ::: .::::m .:.09: :30: :.:::c ..0. ::5 ::: .:::0 9:. x0:: .::9: ::9: .:.03: 5.9 :5 ::.::: .:::..:.9 ::: :935 :0:_: ..::9: .:>0 50.0 :::3 .:3 .0: ::3 .0 ..:30:: :. - :0.:::.:x: .:3::.2 .::.: :0 .:..:.0::: ::.::::::9: .0 .::..3::00 :0..:.0:. ::: .:..::0: .. x:< .::.3:.9 or .9 ::.b. .::: :.:: .9 x:< .:.:.::0: :: ::.93: .::...:: .::3.09 .:..::0: :5 :. ..:93: :30.0:.> : .0 .::.3: x::3 : :3: 39 30> .::>099 :.::.: ...:3 5309 :. .:::c :.0... .5309 :.3:: 90.. :.::.: ::.>09:. 99:: :0..03: :5 ::.:::.9 .:93: .::: 5309 :.3:: E .::.00 :5 .: .::9: .::.::: .::9:. .30> ::9: 3::: - :.::.: :5 ::.:::.3. .::.::9 ::..3: ::9.. .:.:>:: :.3000 ::: :9.. :9:: :5 .: :.:::.: 50: :. 93000 :30:..:.. .x:..:. :30:..:. :.:.39..: 0. ::.3:.9 m ::x:. ..::9: 0.3:: .3: 30> :9.. :5 99.... .933: .m_. .9 ...? .oF ww...._>.._.0< ...zmkzoo wZO....wm...O :o a: :00.: :. :0..:..::0:00 0. .:3:: 5.9 :. :0..:..::0:00 .0:00.: - 99:. 9:: :::3._..:9 .::..00.: .::.:::0 - ::.:::. .::9: 9: 30> .900: .30> 9.9:. :33.:- .:305. .0: ::3.: 3::. E 3.9:: :::. ..:0: - :.:.::0: .:>::::3 “::35 .m :::3: 5.9 :3 ::3: 0.930: we ::::h .::.:09 o ::: .::.:09 m .:x::3 m .:x::3 : .: ..3:: 539:. :.:: .::.:3. :9:. ::.:09 N a... c. 3.8 :.:: :-N E: :.:::.: .9, o .82 .m- :::30:: ::.::: :. 3:: 305. . 0: 30... .m .930: m-m .::>:. :::.::9 .::339. :.09 ::.:3:0 :9.. E :0..:: .:..0:: :...:::: ::.&:..:: .:::.: 9 .:.::: ”::.E 0: .:::3: 3:: .F “::.:::00 ::3.: :.::.: ::: :_..0:- ::.::.: .1: - :::E: m - .::...0: .:.::9:_::3: .9 .::9:.3om .v ..::> .9 .:::9. :.:.:::: :. ::3... 5:09 F .:~::.. .0.:.::...:. c. ::No... 3:: 9 ::3.: 99:: ::.::: .930: :v :99: :: ::0 ::: >.:.:.::99. 99::...9- .::.:::. :...0: .9 5.9 :::.:x: 0. :93: .::9: ::3 ::0 .m 5.9 .30> ..:9: ::0 5.2 .::9: 3:: :: .::.09 :::. .::.0 :09:: : 3 ::>.: .. ::.::00: :::9: 0 .. 30... ”.30:::... .:..:: :: 3s. .:.::3 :::. ::: ::3 9 .::.::: :. :.3:..9 .::30: .:.39.9 ::.:3 5 5.9 .::9: :30 .30.. :~::.: .N .::::..::.:: :. .. .::00: :5 :::. .::9: 30> :.09 :::. .:..::3 0.: - 29:8. ._ 85.398 m. 9.8982: 90.8 2o>< .. :::E: .:.::9:_::3: :59 .::9: ::30:: ::.::: :. 3:: 305. 30> 0: 30... :93 38.8 -..:: :_..0: .:.::9:.::3: : 3:: .30> .:.E 30.. :.30:: ... ::.:::. .::9: 9: 303 .. ww_._._>..ro< ...thZOO wZOFwMDO ::.::::3: .::: :: :: ::0 ::.::.: :.0: .:05.- ::.:::. ::..3: :0...:0: :::::o- ::.::.: ::..090- .::0..:: ..0:: .9 29:39. :932 .::.::.::: .: >.:30.0:.> :.09 :::.3: 99:. :: :.::.: :.0: :::. 5.3 ..:.m- :0..:: ::.:.3: :0:: .::: :93:.9 o_. .9 33: :::0:. w. :.3: ..:3 0: .:9:. .::...- :::: ::.:.3: :9.. 0..::.: :.0>: ::: ::.:::3: ...<- ”::.::.: 90: :3:::: ::.: ::0 .9 8:999: :::.::9 .930: N 9:3. 9:39. .::9:.9 cm. ..0::- ::::::9- :::.::9 99:: .:::.. :::.::9 5:39: :0.- .::::.: ::.03:9: 5.9 :::9:: ::0 .::9::.0::: 9:3: ::3:0:: :::.0>: :: 230:: . .::::.9 9: :::.::9 :9.. 3: .: .3000 ::0 .3: 5m-..” .::.::9 .::9: ::.:.::9 3.960 .:::0.:..: .:>0 9: :.03: 5.5. ”.::9::.0::w mphmocoo much—dm ww30m_n_ ..:.: :..:509 :. ::.5:90: 933.: .::.:.:..< 5.9 :. ::.::. :: 0. :09 .9 :.30: :6 :::.:h 3:: ::: .::.09 .::.0: 9 :9::: .. .. >90 .02 :::09 :.:::0 :.0>: . .:35. :::::99009 .0: ::.: :.9900 ::.: 3:::05. .::9 .::9: 0. 3x0 - ::.::::0 :::.::::o .0998 9 :9:.3 :::3:0 085:. :30:..:.. :.0930 .:3: :44. ::.:: .::< :0..:3..: .00:0: .9::: :::E 9:93.:9w (\im'v‘ ... ”:9:.:0.: .0.. co'rx'oo'oi dm’ ::.::.:.9: 30.. .::.9 :9:.:0.: .::>> mm...._>.._.0< .92th00 $20....ww30 :5:09 : .:::3 .. :.3:..9 0.:0 :::>>- :0.: :::. .:3: ...-N .::>: :::...- ..:_ ::.:::. ::0 ...:3 :3:.900- :3: 9: ..:>>- ::.::9 ::0 :90- :x::3 5: .82 .<- .. 3.9: 30.. :: ::0. m: ::9 .::9:- ::.:::>> .v. x:: ::..3: ::3.:”.- ::0.: ::..::.. ...:3 :9.: 99 .0 ::::: E :.::: 5.3 ::.::.: .::.::: :.:: :::.:- ..:E:3o£ 9: ::9.. .9... 9.8:. 5 .oc E633 .: ::.0.:3: :.:>..: 3 :::..0::.: h.. :0..:0.::5.- :::.::9 9:39. 5.3 3:9: 3.9 .::9: :5 :::x- .::. E >92: .:.0- .::.. €9.- U:0..09:. .::9: .w ::::::9 ::: .::: >.::<- ::>.0:9 ...:3 ::.:::. :0:: .: ::.: ::.09.: :0 ::.:.3: :.:::- .::co. .0 ::.E ::.3: 0.3:: 30..... ::.:::0 :.::.: .:.30...:: ::..960 ::0..90:: :::: E ::.::0m- .0:: .:::9 .0 ::.: :::::::m .:.03: 5.9 ::::06 R 9:93: :. :...0: ::: .0 :0..:::: 90.. 3:9: :: 39 “::.::.:.:.:.o .m. ::.:>:_: :::: 5.3 ::.3: ...:93: ::..3:3 ..:::.: :::::0 .:09 :::>> .:.:3: 3:: :::: 0. ::3:.::0:. ::3- .:... 9.8 .:39 .::.90 ..- .::.5:9: .3233: £03: :.::.:.000 0.99:. .9 :.:: ”9:..:: :m- ::::..::.:: .:::3: ...:3 :.30: .1: 9:3 ::x:>>- wm..:>..ro< :.thzoo sz....wm:O 3:: .::: 9 :.:::3.: .9 :.::..:>: :::... 99.9.30: :00:: .::::0 ::0 ::3.: :.::.: ::: :...0: A:>.::.::x9 :...0: .0 ::0 :. ::.:::. .:3:.>.::_ .: 9.3:. .:::.: .. ::3 9 :00: ..::::::0 - .::30: .0 :>.:: 9 3::: .: ::0..09.: :::. - .:.:3 E 9309: .:3:: 5.3 93.5 999850 .: .::0 :0 :.:: :0..:..:x: :.::..: ::::n ::::39 :::0: .0.: .99. 5.3 :::99009. 09.9.: 599:: 3.39.0“. ::.::.: .9 .::.:900 :.309 ::..S ::.::: :9.. 3:: 58999:. .::.::9: .0: :90: .::..::3: .:9.:.9 ...:9: 09 :.0: h.. :.::.: 3:: .:: .0 :...0: :0 ::0 ::.:::. :::: 99:. .5309 E .30 :.::..: 39 939.9 .::.0: :. ::.::3: :>.:::0x: ::.:. 09 :.0: .. .30.. :.9900 :.0: E ::.: .:.39.9 60.3.. ..:.:3 .9 ”::.::.z ::::c: .::.::.: 90.00 ..::6 .:::.: .0..::.: ”.:..:.:5. .::.32 .93.: ..:9:0 .299: “:::9: ~0 : - N0 3 ”:~.: 0 .-: :::z H::...0: «5% .F .5993: .>...3: .0 :93:::.: .:9 9 :0:::. oz .::9 .:::.: 9 :.::3 9:3 .02 :0..03:0..:. .< H6223:... min—.0: .8: ... 8.38 oz- 838. c. 8.3.. oz- :38. 22. .33 .2 9o:- H$92.... :5:09 : .. :30 0.:0 :::>>- mm.._._>.._.o< ..thzoo wig-5:30 9.39 5:: :::: :0..::0 N ::.30..:3: 0.: 9 :.::..: 0.0:: =9 :::: .:.. .o .3: :>.:::0x: 25.63.. :::E. 5.; 0:.... :.::... 8 :38. .22. .m 3::... :::.0 5.3 ::.w .v ..::c .::.::.::: ::.: ..:00 0:0 :. :.:00 02 .m 0:205 :.:: ..:0:, ..::tan. «35:05 .::.0: :0... ..:00 .N .0::0..0:.:: :. 89:00 :>: :.:: :::E .309: .30.. E 0.00.0 :. .::. :::... :::E. ..:.: ::0 5.3 3:: :.::.o ... ..o: 38 a 9.8 05.08. .o. 83:58.. :.:::.::09 9:930:30 .m:..:0:.: 0:: 0:39.05: :::3 ::0 :0 :.:: :0..:..0x: 0.0:...0 :>:>>.< :50: we :.::; :.3:..9 ::.:::.a ::3 ::.::.:. mv :::. :.0E .00 :.:00 .. 050:5 058:. .2: :23 c. ..:. :.:Eo. 28:0 92935:. :.00. .: .:.:9 .::.:::. :..:.0:0 :: :.:: ::.:::. ...:a ......o .F :.::..0n. E :o:.9m (\im'v'm' ... .:::.: 9 9.9: E95 :::3 :.:00 :. .::9:: ::::.0:_ .:>0 9:. .N0 9 0: ::30:: ::.:—2 .::.:::. .:0 .N0 v 5.3 ::.:- :::0 E ::0. :::.s. .:.:3 3:0: .0: :. .::.::.::: ..: :::)? ::.: :0..:.:a:.: :::.0. 3::: :::.s. .:::.:.aawEfiom 5.932: .::..:3 :.:0m N? :58 ..:.:; o. 9.2850: .: ::..3:. .9 :03m .9 .:::3... .m ::0 ::..3::92 .m :::.:E 30> 00 :.:::9 :02: 26: ww..:>_._.o< 5.25.200 mZOFmNDO 9 u: :0: :::: :3:: .30> E. 9 E: :.3: :m :::: .:50 .30.. 5.? x0:: :.: .:: .0 :3. 5::0 .:.:0 .0 ..:E.: ..:.: .:::3 E... 20... 30> :: .:..3 .30.. :::.:o: «:::0 m... 5.3 0.929 :::. 5:: .:: .::. .30> :0 3:: .30> 5.3 ..w .m :8: :E .:: ..o ..:. 25:0 .::. .:50 .30> .:>0 :::... :E 5.; 0:. ::0 :0 .::. :0:E9: :.c .:: .::. .30.. :0 :30: :09 3:: ..:: .N :::: .:50 :5 5.3 x0:: :.>::: .:: .0 :3. :.::: .:::c ::0 5.; 9.09.3: :5 :0::3w ..:0.30:: .30.. .::.::: :EE 3:: 29.. .9 ”Oh >>OI :.3: 9 3::: :: :::E 0:35.: :9: >:E >::m .v :50: :5 2:: .::: >..:3:3 ..:.:: .m ::0:30 N .::>: .::: :.3: ::.: .< .N 50.0 :.3: : .::.0. ..:00 ... :0:E9: :.>::: E0... ..: ::30::): :>0E:. 0h imam ::.:.zm ..::0... .0 :2: 0.:v. .0 .:::m 90: .0: 0n. ..:.:3 :.::.: 5.3 :::E:_::3: .::.05:.::: .:: ::.:::EE00:. ::5 :.:E.9 :.0E ::.::: .. .:E: :00: :93:.E .:::3... .::..:> :::. 9 ::..9 .. :EF .:.3E.9 E ..:.003 :.3.:.::E9 :::::0 55309. :EE :.3m .::9: :::.s ..::0 59:. c. ..w .::.0::. .::: .::. 9 :::E. 30.2 ..0..:00 .90:.::: .00: ..:EE: :. .:30E: ..:Ew .:3 ::.::.:w .::.::9 E09 E30: x_.E .::>:.: 9 .:.:3 0.00 :. ::0w ::0: :::.s :50: :::E .>.::>: :.3:..9 .::: .0: >:E :>:>>0.0.E H29.5.20 :.3:..9 E :.3.:.::E9 x0::o ..::0 .0 :.::.: c. .3: ..:0:. ::0..:u::EE00:. :>:30.0.E .:>9: :0 .:::3 5.3 .0: ..:E.:.s :50m .:50: E.:>> :50: b:E: 9 3:: :29 ..:00 .2. .NF .2. .0.. 93:: .30.. :.3: 30> 00 30... ::3 ::.:: BB .. :::E .. .::.... .22, ww.....>.._.o< PZMPZOQ wZO....wwDO E ..:0:... :E0.::>: :50: ::.:.32 .::50: :. 8.3. 02 .m .58. E ..:0:: .:E0.::>: :50: ::.:.3:. ::: c. ::50: 02 .N ..:: m:.>:. .3:: 9 :9. 30:09:. .:w .::50: ::.::0.: 02 .F 5:9. ::.:::00 ::: :E:.:0.: ..:w.:50m ..:.:0: >:.::.n. .:::.::30. .3: 3:: :. :.: .65 :::0 >..:0..:E:.: :9:...0 :000E :.::.:. ..::2 .::.930 3:: :5 ::.:.r .:E0.s :5 :. :.::... m: .:::t::: :..::.0E : E 900:. : >:.: ::: >5 .:.3:::.: ::::o 3::: 9 ::E0::: :5 .:::3 :::: .30> 5.3 ..:.: .30> ::0.0: .60: :.>::: m:.0:.: .::9: :09 3:: x.:>> .:.90E o:..:.:.> 9 ::0:::. 9 E::: :.::.:. 30:00 .:0:::. :E0: .0 u_ ::0: .:0 .9 .3:: ::.:... .:::.: 9 .::.. ::.::: >33. >::E 93: :::.>0.: .. :0..0E ::::o ::: 69:00 30: .::..:::3: E :0..::.:E00 ::h .:::.:0 .:0... ....03cw= >3: .0 .50..0m .3:: .30.. ::.:::. .:::.: :.: 30> .. ::.: .30> :. 903:9: x..E .0 :EE E ::.:::. :5 ::::.0:0 .: .m ”0:00 .9 ::.::E:~. :::E .9 :.:::3.: x:< :5:0E m :.::. >..:.:::0 .:.:30: :5 E 3.50932. :::3:0 .E9:>: ::.:::... :5 E >...3.:EE. >.:.::0: .m:.5:E0w .... .0: m. 59:. :::. 0.05:3... :5 :. :0.::9 >: 8.96.3: :. .. 2.5 9 .::.::: .0 ....:.x:: .::.:.:E .:E:.:0.: ::.:::. ..: :::3:0 :: ..:E .. «.:0 :5 E :E.. :E:: :5 E :.3000 >..:.:::o ._ .::: E ::.:::: .90:: .:E:::: .:0..:9:.0 .::.Eog: ..: ::.:::E000: ::E..:E0: .::....0 E 930: :::.:.:x::: 9:30.03 0:00 :0..00 .9 ::.::E:. 30$. 30.. 00 :0..00 :. E:>> wm_.:>_._.0< FZMEZOQ wZO.._.wm30 N. :.: 9 ::.:... .::.:::. : ..:.:: 9 E... 5.3 ..:.: .0 .:...:: :::. 9 E... ::.::.s .... ::0 ..::_0 :.:: :< ..:3..:::. ....:3::.m ::: :.3:::0: :30 ..:.: 9 ..::: 30...: E:::: :E::: .3:: :::.s :::: .::.:::. :::E:o ... .::.3bmzow iOFSzmcuz. 02.0mm“. mePO :.0 ... .. :30:: :50: :5 E09 :::::.s :: :30:: ..::m .::: :. ::50: 0: .::50: :. :0.3.. 0: .:50: :.0: .::: E. ..:00 H9:.... .:...:: :::0x: .::>:.: 9 ::0 ::.3: .0 :.0... .:0::..::x: 3:: E :_.:0 ::>..::: .3: :50: :>.m 9 .:3. .:.::m .:E.. ::..:h E::::0:: .:::0. 0: :50: 5:3 ::0 E09 .:30E: ::::.0:. ..::3::.m _..>> .:E...::E .: :30 :. :.3:..9 .:..O .69... .:.::9 :30 ::3 .:5:0E :.: E ::03:09:. :23. :::>>. :5:0E N To :9. .:...::. 9:30 ::>02- :..9 .0 :00:: .:30 :5 .9 :::0::. .0 :::.G- E:::: :E0: 5.3 ::.w- .:::.:: :::.s .::9 :. .::: .30> .5:0E 9-: ::30.: :30 : E09 :.::: 9 >:::. :.: ::.::: .._.:3:: .::03:0..:. :30 :::.s ::.::m .w Nod ... .::.:::.S ..:.: p.26... :. 35:581.? .:::.: 2 :.::.: - :.3:..9 9 $9 ....._.::..... .:3 ::.5.:: :>.:::0x: .:0..::m:00 .:::t:.: .:::m. .::0.E::. 0.m.:._< ..:.: 9:. ....E :300 E :0..0::09:. ....:: :::.300:.o ..:...B 855...: 5.; no: 2 9.8 2 can 53. :.::: .30.. ::..3::50: SB: 28.. 3.. :>.:: .:...s ::50: :5 E09 .::: : :::.s 30.. 0: 30: ww....>_._.o< :.sz200 wZOEbMDO as an :0.:3..0.: :3::9 E ::.::3:: .32.:3: 9 ......:< .9 .::.:::. :50: .0 .:::.: :.: 30.. .. .:9.: ..:—2 .:::c.:::. :0 ::::: :. ::09 :..0: E :0..03:0..:. .< H$000“. ofiow ..> :5:0E :.: .: ..:.s: 30.5 ::0 ..:...0:: .m :9: 9 .::.:: .E.: 5.3 :..:3_< .:E3:... .N 999::3: 5.9.8. 9.89.9.5: ::.::.:: .9... :.::: o. :82 e :.:9.0:: .0 ::E:.:0.: ::.:::. :0 ::0..::3: .9 :.::..:>: 30.. :.: :.30: .::.... ::..:o :::.::9 :50:..:::.: :0 :0..::..9:. .:::3. .9 .0:. -:00 . .::mm3: 30.. 0: ::0.30::. ....:3EE00 E:>> ::.::E:_::3: :.3E.9 ..:.:3 :.:::3: 30.. 0: :::>> :::.::9 :...0:>:::.: :0 :3:; .30.. :.: E:>> .:..::0: .:00. .: .::..3::00 5990:..- ::.::.: 8.2.0.9..- ::.:::. .:::.: :0 ::.:::.o- 9.00m- ::::..:.>..E::- ::0::::- 21:- 2:39.299- .:E:.:..w :0::3w .m :5:0E N T: :5:0E m :5:0E .. ::::3 :.:. :5:0E :.: ::.::.: N - :.:: 0.. g g .::::::o ::.:::... .N .:::3: ....E ::..::.m: ::.:9 -.0:: 50:: .:9 30.. 0: .50... ::0.0:0 ::.:::. .30.. :. :.: .::. :>. -:0::3: .50: ::.0:: 9 z:< ..900: .39. ::: .::.E 30.. ::0..::3: :E0: :.: E:>> mm.h_>....o< ...zmhzoo mZO_bwwDO 000.0 :000 .0 0050:... 0.0:0 9 0.0500000. 0:0 .005 9 000.0 :000 .0. 05.. 05.0 .50. -00.0 ..05 9 0550.00 5.5 00 0500 9 000.0 :000 ..00 0:0 5000 0:.000. 050.00 -0. 050.090 0 0.0.05.0“. 0000.0 0 9:. 000.0 00.5.0 0 0.0 0>...0:00 0.0 00:..0.0 .0 050.00 00055 059:. ...:00. 00:50.0 .0:....:.0>. 5..>...0:00 055.900 9 009 .50: .050:0 0:.000 0.0.00 0500 5.0 ..05 .05.. 0 .0 000. 50: 0:0 .5.0:0: 5.0..5 0:0 0.050 .5000: 0. 5000 :0:5 0009 .50: 00000.5. .009 0:. .00 ..00 505 050.000 5.:0 5.5 .0550”. .5005 0.5000 .0 x000 :. 000.0 0:0 .:0000 ..050 .0 0.. .000. .0 .:0050 ..050 5.5 00.0 .:0...000 0:....0 0 :. 00. .005 :. .0 ...0:0 00.: .000 .:0.:. .:0...000 .N ... 02.00 05.08... ..000.0 .0 0.0.50. 5.5 50:0“. 00:00 .95 0000.0 .0 0.05.0. 0:.000. 00.0 :0000 0 50.. .00.00 5000 .005 000 H. ...0.009 .5000 .020. 0.0 -..00.000 :0:.5 0.00.00 5.0 :0.. :0.: 000 :00 ..0... .0 :.:. 5.0> 0. 50:90.0:00 .....5 .000.0 .0 0.0.50. 5.5 .00.00 0x05. .0000: :0... 05:05 0 P ...:0 0.00.00 .:0.:. 005500 05:05 0 ...:0 .00.00 00.05 0.0>< .0.00 50:00 :0: 5 .0>...0:00 .000. ..0... .00.00 00.... .0000: :0.. 0.005 .00.00 00.....9 :0.. 050000.00. 0-0. 8.. ......s 005...... 9.0 .80... o. .000 0.50.... 8. 5._00...0000 .00.00 :.0.0 0.0:.0 0. 000. 0:00.500 .0.... .0009 0.0:0: 9 :000:0 0.0.05 0. 50.050 05000.0 00.0 - 0009 .0 00.9.8. .900. :.00. 9 0000.00 0:0 0000: .0:0.....0: .005 9 0.05.0. .0 0:5 .000.0 :05 .050 000. 000: 00.000 55.00: =0 .000 .0 0:.:05 o .< 009.0 :0..00.0..:0 :. 5005 0:000 0:0 05:05 9v .0 0:.000 :0..0:.0.000 0:0505m. .020 000: 5.5 090:.5 0 To. 00000000 ..w .058... 3. 20.2., 5.... 0.0.80 05:05 0 0:090 x0=0. Nm'v' 000. -.00 5000 000. 005 00 .59.. mm.._._>_...0< ...thzco $20....wm50 0. 00 ..0:000 0:000 :0..000.0 .0 00000.0 :. 009 0:0 00000.0 05000.0 000.0 02.00 ..0. 50.. 009.0: 00 5.0.05 050000 9 000. 055050. 0:.0000 02.00 5.5 .00.:00 9:. 0500.. :500 0.00.0 000:... .0000. 0:. 5..0..00 9 0000 0000.00 5.050 - 00:90.0 000.005. $00-05 ..0.05 :.0.:00 __< 090...: ..0000 .00.... ...00 59:00 .00:0_ 0: 0000. 5000 .0.0.05500 ..0... .:0050 .000.0. 5.5 00.0 0.:0.00.0:. .0 .0... .0.00 :0..0..0x0 0.00:0 0.000. 000K .0::0000 .~:.0I .00.00 00:05 965' énim'v'tn' 0000“. 5000 .:0 0.00.: .0 0000 0>00. .0: 00 ...00 ...5 5.5 9000.050 ..:00 000.96 50.2 .0000 05.00 0.0000006 05.5000... 52 00 .502 53 2:8 0:0 0.000 .0: .00 50:. 00 0.005 .0. 5000 .00: 9 000 0.02 on. 00:0000 0.. - 0000. 5000 .00: 0. 0>050.0.5 000 .. 52.050 .0 50:0 .9008. 00:0..00x0 0. :.00. ..:00 .ww: ...02 on. - 0.0000”. .:0.:. 05:05 0. 0.000 .000.0 .0.00... 0.550... - 000 000 0. 050.0000 00.00 - 9050.00... .05.05 .0.05 .0: .0 .05.05 0500.0 - 00.0 05.00... m' énim'v' .0.00..0>< 5050.03. .:50:0 00.0500 05:05 05. :.:..5 000 00.0090 050: :03... 0.00: 00 :.:...5 000 .00:000 0. .0.. 0 00:0 05:05.. :0 .0.0:. ..:00 .000:0:.__.5 .0 :00 .00.000 .0 ..005.: 000.5000 .0.. 50:0: .0 .0000 ...00 ..0. 000 ..:00 .000 .0. 0.0009000 50:90.0:00 0.00 00.0.). .90. 0500 50. 0 5.. 0.00.0. .. 00.9 ..:00 ..:0050 ..050 020 05:05 0-0 9 5..>...0:00.005: 5.50. 00000 9 :505. 0000. 50.00 .0500 v 9 0.00: v .0000 :00 0.0.. .9090 r5'cn' 0:0..0 50... 0.....an 5.61 095. 0.505. 0. 000: 005 00 .0:5 0.00.00 00.0 9 0.9 0.0 005 :0:>> wm_._._>..ro< ..ZMPZOO 020:0ch 0. 0.. 05:05 0 000 0.900 0005050: 0:090 0.0.005 .0 0:090 0.0..00 0:090 0.50. 0:090 .000 .:00:.00 0.9.00 02 .0 9.0.. :00.. 0:0 .00.00.000> :000.. :05 :09. 00: .0 .000.0000 .0000 0:0 ..00 05050. .0: 0000 009 ..0 05:00.5 00.50 5500: 9 .00.. 5 .005 00::00 9.0.. ...00 $0 050: 00.00.000> .0000. 00::00 0:.00 0.0>< .. .0000“. 5000 :50 .00> 050.05. .m 0:005 ...000 .0:0.. -...0:.. 5.0. 0:. 0000 .00>> 0.005 0.00.0 :.0.0.0 0:. 05 .00 90:50 .050 .0 :.0.0.0 0:. 005.. 00.5 - 90:50 .005 :0.:- .0:.::0.0 .005 :. 0.00.000> 00 0000 00 0.00:0 50000.00 00.005. 00.000: 0:0 50.0005 .00.. 0.02.. - 00022.0 0.0.. ... .8... ..0... .0. 0:0 :.0.0... 9905:0900 0.05 ..0.05 000. 050... 00.009092 0.0.055 0:0 0550.5 .5990 :. 00.: - 505 00m .5990 :. :0.1 50:05 .005 .0. :0.....0: .005 - 0.00.2- .00.0:0 .0... 0:. 0. 0.5 .0000. 00:.0500 500 005.. .00:0.: .092 .00.00.000> 0:0 .00—2- 0.05. 0.0.0.08 .022 ..0.. ... .:0050 :. .00:0.: 00.09009, - .005 0:0 00.00.000>. .00:0.0 50.0 0.5000 E0. 505 0.9.00 5:05 00.. 0.5.. :05 0000.00 .050. - 00.00.000)- 0:.50..> 0500 0:0 0000.00 .0 00.000 0000 .0:..00. .000 - 9.0....- 00_0> .0:0.....0: .000 050: 505 - 0000000- 0500.90 000. 0:0 .000.0 9 .0.00m. .30.... 0.00 0:0 50000 .00... 050.0 0.0:.0 00D 0.00.00 09.000 ..000 :05 :9. :. .0:0... .0.05 .000 ..0.. 5.5 00:.0500 000:. 0:0 0.0. - 0.00.00- H0.00..0>0 0000... .0.. 00.0.. .00.000 .005 .0.005 .0.000. ..050. 0059.0 ...? .00.0:0.0.0:00 00000) .0. ..:0.. 00.000 0.00 9.0.2 .00.000 90000.0 .0 ww..:>:.0< 0.28.200 mZOwaDO .0:.:05 03. :.:...s 000 0:0 0:0...00 59.0000 00. .0 0.0:.0500 0:.00 0:0...00 0.0:.0 0N090- .0.00: 00 :.:...5 00:- .0.0:.0500 000.0.0 :005- .005 :00....- ..0. 05050.. 0000090 0.0.00 00:00.5 0. .0:. 000. :00....- 0..0.000 00: 000. .000. :00:.- .:050.000 0:0 00:0: :005- H620523... mmmomn. Dz< wZO_._.D:00 00 .02- H0m.“.u......z...>n.<0.0 0000.00 0:0 0500.0: 90.2- .0000 050.0905 305.- 000.00 .090: ..0000 ...00 000 ..:00- .0000: 0.5000 ..00 0. 0.00.0. 0:0 50:90.0:00 00:0:0 :00- 5_.50. .0. 09.000 000. 50.. 0.0090- H00052439.. 000000: 0. 5050.000 .0:>> «000.5000 :30 .005 0:205 .0 88.8.60 o... 90 .92. 0w.._..>.-Po< ...zwhzco 020....mm30 0.0.0 500005. 0000. .005. .0 000:0 5.00.05 .00:00:0000:. .:0..0:.0.000 000.0500 .0:.500:00 05.. 0:0 50005 0. 0:.000. ..00 0.00000 05. 0000. 0:00. ...00 .00 .0020 0:00. 05. .00 :000 050: .0:. 0000.0: .0 00000 .0.0: .00090 .00.0.0. .00.:0 .00.00.000> >50. .0.0:000 .:.00000 .5000 .005 05.0 .0502 .000. 0.0: ..050 :0 95:0 :00 5000 .000.0 00.000 .05.. 000:0 0.000 000000 ”0:505 0 50:0 0. 00.0 ”0:505 0 00.00.0005 0:0 0..0.. 0000000 05:05 0- 5 9000 0:0 0500 5000 0.9.090 ..000. .x0000.>5N ”0:505 0-0 .V .0 .N .F ”0000“. .005“. .n. .0000 0000.0 0. 0055.00 0.0:.0 .0.0:9. :00. .50.. 0000 00. c. 300...- 50:90.0 -:00 0055.900 00000 0.0.. .0 5005< ..00:0.0 :. 9000.0 .0:.x000 .0..<- .:9.0.:. 0. .00.00 00... :.:. 0. 00.0.. .0:.0 .0 .005 00: 500.0 .000.0.0- HWEN—5. 000.0,. 0.00.. 0:...000 0:.00 00.00 ..000 500.0- 0m..m<...m.wm> oz< 0.051“. 0.0.0000 .. 00.0.5000 00.000- 0_0.0000 :25 500.0- 05.. .0 50050 .0000- 0.0.0._ .0 .:0050 .000-.- 0.0.0000 0~.0 .000.0-.- H0.”..v.000 mm 003010 000..... 00000. .00:.. .0. 0000.000. .0 000.0 0.0 .0:>> mmE>Eb< ...ZMEZOO 020....0m30 0.0.. .0000. .0...50. >0 00:0:0. .>.0:00 0. 00 :00; 0000. 30: 00000.5. 0.0.0 0.00.0 0000500 :0 0..003 0.:0>> 00.20000 >0 :.00. :00 00 2.50. 0..? .00 .E00. 0. 000: ”0050.005 .0 >000: 00.0. ..000 050050 ..050 2:0 .000 .00.0:0.0.0:00 0:0 00.0.x0. .:0.0...0 .>.0..0> 000.000:0 .0.... >00. .00>> 2:0 .00 0. >0:00:0._. .0>05 00. :0 0:..0m. 0.00000 0. 0000.000 .0.00000 0000 0..? >00 0 .005 0:0 0>00 2:0 >05. 00000 0.2.0.0 0:..00 00000.00. 0.00.000 ... 0.00: 05.00 .0.: .0 0500 0:4. 0.20qu 0.05000 0.0.0000 0.05 - 00.005 3 .>0005 .00 .0.0000000 0.05 - 00505 N. .:0000 0..? 005000 .0.000000000 - 00.005 0. .:0000 000.0 - 00.005 0 .:0.0.0>00 >0 0000000 00 >05 .05 ”0:00 00.0 .00.0.0.? .00.0.0. 2.00005 0.00.. 050000.00. 0-0 0. .00.00 000000.00. 0:0 .>0:0.0.0:00 00000 00.0. ..000 ..0.0. >.. .00.0 ”0000. 0.00.—0m. N'm'v‘tn'co'tx' ... ”050.090 0:.000“. .2505 0. 00.0000 00.3000 00.0..000500 :00; :0000 >0 000. 000005-000. ..00 0>.0 N . 000000 .0 50> 00000005 000000 .0 000000.02 .v .0000» .0 ..00:0. 0:0 ..00 - 0.005 0000000 20:. n. .N .00.00.000> 0:0 0..0.. .000.000 ..0... .000005. ... H0000“. 0.00... 0.00.0003. .0.... 0w.....>....0< ..ZMPZOO 020....wm30 8 00 muse—210w... 02.1.2900 >>w_>wm .._> 0.00:0 ..00. 0.0>< .0000: 0000.0: 2.00 ..00. .005 5.2.5 0:00> 0.00 >00 .00 9.0000 >0..000 0-0 0:0 0.005 m .0.000 0.0 >.0>0 .00 0. 000: >00. 00 .000. .0. >..00000 02.5.. 0 0>00 >00. 0:0 00.0 0.0 0000: >0.0:0 0.0.0000 00.2.00 .0 0m.....>_...0< ..ZmPZOo 020....ww30 301 .000 .0 00.005 00.0. 0. 00 :.00 30: .00> 00.50.00 .0 .:.0030: .00> 0..? 00000505500 .N .0.00 00.0.0. 0:0 :.00 30: 0 .0 00.000.00.000 .. "30.30 000.0 000:00 .0.. 0000.0. 00.500. 0. >000 00. 0.0 0. 0000 00 :00 .00. 00.0500 .0 000>. o.>. >...:00. .0 000.000 000.0 .00.00 00. 0000000 .0 .0..0000 00. 00>00. >000 00. 0.0.00 00.0.0500 00 .005 .00. 00.000090 .000. 03. .0... .0 0.0030: 0 .0 0000: .0:0..050 .0.0:0 .00.0>00 0.000 03. 0000000 .0 ..0.000 0.>000 00. ..00 0. >.000.000: 0. .. :00? 005.. >050. .N .000 00.0.0. ..00. 00.00.00. 00.0030: 0. 00.0000 02.000.00.000 .00.0>00 00.0. 0000000 .. ”0. 0.00 00 ...3 0000.00 0500000 .000.0 0.0. .0 0:0 00. >0 “Nahum—.00 > 000.0 0.....0 05.00.00 0:0 :.00302 >mm>3mo 0050 hwy...“— 000. 00300 - ..000 .0 .00. 0. 00.00500 0000 000. 000 0.002 - 000.08 .000.0 - ..00 - “[00:00 ..00» .0... 0. 00000. 07.0 30.0 :05 .00000. 5-0. 000.0>< ”0.000..- ...00 .00 00000 F - N: 0.00 .900; 92 c. 0.000.. .35 .00; .02 0. 00.0; .00.:. .0 0.2.0 ...050 0. 00.0.0. 000. .005. 000 0.0.. 0000x0 .0 0.. .00 >00. 0000000 00.0 .000 .00.03 000. .005. .000000 N: 0. 0. 000.0>< .000000 N 000000 0 0. 000000 0 000000 0 0003.00 .00.03 $00 000.03 - 000.003 000.. - 2.000 0.00.0 - 068. .o 0.002 S. 0000. 008.0820 280 - 0000. 00m. - .00.0000.0 0.0 0.00 0.00.00 -0.05 00 3000 - 000:0 0.00 ..00. 0. ...00 .0.0:000 0.0 00.000 0.00 ...300 .00. 0.00 0000 000 ._ -300 02000.0 00.02.00 ”0000.0 .0.0000 ...0..00 500.03 0 .0 00.05 .0x00. 2.00. ..000 0.00300 0 300 .0. 00.000.000 0.0 0.00.00 >005. .0500 >000 00.0 00> 0003 30050 00000. 0.00 000 00000 00.000 .00.. 00.00000. 00.. 0.00 ...3 0.0... 00.0000 .0.>0000 000 .00.0>00 0.00 00.000.00.000 00.00300 00. 00000.0 ...3 03 302 Hz~00m>>mz MI... - 20.50300102. 000... 0.00. 00.00300 00 .00>> 00.00300 0 .0000 3000. 000 ..00. 00.3 >00. 00.0000 00.00.00 0.000 0000... .00.. .0 >00 0.0 9.003 .00. 50.. 00000000 >0< wm_._..>.._.0< .02th00 020.0.me0 00 0.. 00.0 .0 00000.00 02 - ...00 .0 0.28 .0000 30:0. 000 00000 00.00000.0 000 ...000 .0 .00.. 0. ..m 0000. 00>m. - 00.003 00.0. .0. 00.00.0000 00 >05 0..000 - 00.005 0... .0. .003 ..000 0.000 .00. .0.00. 02 - .0.005 .0... .0. .05.02 .0008 0.0005 .000 0. 000 00>0 00000.0 - ..0... 05 .o .28 000000 0. .00.. 0. 0.00098 0002. ..00... 000 00 0.0. 00 000 00.005 00.0. 00 0.00 00 .0.00 50005.00 ..0.00 00.0 .0 >05 .. 00.003 0-0 0. 0.000000.0 000.00 0000.0 000 .0 00.00 00. - 000000500 .00.0:0.000 - ..005.0.0 000.0000 000 .000.0 000.0000 50.. 5:030 00... - ..0.00 000. .00.0. 00050000 00.000005 - .00.. .0000 0. 000098 0003 .0.000 .0 0.0.5 - .00.. 0. 000.0020 000000. 0..000 - 00.00.0500 .00 0.005055 00 00.00.20. 0. .0000. ..000 - ..000 3.2.00 .0000, .00 .000.00 00.0. 32.0. 00>0 >05 000 .0.000.0. .00.. 0. 00000.0...0 .0 0.034. ..00 20000 ...050 003 - “QM .0>00 N; 0. 0.000000.0 - 00.0 30.. 000 00000 00 0000.0. 50.. 00.0.0.0 - .000.0.0 .0 >000 00 >05. - ”I000“. .000000 000000 000.000 50000.... 0.0.: 0. 00 000.000 0500 0. 0000 0000. >02 - 000.5900 .0 .0050>05 .000.0553 - 00.005 0. 0.0< .000.0 0. 0.000 ...550. 00 0003 00.0 0. 00.0 0000 050... - 0.9. .0529. :00; >08 000 x80 .0000 080:0 - 0. ..00 0 0>00 0000 0.00020 ...000 00.00300 000 .00>> 00.003 00. .0000 0. 0>0.05. ...3 0.0... 00050.0 000. ...00 0 00.00 00 0003 0000000 30. 0 ...00 .0. 0000 ..00000 ...3 00.0005 0.002 - -0.00 .00.000.0 .00000 .0. ..000 0 00.0.00 200000500 .0000_0>00 =03 302 - >000 0 000.000 00.. 00 30... . ..0.0. .00II05. mm....>_.ro< ...zwhzoo 029.5020 30.. .0000 000.000 u 0000.00000 30000 00.0000 - .0000 0.00. .000 000 .0030 .0 20000 00.0.. - 002.00 32.030 0. 300 300.. .00 00 >00. 0000000 .0... .0 .00.0 ..0..... 0050.00. .00. 00.005 00.0. 0000.0 000003 00.0 0000.0 002.00 - 000000020 .0. .0.000 0.300 ..00 00.00.. >..0m 0000.00 .0005 0..0>> 00000.0. 00000. .00.5 .000.0.0 - .00.. 500 00000 0005 00000.0 .00 0000 000 ..000 0. 00000... - .0.005 .0 v.000 0. 0..03 0500 - .0000. .00. 050.0 - .00.. .0 000.00 .0008 00 00002.00 000.000 - ”04002 .0000 000.0 0. 2.00000.. 0805 - 0.00.005 00oz - .000.0 000. 00.00000 2.000 0.05 00.0.. .0030- .0.0000.00.0 0..0>0 00000.0000 .0...m - 0000000025 ..000 - 000.5 .o .:0 0.9.. 5.; .0. 0:0 000.0 - ..0.00 0 0..3 000.00.. .0 0.0.0.. ..050 0000.0. 0 0000000 .. 00 0.00. .0 00000 0...... .00.005 070 ...00 ..050 .0 00000 0...... - .>.0>..00 00000 000000.“. .0002 .000.00 0.0000000 0. =03 .00.00 00.000 - .50.. 0500 ..00. 00002.0 00200.00 000 000000 020000.006 00 00.0 0.0.00 00003 0500 - .000.00 000000 000. >0 000.06 - .00.0. 0. 0.000 00000... .. .0.000000.0 0.00 0. 000005 000 .00 .00 0000. 00 0>00 .0.0>00 0.0..3 0.000 0.05 0050000 - ..00 .0... .000 .000 000 00.0 .0 0.0.05 0.00.. 0>.0: 000 .0m. - ”0.0m ...00; E0930: m :8 £038 30: ww..:>_.ro< 0.25.200 mZOmeDO .0008 .05.00. 0.0.055. .00..0.00..0 .0.000000 0.0.055. ..00. .00000 .00.. .0 .0.00 00.0 ”0.00005 - 00.0 .0 000000 0. 030.0 00 0. 0.0000> 000.0 00.0000 .0. .o .0.0. ...... can 0.000 .o 8.0.0858 ..00 o. 0:0 80 - ..0:000. .0 0:0 00 00:. .00..000 000 00 0000 .0.0.. - 00003 30. 0 0. 0.000000.0 ...00 00.0300. 00000.. - ..000000. 02.00.20 0 00 0.0< 0000.33 000.03 500000 .x.0.0> 0..3 00.0>00 - H00.0 .000000 .9. 02 .00.005 .0 00003 30. 0 0.53 0.00.0 .0000 00. 000 500.8000 00. 0003.00 000.0 .0 00..0_05000< ”050.052.0000”. .>.0>..00 00000 0000 00. .0 ..00 00000090 00. .00.000 05000.0 0. 000 0.000 00. .0 0000.. ..00 00. .0 0:...030 ”50000000000 .0 0o ..05.00 n 0000 ..000 0003 000.0.0 0. 000 .000..000 0..3 0.00.00 0. 00>.0000 00 >05 0.00 .00.005 0 >0 0000.0 .000.00. .000.0< 00.005 03. >0 0000.0 .000.00. .000.000 .0000 00. 00.0003 .00. ..000 00 0.0.0 0.00.0.0 .00..0>00 0000... 030.0 0.0.0.0 000 050.005 .0. 30:3 .00..000.00. .00 ..000 ..00 “m0=0cl.0..|00l.... 0>00 30. 0 0. 000000. 2.05.02 ..0000 00.0 00. 0000.0. 0000000 0.00 -0550000 0. .00.000 000 000.96 00000 00. 0000000 002.00 .00.00> 0..3 .0000 00000 0. 0000000> 005500 - .00...05>00< - ..00. 000 ...00 .0000 .0000 0.0.0000 000 0000 .0 0000.0.500..o - 0.00.0000 00 0.0 0000.. 00 05000 000 ..000 0. 0.002 .0.000. .0.0. .0 v... - H000: mw_._..>_._.0< ...zwhzoo «20....me0 00 00 ..00. 000 00000 00 0000 .000. .0000.0505 000005 .0.0 .00>0 .30.0 .000. 0. .0.00 30..0> - .00>00 000 >0 .000000.0 Em - N: >000...0 .0... .000 000.0000 00 0. 00.000 ..00> 0 0. 00 00.0.00 >05. 00.003 03. .0... 00000 .0 00.0 .0 5000.0 .00.0>0_m 0..05 >..0030..w - ..00> .0... .0 000 >0 .000 -000.0 .0000 .0 0.000 .00..0>0 00 0.000 0.0.0 0.00 0.000 02.06 - .000..00 .02 .00..05000 0..3 00.0>00 00 000 .000. 0. 0000. 0000 0.600 .. .00. {020.050 0.0.0 .0 000000 0..3 .0>0_ .00..0._.000. 0.0.0 00.3 ..00 - .0.0000.0 0..3 0000.0 >00... .0.00> N; 0. .000000.0 .00.). ...000 .0 ..000 000 00000.0. .00..0>0 00 005500 Hgamma ..000>x0 00000.00: 0000 0003 00. 0000 - 00.00000 .0.00 00000 000098 0003 00.0.0.2 - .000000 505.00.. 02 00.003 03. 0. 00 .00. 000 .00 0>00 .00. .0... >..000: 0.0000 .0000 00.. 00... 0.00.. ”50006... 0500.>.m. - .0.00> .00. 0. 00003 50.. 030 00 0.0000005 00.02.00 .0 50.000 .0 00.0 0. .00.0.0 0.... 00.00.. 00.0 00.0.0 ”0.000 00000005. .. .030 00 .0000005 .00.03 00005 00:.0 0000000 0005.00 0. 000 _05.02 ”3.0.0.”... ...000005. 000. .000.0 00..00>0.0. 00.0.5. >..000 0.0200 000 ..00 00.0 - 00.003 30. 0 0. >.000000.0000 >030 00 0000000 .00 00 .0.0.055. 000 00000.0 0000.0 .0030 .0.00 000 0000 00 .00000 0..0>>. 0....2 - ww.....>_...o< hzwhzoo m20_._.ww30 >0 0.. 0.0050 000 030.000.0003 8588 200.090 ..0.00 0:0 .222 .203 00.03 0.8 00.350 - 0000.0 .00.50000 00.0. 000 00.0005 0000.0>00 >..000 0. 000 500.590 - “gag 0500.0 0000 _0.0>00 >0 0032.0. 0. 000 00.0 0.05000 00.0.00.0 0003 000..00 00... ..00>05 0050000. .00.00.0 00oz - ..0.000... .30..000 .0.000 .00 0000.0>< 00.00.550.00 0000.. - .>0.00 000 005500 0.0 0.05.05 .00.000; ..0.000... 00 >05. .00. 000.0>< 00700 0.0. ..00: - .00.0.00 05.00. .0. .0098 00.0000 00 .00 0.0000 002.005. .02 .05.02 00.003 0.0 0. 0>00 _0.0>00 0.00.. ......5 0002.3. 0.5 .0 52.00.00 05.05000. 0.0.. 0.0.000 000 0.050. 000 0.05 0.00 0. 00.0.00 0.0005 .00..0_00..0 .0.0. .0.00 000 05000.0 000.0 00005.00 .00.0.0.). 0005005000 .000.0 - .0000 ..0... 0.0% 00000. 0.-0.. “.0000 .00.000. .0 05000.0 0003 .00. 000. 00.0.00 >05. .000. 0..0.. 00 >05. .0.000 .00 0.0. .0000 0000. H - “0...00.000.u0. .0.00000 ..00 50005.00 0.0.00 00.005 .000 00.0 .0..0 ..00 000. 0. 000.0 .0.0. 00 00.00.. >05 00.03 ..00 ...00 02.0 .00.. .0 0.30.0 0.0.0. 0..3 00.0>00 00 >05 0.00020... - .0..0E0 0...... 000 ..0... .00..00.0.0. _0.005 .00>0.0 0. 00.00.000.. 000.0 0 0..3 00.00.. 00 000 0_0>0_ 00.0 >.050..xw .000. 0. 000000....300 .0 0000.030.0 00000 >02 .00.0..005 0. 080 .00.0>00 00.0.0 ...00__-.__0. .00.. 0.0000 0 >.. 0200: - x0 - .30..0> 0.0. 0. 0.0.0 00. 000000 .0.00....0 ..0000.0->0 00 .. .000 0.08 00. .0 03000005 00. 0.0000 0. 0.0000 0. 00.03 .0.... .0 >...0.055. - .0...0 .0..0 000000 .0000. 00 0.000 00..00..000 00000.00. - ”00000 00.00 .0255: 00. .0 0.8 00. 00.2000. 0..000 000 0.00 00. 0.0 .00>> ww_._._>.._.0< ..th200 wZO_._.wm30 00 00 03653.8 300 0.0 0>00 0.00300 ..0 .0 $00 005.... .>.00.00 >.00000000 0. .. 00.0.0 0<< ... .0. 00.>00 .00 0.0 00.000500 0000.000. >005. ...000. >05 000..00..0500 000 .0.0.00 200.0 .. 000.. .00.0. 000000000 00.00 300 0. .000 00. 0. 0.000090 05.000 000020000 000.0..0. .0 .0.0..00 .0.000 .0 0.. 50.. 0.0.0 .0 .0>050m. ”00.0.05085 - ..0.005 .0.0. 0.0. 000000000 00 0.00 0.0000 00.0..00... - . .0000000. .0005.0... 0>00 30. 0. 0.0000005 .005500 50.0.00 00:03.0 - meolm 20000005000 020000 00005.00 0..00.05 0. 000 0.00. 000.0.00 00.003 30. 0. ..0 0:0. .00. 0.0.0 .0 000.0 ..050 .00. .00.00> - .000000 .005.00.. 02 >030 0000 00005.00 0.050. .0 .030.00..3 >0 000000 0000.. 000.0 00 >02 0.003 .0... 00000 000000 000005 0..03 00.0. .0 00.0000.0 .00.00> U00.0 ..0..:0000 0.00 .000.0 0000 >00 0 005.. o ..-: 00.00..: 0. ...IsEmw .30. 0.00. 000 00.00000 >000.0 0500 0>00 >05 ..0 0:0. 0.00 000>> - .00.0. 000 >.00.0m ..000.000..0 00.0005. 00.0.03 .0..0 0.000000.0 >..000: 0.0.00 .00...05: - .0.00 00. 30.00 0000.0 .000.0 0..3 ..0 0. 000098 000v. - 05000.0 .0 ..050 .00. ..0000 - .00.000 ...00 0.00 00.02 - .000.0 000 >.0 000v. - .00.000 20.0.0500 0>00 2.0. 0>00 070 0. ..0 0:0. 000 00.5 - ..0.00 0.00.0 0>00 30. 0 0. 00.>.0 0..0..» .. ww..:>_._.o< 0.25.200 wZO.._.mmDO 00 00 .0.000.0000.0.000.0.0x0 0.500. 0.005 .0030; 000 .00.0 0.00 00 ..00 .0008 0000 .000000 0000.0 .0 0.000 .. 00.000 000 00.00.0000 .00.. .0 .00 00 >05 000.000 ..0.0.5 000 0000. 0000 00.0 .000..000 300 00000 .005 ..000 0. 0000 .00. 000 ...00 3000 0.003 >0...“ .0.0 ..00. 000. 0.0.0500 0.05 0.00.. - .0.00> N... ..-. 0003.00 000.0>00 00.00.000 .0..000 .030m - .0.005 803.8. 00: .0..0 .0...-..8. .088 .0.0.. - 8:09.080 - ..00.0 0000.0 00.0.0 .0.0; .0. 0.0000 00050.0 .0 00..> 0.00.00. >05 .00.0 000005 000.0 - 00050.0 - ..05.00 0. 0.0... ..00.0 .000.0... 0>00 0-0 00 >05 >000 000 .0 00.005 03. .0..< ..000 0200000002 000.05 >0 00.00 000. 0...... 00..0> .0.00 0.000.. .0..0m 00.005 03. .0... 0. ..00 .00 .00 0. 000 ..0.00 0. 0.0.005 0. 000.00 - flog - .00.. 00 .. 000.0 ...00 ...00 .00 00.0. 0. 03... ...000 000 ..00 ..000 .0000..0 00.000. 0.05 .005.0. 0.05 .30..0> 0.00 - g - ...000 0. 00. 000. 00 0000000 - 0.109% 0..... .0..0 0>00 00.0. 0. 0.3 ..0.00 0. 000.0 0. 030.0 .>5..0 .0000.. - ”020422.0cmm .0.0.0 0. 0.0.. 0..0.050 00. 0...... 000.0 0032.030 0.0 .00. 0..00 00000. ..00.. .00..00.0. 50.. 0..00 .0 00000500 0. .00.0 0.0.. 00.0 .0..0 .....000 .0 00.0 .< .000..000 000 ..0.0.5 0000.00000 0. .0.0. 0.00.0 - 5.||0.000..0.2.. - .00.0 .0.... - 500005. 0. .003 0. .000.0.000". - 0>00 Wm 00>0 000 .0 ...00 .00 x.0 0. 0>.0 00..0> 500000.“. - ”I0.00....w. 00.... x00. 0. .00.0 0.50.0. 00 .0096 00.. 00 .00>> mw_._._>:.0< ...thzoo mZOmeDO 00 00 .000. .0..050 0. 00.000.00 000 00. 0.0 .. 00.x0...0.00 0. 0..000. 000. 0. .000 50.. .00. .0 0.00 00. .0 000.000 .00... - ..00> .0... .0 000 0.030. 0.0000000. ”x0000 0.00.000 00.0.03 050.050 ..0000 00. .0 00.00008 0:0 050:8 .050. 0058. .8. .o 0.8 8 200 ._ .000. 0.8. 0..; 0.005055 05000.0 90050.0 0. 0..000. 0.00.0.0 000. ...00 00. 0000. 0. .00. 00. .0 00.00 00. 00.2.0.0 .>000 00. 00...... - .0:.0 .0..0 0x003 _0.0>00 0.00.. ”gamma .0.005 30. .0... 00. 0. 0.0000005 5.0 0..00000 00. .0 0006.. 000 .000.0. 0. 0000 00. 00.03 0. 00.0 00. 00 5.0 00. .0 00.00050 0. 0..000. 00.0 00. 0. 0000 00.50... .. .00.000: ”x0000 x002 0.00... 00.005 00..... >0 0.0000005 .0000 >000 000 .00 000.. 0.0 00...50..x0 .00. ..< 0000.. 00.00 ..0050>05 000000 >0 ..0..w - .0000000. 0.00.0. “x0000 0.0.2 .00.... 0003 .00505 0 .0. 00 0000 0. 0.00. - .0..000. 000. ..0 .0 02.6.. 000 .00. .0 ..00 .00.000 00500. 000.0 “.0.00_0 .. 0000.0 000.0 0.000.. 000 .000.. 0..3 00000 .0 000000 .05.00 000.0 005.00 - .00.005 0.0 0.00.. ”00000 000 0. 00.0 000.000 00.0.05..0 00000.0 00.. 000>> 000.000 0.50.>0. 0..0..0 0.005 0. .00.00 0500.0 ”0% - 0.0000 000000. .00. 00.0.>00 0.030. 0000 00.0... .00.. 00. 0. 00.0.05..0 0..? 00000 >..000: 0.00.2 00.0 00.0.05..0 00. 0.030. 00.0.0. 000 0. 0..000. 0.. .030. 000 .0000 .0.005 00. .0 0.00.00 00.0.0.5 ”mam-0| - ”gag UwmeOnamm 0. 0.5”.sz ww...._>.._.0< ...ZMPZOU szmeDO .00.000 0 .0 .0003 00.000 0. .00.0. .. 00000 0000 .00 00.0.>00 00 0. 00000000 .02 .. .000000000 00. 0.0. 00.00.0500. 00.00 000. .0 50050 ..050 “00000 0.0.0000 - ..500.000.0 00. .0 050000 00.00.90. .0000 000000. ”09% 00.20.0050. 0. 0000000 000000 0.0>< .0000.0>00 0.0. .00 50.000005 0000.000. 0.0.0.0050... 0000.000. 0.0.0.0050h .. ”I060 000 l.000 0. 90.0000 .0.0.E000.0 .00 0.0>0.. .0..000 0.0.2 00000.0 0. 0.0>0.. .0030 000 .000.0 0002000 0000002005 - .0.00 300 00 000. .00.0. .0.0. >05. 00.005 0 ...0 .000 .00000 ..00000 00.03 ..050 00 .0. 0 0000000 .0000. .0 00000 0.0... - 0.00%.... .|0|:0 0000 .00.0..000. 50.. .000 000005 .00.0 0. ..000 0.. 00 000 000 000.0000 .0.000 00000000000 0....) 0.5.00 .. ..0.0000.00 .00 00.00.0880... .. 0.005055 005500 0.0 00.02.20 000 0.050.. 0000005000 000 .0..0 .00.0.. - “0.005055. 500d0|m 0.0.055. 50.0.0 000.002 - 2.00m 00.00% mm.....>.._.o< ..kaZOo wZO_kwm:O «000 5.0 0..) >0.0 .>000 0.0 00> .00 00 0000.0 0003 .00.000 .. .... .0008 000 000.3 0. .003 .00 00... 0. 0.05000 000000 .000..) 050.0 00..00 00000.0.0 .0. ..0. 00 0.0000 0..00 00. 0.000. 0. 0>00 >05. .0.0000.000500 .000.000 .0.00 0000.03 ..00000 .0. 000.0000 0.0... .00000. >00 .0>000.0 ..000 .000000. .0. 0.0000- I.05|J..|... 000l0 .00...>..00 .00.0 .0 00000 0.0 000 000 00 0003 00.005 0. - m .0 >030 30.0. 000 .0000 00 000>> 00.0.00. .0 00.0.00 >.. .>...00 .00. 000 .00.000 0 000 00> .. .0500. ..000 ...3 .0 .00.000 0000 >05. .000.000. >0 0000000 0>0>z0 .02 000.000 .0. 0000 0 0>00 0.00.0.- .0508. 000 0.00. .0. 00.. 000 00000. 0..; 00.296 000 0.005 0. 0.00 00000 0..3 00.50x0 ..00000 00.0 .0..0 00.005 >005 0.0.98 0. 0000 0000 000 0.00.2 .000 0.0. .0 .0.000.00<. Ilqlbeat 5.8.0 0.2.0... >005 00. 00065086 .0..0 .0.0 02.0.0500 0000.6 .0 02.0000 000 0.00 0.0>0 0. 00005 - .000..00 3.00.03 000 000.0 .0 0.0>0. .00.0...0 ”0.0>0 000.0 - 58... .o 00.0 :.0.0 :.: 2.59, ..- ...00; .. 93 :.3. 0000 0.0.000. .00 ..0. 00.0 00.0 .0 0.000 ”000.000 - .000.0 0. 0.000 0000 000. - 000x030 .852 .000.00 000 0000. 000.05 .00>0.2 ..0000.0 00000 0.02 - ...05..0 00.000. - ..00.0 0.00 00 00 00000.00. 000.000. 0003.00 050.0 0.000.. .000.000. .0. .00.0 0 005.. m-N 0000.03... .0000 000 .00.0 00..00 000.0 ...3 00 00 00> .0. .00.00>000 005.. .0 >00 00..00 .000 00> ... 00030 5.0 000.. 000 .00.0 0.00 0< .>00 0. >00 >.0> >00. 08.0 ___; o; 08. 39. =00 .2 8000 .05 020.8; 00-0. - 000.000 .0.0. 05000. 0. 00..» .:05035 .59.: 0.25.0 mgcx USN U@m_m.. .Umxmc was: ::3 m0: n d0. 0.0.. «>.0 2 >000 .0. >000 .. 0. 000. 30: 00500. 0.0 .0 .00.000 0 000.000 >000 .00> .0000 .00. 00> 00 30... 0000.0 0.00300 0 0000 0.000 >005 30... 000000 00> 0.0 .00>> 0000.0 500300 0 0000.03 0>00 00>. .0 >005 30.... mm....>_...o< ..th200 wZO....meO «.08 .00.00 000 0000.. - >000000.n. 0.. 05.00.00 ..000... .>.0 >000 .0. 0. 00..00 0.00 0. 00.055 0 ..-o. .00> ..0. 0. 00.>.. 0. 00 .003 000 >...0000.00 0.>000 .00> 3000. 0.05.. 000. ...3 .. .00.0...0 0. >000 000m- .000.000. 000 000..00. 030 .00> 0.0000 .9000 .0 000.000 .00.000.0x0 _0.00. ..0.00. >000 020000 .0600. .>..000.0. 00. ..00.. 00.0.0500 00.>00 .0 >0; 0 000 >.0 .00.0.00 .>000 .0 000000 000.000 00.5500 ...0.0 .0.0000 .000. ..000.0. 00000 0.>000 .005 0. 00.>.. .00.000 ..00.0> .0 000.. 00.0..0. .00.0.00 ”.00.0. 00.>.0 00.0.000 .0 0000.02. .00.0.0.. 00.0 .050 >000. .0003 00. .0.00 00. .0.000.0 .03 .0.0000 .00..0000 .0 000000 000.000 .0. 0000 5000.00 00000. .0.00 .0.005 0. 0000. ..00000 “0000 >000 >03 000000. 0...... 000. >00__0.. 05.0. .00.0 0.0 05.50 .00.000 .00..0x0.0. .00.000.0xw 00000505500 .0 5.0. .0.... 00. 0. >.0- 000.0. .0 00002005500. “000000505500 .00. 00.00 .0..0 005500 2.00 .>0..0 00.000. .0 00.055 0 .-o ..-m >000 00.>.0 0.00 .0 00.055 0>.0 ..00 .. >.0 >000 .0. 0. 0000 >0_2 00000.0 00.0.02 >00 .0 05.. 0.0000 0 .0 0.0.0000 0. 0.0000 < 5.0 00.500 0. 00.>.. .0 00..00. 0 00> 00>.0 .0000 00 00 0. 05000 .00.0. 00.0.00 0..03 .00. 00.. >05 .0..000 0. .. .0.000 5.00 ...00 500. 0>00. ..000 0.00 0. >000 000.0 .0008 00.00. 0.0 00> .00. 00> .. ...0005 .00... 0.000 ..000 ..0.00. .>0.. 0.005 .0530 ..0:000 00... .00> 000 000 00 0.003 500. 0. 5.0 0>00. 0. >.. 000. - 0..030 00.00300 00. 0. 0.00.005500 03 00 30.. 000 0. 0.00.005 -500 0.00300 0 0000 30... ww..:>....o< ..zwhzoo mZO....mmDO .0 0.. ...00 00>0 000.0. 0>...000 ..00- .0000...- .mc_x8. 05080. .00.00 00500 00 ..000 ..0.0w- ...0.500 0. 20...- 0.0000. .00.0. 02 ”000.000. .0. 0.0...- 00>0. 000 0.0000 .00. 0. 00002 U...m DZ< -._.._n. - womwz o.mm00 0. 0x00; 30. .00.. .00.0. 0. 05000.0 0000.0. 0000 .00055. 0. .00.05 .. .00.0005 000 0005000 .00505 .x00..050 .0. 00.000..0< 00.0055. 000000.- ”b.0055. 0000005 .00 .. 00.005 0.0 0. 3.0055. .0 0000.00 00 F 00055. 050000 000 .00.0.... 00. 00....>> 0. 00000.0 0 0. >..—.00.0.. 0..3 ...00 0. .00.0. 00. ...000. 0 0< .>000000.0 0000 0. 00.0. 00. 0. 05000.0 0.> 00.0.0000 0.0 000 00..00 0..0..000. 00 .0. 000.0 .00 0. 00.0.00..0 0.050. 00.00.58 000 .00.05 00. 0000000 00000.50 50.. 000.000. 00.000..0< ..:-Em ...< 20:05-01...— wm> ..0.0- >0.0 ....50. .0. .00.: 0 00.055 0. 00000- 0.50. 0 00 .000.. .0..0..w- 3.2.00 300005050050. 05.. 0.00 00.0.2- 0.0.0 000 00.298 .0. 05.. 0 00 000 0000000 .000.0 000 0.00 .0:... 00 0.030 000.0 00.005 30. .0... 0_- .5.0 0000.0 0..03 000 >000 .0000 500.. 0.0.0 0000.0. .00.0 0000 300.. 0. .00- 000000 0.000 0.>000 .0 0500 0.0 .00>> «00000 0.000 0.>000 .005 00.. 00 30... .>_ 00:50 ..000 0 0000 000>> wwE>_..-o< HZMHZOO wZO.._.wm.DO 000: .0.0000.0 000.000 .0. 0000 00000.00. 0.0 00.00.00 .0 00005 0 00 .0...000 0 0000 00.0 05 .00.0.- .0_00.00_.0.0. 0.05.00 00.0>00 .00 00000.0 ...3 000.00 00.0.05..0 000000 00000. .00 0000 .00.0. ..- .000; .0000.00 0.0 0. 0.00000. 050000 000 .00500..>00 .0005 0000000. 0. >....00 030 .0000 >05 .00.0. 00. .05 .00 000000 000 0.6. .0. 0000 ..- .000000 05.00 .00 .0 00..00.0>0-00.x00 ..0.0x0 >05 ..05 .00 000. .0. 0000 ..- 00002 .0 02.0.00... 0.00.0 .00.. 0. .00.0 0. 000000090 50000.0 00000 00 000 0.0008500 .00.. 00.00 0.0 50.. ..000. .00 0000 000.000 5000.0. 0.00 0. 00..000 00 .00000 .00.0. 00 ..05 0.0 00000 0.000 0.0 ..- .00..0_05..w 000000 0.0.500 000 0.5.0>> .00.00. 000>> 500. >0..0m .000.0 .0. .00.0. .0 0000 2000 00.0.05 0. 0.0. 000.0 ...3 00 >00 00..00 05.. .0 .00050 0..0..00.00 00.030 .00.0. 000.. 0. >.. 002, 0.00.05 .0 0.00: 0.50. .0. 5050500 0.000000 0.0. ... .00 >05 .0.00<- ...00 0 0.000 00.0.- ”000.0 0.0.0.. 00 ...00 0. >00 00>0 000 ..00.0. 0. .00.0. 50.. >.0> 00000 00.....02 0.50. .0. 50.0058 0.000000 0.0. ... .00 >05.- ..0.0_ 0:000. 0005000002 0000.000 000000- .00 000 000.0- 38.. c. 05.8. ._ 8.05.0.0. .8 0.80. $2.80 00 >000 0.00300 0 000 mm_.:>_._.0< ...ZMFZOO 020....wm30 000.. ...00. -00 5.0000 .0. ..0.. 0.00.0 0 .0 0.0 0000..- ”00000.0 .000000 0.0.0.0050. 000000 0.0>< 00.0 .0000 .0. .0 0.00.. ..00500..>00 0. 0000000 0. 0.0590 0000001000 0000.000. 0.0.0.0050. ..000 - 0.0002.- .00..0.005..0.00>0 ..>.. - 05.00 .0. 3.000 00 ...00; 00.....02- ”00.520 >0 000000 0.00 .0.0000 00.....00 0000- .00.20.50 0. ..000. 0. .00>> .0 0000.305.- .0.00 .0.000.0 50.0.0000- 00..00>0.0 0.50 0.00 .0.0000 000 5050.000 00000.0(- .0000365. .00.005 00000>0<- 0.005560% .0.000. 0..? 0.00 .0.000.0 0.0m.- ”0.0. .0>.>.00 0. 50505.05. 00.0000- 00.000.0- .00.....00 .000- 00.0.050- 0.50.6.7 0030.0 0500 000 cm 000 .0000 0.00.05 0. 0.00.0- 0.00 0000.0 .0.0>>- .00000.00 0050000 05000.0- .oom. 0.0.00 0x00; 0 0.0000 .00.0. 00000 N: 0. 000000 N: m .0>0 00.03 0. 0000 .0. 000000 000. 0.00 0003.0 ..00000 .00.0.>. .000.0 0.00.0.2- .00000. 000.>00 00 $00 0. 000.0 0.63.0 .00 0000000- ”000000 .50 comm 000. 000. .0 000000 N: m .000:- .0..0>, 00.0.00 .0. >000. 0.00.0..00 .02- ...05.00 00. 0000.000 0x00; 00 .0000 .00.0. 500 00..- 00...:000 Hw._.z 0.00.0. 0.0.0520 0 0. .00>> mm.._..>_._.0< 029.200 wzo.._.ww30 0050.090 500.00. 0000.0. 00.0 .0.50000000.. .0. 020000- .0.0.000.0 ...—.0 00.50. 00.00 300 0.0.000 >005.- .00.000.0 .000..0.000 .0 .00.05 00000.0 .0 000.000.000- .0508 8.80 0.8..- .5050 0.05 >.0>..00 .00.00> 000.05 .0>0 000 000000 000- Hmm=m05 0.00005.- .000. 0. 00000030 00.000.0- 0000.050 0.000 0.0.00.000 .0000. 00.0005000- .>5000 00..:- §0=030 0000.000 0.000- ..0.000... 000 32.000 0:000-..000".- .000. 000 0.000.. .0 0000 0000. ..000 2.0000. 000 .000.0- ..000.50.0 00.0.00 .00.0. 0.000500- .0000. ..00..0- .0000 0. 000.0 0.0 0.0m.- .000....00 0000.0>00.0000 - ..00 0000 000 0.0m.- .00.0000_ 0. 000.0- .00000. 500000<- ..0.00 00000.8 00500500 .00. 0000 0 .. 00.>.0 00.0 0000.0. 0000 0.000 0.0000> 000.0 ..0. 000000.00000 00.00. 000900000 50.000000 00.0- 000000004. .00.000. 0.000 0. 0000 ..0 00.0000 0000. 0. 0000.00 000.03 0. - 00000.0 000.050.). 00..0>:- .00.000.2 .00>>- ”0008.0000- ..00.05 50.. 00000.0000 00.00.20 000. - 00000.0. 50.. 0000290- .._> ww_.:>_._.0< 0.25.200 wzocbwad .000 .0 0.00.. 0;. .0..0 00.00000. 0.0.0. .00.00. .00.00 000 .0... .0 00.005 .00 00 0.00 00 .0000 000 000500 0.0.0 0000000 00..00 E0030... 00. 0. .000.0 0. .00.000 0.0. .0 00.000000- ..00.050.0_. 0.05.0. .0030 m 5.; 85.00030 00:000. 0.02 005.0020 .0 9.0.... .00.00 00.0...00. .0 .0000. 0.0.0.0 .0.0.00 .0 00.05. .00>0.0. xm- ..00500.0>00 0.0.0 .0000: 0.00.0.0 - 00.0.050000 .50._000.05 00.0.0. 50._000.05 00.00.00.0000 0. .00.00 .0..000000 0. 000- .220 09.0.83 0.00... .05.... 08.0. 00>0 c. 0:0- .00.00.0...0000 .0. .00. 000.0- .00000 000.000.5000 .0. .00. 000:- .0..000.0x_>0000 - 3x0 00>.0 00 05 00000.0. v. 0.50..)- .000.0 000 .0 000.2 .00.0- 0.000 0N 0. 50x0 .00.0>00- ..0..000... 0. 0.2.002. 00 mm- .00000. 0000-.- ...00 0.000 000 .0000. 0.02- 000000. 05000.0 00.0..000 .000. 50.03 .0000. .0000. 00000 00.0- .0000... mm 000. .0000. .02- 00003 N0 .0>0- H.ww.m 00 .002. ._=> mm.._._>.._.o< ..th200 $20....me0 00 00 ...00) 080 000.0 0..? 0.000 2 9.00 o. 05.0 .03 0.0 $5682.02?» 3.2 ...00? .x00 000.0 0..... 0.000 0. 000.0 0. 0000 ...000 0..... >030 0000.0..0 00 .0. 000 .00 -0.0 0 0.08 o. .0820 . 0.2 00850 5:30:25. 82220 00000550000 9.00 00005000. 00..0x0.0. 000 00.0.8.0 3030”. .00.00005 00.500. - 00000000. 0.. 00000.00. 00% .020 0:80 5.; B... .002 00800- 00.8050 5.... .0.0.0000 00 0000 00 0500000090 02.0006 000 ..- .00.000..000.0 .. 000500 00- .000..00 0.00 ..000 ...00 .00000 00 .005 0500 .0. 02.00 .0. 0.000 0 >.0>m- ”.0..0000 0. 0.000000 00.000“. .00.000. 0.05.0. .0 .000.0- 0000000055. ..00<. .0100 .0 00.. .280 .0 00.. 0.000000 000050055. .0>0 00- 00000.0 0.000.005500 .00.000 00000.90- 0200.0- ..000 000000 .0:0..... .030 0. . 0.0.- . .0..000- ..00000: .000..05m- 5050.050 000 0.30.0 .0 00.03.0000- 0002.00 .0..0 0.00 .00.005 .0 00.2.2.0“. 50.9.0 .0 .00 0.00....0 000.. .00 ...3 000050520000 .0.0>> 0.0>0. 0.00....0 00.0000. 0. .000.0 0.0 .00..0005 ... 000.000. 50000.... 00.0000.— 00..00>0.0 0. .00..005. 0. 52.00.00 00..00 0...5.000.0 0.00 00. .00. 00.3000 0. 00.0000. 302 .000..00 0.0.0 .0 .0300 0.00.0. 0~.0.x0 0. 0000 3905220 0520.. ..0... 0.2.0,. 58 .9: 23005. ...000 :05 .0.00.0 005.. m 0. N. 0.00....0 u 000 00..00..000 ”00000 ...00; 000 0.0000005 50000.000 0>00 v.0 .0000 .00 >05 .0 >05 ”00.0000..- .8052. 00.022030. 003...... ww..:>....o< 0.25.200 02005900 arenting in Pregnancy . . begin a/ [be bqqz'mn'ng “CUES & CRYING” Cues babtasgivetba'rparentsallowmposqmrmm rammdbabymtbdrparmforpbyawlmdmcbologmmal. WmmgMmeWsmewao/‘MW. PURPOSE: To clearly show the parallels between the cues given by a mom in labor with the cues given by a crying new born, as well as the responses necessary for both. GOAL: To teach parents what their newborn is capable of understanding; dispelling the myths and replacing them with enough truths to help parents cope more effecrively with the frustrating and/or confusing behaviors of their child. To help parents identify “cues" in labor and postpartum that reinforce reattachment or bring the support sysrem surrounding parents closer. DISCUSSION: Ask parents— . WHY does a baby cry? I WHAT does a baby’s cry mean? I WHEN does a baby cry? MYTH: Crying at birth serves a child's need to control or manipulate parents/caregivers. A parent can always comfort their baby. If a parent shakes their baby enough. he/she will know to stop crying. Picking up your newborn every time he/she cries will “spoil” your baby. Every new parent will automatically know what their child’s needs are through common sense. TRUTH: Crying is a babies'only form of communication at birth. It is designed to bring parents/caregivers into closer proximity in order to get survival needs met Gt reattach. Babies do not reciprocate parent interaction at birth. Even when their needs are met. babies sometimes continue to cry. A baby cannot be spoiled in the first six months of life. Baby’s needs are learned by parents as they grow with their child. The meaning of a cry gets clearer through time and observation. Clarification of myths about child development and infant cognitive capabilities before birth can increase parental understanding of what to expect of their newborn child... and possibly prevent abuse. © 1997 Ann (20min. Ph.D., 3341 Crown Valle} Parkway. Suite F434. Laguna Niguel. CA (MW-1400 Tel: (71-1) (HS-99’s arenting in Pregnancy . . .begm a! [be beginning COMFORT MEASURES Eacbdfldneairtbermurmlbaubmirwmway‘lmcalmnMwbenl/wlpdn'—notfiflaaud1anawmanmlab0t PURPOSE: To identify and parallel the discomforts and remedies that are part of pregnancy. the birthing process. and parenting. GOAL: To use labor as a training ground to teach parents how important, necessary. and literally life supporting comfort techniques are for newborns and their families. DISCUSSION: Discomforts are a part of pregnancy and starting a new family. As the mother learns different ways to comfort herself in labor. it becomes a practice ground for determining the necessary comforts the baby needs in postpar' tum. Just as parents learn when and where it is appropriate to use their comfort objects. it is a parent's job to teach that to their children; Examples of comfort measures: PARENT BABY I listening to music I blanket I exercise I pacifier I reading I fingers Every baby is born with a need to suck. not only for nutrition. but for comfort. Parents provide themselves as comfort objects. but also need toprovide Other objects as well. Parallels: lf music is what you use for comfort. take a walkman into labor and plan on a music box. mobile, or CD player for your baby's room. FACILITATED DISCUSSION: As families prepare for birth by anticipating the potential pain in labor, comfort techniques become their c0ping mechanisms. Parents will need coping mechanisms in postpartum to comfort their infants. What do you do to comfort yourself? How can this technique be used in labor and again in postpartum to comfort your baby and yourselves as parents? © 19‘)" Ann (10min. Ph.D., 2834! (Imwn Valley I’arlm:1y.$uile F-lli. Lagium Xiguel. (Ll 930711400 'l'el: (7H) (HS-9978 8.2 30503”. $55.50 .x. 28:3 Eaton “won. .0 858g... 53 .38 .m. venom: E9533 Bun 6 3030”. .v .395: ho 9:03.53 new 39w .m ..oo new 059.. m5 5 bmfiw .N EcoEumafim 2.8m“. ... 13% 9:03 .2360 5.5 ..o uoSmE oco >5: 5990 s .mamfi E::maaoa on. 5 3.258% on >9: 5E; mEoEFSm ooh: 3:52 .m @8589 >=caEEoo 92 a: .m 80an: m5 .2 new: on cue $5 E93560 Co moomfi 58 Co woe—zoo.— bmfim o5 >252 .v .5333 m .8 meme: new @5520 9.33 con; 8.62ch on 2 com: .9: 3.23. 095 3.3 .m .mczcocma ..o 33:53:88. 8.5 E: .N .oEoc 2955 m. Ban 9.: Eco omamzfim on 2 com: .68 “m5 0.3m 8: :05 8 305 m9...“ #2.. .F ”2 03m on :3, 3:5ch 36:35. 9: .320 £5 3 new 9: >m " wEomao _> 320 533m .5 as; >mm>_._mo mmfio hwy—....— 2: 2 .853 83 was 6.28.23 .22 $5.8 .65 5? $2. on; E93 2er w 9 2.9:: 332 9:?» new .we>> «.32 m5 5.. w_e_meoemoe m_ 0e; $330 .meozmwac 8:85 .3520 x33 x_m cocw .::: aw; 30> newEEoowe >=w=m= EB .2000 65: 9:8 .8 nwmmoeeoc come mwe 3.5 306205 - ”mezwn. _waxwm .ewcn__eo :95 088.03 «we. mwowa cow new «$88 w mw econ we ewo “we“ 322.8 .2 x03 - .meoeoo 50> omwm new Ewe 50> Soew Ewe. 2 mwztw .ew_e_ ewe; So Ewe ewEm _wneweoa w 93.. - .920: «w 29: EwtoEm - ”£3 _w_oow .030: $263 w ewmx 2 nwfiwexw we «oeewo 30> .coh 0er 0. E35 ew m>we 30> eoe>> .mwzeoee em__ew.mw.mm - “mefiwmxwmaoz .2; 5.; 8.. 25 38. 8E. 2 new 2. ..coe - .e_ new? Emcwe weo no. 2 mneoxowa eo mEB oxw... - .3539. 29: ..0.. a: mefiom mEB 3w... - émawe Ewe ewe; qwzv ”e005 .m_ewfiwoow weoE mEoowe $993.. .. .56. ..o. =we 33: new eoEoe w_e:on oxwz - 69.86 mm: - .>wn e_ emem _wwE mwa 2 E ewo - énmeofimoa co 82.2.25 we Es: 68F .35. EwEeo§=w 86: Sex meawweo ..Eewemwel 5 9:5er 03 023 mewwu me_E_we>.eo>o ew we o. :53 ES 3569: “w new 9:: 9:8 9.2 :3, meewcwe ere o. mezman< Fzmzhwzaxx 535$. ..mAnw 2 we: oxw. £050 .38 new weamwwa £5 nooeaewewa ..o o.o. 05 oE:mmw >.2w.nwEE_ 9365352: 9:8 923 .aezewewe Ewe new Ewe 50> no 98 we“ Soew £2 2 mefio 2w a? 29:3 Hzo_._.n¥._oOm._.z_ «5:538 w e. .2 o.oc. 30> on E:>> onenewewa 2 EoEfilnw 7629. we. 8 :3 :5 no» on “22, 50E: oEOm 3wa .0 $580 .652 .e 26%. age .m omeaooo nooeeeoewe 2 05 .3:? x55 :9» on :22, wm_._._>.._.0< hzmhzoo wZO_._.mmDO «2 on 65:00 comic eo=eo>oi eofloa 2 onSO $385 .meewo .meEowo. 65.93 6:32 .o._ .30> 2 oezeoewe moeeomon .9: :05: e_ mEneo n83 w ozm 2 eeroE e305 eowo xm< H965 Ewe mw 325m ”ooze: 39n— Ewm. mewm oeaow- 3.2522. momno Ewew- 5E. e. e8 x8. 2 E:>> - .2938 m5 :5 ..Bsaxmca 2. .8 new; .58m in. 2 59.8.5. ”fleonoow ho eozeo>ocm “.mmwfi ..o__..wo ew e_ nommaomav bEnoou .mo_.___e_meoemoe noeroewa «ooco. nocwem 99.. 30> mneoz, o5 Co oEow me_.:.=m_wzon_mwm QOOIhzmmxi .oeoeoe EoE w nwe ..o>oe wwe Ewe 50> ....ceroEom .o>_o 30> o>o_ new 95.3 8325 Ewo. 30> .30> ho noeScoe mxmw. o5 =w mEEeotoe Eootoa oe 6e >wE 30> o__e>> .mEoe ewEse .oc.oew co. o_e_meoamoe 2.92 oew 30> meon 25 w oeSwI .oeo_w Eoe. ::3 En bo>o oE: neoem new ._w_ooam .Em oew E5 265. Eoe. 5.. .28 Em: e_ 320:. .Eoewa ocwem 2 Ewo. 3533. 7.22 .eozeozw no .250 59:0. 0: 230 we... ”Eases? mesa .Eeweooea noeewae: Eo>oce 2 85.....on 9.2 new .250 eoeeoew new; 30> cog: 38% 2 now: 30> mo>Ew Ewe ocoeom ”_eroo eta - .E._eo 2 38:3 3255 cozw 2 o>we EE _erwEoE. intone. wa EEO - «>mu -2 omzoe 50> e. 3on eon -ewn o5 no oEom oew E:>> mmueoewe ho mo_z__e_meoom -oc o5 u.o oEom o..w ~we>> mm_._._>_._.0< hzmhzoo mZOFwwDO we a . . .332 now. noon new oe_e__e_om_n 555w: .eo_.eo>oee Eonoow .o mwoew e. 0:232 9533 2w 30> maeoewa oe_oe >m .omwfi _w.eoEeo_w>wn m.n__eo 50> ..8 oaweeoaew wow oew meozwfioexo new mE. e_weoo ova—2. .mo.w=_e_ on 932 o.o.eEoo 2 E: 38:02.“..- .EE wflwa new EeoEemzanoow »_e e_ 322$ seem- .96. won o. 25; EB 39%. .230 50> 5? En. ”meozoaems .9390 .3830? ho .eoEoE w mw ..o3 mw wE: _weozwoznw ew mw oEiwa eon: o.oc.. .moeofiozE _wEwEeo_w>on 3o: w>oEow o. 2.5 w o~w_:E:m Eewewe .>w_a emaoee... .mEEww. m_ meSwE émwmewm me_ao_w>wn 23:56.. ”eozwoanw .xwweo SE e33 .Ewe 2 coed ”meozwgnwE co me_Ew._>. “mongeeoo... ocwo e=wwI o.o \ 0:0 \ mo_e__0- ”meonwfleaEE. new wmwwma w_ewo_e:EEoo- .eomeo .w~_m aw: ..o nom_we .co_oo _wwew .. ewwm- o5wee< ssweofiwm- .wwethBeEEo). .eewmwee cw>wb oco. 26:- .bw___x< 69.2 26: e_w_axm ..o>ou- seam x2e winweow eozwfleaEE. 3o_>wm “:o:oo: ..o .eoEfioeh mew“. 59.35 me_ewo_o .meewE ”eozew>oea eom_ow- 8.03 bowww .moeww- meaewz “oz - mncoo 2:83. 3900 5:30 oefiofi- EmoE 9: so» 558 a; E:>> SmoE we. >o_eo =5, 8., x55 8» on .22, Sewewe w mee Co 35:20 «momge 50> 8 =5, xe_£ so» on E:>> wwcaweanw. mee w oxw. 30> on 26... «..oo 30> ewe; xmw meofion on meonmwaa E:>> mm.._._>_._.0< .PZMPZOU wZO.._.mm30 3. on .nwe 3:23 .0 one. o. eeo eow..w co .nwe me? .o ewoao 92 o. ego: ...ofiwo 359:: .emE mwxwz .w>_.we..o..w o_ew.eooow new mEnchoe w m_ Ewe. ex; 82» Ewe ewe. oe_>we ne... oaooe EwE- ._oe.eoo nwwe new o>oE o. >.___ew MEwe o. xowe xe_e.. .eo_.woot:m 2930.. 65.3.. .0. nwe ”$52.3 oz- .39sz noon w nwewnfieoo - £8 inseam ...mem 8. on a; magma 2.; we. 8.2 .260 mmv .:oew o. a: .eweer_ m. .250 :8 - $9.65... 20% e032 .0. >.eEwmmw ewtw xooeo- .wn_m eeo new mow...wE ewwEoe mewme: 0;. ewe. oeoE oz- .Eoe. eo eE=o ES .65 om eeo .o .:o 259: .33 ..waEze _mE. oxw. .new..«. 0. =3 ewo Ewe mw :08 m4: 2.85 «no. 5 e8 3998 ...; 2.5- ”meozmoomam ewe.0- ..nonowe oew m__we ow meEoE m .2: .w>o 2.9 Eme go... new ..: .3 65830. ew.m 03. mweaow. - m=wm 35. zone... nwe E n_:oem ewe .o oo. o. www.cwE .o no. Eo... ..wm we .maE wewe. 5:58 .326. e_ - 82.68 $9.55... ..:0:, nwwe .23 5923 moon Eom eww> ewe we.wwn newmaoe. 80 .58 ..mB N ewe. mew. mewm- . .65.... - .e_we o_xo..eoz .95» we .0: >wE com. 0. Bee mw_>.w .:..:waa .oc. 32w». .0. 8.2.69 >__w.ono. Boe - etc- .339. nezoew no>oE we ewo ”wow. .0 me.eoE Va .9... - .we_mmwm- Qso=fi w nwwe Ewe moon. ammo... -.wE w e. co. xoo. 2:05 :9. 3:3. wEOm oew .we>> ...eeo w $9930 230 w :5, eoe>> veto w E .o. ..oo. :9. 2:05 .we>> . wewofi .ewo.m 0. wow... zewtoEoo new 323 .m: ..0er mnwwz Ewm .>.w.wm ewnfieoo o. 93 om .wEoe eeoezwe w ewo wewe>> ”.:onewI moEoo Ewe we. o.o.we w>we o. nwwe >__wwe 30> .weB .w x8. »..oe FzmsESOw >95 .2 wm_.:>_._.o< hzwhzoo mzozmwno we. we _ .mefiweoSe o.o.we b. - xowe xowe 8. we.eoE m-.. tween» nwwe nwwz .eEoz. e_ ue_we ww.w_:E_.w .323 3. .88 .33 ....2.8 3. Boa ”.nwe not new .nwe- .toaaw: .oo. ...3 economeo. me_e.>e< 22 o. Eww .Eoewo w.wwe3 $23.... .0 nox: ew>eoo wew=oe.w wEow- .nwxowe .ewna.m owe ewe .Bmam ..o.new ew=oe.w- -w_n emaoee. om .mmwB w w< was“. waewebwm erwE- ..ewnfiow ew e. e .203 ..oo .32 wmocow nwowa w.wwm .wo? n_:oew ewEoz, .eweowi. .Ewe oeewnwe w wwEoowe Ewe m.Eos_ ewo we. e. chw 59. e_ Ewe .Ewo ew>wz.. ...we aw. ewe. eo_.ow.oee wees. w»: o. Ewm .n_w_ew ewEonew ex; .wfiooe - .www ..w_nno.r go; ..oc. 8:83 22% ox: ..eon 5.220 .5266 .5. Eco. mew. Jaw...“ w.ew.w:..nw xoom .own. >.w.wm ewo n__eo .weww> So. 0. a: ow: ”Ew.m>w n_w_ew ew_nno._...ew.e_. .33 m_ .wwm xowe .0 ..o.er ”.w_eeEwn_ ..wwm xowe B .:0... e_ om: .eo_.w_:oew..w co ewwEEB m.ew>wea Eek .mEow. .wwe wcw mnewee ..< .353 «no - »_eO .ewE... nwwe»... .weo_.owc_n .wm o. wean we ..wwm now: .. we: ..o. 32.3% o>we m.wwm __<. .nwmawE wcw m.www .wo wwawowe w_ £5 .3. wtwaxm .noEeEoo wwwmwea =w ewe. eww> ewe ewenzeo 90E :2 35208 o.:<. gown s 9.6: ._ =8 .8... om: >wE ..wwm .:0: e_ ._ 2ww> v... E9. ow: .35. .8» .8 e_ we 59. weo o. 5.5 Eo... ew._n__eo __w mwezaw. 3w. ”.e_w._.wwm >.w.wm ewo- ”.ewEaSwm ewe.0 me.o_oemw3 new 296. Wm 33:99 28 6 9.5.. 3 $3 w._w wewawm - $9.53 @5282 WV mnwe aw_ wé .chwz, wew £35 :5. - w.wwem eeo wé ”mewefi meme ..wew_n w 0.5 moom .we>> two 50> e_ .ew.e_ ew .0. wow... 7.83 we. m. wewe>> wofiwe w_ .3. 30> on .ewEeSww ewe.o .we>> «nwwe :9. =5 wewe= .we>> wm_._._>_._.o< ...thzOo mzcfiwmnc 8. on .880. .meo_.w.weowm ewwoo_ - EE .EwB ..o .w_E _ooo - ..wweoaw? .e. aw...» - m__w. o. wan boa—w... - w_ew. oeaeweo- ...meo 8:8..- .98. new- .me._ maoewmewn new m>wze_w.m o. mmwoow 3o=w new 25$ a: 2ng n5 .w_eww>oE ..eoe ._wnoE .ewowe .on ...eo Em .2988 33.595... ewx_w>>.. .Ew. ..oon eEae ..wE - .wo_m:E - .wm_oewxw >w>¢oon .meesw w_ew.._oe .w_nweo- .wwunw Ewem oz .Eeme x02 new ..0er 5:3 new aw.m N we 2:05 9.00..- .Eo..oe we. mwoeow eoeeam ew.ewo- . .eeo mw wEwm weozwfimwe ”now; :0 w.w_w- .w>ww>> __wEw .mewoe: eo.w>> .nw.w_:ow. w_ ewwE .o wN_w- .weoee .m.._w.me3on - En w mw.:e_E m .-o. .88 .w om: Homoecam- .>.aew meo_.w_:mwe _wewnw. - mewaxwi- ..ew.e_ >..ch o. »_co now: we n_:oew - .e_we.mwe cow .0: - m.www .ew.e_- .2993 .0 QED. ..emwon n__eo new w_ew. 0:26 :0 now: ._ v.0 - m.www Emww- ..:o wxw. ewe. new now“. .mee ..o .w nmeweam we 2:05 220 new .waoewoewn bw> nwewnweoo we n_:oem meweo e91- .w~_m ..we. w.w:ownw we ewo new to nwxooex we ..ewo .we. o>we. dwem 5.90 .we.. mmewe - Ew.m>w erwe weaoww .mwowee xowe new .:0... 55, wow. wn_>> eon. .63. ago >.w.wm om: ..w>o xooex :8 ..00 .23. to newkxowe emae ewo n=eo 639 0. $20 oo. nwowa ._ .eoeeam co. wmwe wn_>> .593 x85 3&5 2.5.5 m e ...me - .20 :9:. «5963 w new: .:oew maceww. .59. wew .we>> 220 :9; w e_ co. xoo. :9. on .we>> ww_._._>_._.o< ._.Zw._.ZOO wzozbmbc 3. we .nwn .6 :EE .0. >._>_.ow oe_ew>w .wwew .nwxw.w.. new .3wa >ewe wwa .35.. .358 me_nww. w >w_wn 0. .0wa ..e00 .829. mwe now. __.e: ._w>> .oSnww. ewcw .eme .02. .3339 >__wn 50> e. we... .ew.m_weoo w we nice... we... we. .:e 60368 .w:n_>_ne_ ew we :.:. flee. .eo_.a_e..w.e_ Ea... wwe. we =3, 30.. ewe; >wn eoww 2:. 9:3 we. e.we wen o. >..... 5mm 8 2.: $.wa metan 2.58 533.26 50 new... x.eo eoww_m- .>oewe8wew wwwwweown - .wew..0m oeew. oz- .3». eoww .o 230 we... w_e:on dwOm n__E .563 .0... .:we .wew_n e. .30me - me_emw>>- .ewezo new moi w .3800 .835». ewwwE ...wEmw. .520 .8289... .520 .5er .39...- .mea wmo_o m>w>z< .m.wm x5350. >6.me we... ewewE- .mewewn ewzw. wm: Ewe >wE Ewe: ewewE- ...wa we we “wowew>< .meEBe e0. ew~on weO .wEoe .w nwemwz, ._ .meewew_n eo. ew~on Ym ”nwnwwe .e:oE<. “mewewE £203.02 nwwe... was 29:: ww.weawoee mw w.ew9w.wn 223 .8530. $520 m.>ewe eww>> .35. 2250 .eoww_e ..eoo .oefi: w.o.we $520 __w emwz, “me_eww>>- .mw~_w .o >.wew> w .o. xw< .w~_w EoeBwe .0 92 >3 ..:00 .8358. bne:w_ w_ew__w>w new ..wanae .w.mw. .weowewe eo newewn fleece}... ..ew.m_mw.. w._..._ ..w_ewe.ww.e.. .3:. e280 $00.. .EanewE wew e220 we. .w mewem .nwwe .96 ::e o. $8 .:0... we .me_w.w 9082 new ewwz, o. .63 6068 29:6 ”mw.:.ww. .wewewmu- H3529 252 m 2.2 o. 2:. .92 2. 2 :22. $wa w e_ wm: :.:. wewew_n >ewE 26: w>ewE 261 $2.20 B2 c. 5. ..oo. :2. on 85.8. .we>> me>_._.o< ...ZMHZOO wZO_._.wwDO 8. we ..:... .. 32.3 :26 2.22., 26 0. 2... Bow Eu >wE new nwwmwene... we.we 9... .oc ..wE ..ewm Sewe mmwenea- .82 2. .o no. we. Ea... wwe. .wwe nawe we. 0. wan >noe we. ..wcw ...3... new ..we 00. in .we - e.o.o emws new .w.w3 e...» .wwwm- .eo..oo nw_.9 5.3 520 .832. .302. .3. mew. >ewm 6.9.70 02 ..w.w3 new ..we eo..oo w 5.3 emw; ”meww- .wEweofln .o mmwenw. .o. wzwmeo ewEoo ..w.:o we. 0. w>w we. .o 365 we. 89. ewwz. ..w.w3 .ww.o 5.3 ..we eo..oo w we.we .83. .wow. new nwwe emwB ...ewe we.wwwene: we.we- .n. 8.. .:oew - .Ewiwxz. we n.:oew ..soe.w 50> 5.3 .w.w.s .mw... He.wm ea» .28 .wo___ee5 we. .0 oeiwom. .555 o. m. m_e.. ea. .0. ..nww. w. ..ewe ..o to w. neoo ...e: we.we woeoew .e.wm wmeoaw .535 .6 e600. .3520 590. .22.. 3039a 23 eim .550 new .0382... dwom .mea ..oeoo.w .eo..oo 5.; >2..- .nwe w_ew. new .5223? new .36.... ..w.w...<..e.w.e:...- .>ewe we. .wo :9. 20.3 nwwe ...3 30> oe_e.bw>w a... .ww ”.ewEeSem .eo_.w.wn_meoo w w. eo_.woo. ..w.w.s .o woeaow- .e.we mwon >..w:.ow .ewn:.w ..ewEeScw bwmmwowe .6. Eco. emaoew m. wewe. wewez, new :9. .o. .ew_ew>eoo m. .. weweB .w_ew. oe.mmw.n\Eooee.weEweo..v.- ...3. 2.2:. 2... =8 .... .8. so. 8 25: m>ewe we. .0. we .w.w3 e.we we. nice» w..:.w.wee.w. .we>> «32 50> we.we 30> w..o.we newe .w 320 nwwe 30> ...3 .we>> xewe we.we w.w..meoEwo .w.:.w.weEw. w.eweo.Eoo w new dawn E9. wwe. we n_:oew w>ewe 50> we.we o. ewE :9. on 29.2. ”wow... wwE>§o< hzwhzoo wzo...wwDG 8.2. .nw.wwe new an ...e: 3.60 ea _oeoo_w oe.ee..e .o ewzfi _oeoo_w ”_w>wz- .eoew.me..oo .38:th - guano... >ewe o. mw>...nnw eoEEoo o. w>...weww- ”w.wo e.v.w .wEoe 3w. w e. benzene. emwz. new ..o .23.... 5.? e2 .35. n._ ..wxww3 x.w neeoew w.wwaew >.eoEEoo 7.20. .eww 2an .0. eo.w>> ..eo.eww. ..we.oo. 205 e:. we. .55 253905351 .w_wew.eo. to... we. .0 n.w..w we ..:00 .0882... ..o .eaoEw =25 w new newe .50.. 5.; eww>>. ...wa ewe nwe... m-m eww>>. .mwo. .wwe o. wan .mw_ emw>>. .e.wow new ..w... emw>> ......wese mw w.w. mw 8.5.9.5.». .2382 .e.www .. on o. w.ew m. 2.5 we. ...e: twmmwowe .0: m. eo..uw..w. e235... .63 ..o .wwe wv... w.ewe emwz, >.eE.w 2.3.3.0. e233. 62.2 .52 on .nwm.oE:o._.oe: .. .wmese .w..emoe .o 8.03 .3 nw.ow._.n ww w~awo we..wmw> ewe... .nw.wwe ewe; 5.60 5.3 eww.o .nwm.oe.:o._.o 2 Sam .w..ewm wm .xowe o. .:0... ewws £632 .520 :3... was .w>_:> .o mn_o. wn.mw ease ....0 e202 _w..ewm eww.o- .>..n .we new .950. e. >ewe ewes. .e... .o .8 .52 22 .62 2.. ES. swam 32 22 o. 32 :28 ......e. e.o_oemw3 5.3 one: new emw>> ..chw. w.ew.m. w.w., o.e. >..ewm .2..- .wwmwweo o. eo..ew..w ..we .50... .o mnewe 5.3 >.w.w_eEoo ..ewe ewow- H>ncm eww>>. mm_._._>_._.o< ...zmhzoo wzo_._.mw30 a: 2. .wwoe..eoo .. .. 2.32.: wageofion __wo 5359. ...wxw .96 oo.. .. e.wow nwe Emee Ea. >wE w.eoo. wee. .nw.wwe. wwE. .o o). .:oew .w - w9weom.n em...e.s.we.w £53 .5 «wow we... mw wmwwbwn ...3 .eooEw we... .8 .o >wn £3. o. new .829... £53. £595 o. ..e.o wwEoowe we.weomn we. .o .28 we .. .320 2.8 mmwo >wE :o> .o» o o>wn wwee. .2... we. .o. .23. w.eoo: nwe Ewen .9.ww.s .298 .o. new .cw>..wn ..w..w 2:03 .we. ..me.nww_e... we.weom.n web Hw.eooe ...owe o. .eo... wo.>> nwwewo wmeweo b.5302”. E:we..wo .52. co noon .ww. new oo.. .86.. ...3 .w.w.s Eew>> .nw3o=w wew oo.. ewe; .wBoew oo.. o. ew>.o meo..o:..we. ..w new.m.wne: oo.. .we. om _w..owoe we. e. meo..ww:o xmw o. 23 wm 658:. .o .353 w mwxw. .. .585 w e. .wEoe o. xowe.>..w.o. we 0. ..noe 5o» .owoxw .oe on Sm .9.wa x.m >.w.wE.xo.oo< - w.w.m .wEoe w.. o. mEBw. Ew.m..m w>..o:no.ow. 59. :.:: .52 .2... .0 £2 2. 926.6. 2:2 2. m. .5222} .< mm> .55wa me. ..o. w.w..ooeoow 220 .3520 cc .wm ..mww new w.ewto.Eoo ...3 .023. .38 320 twe.ww.s we. .o. ...eweoteoo nwwwwen m. >ewe 5o» ..w. oo.. ewo 3o... ww..:>.._.o< ...zmkzco szmeDO E we .22 ....w: o. .m:_nw 2 we... mwxw. ._ .28 9.53 .:oew nwwmwew new nwE.we.s..w>o .ww. ..ws. .mwaeweo w... .w...m..w. .mwoeweo ocoeeoe .82.. .35.. .w nwmmweown .ww. o. ewEoB .o. .335 62 .P ”.wwe? Eatwofion. ....o.Eoow.n wwww ewo m.mww.e o. 322.580 28 .o e:w.$ .2232 m; bw>wv 2.5302. nwwemwwee .me.nww. .mwwee 2w oo.. .. .::... ..wm.w_ wEoowe w.mww.e new e. .....wEoo ....E ..wS.wE.. 96:. .m ..wn neooe< .bw>..wn .wew own .226». .o. :Ewe .o. noom Ew> ......e .2. - n.:.. 26:93 52.8.8 w.w.oww ”flmwwem ..wwe o. >Eo.o.m.ow w.we ewo wwwfiewxm. _wowv. oe.oo ..Eooee.we we. on oo.. we... bw>w ane..wo eo ..w.w.s ::9... ..o w...oe .6...» was. eww.o Eowe..wo owwv. ...o.oon 2.5.. ..e nwewneo we ...3 9.2% new .ewE.e.o nw.wo.nwE .e.we... ...wsoem .we.we N..m .oBew e3... .9.wa _w.w>wm .o. .....e.wotwnew. .o >eo.. we ..ws. .>Eo.o.w.om 32, .28. 2.. no... .ww ..wewcom .oo.m wxw. .28....— weEm. one... .o 92 ..:.:“. .eo..wo..meoo 2.2. .o 22.. 2.. .62 ..2, 2.2.. 35.8.59 - m.mw.oeow.o .nw~..w.we.wo we ..we. :9. .oe..wee: 3.356 w>we no» ._ ns.. 88.8 .o ..wfl. wne ..nom .bw>._wn .wcw awn 5o. o. o). .o. eoEEoo m. .eo..we.5 nwmwweoE p.235 .52.. 2. .o newwe .96 oo.. .o >ew w>w... mmE>..-.O< ...zwhzoo w20.bwm30 N: on .252. .928 5.... 3: o. 22...: .. .2 a. 2.88. ....w .385 .o .252 a 2m. ..2. ._ .262. 32... n._ .22; o.o ....»3: 2.8222. .2 .. ....22 .eo..wE.wew.2 new 5.530 MB E:.wm .nwe.w.eo .nwmmoom.n we .....> mnoe.w.e .o...eoo 5.3 .waw £5 .< .nwxoweo we ...3 weowwweo 303 new .em.w.s So> .982: .o eo...moo new w.ew meoweo zn.> ...wn w 8.3. ..o woeo ewe. weoE 2.2m :38 new a: om .oe oo in. 9.wa w.w. ozxoweo 53.2..on .59. .wcw new nwooofi mwe me.nww.e nwe 59. .wew _..e: weon we n_:oem woooewefi me.e.oz ”www.2wxw ....wE.oe o. ..owe .wa new .w..we .ww. __...> oo.. ..:0:... 29.. we. .62 oo.. 22. we .. .nw... we ...3 :o> .moww.w ..ewe .39. em...) awwa .mewaOa mw>wzmI>> aww.» new 5.3. ”.ww”. .me.nww..mww._e 2w oo.. .. .w.n o. we... w .oz we... ..wmeog w>.m new >..:.e._wwe .ww .355... .o .weEae w. ..oo. we 2 .eo.w.s .weo..nnw .o. we... wwxw. ._ .m 22.8.on meow; ..0..... e. mmo. n5: neaoo m >.w.wE.xo.oo< .N ..cw>._wn .wcw moo. mneooo N. >.w.wE.xo.oo< .r 292.. .o ”2.. .2285. .... 2: Ed: 50 22:... _wo.oo_oeo>wo .meo..wo.nwE .ewmmweown..ew e....> w.ew.ww.. m. 5.985% Eotwofiom .ew.o.m>eo 5.3 o... 32.2 .nwoo..w. new nwwwweown .cw> .ww. oo.. .. .N ww..:>_._.o< ...thzoo wZOFwwDO a: we ewen=eo meao> new 35.5 .0 35er 9:22.. ”.wEaEwm wew>oen_ oawo menwwe. fleweowen. 8 .ewEaSam >ewm Am 3520 >._Ew.w_2 3 .8 3.: .we>> - u weoea weE new .5 .ew.ewo >oeweowea weoemwxwe A< Hown_> wmomanvwwm tin—2.200 .___> 35:00 5.5 no $00,305— umrzo DEN ..OZ: ._O.=COO r255 *0 mUOPSQ—t m30tm> meOm_Dn ”.wEaEwm wooths. ..Omkzoo 1.52m .__> .635 nwe new newe Ewe, .mwaeE me_nww_e eo nwxoweo .m w.wee: :9. ewe; meESe 5 men: .6320 .0 >noo.m .w .Ewa .we_Eonew 239.0. N .eo_mmwawn eo mmwenwg. 95er .w .me_we .35 en _oe_e.wwee 5 3.355 .m wow. 5 Ewe eo wwwEwnewe. .v .m___eo new $5... .m .wmeweomfi _we_mw> oe_=wEm nwm .N .::9:... wow. .0 8.53.9 9683 _we_ow> nwe .55 .F “.o.ooo 0. nwtoawm we n_:oew eoE>> mmwe___ .o meQm .m .36.. >-v: eo_.woee:_ nwwe ..ws. .a:-xoweo 59. ewtw __.e: erw? .883 .32 .30> wm_>nw =5, zm ”8.38.6.5 _waxww d mw_._._>_._.o< hZMono wzo_._.ww:0 n: we Lozeoo new weonomeeoo. .. xoeweuwi new menewewl. mwaa_eeow. eo_.wxw_w. new 9.5wa 33.6. - eo_.w:nw..0 .0 285.30 .x .nw.wom .wueweo. .xoeweuwi e. ueeewewl .x. .mwamw. .ewe_...we eo meofiwaown 9.0.6 ww =w3 ww nw.wew we :5, 3.850 98 2.5 ....ewn e. wens. .m.ewn:.w B. nwoweaooew new nwoano..e_ 390 .3925 .5er 5 meow .2 5:55... e. ewEo>> .2 .250 :2 we... 05.55... 3 5.3.5. 5.0 new=or Q ....on .25.... 2.5558 ... 32wa 2.83 new 220 A. amoEmw .908 2.2.8 E wonww >ewe.wm .0 >52 8.6%.... E wwaoz eo_.o< >..ezEEoo Aw ew._.wEwm none 3 05> G mwo_>.ww toeaam .wEw.ws_ C 9.598 5.81.32 .w .::.0 95.3500 wmews. 3 -w. €9.35an ::3... 5.0... .ewE.ww.._. new meemw... 0.5 .v meEewE >..Ewu Am 3.33.. 3.3.09.0 ..ewm =w>> .N ..we. wannabe. o. 9:88 eo_.w~_e:EE_ 2. me... o. wEoo o. mwoeaow -w. >..e3EEoo wwwe. .o weo w.ew__w>< w.wES E9. w>. w ewmwenw. w u .~ w x2 mgeo V «COEtWQQD ..:—MOI 5.5300 $3030 Am me>Eb< hzmhzoo wZO_._.mm:G arenting in Pregnancy . . .begin a! {be bqqilmmg CREATING YOUR HOME ENVIRONMENT From tbed‘mlyh‘t, ”1W mmflojtbewawmbebfigbl, loudwldcanbeasbodringmza. HoprrepnareMbom/brmmmBmeeu/bokfanflu PURPOSE: To underStand the relationship between the home environment and the physical and emorional health of ‘ the family. GOAL: To encourage parents to look at their home environment with the same critical eye as they view their birthing center. DISCUSSION: . Discuss what parents look for in a birthing center and how they should incorporate those attributes into their home environment. RULES AND REGULATIONS THE BIRTHINO CENTER THE HOME ENVlRONMENT Know when it opens and closes, the visiting Decide when to open up your home for friends. hours, who can observe the birth, who is relatives. and neighbors. esrablished amounts of allowed to take and hold the baby, etc. time for visits mu5t be set. SAFETY AND SECURITY THE BIRTHINO CENTER THE HOME ENVIRONMENT Know how sterile the room is kept and Create a safe environment so baby’s brand new the precautions taken to clearly protect and immune system is proteCted. Parents secure their reassure parents of their family’s security. infant's safety by eliminating potential sources of harm. CLARIFICATION OF ROLES THE BIRTHING CENTER THE HOME ENVIRONMENT The doctors, nurses, and hospital staff all Specify roles mom, dad, relatives and friends will have specific roles during your hospital Stay. take, considering what needs. to be done and who will do it. (i.e. cleaning, feeding. laundry, etc.) Discuss how parents will take turns to support each orher’s sleep deprivation. Parents: Ask at least as many questions of yourselves about your home environment that you ask of the birth center. Each precaution parents take to be reassured about the capability of their birthing center should be mir— rored at home to strengthen the security of the family. © 1997 Ann (20min. Ph.D.. 38341 Crown Valley Parkway. Suite F-ll‘i. LuglmaNiguel.(LA\‘)l(i'."’-l~100'lblz ("14) (HS-9978 arenting in Pregnancy . .begin a! Ibo beginning “SCARED” Mothers, Fathers, babies... tbefarm‘lyasa whole... is ‘tscared"ofbeooming. [Hubris/ear (barbelpstbem recognize tbeneadbprq’iare—jbrlabonmymdpwm. PURPOSE: To recognize and identify the fears of childbirth and parenting, noring the parallels between prenatal and post- partum fears and solutions. GOAL: To give parents specific techniques for overcoming these fears using the acronym “SCARED.” DISCUSSION: Prenatal— S Support (Allows Others to share the joys and burdens of the developing fetus) C Comfort (Tools provided for relief; a way to ease the pain in pregnancy) A Attachment (Physical—for survival) R Relaxation ( To lessen tension and reduce stress of pain) E Education (Provides facrs about the non-exact science of birth and insights about labor, delivery, and postpartum) D Discipline (Re'learn how to react to pain through repetition of new coping techniques) Postpartum— 8 Support (By identifying and expressing needs of family) C Comfort ( For the newborn through sucking—their mouth is how they discover their world) A (Re) Attachment (Through touching, morhers 63' fathers bond physically and psychologically) R Relaxation (Using techniques learned in CBE allow for relief from sleep deprivation) E Education (Answers provide solutions to the problems of parenting; the more parents know, the more techniques they have to choose from) D Discipline (Allows parents and babies to recognize their capabilities together, process begins at six months when ababycanlearn behaviorsandiscapableofchange.) Fear gives parents the cues necessary to pay attention to the need to prepare. Beginning to problem solve in pregnancy by labeling your family’s needs and finding solutions is the first logical step to developing a healthy family. © 1997 Ann Corwin. Ph.l).. 28241 Crown Valle} l’urlm'uy. Suite F-ll-i. Lamina Niguel. (2A ‘)3(i"-l~l()0 Tel: (’14) (HS-9978 aren ting in Pregnancy . . .begin (I/ [he beginning CONTRACTIONS & CONTROL Contraar'onscan bees um’queas children. Sometime mom orcoacbistaben ofliguardbyadxfiicull wruracaonandebemotknow bowbbanrfleit-.jufimahldmmmmefimbedjfiimhwmmlmdbarbebanorwdmpwmbym’ PURPOSE: To demonstrate the similarities between the hard work and feelings of loss of control experienced in labor with those same feelings experienced as a parent. GOAL: To teach parents that techniques used to deal with contraCtions can be used in many parenting situations. DISCUSSION: Say—“Let's praCtice handling the contraca'on and handling your new role as parents. You will be better prepared to handle bOth delivery and becoming a family." Contraction begins... Parenting begins... Take a big, deep breath to give plenty of Take a big, deep breath to calm yourself, oxygen to the baby, signal to your coach. signal your partner for patience. and prepare and prepare yourself to handle the unknown yourself for handling the unknown pain of labor. challenges of parenting. Contraction builds... In parenting... Distraction techniques are needed for copv As your child grows. c0ping techniques are ing with the pain. Soon your contraction, needed to deal with the changes in develop! like a wave, will break and begin to fade ment, but each stage eventually fades away away. and gives rise to the next Stage. Contraction ends... Parenting never ends! You are that much closer to delivery and You can look forward to a lifetime of chalv the beginning of your new family. As the lenges and rewards. contracrions and the pregnancy ends, parenting begins! No two families, like no two contractions. are exactly the same. Each contracrion... each child, is completely unique. © 1997’ Ann Corwin. Phi)- 282+] Crown Valle} Purlmu}: Suite F-ll-i. Laguna Niguel. CA 036711400 Tel: (7H) (HS-9978 First Class Delivery Pre and Post Questionnaire 1. What is the cervix? a. an opening to the uterus b. the cut that the doctor makes to allow the baby to be born c. fluid that surrounds the baby d. the way the baby cats inside the mom 2. It is OK to drink 1 beer a week during your pregnancy. T F 3. Fetal monitoring would measure: a. number of hours until delivery b. mother's heart rate c. size of babies head d. spacing and timing of contractions 4. How can your coach help you decrease the pain during your labor? a. let the nurse know when you need something b. do not criticize her c. help you time contractions d. all of the above 5. What is a sign of labor? a. vomiting b. contractions that are irregular and short c. pressure in the pelvic area (1. contractions that are regular and closer together 6. Why is a caesarean section done? a. abnormal position of baby b. fetal distress c. baby's head is too large (1. ineffective contractions c. all of the above 7. How often do you feed a newborn? a. whenever the baby is hungry b. every 4 hours c. only during the day d. when you eat your meals 8. How do you stop your baby from crying? a. spanking b. cuddling your baby c. holding the baby while taking a ride in the car d. play loud music 9. What is a normal characteristic of a newborn? 3. having a cone shaped head after birth b. enlarged genitals 0. yellow skin d. a and b only 10. It is OK to have sex without using birth control during the lst six weeks afier delivery. T F 11. When is it not safe to have sex during your pregnancy? a. the last three months b. after the water breaks c. all during pregnancy (1. if there is a risk your partner has an STD e. b and d 12. What services are provided at the Ottawa County Health Department for you and your baby? a. birth control supplies b. well baby check ups c. free immunizations d. parenting education 6. all of the above 13. I am most fearful of in this pregnancy and on a scale of 1-10 (1 means afraid; 10 means most afraid) I would rate my level of fear at a Bostjquuestinns Please answer these questions to help us plan for the next prenatal class. We appreciate your ideas to help us improve the classes. Thank you! 1. I was able to attend how many prenatal class sessions. (circle the correct letter) a. all (I. 3 b. 5 e. 2 c. 4 f. l 2. If you did not attend all the classes, why didn't you? Did you need a coach? Yes No 3. Was the location of the class convenient for you? Yes No 4. Name one of the community resources you heard about in the class which you hope to use in the near future 5.The prenatal education class helped prepare me for labor and delivery Yes No If your answer is "no" explain 6. I was less fearful of labor and delivery after taking the prenatal class. Yes No 7. The thing that helped me most from the class was 9. I wish I could have learned more in the class about 10. One suggestion I have to improve the prenatal class would be 71227