Wasatch Review

Business Name

February 2016

Letter from the Executive Team Volume 10, Issue 2

Zero Suicide Initia- Inside this issue: tive – Wouldn’t it be fantastic if you Executive Report 1 Upcoming Events 3 could save a life? Birthdays 4 Over the last year, WMH in part- Employee Move- nership with the Division of Sub- ment stance Abuse and Mental Health (DSAMH), Weber Human Services Briefing Reports 5 (WHS), the National Council for Behavioral Health, the National Randy Huntington, LCSW, Adult Ser- Success Stories 7 Action Alliance for Suicide Pre- vices Director vention (Action Alliance), Suicide Employee Recog- 9 Prevention Resource Cen- Community. nition ter (SPRC), and 5 other States: Observances for 11 February Texas, New York, Missouri, Ken- What is Zero Suicide? tucky, and Indiana have partici- pated in the Zero Suicide Initiative Zero Suicide is both a philosophi- 10 Ways to Lose 12 weight Breakthrough Series. Reading that cal ideal and a systematic approach paragraph is a mouthful, and it il- to prevent death by suicide. In the 6 Foods to help 14 lustrates a National trend toward words of the SPRC and the Action you Lose Weight Suicide Prevention, Intervention, Alliance: and Post-vention and how WMH is 5 Must have Sea- 15 a part of it. “Zero Suicide is a commitment sonings to suicide prevention in health Naturally Boost 18 WMH is committed to making ad- and behavioral health care sys- Testosterone ditional changes that you are al- tems, and also a specific set of Key Indicators 19 ready witnessing and perhaps may tools and strategies. Its core be slightly confused by – why is propositions are that suicide the warning popping up when I deaths for people under care are open Junction? Please allow me to Contributions for the preventable, and that the bold newsletter are welcome! clarify a few points of interest, and goal of zero suicides among comment on how this will have an Send to persons receiving care is an as- [email protected] impact upon you, WMH, and our pirational challenge that health

systems should accept. The Zero Suicide ap- proach aims to improve care and outcomes for We have used the OQ & YOQ measures for out- individuals at risk of suicide in health care sys- comes of treatment now for years. In fact, as a tems. It represents a commitment to patient safe- center we collected over 49,000 of them in FY ty—the most fundamental responsibility of 2015 alone. These measures are really part of health care—and also to the safety and support WMH’s DNA. Perhaps one of its hidden secrets of clinical staff, who do the demanding work of however, is it acts as a screener for suicide. We treating and supporting suicidal patients. are now using it as an initial trigger for the C- SSRS in our (EMR) Junction. The challenge of Zero Suicide is not one to be borne solely by those providing clinical care. Zero What is the Stanley/Brown Safety Planning Suicide relies on a system-wide approach to im- Tool? prove outcomes and close gaps rather than on the heroic efforts of individual practitioners. This initia- “The Safety Plan is a written, prioritized list of tive in health care systems also requires the engage- coping strategies and resources for reducing sui- ment of the broader community, especially suicide cide risk. It is a prevention tool that is designed attempt survivors, family members, policymakers, to help those who struggle with their suicidal and researchers. Thus, Zero Suicide is a call to re- thoughts and urges to survive. It is a brief inter- lentlessly pursue a reduction in suicide for those vention for reducing suicide risk (Barbara Stan- who come to us for care.” For further information ley and Gregory K. Brown).” see www.zerosuicide.com About two years ago, WMH incorporated it as What is the C-SSRS? part of our (EMR) Junction. For more infor- mation go to The Columbia Suicide Severity Rating Scale, (C- www.suicidesafetyplan.com/Home_Page.html SSRS), is a suicidal ideation rating scale created by researchers at Columbia University. It rates an in- dividual's degree of suicidal ideation on a scale, Practical Steps for using the suicide preven- ranging from "wish to be dead" to "active suicidal tion tools and interventions ideation with specific plan and intent." The scale detects behaviors which may be telling of an indi- 1. Client takes the OQ-YOQ and scores at a vidual's intent to commit suicide. A person display- “frequently or almost always” on the critical ing even a single behavior identified by the scale item for suicide was “8 to 10 times more likely to commit suicide.” The C-SSRS has been found to be reliable and valid 2. An alert is then triggered on the Junction in the identification of suicide risk in several re- Chart indicating “OQ®-45.2 Suicidal Warn- search studies. ing”

The CSSRS has recently been incorporated into our 3. Therapist or Case Manager addresses the risk Electronic Medical Record (EMR) Junction. There by asking questions 1 & 2 on the C-SSRS have been and will continue to be some refining of (note: these are the only 2 questions that are how we use the C-SSRS. Later in this article I will required to release the warning from coming attempt to give a summary of how this process up, and then it is left up to clinical judge- should work. ment)

What do the OQ & YOQ have to do with Suicide 4. Based upon clinical judgement, the rest of the Prevention? C-SSRS can be completed if warranted

Volume 10, Issue 2 Page 2 5. Safety Plan is created or reviewed with the client Summary based upon clinical judgement WMH is making a concerted effort to keep up with 6. Documentation in should justify clinical national trends and research. Our partnership and decision (note: for a Case Manager or Nurse this collaboration with other mental heath centers, the should be coordinated with treating Prescriber or DSAMH, and national organizations places us in a Therapist) position of opportunity. The Zero Suicide Initia- tive is a bold approach to prevent death by suicide. The C-SSRS, OQ-YOQ, and Stanley/Brown Safe- For other providers such as HSW, RPS, Support ty planning are tools to assist us with Suicide Pre- Staff, FRF, PSS vention, Intervention, and Post-vention. As we role out the next phase of implementation you may 1. Address the alert by reviewing the chart to see if consider the question – Wouldn’t it be fantastic if there is a Safety Plan and/or a C-SSRS in place you could save a life? (note: this is not required but encouraged)

2. Notify the Therapist or Case Manager of the alert Upcoming Events

Guiding Principles for using the additional suicide GIANT Steps Dinner and Auction prevention tools and interventions Coming in March—More information to follow Provo City Library  The C-SSRS, Stanley/Brown Safety Planning, Donations are welcome for the auction, please take and OQ-YOQ are TOOLS to help in Clinical items to Parkview Judgement

 The TOOLS do NOT replace crisis or supervisor Generations Conference consolation, clinical judgement, and common March 31—April 1, 2016 sense Interventions for professional s in behavioral Health and Addiction treatment of todays adult  The first time the C-SSRS is completed it will generations read “Lifetime.” For example, “Have you Salt Palace wished you were dead or wished you could go to sleep and not wake up? 100 S. West Temple, SLC

 After the Initial screening, the C-SSRS questions Critical Issues Conference should be asked in a time sensitive manner. For example, “since your last visit, have you wished May 11 and 12, 2016 at the Utah Valley Conven- you were dead or wished you could go to sleep tion Center and never wakeup?” *If want to attend a conference please check with your Program Manager.

Page 3 Wasatch Review Happy Birthday to those born in February

2/2 Jason McBride 2/16 Daniel Bernards 2/4 Camille Jones 2/16 Adrianne Grose 2/7 Tyree Thurgood 2/16 Jennifer Brown 2/7 Helen Latu 2/19 Nancy Despain 2/8 Kaylee Au 2/20 Evan Jenny 2/9 Thomas Yee 2/21 Melissa Blumell 2/9 Carson King 2/21 Mhai Lee 2/9 Nicole Bastidas 2/22 Craig Limb 2/9 Cristina Wilson 2/22 Sheri Rowley 2/9 Courtney Smith 2/23 Linda Taylor 2/10 Valerie Paul 2/23 Lindsay Hansen 2/12 Lorraine Crossley 2/23 CharLynn BLacker 2/12 Tyler Jenson 2/26 Dallas Bean 2/12 Frances Williams 2/27 Christine Hill 2/13 Gregory Robinson 2/27 Dennis Rasmussen 2/14 Jeanne Channell 2/27 Lynette Beard 2/14 Tabitha Webster 2/29 Doralia Serrano 2/15 Evan Clinger

So Sorry To See You Leave

Peggy Kanakis

Welcome to Wasatch Mental Health

100/ADM Leann Allred Melisa Richardson 200/YS Courtney Bradshaw 341 /NV Tyree Thurgood Doris Adams 355/Aspire Alexandra Lamoreaux Nictehai Martinez 250/CY Fast Kathryn Broberg Jonni Clark 340/Giant Kori Casperson Steps Sarah Winkelkotter

Volume 10, Issue 2 Page 4 Briefing Report Highlights

Doran Williams was presented Giant Steps had its annual ionship. These with a special award at the an- Christmas Program December qualities make nual Suicide Prevention Confer- 18, 2016. The auditorium, at animals ideal therapeutic visi- ence acknowledging his tireless Foothill Elementary school was tors for the girls at Aspire. filled to capacity. The children work in suicide prevention. Alt- PFC— A huge thanks goes out behaved and performed very hough he is on the planning to Josh Jenkins who translated well. Many parents expressed committee for the conference, the intake paperwork into Span- how impressed they were that the presentation of the award ish. was a complete surprise to him! their children were able to sing the words and do the actions for School Based Services—Staci Wasatch County Family Clin- the songs—all while staying still Oakes organized collecting ic hosted the Utah State Divi- through the whole program. cards our youth clients made sion of Substance Abuse and XCEL—Kathy Farmer, case and have them sent to a charity Mental Health for the annual during the holidays. audit in November. The official manager in the XCEL program, audit report states that there are once again organized sub-for- WCFC—This past year Rich- no findings or concerns. In just Santa efforts for children served ard Hatch has served as the three years that clinic has gone in youth services. We were able chair of the Wasatch County from serious problems (prior to to provide Christmas for over 70 Children’s Justice Center Advi- Wasatch Mental Health taking children with the help of two sory Board. He will continue on over) to a totally clean audit. BYU student wards and a group the Advisory Board but his term Kudos to the great leadership of of IHC volunteers. Also, 17 for chair has expired. Richard Hatch and his treatment bikes were donated by the Provo Bicycle Cooperative. WCFC continues to work with team! the Health Department, law en- Catherine Johnson presented Aspire—The residents were all forcement, Wasatch County two sessions at the annual Sui- excited for the holidays, we re- School District and other com- cide Prevention Conference on ceived some generous donations munity partners and individuals The ACES and Trauma In- from the community to help with the Caring Community Co- formed Care. The presentation make the Holiday’s brighter for alition and Wasatch County Sui- was well-received. the girls. The girls were grateful cide Prevention Coalition. This and appreciated all the Christ- Coalition is considering chang- Youth Services once again mas donations. ing their name to the Wasatch hosted a great Christmas Lunch- County Wellness Coalition. Therapy is going well. Recently, eon at the Provo City Historic WCFC is also involved with we have added pet therapy to Library Ballroom. The theme, United Way in working on the our services. Mirage, Gypsy, Elf on the Shelf, was received homeless Point in Time Count and Diesel are scheduled to well and all the programs at Wa- in Wasatch County. satch Mental Health went out of come and visit on Mondays. their way to come up with very Pets as therapeutic partners are a WRC—We have 2 excellent creative table decorations. In valued approach today in both prescribers in the WRC clinic, fact, the luncheon was such a the physical and psychosocial Travis Hunter and Lisa Olsen. success because of the great par- arenas. The girls have felt a con- They are so easy to work with ticipation of all employees. We nection with the dogs and expe- and helpful to the clients and especially want to thank Merrill rience that unconditional love, staff. One of the excellent ser- Yesslith for the beautiful Christ- understanding, and acceptance, vices these 2 prescribers provide mas piano music. and the value of a pet’s compan- is a short summary of each visit they have with clients. The de-

Volume 10, Issue 2 Page 5 Briefing Report cont... sign of the WRC is mainly everyone felt comfortable stat- WATCH—We currently have groups and a Primary Service ing opinions and that diverse 8 individuals housed in the Coordinator (PSC) may not see opinions were expressed and CABHI (homeless assistance) their client for weeks at a time considered. He thought that program. We were recently if they are not in that specific trench employees had a voice informed that we will need to group. This clinical summary that management was willing to have 21 individuals housed by from the prescriber visit is in- hear. He liked that staff had the end of October to meet our valuable in helping coordinate some involvement in the deci- grant obligations. This is a follow up care for both the case sions and evolution of changes. challenge for certain, but we manager and the therapist or He particularly commented on plan on approaching the Boul- group leader. It is unprecedent- the refill/walk-in clinics that are ders about the possibility of ed for these prescribers to pro- taking off and how it was excit- partnering with us in this en- vide such a service and is much ing to watch that happen. He deavor. appreciated in our clinic. concluded with, “this seems like During the Division Audit, the Medical Department—After a really healthy organization”. JRI program was commended efforts from several levels of (Tom Yee is a prescriber who for taking the initiative in care, a client was approved for recently joined our team). moving forward with the pro- placement in suitable housing Dr. Brinley from PCBH made gram where so many others to keep him from the harsh a personal outreach to each of are still contemplating how to winter elements. One of the the youth prescribers introduc- use . employees involved summed ing himself, giving them his cell up the situation with a saying phone number and indicating from his home culture. “There's that he would be involved in all an island saying ‘Neva a prob- WMH youth who came to the lem, just one small kine situa- hospital. One of his emails gave tion’.” It took a team to pull an update on a currently hospi- this off but was great to see it talized youth to demonstrate the come to a positive conclusion. collaboration. This was a result Consult your local islander to of feedback that WMH was get- find out what “kine” means. ting youth back from PCBH on complicated medication regimes The comment came to one of and without consultation result- the prescribers. ing in the outpatient prescriber “It’s been another successful feeling like they needed to undo year for me! I’ve made a lot of what was done while inpatient. improvements and continued to Psych—Geri Alldredge set up do well in school and at work. a booth at the “Veterans’ Cele- I want to thank you for being a bration of Light”. Veteran’s part of my care this year. events seem to bring a big show Thanks for always being will- of support from the community ing to answer my questions.” but reaching the veterans who Tom Yee came into my office need the support is still a mys- recently and related his obser- tery. It was a good networking vations of our staff meetings. opportunity and the event organ- He said that he enjoyed that izer’s appreciated the support.

Page 6 Wasatch Review Success Stories

Stride—Christina Wilson Strengthening Families Pro- looked forward to the meetings who runs our Lehi Stride pro- gram. each week.” (This parent is on gram was excited to report that “I have learned a few new the autism spectrum and so are one of the female children in her things & I am able to teach my several of his children). group is no longer demonstrat- son some new ways of learning. Wasatch County Family Clin- ing hiding or pouting behavior. I really like the kids play thing. ic—In December one individual Previously this was problematic It was a ton of fun to see him graduated from our Drug Court. for this child and it is an excit- make up the rules of the game… They expressed gratitude for the ing clinical development in her I like how nice the staff are. assistance the program has giv- treatment. Additionally this Like even though I have known en them. They report in addition child has demonstrated im- them for a couple of weeks, I to their sobriety that they are provement in her ability to take like how I can ask them any- working in a good job and have responsibility for herself . thing & they don’t judge me made positive changes with GIANT Steps— they just help with what’s the their family. best thing to happen.”  After our Christmas Pro- Westpark Family Clinic— one gram, one of the parents said Strengthening Families—We of our Budget Specialists re- she was “astonished that [her received the following feedback ports. We successfully took boy] was able to stay sitting from parents about our recently care of all the clients’ financial through the entire time.” The completed Strengthening Fami- needs during the time we were child is non-verbal, but it was lies Program. closed for the Christmas break. “amazing how he did all the ac- Parent #1 “There were no calls or anyone tions to every song.” “Regardless of how great you in crisis over money issues.  Cathy Matheson, principal are as a parent or child you They all seemed to have man- of Horizon Elementary in Sara- would all find something valua- aged their money okay, or at toga Springs, said she was ble to add to your household. least dealt with their spending “really happy with the way Gi- We have loved this program and choices”. ant Steps employees and her the friends we have made. Eve- A second success story came staff are able to work together as ryone was so supportive and from WFC and CSS’s efforts to a team.” loving and knowledgeable to- provide excellent customer ser- Dr Joe Backman, principal of wards all the concerns we had as vice. On Christmas Eve about Foothill Elementary in Orem, a group. I am very grateful for noon a mother brought her 2 stated he is “very happy to have this program and the time and kids to WFC stating that she the Giant Steps program in his effort that everyone put into the had an intake scheduled for her school.” He said he has “always program. Thank you for your kids. Scheduler was reviewed, been impressed with the pro- example and advice. You all but no appointments could be gress they make while in the handled our group and the stu- found for them. PFC was con- program” and that he “[loves] it dents amazingly. It was great to tacted to see if they were sched- when the children continue on be a part of it. Thank you.” uled at that office. PFC indicat- to kindergarten at [his] school” Parent #2 ed that they were not doing in- because he knows those kids “At first I was unsure how [it] takes that day so no one was usually do very well. would affect or benefit me and scheduled there. The WFC sec- my children. Over the weeks it retaries who do intakes were not School Based Services—We became easier to relate to, un- working that day as no intakes received the following feedback derstand, and learn from the oth- were to happen on Christmas from a parent who attended the er adults. Also the children Eve in WFC either. The WFC

Volume 10, Issue 2 Page 7 Success Stories Cont... and CSS Program Managers put Walmart, and would like a more their own without assistance. their heads together and decided meaningful job that requires This is a great example of that somehow we would make more skill. teaching a skill that has multiple the two intakes happen. A ther- facets of success. This initiative This was the first time B. ac- apist who could do the intakes will be expanded to others who tively engaged in a conversation was out helping case managers need a bit more encouragement about his ambitions for his fu- deliver client Christmas gifts at and skills development to be ture and how he could reach his the time. She was contacted by more successful. phone and agreed to hurry back goal. IRT—We had a client at IRT to the office to accommodate He and his SDS worker sat who has a long history of self- this mother and her two chil- down and wrote out the goal on harm and other maladaptive be- dren. She completed the 2 in- his IRP plan and he has contin- haviors. She reached out to the takes midafternoon on Christ- ued to come into the units and crisis team when not doing well mas Eve. The mother expressed participate in activities to devel- and has used IRT instead of sincere appreciation for our op his workability, stamina, and seeking admission to inpatient working to accommodate her socialization since that date. psychiatry. One of her chores and her children. His mother has reported that was to clean the women’s since coming to Wasatch House WH—Melinda Chamberlain, showers, she became frustrated he has done better than he has SSW reports the following, over some issues with this chore for quite some time. highlighting how even the and a staff member started to smallest improvement can be a Supported Housing—We have clean the shower when she tremendous victory; been running a laundry group at would not. When the client saw the staff completing this chore When B. first came to Club- Supported Residential Treat- she stated, “I felt guilty seeing house, he kept his head down, ment (SRT) in Payson for a few someone do what I should be shuffled his feet, and made no months now. Tis group was helping with.” This may not attempt to communicate either created for a few clients who seem like a major accomplish- verbally or nonverbally. Today were not taking care of some of ment, however her entitled and and in recent days B. has been the most basic needs such as self-centered past has been in- found working in the Career and their laundry. Even with en- crementally changing and im- WAG units. He has quiet yet couragement, their laundry had proving. Without the leadership steady conversations with staff piled up to the point of discour- and example of a healthy staff and members. He expresses his agement and less then pleasant member, she would not have needs and views on topics, and aromas in their apartments. learned this valuable lesson. It lets others know his interests. This was affecting their apart- was very nice to watch the staff On January 3rd B. initiated a ment life as well as their room- not engage in a power struggle, conversation with his SDS mates as well as their public which is easy to do with this worker, stating that he wants to presentation. The group has individual. find better employment. His been so successful as skills are taught, moods are improved and goal was explored further, and it BRIDGE—We have a client self-esteem is lifted. The was discovered that B. wants to who was discharged from the amount of Laundry completed have part time employment, state hospital approximately in the group is reducing signifi- “working with computers or two years ago. When stepping cantly as the clients are com- working outside with my down to IRT, this client was pleting more and more of it on hands”. He is tired of working more stable, was still very tor- his job as a cart runner at mented by his psychosis. He

Page 8 Newsletter Title Success Stories Cont… Employee recognition would walk around at least 16 Employee Recognition nal “on the spot recogni- hours of the day talking to Program tion” ability himself quietly, and holding Early 2015 we conducted his hand up in the air above Enabled peer to peer nomina- the Measuring Stick Em- his head. All day long he tion for recognition utiliz- ployee Survey. To improve would look at his hand and ing simple “recognition” pace around the IRT campus. employee engagement we email pro cess He has progressed in his treat- committed to work on a sur- ment and insight to the point vey item and an employee Introduce new midyear con- where he is living in the com- focus group was established ference divisional awards munity independently with to help us understand re- some wrap around services - to be selected by pro- from a diligent BRIDGE sults. Through this process gram managers treatment team. He is not uti- employee recognition was lizing any of the WMH sup- identified as a significant Added annual “Direct Care ported housing placements. opportunity: Staff” award category for Over the last two months he both youth and adult divi- has voluntarily participated in 1. Employee Recognition sions a new Peer Support Specialist programs and selection group facilitated by Leslie process not fully under- Communicated annual award Klein. He is volunteering to stood or utilized selection process read in this group and verbal- izes openly that he enjoys the 2. Supervisor and peer group and getting to know recognition ability is Overall the response to our em- other peers who struggle with ployee recognition program en- mental illness. To see this cli- important and could be improved hancement has been very positive. ent’s insight and charming There has been a sharp increase in personality from the start of nominations and recognition ac- our interactions with him is 3. Options for managers to provide timely recogni- tivities both with managers and truly a heart warming story of employees, and our hope is to tion needed recovery and progress. continue building a culture of ap- Med - PB has gone from using In response to the focus preciation and gratitude. drugs and panhandling to be- ing clean and working part group recommendations and the recognition survey re- -Katherine Hardy was recog- time at DI. He has been able to nized by Janene Candalot, super- sults, the executive team has gain some weight and seems visor for making the programs for to be doing all around well! I taken these actions to im- our company Christmas party and congratulate him every time I prove employee recognition: volunteering to decorate a table. do a UA and the dude lights up...I hope everyone working Continuation of CEO with him will congratulate him recognition program -Merrill Yeslith received recog- and encouraged him to contin- nition for playing the piano dur- ue working hard regularly Managers have been ing the Christmas program. provided with nomi-

Page 9 Newsletter Title Success Stories Cont… Employee recognition

-Ben Weinheimer received thusiastic "It was awesome." recognition from Vantage Thanks to Ben from Vantage Lorraine Crossley received a Point clinician: I would like Point for his efforts to provide very nice email from another de- to submit a recognition request quality care for his clients and partment acknowledging how for Ben Weinheimer. He has to keep us all in the loop! well she manages testing appoint- had some particularly chal- Elizabeth Feil, LCSW ments and how she keeps refer- lenging clients to work with Therapist, Vantage Point ents informed of the status of the who have utilized Vantage testing. This co-worker was im- Point recently. Ben has a very pressed with the organizing and busy schedule, but when he Tom Parkinson created a note communication that Lorraine fa- has a client at Vantage Point auditing instrument for nurse’s cilitates between departments. he always tries to come visit notes that was based on the Lorraine was acknowledged with with the client while they are guiding principles we have an SIR. Lorraine has done a phe- with us. This is beneficial be- trained on. An SIR was put in nomenal job of keeping up given cause it frees VP staff up to his PEP for “leadership”. the growth of the department. meet with new clients and it We received positive comments shows a positive therapeutic The following was put in the relationship. He knows his about Dr. McGaughy from a cli- PEP program as an SIR for ent. The comments were noted in client much better than we do Tom Yee. and we appreciate his willing- an SIR in the PEP program. ness to really show his clients “Crisis services sent over some Jennie Reese did a great job lead- that he cares by coming over youth who were in need of pre- ing the Sub-For-Santa and many to meet with them. Just yester- scriber attention during the holi- volunteers helped as she orga- day we had one of his clients day closure. Tom was here and nized their efforts where needed. at VP. Ben's schedule was full willing to see them even though We were able to serve over 200 all day yesterday and today, they were not his clients. His clients this year. flexibility in practice and will- but as soon as he found out his 2pm appt had canceled, he let ingness to meet agency and cli- us know that he would come ent needs is greatly appreciat- get that client at that time for ed.” an early therapy appt even Psych—Jaime though they have an appt Houskeeper spent scheduled for Friday. Many time crunching num- therapists might say "Just wait bers to help us better until Friday" but Ben didn't. understand our cur- After meeting with the client, rent rate of referrals he sent an email to the pro- and capacity to han- gramming staff at VP and oth- dle them. This infor- er members of the treatment mation was submit- team to let us all know how ted with the request the appt went so we can all to post the empty coordinate efforts. I asked the Resident position. client this morning how his An SIR was put in appt with Ben was yesterday her PEP for “Data and he answered with an en- management”.

Page 10 Newsletter Title

ObservancesWasatch for February Wellness—Long Lasting Life Changes

MONTHLY OBSERVANCES 3. Four Chaplains Memorial Day American Heart Month 4. World Cancer Day Boost Self-Esteem Month 5. Weatherperson’s Day Library Lovers Month 6. Canadian Maple Syrup Day National Bird Feeding month 7. Popcorn Day National African American History Month 8. Chinese new Year National Hot Breakfast Month 9. National Stop Bullying Day National Mend a Broken Heart Month 10. All the News That’s Fit to Print Day National Parent Leadership Month 11. Make A Friend’s Day National Time Management Month 12. Lincoln’s Birthday National Teen Dating Violence Awareness 13. World Radio Day Month 14. Autism North American Inclusion Month Sunday Plant Seeds of Greatness Month 15. Clean Out Your Com- Relationship Wellness Month puter Day Spunky Old Broads Month 16. National Wise Health Care Consumer Month Almond Sweet Potato Month Day 17. World Hu- man Spirit WEEKLY OBSERVANCES Day 1-7 Women’s Heart Week 18. The Great American Spit Out School Counseling Week 19. Chocolate Mint Day 7-13 Celebration of Love Week 20. Love your Pet Day Congenital Heart Defect Awareness Week 21. Daytona 500 14-20 Random Acts of Kindness Week 22. George Washington’s Birthday Education Week 23. Curling is Cool Day 21-27 Brotherhood/sisterhood Week 24. Inconvenience Yourself Day National eating Disorders Awareness Week 25. National Chili Day 28– 3/5 Telecommuter Appreciation Week 26. Levi Strauss Day

27. International Polar Bear Day DAILY OBSERVANCES 28. National Tooth Fairy Day 1. Change Your Password Day 29. Rare Diseases Day 2. Groundhog Day

Volume 10, Issue 2 Page 11 10 Ways to Lose Weight Without Going on a Diet

By Jennifer R. Scott member, fiber takes a while to di- Weight Loss Expert the night. Plus, going too long gest so you feel fuller longer after If you're ready to start losing without eating may cause your eating it, which will help you eat weight, but you don't want to metabolism to slow down. If you less in the long run. follow a diet, I have good can't eat first thing in the morn- news. You can make a few ing, a healthful, mid-morning 5. Make a salad your starter. "painless" changes to your snack is a good idea. If you are Having a salad before your meal everyday diet that will help not hungry in the morning, it will almost certainly prevent you you eat less, eat smarter, and could be a sign that you are eat- from overeating. Load up all the lose weight! ing too close to bedtime. Set a veggies you like, but just be careful cut-off time for evening eating about adding high-fat extras such as 1. Don't drink your calo- (such as 7 p.m.) and you will pasta salads, shredded cheese or ries. Beverages are bottomless probably feel more like eating in cream-based dressings. (Tip: Spray these days -- you can't order a the a.m. dressings are excellent for cutting soft drink or iced tea at a res- calories as most only have about 10 taurant without being provided 3. Drink plenty of water calories per spritz). Prepackaged, quick, free refills, or having throughout the day to stay hy- washed salads make it easy to add a the freedom to get them your- drated. You hear it all the time, salad to any meal without extra ef- self. To keep from drinking a but you really do need to work fort. Most fast food restaurants offer day's worth of calories, choose in those recommended six to a reasonably-priced side salad, or herbal tea, unsweetened iced eight 8-ounce glasses of water some menus offer the option to sub- tea with Splenda (or another each day. Thirst can easily be stitute salad for another side item artificial, no-cal sweetener), mistaken for hunger, so you when purchasing a "combo" or diet flavored-water, bottled or could be reaching for food when "value" meal. tap water with a spritz of lem- you are actually thirsty. Eating on or lime, or diet soda. If water-rich foods like fruit will 6. Be a better baker. Start baking none of those better choices help you stay well-hydrated, too. immediately following a meal so suits you, allow yourself one Don't wait until you are thirsty you will be less likely to sample. glass of the "real thing" and to drink; try sipping water Chew flavorful gum like peppermint drink only water thereafter. throughout the day and you may or spearmint so your mouth will be (Tip: Ask for extra ice in that be surprised to find that your otherwise occupied. Healthier bak- first glass of soda and you will appetite seems much tamer. ing ingredient substitutions help cut drink less.) By stopping at one fat and calories. glass, you will save yourself 4. Add at least one more serv- hundreds -- or even thousands ing of produce to as many 7. Go for grains. Whole grains -- of calories. meals as possible. Veggies and will help you feel full longer than fruit are all nutrient-rich, low-cal refined carbohydrates. In the morn- 2. Always eat breakfast. and filling -- just be careful of ing, fiber-rich cereal like Kellog's Taking the time to eat could creamy dips or dressings, butter, All-Bran, is a good choice, as is oat- prevent costly mistakes as the cheese sauce, and fried vegeta- meal. Brown rice, whole grain day progresses; skipping this bles. Salsa, soups, and pasta bread, and whole wheat crackers, important morning meal can sauce are easy ways to work in are all good ways to include grains lead to an out of control after- even more vegetable servings. in your day: A slice of whole wheat noon appetite, oversized por- Keep the skin on fresh produce, bread goes well with a salad; micro- tions, poor food choices, and such as apples, whenever possi- wavable, single-serving brown rice overeating, even later on into ble as it contains more fiber. Re- is easy to add to lunch at the office;

Page 12 Newsletter Title

Healthy Recipe

keep wheat crackers stored in your desk drawer Lentil Salad with Tomatoes and Apple for when the afternoon munchies strike. Lentils, the tiniest treasures of the legume fami- 8. Always keep healthy frozen meals on hand. ly, may be small but they are powerful, provid- They will be a backup plan for nights when you ing a large dose of dietary fiber along with im- don't have time to prepare and cook a healthy portant vitamins and minerals. Add in lycopene- meal. Try to choose meals with around 300 to rich tomatoes and crunchy, tart apples and 350 calories. (Tip: Even some of the healthier you’ve got a delicious recipe for good health frozen meal choices are skimpy on veggies, so be (and happy diners too!). sure to add a packaged salad or a microwavable, single-serving frozen vegetable to your "instant Servings: 4 meal" to better round it out. Ingredients: 9. Choose foods that will help you feel satis- 1 cup French green lentils fied longer. While both protein and fat help you 2 tablespoons fresh lemon juice feel sated longer than simple carbohydrates, pro- 1 tablespoon extra virgin olive oil tein naturally contains fewer calories per ounce 1 teaspoon Dijon mustard than fat. Eggs, lean meats, skinless poultry, and ¼ teaspoon freshly ground black pepper reduced-fat dairy products are ideal protein 1 pint cherry or grape tomatoes, halved sources. A snack like yogurt, a boiled egg, string 2 scallions, sliced cheese or turkey slices will give you an energy ¼ flat leaf parsley, chopped boost and quell hunger pangs. Whole grains also 1 green apple, cut into matchsticks contain protein, so you may find combining an animal or dairy protein with a complex carb such Instructions: as whole wheat crackers or whole grain bread to Place the lentils in a strainer and rinse well. be even more effective at keeping your energy up Keep a watchful eye for any pebbles that may and hunger down. If you don't eat meat or dairy, have slipped through. Fill a medium saucepan there are also several other sources of protein, with water and bring to a boil over high heat. such as beans, legumes, and nuts. Add the lentils and lower the heat to medium so the lentils simmer gently until just tender, 12 to 10. Catch some "Zs." Did you know getting 15 minutes. Drain and rinse under cold running enough rest can have a direct impact on your abil- water to cool. Meanwhile, make the vinaigrette. ity to lose weight? Not getting enough sleep can In a small bowl, whisk together the lemon juice, cause you to eat more often or make poor choices oil, mustard, and pepper. Set aside. In a large (In an effort to compensate for feeling groggy, we bowl, combine the tomatoes, scallions, parsley, tend to naturally reach for higher-calorie, high-fat and apple. Add the cooled lentils and drizzle the foods.). Getting enough sleep also ensures that vinaigrette. Gently stir everything together. you feel energized enough to exercise and that you work out to your fullest capacity when you Nutrition Info Per Serving: do. Even if you can't add additional sleeping (about ¾ cup) 120 calories, 4 g total fat, .5 g hours, take some time to simply do nothing, prac- saturated fat, 0 g trans fat, 5 g protein, 19 g total tice deep breathing, read, or listen to some calm- carbohydrate, 7 g fiber, 8 g sugar, 0 mg choles- ing music every day. Making a point to relax terol, 110 mg sodium more can keep emotional eating -- particularly stress-eating -- at bay.

Volume 10, Issue 2 Page 13 6 Foods to Help You Lose Weight your food. A study in the Journal of Agricultural and Food Chemistry found piperine, a component in Losing weight and keeping it off is not easy — black pepper, may block the formation of new fat but it can be done! It may seem that at every cells. corner you turn, there are obstacles to keep you Peanut Butter from your goals. Many factors are to blame: the Ever heard of something called piceatannol? If you company you keep; the line of work you’re in; haven’t yet, you may soon. A new study in the Jour- increased variety in stores; and shortcuts to get nal of Biological Chemistry found that piceatannol, a from point A to point B (e.g. motorized scoot- component found in peanuts, grapes, and red wine ers, elevators, etc.). You may also be confused, that is similar to the compound resveratrol, has the like many, about what to eat, what to avoid, ability to block a process that allows immature fat when to eat, and how much to eat. Deceptive cells to turn into mature fat cells. Peanut butter may food labeling, which can make unhealthy food be one of the best ways you can prevent fat cell seem healthy, adds to this confusion, as do so- growth and curb your cravings. Important clarifica- called “diet foods,” with their multitude of in- tion: I’m talking about 100 percent peanut butter, gredients. Here’s the good news: There are a where the only ingredient is peanuts. You won’t find few diet perfect foods that can help you lose the same effects with any other kind of peanut butter, weight. Try adding these six foods to your diet even reduced-fat versions that are often loaded with to help you satisfy your cravings, keep you full, sugar. and ultimately arm you with the tools you’ll Legumes need to reach a healthy weight and maintain it! What is one thing that the healthiest individuals in the String Cheese world have in common? They all eat legumes. A Many of my patients start off with a common study in the Journal of Nutrition found that low- plea: “I can give up anything, but please don’t glycemic foods (those that are slowly digested, like ask me to give up cheese!” Well there may be a lentils) helped to increase a hormone that assists in happy medium, and its name is string cheese. regulating metabolism of fat and sugar. Additionally, This cheese is just 80 calories, has no carbs, is low-glycemic foods were found to significantly re- easily portion-controlled, and can be taken al- duce inflammation markers in obese adults. most anywhere. In fact, it is perhaps the perfect Popcorn snack for dieters. A 2011 study in the Journal of High in fiber and low in calories, popcorn is a great Nutrition found that increasing consumption of example of nutrient density at its best. Nutrient densi- dairy foods and protein during weight-loss ef- ty means you’re getting the most nutrients with the forts promoted fat mass loss and lean mass gain. least calories. For example, you can have three cups String cheese is my only exception to the “one of popcorn for 100 calories or you can have three lic- ingredient” rule, due to the addition of enzymes orice twists. While the calories are the same, the pop- in the processing of skim milk. corn will give you fiber (making you full) as well as a Apples healthy dose of antioxidants. In fact, a 2012 study A study in the journal Nutrition found that found that popcorn could have even more antioxi- women who consumed either three apples or dants than some fruits and vegetables. Of course, that three pears a day were more likely to lose doesn’t mean you should skip the produce aisle and weight and have better blood sugar control. As fill up on popcorn instead! The licorice, well, it will an added bonus, many studies have linked apple give you a big boost in blood sugar and insulin, fol- consumption to improved bowel function, as lowed by a crash, followed by yet another craving. well as reductions in the risk of breast cancer See where I am going with this? If you’re going to and stroke. snack while trying to lose weight, snack on some- Black Pepper thing that will help you get the most bang for your Looking for a way to spice up your weight-loss nutritional buck! Popcorn is a snack that will actually efforts? Ditch the salt and use more pepper on make you feel satisfied after you’re done eating it.

Page 14 Wasatch Review 5 Must-Haves Seasonings to Spice Up Your Food Routine

By Lisa Lillien, a.k.a. Hungry Girl Optional toppings: Fat Free Reddi-wip, cinnamon Diet Advice Expert Directions Preheat oven to 350 degrees. Spray a deep-dish 1) Mrs. Dash Original Blend Salt-Free Season- pie pan with nonstick spray. ing Mix In a large bowl, thoroughly whisk all ingredients This is the mother of all versatile spices. Serious- except graham crackers. ly, I wish Mrs. Dash could be all of our mothers. Transfer mixture to pan. Bake until par- Her Original Blend Salt-Free Seasoning Mix is tially firm, about 45 minutes. delicious, and it has the added bonus of being -- Refrigerate until completely chilled and firm, at you guessed it -- salt-free. If you’re looking for least 3 hours. meals that are low on sodium but not low on taste, Sprinkle with crushed graham crackers. Enjoy! this seasoning mix is the way to go. With over a MAKES 8 SERVINGS dozen perfectly balanced spices, this blend goes well with chicken breast, lean beef, turkey breast, grilled veggies...pretty much every go-to dinner 3) Taco Seasoning Mix item. Taco Tuesday, anyone? Taco Wednesday? Taco Thursday? With your new taco seasoning mix, 2) Pumpkin Pie Spice you’ve got the key ingredient to make every day I’m a BIG fan of all things pumpkin, and my love of the week a fiesta. A typical taco seasoning mix for the gorgeous gourd goes far beyond pumpkin is made from a combo of chili powder, garlic pie. So what exactly IS pumpkin pie spice? It's powder, onion powder, red pepper, oregano, pap- a blend of cinnamon, nutmeg, ginger, and all- rika, cumin, salt, and pepper. Yeah, you can see spice, and it’s fantastic when you’re craving a lit- how this mix is a time saver! Mix it into extra- tle fall flavor. Stir some into fat-free vanilla Greek lean ground beef or lean ground turkey, or get yogurt, or spoon a bit into your morning oatmeal. creative with chicken breast or fish fillets

Upside Down Pumpkin Pie 1/8th of pie: 144 calories, 0.5g total fat, 110mg sodium, 30g carbs, 2g fiber, 26g sugars, 5g pro- tein Salmon Fillet + Taco Seasoning Mix

PER SERVING (one raw 4-oz. fillet + 1 tsp. seasoning PointsPlus® value 4* mix): 192 calories, 9g fat, 268mg sodium, 1.5g carbs, Prep: 15 minutes 0g fiber, 0g sugars, 23.5g protein -- PointsPlus® Cook: 45 minutes value 5* Chill: 3 hours Ingredients If you've been wishing for a fish dish that doesn't One 15-oz. can pure pumpkin (not pumpkin pie taste... um, fishy... this one's for you. Spray a grill pan filling) with nonstick spray, and bring it to medium-high heat on the stove. Rub half a teaspoon of the seasoning mix One 12-oz. can evaporated fat-free milk onto each side of a skinless fillet. Grill until flaky and 2/3 cup granulated white sugar cooked through, 4 - 5 minutes per side. Fiesta time! 1/2 cup fat-free liquid egg substitute Pssst... It pairs nicely with some of that pico-ed up 2 tsp. pumpkin pie spice broccoli slaw and a cheesy corn on the cob! 2 sheets (8 crackers) low-fat cinnamon graham crackers, finely crushed

Page 15 Newsletter Title 5 Must have Seasonings cont...

4) Chili Powder well over 100 percent of the daily value for cho- Speaking of fiestas, what better way to add a little lesterol. The equivalent amount of fat-free liquid kick than with chili powder? If you think taco sea- egg substitute -- half a cup -- has about 60 calo- soning mix is for amateurs, you’re probably a ries, 0g fat, and no cholesterol. If you prefer to spicy-food lover with a penchant for some added use standard egg whites, that's fine too -- those heat. Chili powder is an easy way to spice up have virtually the same nutritionals as the egg (literally) any meal. Add a sprinkle to chopped substitute. chicken, stir-fried pork tenderloin, a lean beef steak, or even an egg scramble. Light cheeses: You can't have an egg scramble without cheese... at least, I can't! My absolute fa- Egg Mugs vorite cheese for an egg mug is a wedge of The Laughing Cow Light cheese. It adds creaminess TOOLS and awesome cheesy flavor. The Light Creamy Swiss variety is classic, but try 'em all! Each Large microwave-safe mug: When you prepare wedge has only 35 calories and 1.5 - 2g fat. The eggs in the microwave, they puff up as they cook, runner-up? Shredded reduced-fat cheese, either so you'll need a sizable mug to avoid any spillage. Mexican-blend or cheddar. A 1/4-cup serving has I recommend a 16-oz. mug that's both tall and around 80 calories and 5.5g fat, but two to three wide. If you don't have any mugs this large, you tablespoons is all it takes to get major flavor. And can use a microwave-safe bowl. for a Greek-inspired mug, try reduced-fat feta crumbles. An entire 1/4-cup serving has about 70 Nonstick spray: This is key. Spritz your mug calories and 5g fat -- you'll only need a couple of with nonstick cooking spray to avoid the other- tablespoons. wise inevitable stuck-on egg bits. And here's a related piece of advice: Soak your mug with soapy water immediately after enjoying Fresh vegetables: There are no wrong choices your breakfast. It's much more difficult to clean here! I love spinach, onions, and mushrooms, but once any remaining egg hardens. go with whichever veggies are your favorites. Just make sure they're chopped to a similar size so that Microwave: Kind of a given, but I'm not leaving they all soften up in the same amount of time. To anything to chance! A standard 1,100-watt micro- save yourself some prep, you can use frozen wave is what's used to develop Hungry Girl egg precut vegetables... bonus if they're already mug recipes, but any wattage will work (I've even mixed! used my low-watt Hello Kitty microwave); you'll just need to adjust the cook time. Extras: Pump up the protein with chopped low- fat breakfast sausage, ground-beef-style soy crumbles, shredded or chopped chicken breast, INGREDIENTS crumbled center-cut or turkey bacon, or fat-free Fat-free liquid egg substitute or egg whites: I'm refried beans. a big fan of fat-free liquid egg substitute, like the kind by Egg Beaters. It's essentially egg whites Spices and herbs: Garlic powder, onion powder, with added nutrients. Using this instead of whole chili powder, cumin... All excellent ways to add eggs will save you fat and cholesterol. Two large flavor without any calories. For a shortcut, try a eggs have around 150 calories and 10g fat, plus little taco seasoning, fajita seasoning, or Italian

Volume 10, Issue 2 Page 16 5 Must have Seasonings cont... Shrimp and Asparagus Salad

By Diana Rattray seasoning. I also like salt-free seasoning blends This tasty shrimp salad is dressed with a Rus- like the kinds by Mrs. Dash. As for herbs, basil and sian dressing. Feel free to use crab in this fla- cilantro are at the top of my list. vorful salad. Ingredients Condiments: I love salsa on my eggs. If you're  1 pound asparagus, trimmed, or use frozen watching your sodium, stick with fresh salsa or pi- asparagus (10 oz package) co de gallo, which are generally lower in salt than  Lettuce jarred salsa. Other options? Ketchup, hot sauce  1 cup (about 6 to 8 ounces) cooked (Frank's RedHot is my top pick, although Sriracha shrimps, halved lengthwise, or crabmeat is also great!), and light sour cream (fantastic with  2 hard-cooked eggs, halved Mexican-style mugs).  About 12 cherry tomatoes, halved (1 cup)  1 small cucumber, peeled and sliced Russian Dressing (below) HOW-TO Directions for seafood salad Spray your mug, and add any veggies. Microwave Cook asparagus just tender; drain and cool. until softened, and blot dry. Then add the egg sub- Line platter with lettuce. Place shrimp or crab stitute or egg whites -- 3/4 cup is a good amount -- in the center of the platter and arrange eggs, and spices. Microwave for 1 1/2 minutes. Stir in tomatoes, cucumber and asparagus around sea- cheese, extras, and herbs, and microwave until egg food. Serve topped with Russian Dressing is set and extras are hot, about 1 more minute. Top (below) or your favorite dressing. Makes 4 with condiments, and enjoy! servings. Russian Dressing 5) Lemon Pepper Seasoning  1 cup mayonnaise OK, it's not exactly a mystery what flavors you'll  1/4 cup chili sauce find here. But lemon pepper seasoning has some-  1 tablespoon prepared horseradish thing really special goin' on; it packs its own deli-  1 teaspoon grated onion cious punch. If you have any experience with lem- Stir all ingredients together until well blended. on pepper, chances are it’s as a seasoning for your Makes about 1-1/4 cups favorite fish dishes. It’s no secret that a squirt of lemon can bring out that delicious salmon or hali- but flavor, but lemon pepper can do the same thing. (And if you really love lemon, do both! Nothing wrong with lemon.) Another great way to use lem- on pepper is as an addition to basic grilled chicken or a veggie dish that could use a little pizzazz. In fact, lemon pepper seasoning is basically bottled pizzazz.

Volume 10, Issue 2 Page 17 How To Naturally Boost Your Testosterone To Burn More Fat By Chris Freytag production of testosterone. So if you’re trying to Weight Training Expert burn fat and gain muscle, limit your alcohol in- take. If you thought testosterone was only something men needed, you’d be wrong. While testosterone 4. Don’t skimp on sleep is the primary male sex hormone, women have— No, you are not the only human on the planet for and need—testosterone, too. Among its many which the CDC’s recommendations for getting at functions, testosterone is crucial for healthy met- least 7 hours of sleep a night do not apply! abolic function. In fact it’s one of the most potent Sleep is as important to building muscle and fat-burning hormones in the human body. And as burning fat as your workouts themselves. So genetics dictates, women generally have about many important processes happen while you fifteen to twenty fold lower concentrations of sleep that help your body recover, maintain a testosterone than men. healthy metabolism and get stronger. Skimping on sleep will inhibit your body’s testosterone pro- 1. Cut out sugar and processed foods duction and raise cortisol levels—making your Whenever you eat sugary foods or refined carbs, body cling to fat instead of burn it. your insulin and blood sugar skyrocket, which decreases your testosterone levels. Eat fewer re- 5. Make sure you’re getting the right vitamins fined, processed foods and more protein-packed and minerals foods like fish, eggs, nuts, beans, and meat. Supplement a healthy diet with zinc, magnesium Also, incorporate plenty of fruits and vegetables and Vitamin D: these three powerful vitamins and into your diet—cruciferous vegetables like broc- minerals promote testosterone production and coli or leafy greens like spinach are best for increase your muscle building capacity, in addi- boosting testosterone. tion to being great for your mood and mental fo- cus. B6 is another vitamin cited for its important 2. Increase your intake of good fats role in testosterone production as well as its im- By now you probably know that fat itself is not mune boosting function. always the enemy—it’s the type of fat you eat that affects your health (and your weight). 6. Lift heavy weights Choose healthy fats—flax, olive and peanut oils, Short, intense workouts are key to boosting your avocados and fish. Consider adding a flax or fish testosterone production and building muscle. Try oil supplement to your diet, too. These types of HIIT workouts that include short bursts of high fats are essential to testosterone production; aim intensity exercise. Go heavy with your weights; to get 20 to 30% of your caloric needs met by not so heavy that you’ll injure yourself, but heavy these healthy fats. enough that it’s very challenging. This heavy lift- ing is what’s going to increase your testosterone 3. Limit your alcohol intake levels—in turn, helping you burn fat and build Most of us enjoy a nice glass of wine or a few muscle. cocktails now and then, but is this: alco- hol has the potential to disturb many of the Try these six tactics to ramp up your fat burning body’s natural hormonal processes, including ability and no—you're not going to grow a mus- testosterone production. tache or turn into a bodybuilder overnight, but While an alcoholic beverage a day isn’t going to yes, you will notice yourself getting stronger and be harmful, any more could impact your body’s leaner!

Page 18 Wasatch Review Let the good vibes roll! For weight Loss surround yourself with positive feedback Among your must-haves when trying to reach a healthy weight or keep it off: regular exercise, nutritious meals in appropriate portions, and good old-fashioned love and acceptance. Among the must-not-haves: tough love. However well-meaning it may be, pressure or criticism from people you love doesn’t help you lose weight and, in fact, can lead to more weight gain, according to new research. We are social animals, so messages we get from loved ones affect how we feel about ourselves. Being accepted - just the way you are - encourages acquisition of the eating and activity patterns that help you feel good, support your overall health, and guide you to a healthy Wasatchweight. So Mental if you’re Health trying “Vitals” to lose a few pounds or maintain the weight you’ve lost, ditch the critics. Surround yourself-- Key Indicatorsinstead with -- the very thing that the world needs now: love, sweet love

Percentage of Collected OQ/YOQs

70.00% Series1 64.94% 63.32% 62.78% Linear (Series1)62.15% 60.74% 59.34% 59.86% 60.99% 60.20% 59.57% 60.00% 57.16% 54.22% 50.61% 50.00%

40.00%

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20.00%

10.00%

0.00% Dec-14 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15

Volume 10, Issue 2 Page 19