las noticias - San Diego National Association of Hispanic Nurses

Transcription

las noticias - San Diego National Association of Hispanic Nurses
������
���������������������������������������������������������
LAS NOTICIAS
To serve the nursing
and health care delivery
needs of the Hispanic
community and the
professional needs of
Hispanic nurses
through the
improvement of the
quality of culturally
sensitive health and
nursing care for
Hispanic consumers
and by providing equal
access to educational,
professional, and
economic opportunities
for Hispanic nurses.
Next
SDNAHN Chapter
Meeting
Saturday, March 13,
8:30 – Noon at
Alvarado Hospital
6th Floor Conf. Rm
6655 Alvarado Rd
San Diego,CA 92120
Chris Bajkiewicz,
RN, MSN will talk
on
“International
Health Issues”
Chapter meetings are open to
the public. There is no
charge to members. Nonmembers donate $10 for
continuing education credits.
Breakfast included.
President’s Message
“We spend January 1 walking through our lives, room by room, drawing up a list of work to be done, cracks
to be patched. Maybe this year, to balance the list, we ought to walk through the rooms of our lives... not
looking for flaws, but for potential.”
~Ellen Goodman.
This is how I am approaching the New Year as well as the goals, activities, and
membership of SDNAHN. At our first meeting we had new attendees-- yeah! If each
member commits to bringing a potential new member to a meeting this year, we can
double our membership. So, SDNAHN members, let’s get the word out. I am asking for
your commitment to our organization.
As your new president, I have commitments to you in return. I realize that your time is
valuable and thus pledge to conduct timely meetings that are interesting and informative.
Our January meeting had a great presentation by the American Cancer Society, a fun gift
exchange, and breakfast provided by the Tri-City Medical Center of Oceanside.
Continuing education credits will be offered at most meetings, and I will keep you informed
of any educational offerings that come our way, such as scholarships and volunteer
opportunities.
Our primary function as an organization is to serve the nursing and health care delivery
needs of the Hispanic community, as well as to address the professional needs of Hispanic
nurses. To this end, we try to form collaborative relationships with community
organizations that support those in need. In December we were asked by Family Health
Centers of San Diego to once again participate in their successful Adopt-A-Family
program. Our family this year was a young couple with one child and another on the way
(the mother, Jennifer, is due in February). The dad�had lost his job, and the family was
obliged to move in with Jennifer’s mom and ten year old brother. The couple’s four year
old son, Sebastian, loves Spider Man so our SDNAHN chapter bought a Spider Man bike
and helmet for him (many thanks to Felipe and Jeff for assembly), a bike and gear for
Jennifer’s brother, and clothes for the entire family. In addition to all the wrapped gifts,
Felipe and I also delivered a gift card with collected donations totaling $200. Thank you so
much for your donations. We made their Christmas a much happier holiday.
In an effort to support the regional chapters, Paloma and I attended the NAHN
Scholarship and Christmas Dinner in Los Angeles in December. It was a nice event with
very pretty Christmas decorations, and we came away with many ideas for our November
event that will be shared at the first planning meeting, date to be announced.
Thank you for honoring me with your vote. I will work hard to promote our organization
and help it to grow while supporting you, our members, in any way I can. We are very
fortunate to have a great Board, and I look forward to working with them, too.��
� Feliz Año Nuevo, Monica Garcia�
El Invierno 2010
�
SDNAHN Holds first general meeting of 2010
Our first general meeting of the year
was held on January 9, thanks to the
generosity of Tri-City Medical Center,
Oceanside.
Following a first-class buffet breakfast
provided by the hospital, we were
privileged to hear a presentation by
the San Diego chapter of the
American Cancer Society. Whatever
we all think we know about what they
do just barely scratches the surface.
This is an organization that provides
tools and resources that all nurses and
other healthcare professionals can use
in practice all of the time.
The American Cancer Society
provides patient services in no fewer
than fifty-one languages, with trained
volunteers that are matched with
patients nationwide by diagnosis to
provide emotional support, tools, and
resources (though without giving
medical advice).
We now know how to source goods
and services such as makeup kits for
female patients (provided by the
manufacturers and worth $350.00)
and transportation to medical
appointments (or gas cards) to help
pay for the cost of getting to
medical appointments. There was
far too much to list here, but let’s
just say that they offer an extensive
menu of programs that are
available to patients, providers,
caregivers, and physicians. The
only limiting factor is the
availability of money and,
especially, volunteers. We, of
course, learned where to obtain all
the necessary information and how
to access services and informational
flyers on all of their programs in
several languages.
This meeting was a true learning
experience, in addition to learning of
all of the regular business of
providing services to our members
and to the community.
Will we see you at our next meeting?
Save the date Saturday, March 13
(see our cover page for details).
� Joe Atkins, Vice-President�
LOOKING AHEAD
February 5-6: Thousand Smiles Foundation/Fundacion Mil Risas
Thousand Smiles is a non-profit organization focused on care of the less fortunate children in Mexico who suffer from
lack of dental care and from maxillo-facial deformities such as cleft palate. Bus trip to Ensenada leaves at 6am Friday
morning and returns late Saturday night. Cost: approx $100 for hotel, bus & food. For more information, please
contact Lydia Stewart, 619-806-9176, [email protected] . Thousand Smiles,
http://www.thousandsmiles.org/
February 13: SD Black Nurses Annual Scholarship Luncheon
11am - 2:30 pm, Jacob Center at 404 Euclid Ave, SD,CA 92114
$60 per person (students with ID, $30). For more information, please contact the SDBNA at
619-262-9133 or Lydia Stewart at 619-806-9176.
March 6: Women's Resource Fair
8 am - 4pm, Great Hall, San Diego Civic Center, 202 "C" Street, San Diego. Info: [email protected].
March 6: American Diabetic Association’s Feria de Salud: Por Tu Familia
10 am – 2 pm. Kimball Park, near City Hall & the Mile of Cars, National City. Info: [email protected]
March 13: SDNAHN Chapter Meeting for all members (see cover for more information).
April 5: SDNAHN Executive Meeting
All members welcome.
6 – 8 pm, Pepsi Bottling Group��8014 Armour St. SD,CA 92111�
�
El Invierno, 2010
�
2
The Hospice Corner
Hospice is… A philosophy of care and therapeutic
model that consists of the interdisciplinary, comprehensive,
and continuous management of physical symptoms,
psychological concerns, spiritual distress, caregiver burden,
and practical needs in the home. Hospice is a health care
system. It is not a separate medical facility but, rather, a
home care program supported by a federal benefit
(Medicare and Medicaid).
The benefits of hospice care include:
Routine Care: Hospice care is delivered wherever the
patient resides whether it be the home, skilled nursing
facility, assisted living, or group home. Hospice care,
however, does not cover the cost of the residence. For
example, a hospice patient in a nursing home is still
responsible for the room and board charge.
Continuous Care: Continuous care is provided during a
“period of crisis” to maintain the patient at home. “Crisis”
occurs when the patient has an acute episode of increased
symptoms not relieved by the conventional treatment.
Hospice care will provide a minimum of 8 hours/day
during a 24 hour period, but not necessarily continuous
care. Nursing care must comprise 51% of the care, either
by an RN or LVN. However, hospice aides may
supplement nursing care.
General Inpatient Care (GIP): General inpatient
care may be provided for control of acute pain or other
symptoms that cannot be adequately managed in the
patient’s home. Short term care may be provided in a
contracted facility with hospice continuous care to
manage the care plan. GIP care may be needed for
symptoms of imminent death or when there is a
breakdown of the family caregiver support system,
especially if there is an intensity of care directed towards
symptom management that cannot be managed in
another setting. GIP is not available when only custodial
care is needed.
Respite Care� Respite care is provided when
caregivers require a break from care giving
responsibilities. Respite care must be provided in a
contracted facility and can be provided for a maximum
of 5 days per benefit period.
� Luis R. Velasquez, RN, MHA, LNC is Clinical Director
and DPCS/Administrator at Apreva Hospice in San Diego, CA.
Pablo Velez named CEO and Senior VP of
Sharp Chula Vista Medical Center
SDNAHN member Pablo Velez has recently been named
as Sharp HealthCare’s new Senior Vice President and
Chief Executive Officer of Sharp Chula Vista Medical
Center. Pablo began his health care career nearly 25 years
ago as a nurse manager at the Boston VA Medical Center
and served at several hospitals in progressive leadership
positions in the Boston area before moving to San Diego.
Pablo joined Sharp Chula Vista in 1996 as Nurse
Manager, Intermediate Care Services, where he managed
two intermediate care units with a total of 73 beds. Pablo
was later named Director of Critical Care Services, and
was responsible for the leadership and operations of the
Intensive Care Units, Post Anesthesia Care Unit, the
Intermediate Care Units and the Radiation Oncology
Department.
As Vice President of Patient Care Services, Pablo’s many
responsibilities included leading, planning, organizing, and
directing operations of nursing, respiratory services,
pharmacy services, long-term care, ambulatory outpatient
surgical services and other ancillary departments in a 343-
bed facility and a very active ambulatory surgical facility
adjacent to the hospital.
As Dan Gross, Sharp HealthCare’s Executive Vice
President of Hospital Operations notes, “Pablo’s depth of
understanding and firsthand experience in numerous
areas of hospital operations make him the ideal executive
to lead Sharp Chula Vista in its continuing journey as the
South Bay’s premier health care center.”
Many congratulations to Pablo from SDNAHN!
Pablo Velez
with past
SDNAHN
secretary
Fabiola Carapia
and past
SDNAHN
treasurer Lupita
Mora-Rubio.
El Invierno, 2010
�
3
Congratulations to the 2009 SDNAHN
Scholarship Recipients
Rosalinda E. Alfaro (California State
University, San Marcos). I have wanted to be a
nurse since working as a US Army CombatMedic/Psychiatric Specialist. I am involved and
proactive by my participation on the
curriculum committee and special events committee of my
nursing program. My two wonderful children are my life’s
motivation and, when possible, I volunteer at my son's
elementary school. My goals as a student and future nurse
are to be a health care provider and educator as well as
patient advocate within San Diego’s diverse community
while always respecting my patients’ cultural background.
I thank the San Diego chapter of the National Association
of Hispanic Nurses for providing guidance and support for
my educational goals.
Natalie Alonzo (California State University, San
Marcos). I have been practicing as an Adult
Medical-Surgical/Pediatric nurse at Tri-City
Medical Center for the past two years,
completed my New Grad Nurse Training
Program this July, and will be completing my
RN-BSN in Spring, 2010 with hopes of attending the
Master’s Program afterwards. I would like to eventually
work as a Clinical Nurse Specialist in Pediatrics and to
teach at the university level.
Claudia Gonzalez (Southwestern College).
After receiving my RN license and BSN, I
would like to earn my Master’s degree to
become a Nurse Practitioner. I know that my
passion, dedication, and perseverance will
open many doors for me and for the benefit of
Latinos and those lacking access to adequate health care.
Claudia Guzman (University of San Diego). I
was raised in Antofagasta, Chile and came to
the U.S. at age 12. My Bachelor of Science
degree is in biology (Magna Cum Laude and
Phi Beta Kappa) from San Diego State
University and have since worked in a
multicultural community clinic in San Diego for 18 years.
I will be graduating in May 2011 with a RN license and a
Master’s degree in Clinical Nursing.
Ma. Christina Guzman (California State
University, Dominguez Hills). I currently
work for San Ysidro Health Center, an
organization whose mission is to “improve
the health and well being of our community’s
traditionally underserved and culturally diverse
people.” As I continue my education in health care, I
plan to continue working in underserved communities.
Alexia Hollins, LVN (San Diego City
College). After graduating, I hope to
attend National University to earn my
BSN. Afterwards, I would love to work
with Doctors Without Borders to
perform humanitarian work in
developing countries in South America and Africa.
Esperanza Dulce Martinez (Southwestern College). I
owe my hard work and dedication to my
11 year old daughter. I am an active
community volunteer leader for the
Girls Scouts, PTA, and ELAC (English
Learner Advisory Committee). I hope to
continue my education at San Diego
State University in Fall, 2010 to pursue my BSN, and
then pursue my Master’s degree to become a Family
Health Nurse Practitioner so that I can work in
medically underserved communities.
Amy Rose McCraken (Point Loma
Nazarene University). I have a love and
passion for pediatric nursing, which I
hope to practice in a medical mission
field someday. I also love the Spanish
language and hope to use my knowledge
of Spanish to serve in Latin America. I am extremely
grateful to receive a SDNAHN scholarship this year!
Jael Niebla Muriel (Southwestern College).
I am happy to be in my last year of nursing,
a step away from my lifelong dream. Three
children, one income, sleepless nights,
STRESS, clinical rotations, and studying
have only motivated me to live through
nursing school, ONCE! I’m the nursing class president
for the class of 2010 and maintain good standing as a
student and volunteer. I have taken classes in Spanish
for Translation to increase my fluency so that I may
give much needed and better care to our Spanish
speaking population. Thank you SDNAHN for your
support.
�
El Invierno, 2010
4
Thank you!
Our November Scholarship dinner was once again made possible by the
generous support of our sponsors and supporters. SDNAHN allocates 70%
of all funds raised during this event directly to academic scholarships for
nurses. These scholarships, awarded to outstanding nursing students from all
over San Diego County, help to achieve the goals of promoting the nursing
profession and providing diverse health care professionals in our region.
�
Sharp Healthcare
Joseph Atkins & Iris Rosario-Atkins
Grossmont Healthcare District
Kaiser Permanente
Paradise Valley Hospital
Scripps Health Care
University of California San Diego Medical Center
Rick Garcia Construction Company
San Ysidro Health Center
Tri-City Medical Center
LightBridge Hospice
�
�
�
�
Additional Sponsors & Supporters
Palomar-Pomerado Health, Rady
Children's Hospital, Heritage Financial
Services, Inc., Philippine Nurses
Association of San Diego County, Inc.,
San Diego Hospice & Institute for
Palliative Care, San Diego Black
Nurses Association, Inc., Southwestern
College, San Diego City College, InterAmerican College, University of San
Diego Hahn School of Nursing, School
of Nursing at California State
University San Marcos, Health Net,
Walden University, Armida B
Creations, DK Hair, Jana Staples, San
Diego Padres, Pepsi Bottling Co.,
Benihana, Christine Wines, Esther
Stewart, Josephine Marquez, Pala
Casino Spa & Resort
As one who has attended the dinner every year
for quite some time, I must say to all of you who
were not there that, more than ever, you missed
a lovely evening.
Not only has it gotten more fun each time, but it
is so gratifying to meet an incredible group of
scholarship winners. Our organization provides
a greater amount of money to a larger number of recipients
than any other such organization, to my knowledge, and we
should all be proud to be a part of it.
In addition, the dinner provided a rare opportunity to dress
up, have a delightful meal, network, and go dancing. Come
join us next year, and lend your support (and your dollars) to
one of our most important activities!
� Joe Atkins, Vice-President
�
El Invierno, 2010
�
5
Celebremos la
prevencion
On November 28, 2009, several members of SDNAHN
helped San Ysidro Health Center’s SALSA en la
Communidad group with their “Celebremos la
Prevencion” event held in San Ysidro. SALSA en la
Comunidad is a community-based program made
possible by funds from the Office of Minority Health, a
branch of the U.S. Department of Health and Human
Services. The purpose of the SALSA en la Comunidad
project is to reduce health disparities in the Latino
community by increasing early detection of
cardiovascular risk factors and promoting therapeutic
lifestyle changes. About seventy attendees received free
blood pressure, body mass index, and cholesterol
screenings. SDNAHN members Paloma Garza,
Jeannette Martinez, Yolanda Arroyo, Bel Gastelum, and
Juan Bartolome helped the group by interpreting and
explaining the results to the attendees, as well as assisting
with health education. The group also enjoyed and
participated in a lighthearted lesson in “Laughter Yoga.”
Most attendees had metabolic syndrome, and were all
very interested in staying healthy. They were very
receptive to the health education and appreciative of our
participation.
�
Crawford High
Educational Complex,
Community Health and
Medical Practices
(CHAMPS) Career Fair
On December 2, Crawford Health Complex: CHAMPS
had a large Career Fair. Almost 100 community and
college organizations set up booths and answered
questions from students about college and career options.
Various colleges were represented, including San Diego
State University, San Diego City College, Southwestern
College, and the San Diego Fashion Institute.
Organizations as varied as the FBI, Humane Society, Sea
World and even a local mortuary came to answer
questions and give students ideas about career choices.
SDNAHN had a booth with information on nursing as
well as other health professions. We talked to about 150
students and hope to have steered a few students towards
our profession.
� Paloma Garza. For more information on how you can get
involved in community outreach, please contact [email protected]��
California Wellness
foundation funds
center for diversity in
nursing
Tri-City Hospital Foundation has received a $50,000, 3year grant from the California Wellness Foundation to
support a comprehensive Center for Diversity in Nursing.
The grant falls under the California Wellness
Foundation’s funding allotment for Diversity in Health
Professions and “pipeline” educational programs for
nurses. The goal of the grant is to increase the number of
students who are earning an initial or advanced degree in
nursing and are trained in clinical rotations at Tri-City
Medical Center (TCMC). To this end, the Program
Coordinator will also organize community outreach
efforts to encourage young students to pursue careers in
health care.
At the completion of the three-year period, the program
will have:
Assisted 30 minority nursing students in applying for
financial aid, as well as in securing nurse mentors and in
completing or continuing various levels of education (this
includes scheduling clinical rotations in TCMC). Of the
30 students, 15 will be TCMC employees.
Coordinated 36 outreach events reaching 300
individuals in local high schools, community clinics, and
other community organizations in order to spark interest
in the nursing professional careers.
Organized 36 activities exposing 150 students to
TCMC and nursing professional careers. These will
include touring the hospital and shadowing nurses.
Supervised 9 high school nursing interns.
Encouraged and supported all employees and students
at any academic level in completing their education and
clinical rotations in the hospital.
Held 6 cultural competency training sessions for 90
nursing students and clinical nursing instructors.
TCMC’s Center for Nursing Diversity is attempting to
address the shortage of nurses in North County by
initiating a "fast-track" process to recruit students through
outreach programs, which will result in an increase of
nurses from culturally diverse communities.
� For more information, please contact SDNAHN member Natalie
Kolodzik, RN, BSN, Nursing Diversity Coordinator at Tri-City
Medical Center, (760) 940-7301.
El Invierno, 2010
�
6
Cancer Does Not
Discriminate
Cancer does not discriminate. This fact was conveyed to
us by the three representatives from the American Cancer
Society who spoke at our first SDNAHN meeting of the
year. The information presented was especially useful for
our members and the ethnically diverse patients for
whom we care. ACS Representatives Linda Melendez
Force, Kay Clark, Demy Din, and Robby Medina also
spoke with our group about the research, education,
advocacy and services provided by the American Cancer
Society.
The services of the American Cancer Society include an
informative website at www.cancer.org and an 800
number (1-800-ACS-2345) where cancer specialists are
available 24-hours a day, 365 days of the year. Other
services include programs that offer a variety of patient
needs from connecting patients with other survivors to
providing a camp for children with cancer and research
programs. A research study coming to San Diego in April
is the CPS-3 Cancer Prevention Study.
CPS-3, is a nationwide research study to better
understand the lifestyle, behavioral, environmental and
genetic factors that cause or prevent cancer. The goal is
to enroll 500,000 adults of various racial/ethnic
backgrounds from across the U.S. If you would like to
make a difference in the fight against cancer and be a
part of a historic event, save the date! On Saturday and
Sunday, April 17-18, 2010 an enrollment will be held at
the Oceanside Relay for Life Event at MiraCosta
College, from Saturday 10 am to Sunday 9 am.
Qualifications are simple: a man or woman between the
ages of 30-65 with no personal history of cancer.
Volunteers are also needed to help with the enrollment
area at the venue.
For more information, go to www.cancer.org or call tollfree 1-888-604-5888.
� Sylvia Mac Manus RN, BSN, OCN
�
Chula Vista Florist
Floral Designs For All Occasions
575 “H” Street, Chula Vista, CA
619-422-0144
619-253-1530
�������������������������������
El Invierno, 2010
�
7
�����������������������
��������������������������������
THE SHARP
EXPERIENCE
���������������������������������������������������������������������������
��������������������������������������������������������������������������
���������������������������������������������������
�����������������������������������������������������������������
��������������������������������������������������������
��������������������������������
��������
���������������������������������
������������������������
������������������������������������
��������������������������
�����������������������������
�����������������������������������
�������������������������
�����������������������
����������������
������������
�����������
�������������������
�������������
��������������������������
����������������������
��������������������������
�������������������������������
������������������
��������������������������
�������������������������
��������� �������� ������� ������ ����� ��� ������ ���� ���� ������
��������� ������������ ��� ��������� ������� ���� ������ �����������
�������������� ��� ���� �������� ����������� ��������� �����������
���� ��������������� ���� ������� ���� ��������� ���� ������ ���
������������������������������������������������������������
�����������������������������������������������
������������ �������� �������� ��� ����������� ���� ����������� ���
�������� ������������� ��������� �������� ���� ��� �������� �������
�������������� ��� ������ ������ ��� �������� ����� ���� ������ �������
��������������������������������������������
���
�������������������
El Invierno, 2010
�
9
SOUTHBAY
DANCE ACADEMY
4370 Palm Ave Ste. # G San Diego, CA 92154
619.428.3301 • 619.395.1316
www.southbaydanceacademy.com
El Invierno, 2010
�
10
Join Us!
Membership in the San Diego National Association of Hispanic Nurses
includes:
� CEUs at no cost for chapter-sponsored presentations.
� Special membership rates to SDNAHN and NAHN conferences.
� SDNAHN newsletter and the official journal of NAHN, Hispanic Health
Care International, which provides information on the latest research on
Latino heath care issues; information on professional events, opportunities for
employment, education and scholarships, community, local chapter and
NAHN activities, and membership achievements and recognition.
� Networking among other Hispanic/Latina(o) nurses, health care providers,
and business organization for professional development.
� Promotion of the Hispanic/Latino(a) professional image, leadership, and
visibility through partnering and collaboration in health care community
activities.
By becoming a SDNAHN member, you join a membership with the passion
and desire to make a difference in our community as well as have a voice in
improving the nursing profession.
Help make a difference by joining now!
Our “Membership” link may be found on our website at www.sdnahn.org.
We welcome our new and
re-instated members
Matilde Montoya
Robert Lemos
Nancy Coffin-Romig
Alicia Cordero-Canedo
San Juana Gonzalez
Sara Medina
Lorraine Mauntner
Robert Robledo
Luis Velasquez
SDNAHN Going Green
�
Protecting the environment is a movement that started on a small scale in grass root organizations and
grew quickly into a cause championed by many organizations and countries. Politicians now address
the issues of global warming in speeches they give, and policies they support. Protecting the
environment has become everyone's responsibility.
This is a discussion that we have had at several meetings, and so we are going to incorporate some
small changes in our effort to become greener in our practices. The meeting minutes will be sent out
and approved electronically, and posted on the screen along with the agenda at the following meeting. If anyone
would like to see�them, once approved, all you have to do is send us an email requesting them and we can send you the
minutes.
The newsletter will also be sent to all members electronically. We will continue to send our sponsors a paper copy. If
you would like to receive a paper copy, please send us an email requesting one, and we will mail one to you. Not only
will we cut down on the number of newsletters printed, but in a year, we can save over a $1,000
in printing and mailing costs.
Thank you for your support in this new endeavor.
� Monica Garcia, President�
El Invierno, 2010
�
11
El Invierno, 2010
�
12
El Invierno, 2010
�
13
San Diego Chapter of the National Association of Hispanic Nurses
For the Calendar of National chapter events, check the National Association of Hispanic Nurses website at http://www.thehispanicnurses.org.
For San Diego Chapter events, go to www.sdnahn.org or contact us at (619) 370-454, email at [email protected]
��������������������
���������������������������������
���������������������������������������� � ����������������������������������
��������������������������������������������������������������������������������
���������������������������������������������
������������������������������ �
����������������������������������������������������
�������������������
���������������
��������������������������������������������������
�����������������������
�������������������������������������������������������������������������
����������������������������������
���������������������������
����������������������������������
��������������������������������������������������������������������������
����������
����������������������������
������������������������������������������������������
��������������������������
������������������������������������
�����������������������������������������������
����������
�����������������������������������������������
��������������������������������������������������������������������������������
��������������������������������������������������
��������������������������
�������������������������
����������������������������������
������������
�����������������������������������������������
������������������������������������������������
������������������������������������������
�����������������������������������������
������������������������������������������������
���������������������������������������������������
������������������������������������������
�����������
���������������������������������������������
������������������������
�����
����������������������
�����
�������������������������
����
������������������ ����
�������������������������������������������������������������������������������������
��������������������������������������������������������������
��������������������������������������������������������������������������
������������������������������������������������������
��
��������������
�������������������������
�������������������
���������
��������������
El Invierno, 2010
�
14