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By,
Penny Simkin, PT, CD(DONA)
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,CPC¿TUVVKOGOQVJGTCEEQORCPKGFD[JGTRCTVPGT,KOCPFJGTFQWNC/QNN[ICXGDKTVJVQNKVVNG
-GGPCPCHVGTJQWTUQHNCDQT,CPCPF,KOJCFVCMGPEJKNFDKTVJENCUUGUVJCVGZRNQTGFVJGGOQVKQPU
QHNCDQTYC[UVQOCZKOK\G,CP¶UEQOHQTVCPFYGNNDGKPICPFXCTKQWUCRRTQCEJGUVQECTGFWTKPI
NCDQT$GECWUG,CPHGNVEQP¿FGPVVJCVDKTVJKUCPQTOCNVJQWIJKPVGPUGRTQEGUUUJGVTWUVGFVJCVJGT
DQF[CPFJGTKPPGTUVTGPIVJYQWNFGPCDNGJGTVQNCDQTCPFIKXGDKTVJPQTOCNN[5JGCPF,KONQQMGF
HQTVJGMKPFQHECTGVJCVYQWNFCNNQYJGTVQRCTVKEKRCVGHWNN[KPVJGDKTVJRTQEGUUHQNNQYJGTKPUVKPEVU
CPFCXQKFFTWIUQTKPVGTXGPVKQPUWPNGUUPGGFGFHQTCRTQDNGOYKVJNCDQTQTVJGDCD[
,CPEJQUGVQIKXGDKTVJKPCPQWVQHJQURKVCNDKTVJEGPVGTCPFVQJCXGCOKFYKHGCUJGTECTGIKXGT*GT
NCDQTYCUNQPICPFRCKPHWNCVVKOGUDWVUJGYCUPGXGTQXGTYJGNOGF#UOWUKERNC[GFUJGDCVJGF
YCNMGFUYC[GFQPVJGDKTVJDCNNCPFTQEMGFYJKNG,KOJGNFJGTCPF/QNN[TGCUUWTGFJGTCPFOCU
UCIGFJGTJCPFUHGGVCPFDCEM,CPJCTFN[VCNMGFDWVUJGOQCPGFTJ[VJOKECNN[YKVJGXGT[QWV
DTGCVJCPFJGTVGCOOQCPGFCNQPIYKVJJGT*GTPWTUGCPFOKFYKHGGPEQWTCIGFJGT7PQDVTWUKXGN[
CPFIGPVN[VJG[NQQMGFCHVGTVJGENKPKECNCURGEVUQHJGTECTG
#HGYYGGMUCHVGTVJGDKTVJ,CPUCKF³9QTFUECP¶VFGUETKDGJQYYQPFGTHWN+HGNVYJGP+¿TUVNCKFG[GU
QP-GGPCP+VYCUVJGDGUVFC[QHO[NKHG+HGNVUQECTGFHQTCPFUQUVTQPI+PGXGTICXGWRQPO[UGNH
GXGPVJQWIJKVYCUVJGJCTFGUVVJKPI+¶XGGXGTFQPG´
2CKPXGTUWU5WHHGTKPI
#NVJQWIJRCKPCPFUWHHGTKPIQHVGPIQJCPFKPJCPF,CP¶UNCDQTKNNWUVTCVGUVJCVCNQPIRCKPHWNNCDQT
FQGUPQVJCXGVQECWUGUWHHGTKPI2CKPKUCPWPRNGCUCPVRJ[UKECNUGPUCVKQPVJCVOC[QTOC[PQVDG
CUUQEKCVGFYKVJUWHHGTKPI(QTGZCORNGVJGRCKPRGQRNGHGGNYKVJYQTMKPIQWVQTJKMKPIWRJKNNKUPQV
UWHHGTKPI
³PQRCKPPQICKP´PQTGXGPKUVJGRCKPQHCDTQMGPNGIHQTOCP[RGQRNG5WHHGTKPIKUC
FKUVTGUUKPIRU[EJQNQIKECNUVCVG
KGJGNRNGUUPGUUCPIWKUJTGOQTUGHGCTRCPKEQTNQUUQHEQPVTQNVJCV
OC[QTOC[PQVDGCUUQEKCVGFYKVJRCKP(QTGZCORNGYKVPGUUKPICRGTUQPDGKPIJWTVQTKPLWTGFQT
DGKPIGOQVKQPCNN[CDWUGF
KIPQTGFKPUWNVGFQTJWOKNKCVGFOC[ECWUGUWHHGTKPIGXGPVJQWIJVJGTGKU
PQRJ[UKECNUGPUCVKQPQHRCKP
/QUVYQOGPVQFC[CTGGZRGEVGFGXGPRTGUUWTGFVQJCXGCPGRKFWTCNKPNCDQTDGECWUGVJG[CPF
VJGKPÀWGPVKCNRGQRNGKPVJGKTNKXGUGSWCVGNCDQTRCKPYKVJUWHHGTKPI9JKNGCPGRKFWTCNGNKOKPCVGU
CNOQUVCNNUGPUCVKQPKPENWFKPIRCKPKVFQGUPQVCFFTGUUHGCTYQTT[NQPGNKPGUUJGNRNGUUPGUUQTQVJGT
GOQVKQPUVJCVNGCFVQFKUVTGUUFKUUCVKUHCEVKQPQTGXGPUWHHGTKPI6QRTGXGPVUWHHGTKPIYQOGPPGGF
OQTGVJCPTGNKGHQHRCKPVJG[PGGFVQTGEQIPK\GVJCVNCDQTRCKPKUCUKFGGHHGEVQHCPQTOCNRTQEGUU
PQVCUKIPQHFCOCIGQTKPLWT[6JG[PGGFCUGPUGQHOCUVGT[CPFYGNNDGKPICUVJG[TGURQPFVQVJGKT
RCKPDWVVJG[CNUQPGGFJWOCPGECTKPIEQP¿FGPVRGQRNGIKXKPIEQPVKPWQWUUWRRQTVVJTQWIJQWV
NCDQT,CPYCUPWTVWTGFCPFUQQVJGFKPCRGCEGHWNCPFUCHGGPXKTQPOGPVCPFMPGYYC[UVQTG
URQPFVQJGTEQPVTCEVKQPUYJKEJGORQYGTGFJGTVQEQRGYGNNYKVJVJGRCKPCPFTGOCKPECNOCPF
EQP¿FGPV
2GPP[5KOMKPRTQXKFGUDKTVJGFWECVKQPUWRRQTVCPFEQWPUGNKPI5JGJCUCWVJQTGFOCP[DQQMUCPFRCRGTUTGNCVKPIVQ
EJKNFDKTVJCPFOCKPVCKPUCDWU[UEJGFWNGQHYQTMUJQRUCPFEQPHGTGPEGUHQTOCVGTPKV[ECTGRTQHGUUKQPCNU
Š2GPP[5KOMKP#XCKNCDNGD[RGTOKUUKQPCVYYYEJKNFDKTVJEQPPGEVKQPQTI
+NNWUVTCVKQPUD[5JCPPC&GNC%TW\Š4WVJ5#PEJGVC4GRTQFWEGFYKVJRGTOKUUKQPHTQO6JG.CDQT2TQITGUU
*CPFDQQM'CTN[+PVGTXGPVKQPUVQ2TGXGPVCPF6TGCV&[UVQEKCUVCPFPF'FKVKQPUD[2GPP[5KOMKPCPF4WVJ#PEJGVC
1Z
HQTF$NCEMYGNN2WDNKUJKPI
&QYPNQCF5QWTEGYYYEJKNFDKTVJEQPPGEVKQPQTI
5GVVKPIVJG5VCIGHQT/CZKOWO%QOHQTV&WTKPI;QWT.CDQT
6JGEJQKEGUCPFRTGRCTCVKQPUVJCV[QWOCMGDGHQTGVJGDKTVJJCXGCITGCVKORCEVQP[QWTDKTVJGZ
RGTKGPEG6JKUKUDGECWUGQHVJGYKFGTCPIGQHCVVKVWFGUCOQPIVJGOCVGTPKV[ECTGIKXGTUCPFENKPKECN
UVCHHUCVFKHHGTGPVJQURKVCNUDKTVJEGPVGTUCPFJQOGDKTVJRTCEVKEGU+VKUKORQTVCPVVQOCMGEJQKEGU
VJCVOCVEJ[QWTCVVKVWFGUCUENQUGN[CURQUUKDNG9JGTGVJGTGKUQPN[QPGJQURKVCNQTQPGITQWRQHFQE
VQTU[QWOWUVVT[VQYQTMYKVJKPVJCVEQPVGZVVQJCXGVJGDGUVDKTVJRQUUKDNGCU[QWFG¿PGKV
(KPFCEQOHQTVCDNGGPXKTQPOGPVHQT[QWTEJKNF¶UDKTVJ
9JCVMKPFQHDKTVJGPXKTQPOGPVIKXGU[QWVJGDGUVEJCPEGQHCPQTOCNDKTVJ!9JGVJGT[QWTDKTVJ
UGVVKPIKUCJQURKVCNDKTVJEGPVGTQTJQOGKVUJQWNFDGIGCTGFHQT[QWTEQOHQTVCPFYGNNDGKPI6JKU
OGCPUJCXKPIRNCEGUVQYCNMUJQYGTDCVJGCPFCXCTKGV[QHHWTPKVWTGCPFFGXKEGUVQGPJCPEG
OQXGOGPVCPFEQOHQTVUWEJCUTCKNUCNQPIVJGYCNNUHQT[QWVQNGCPQPFWTKPIEQPVTCEVKQPUJQVCPF
EQNFRCEMUC%&RNC[GTTQEMKPIEJCKTDKTVJDCNNNQYUVQQNUSWCVVKPIDCTCPFEQOHQTVCDNGDGF
#NQPIYKVJVJGUGVJGDKTVJUGVVKPIUJQWNFJCXGRQNKEKGUCPFEWUVQOUVJCVGPEQWTCIGOQDKNKV[CXCTK
GV[QHRQUKVKQPUCPFURQPVCPGQWUEQRKPITKVWCNU5WEJCOGPKVKGUCNNQY[QWVQUGGMCPF¿PFEQOHQTV
YKVJQWVTGUVTKEVKQP1HEQWTUGCEEGUUVQCRRTQRTKCVGOGFKECNECTGKHRTQDNGOUCTKUGKUGUUGPVKCNVQ
UCHGV[HQTOQVJGTCPFDCD[
%JQQUGECTGHWNN[VJGRGQRNGYJQYKNNRTQXKFG[QWTECTGCPFUWRRQTVFWTKPI
NCDQT
-PQYNGFIGCDNGECTKPIFQEVQTUPWTUGUOKFYKXGURCTVPGTUNQXGFQPGUCPFFQWNCUYJQJCXGEQP
¿FGPEGKPVJGPQTOCNRTQEGUUQHDKTVJOCMGCPGPQTOQWURQUKVKXGFKHHGTGPEG$GKPIVTGCVGFYKVJ
TGURGEVFKIPKV[CPFRCVKGPEGFGETGCUGUUVTGUUCPFKPJKDKVKQPUCPFHTGGU[QWVQ¿PF[QWTDGUVYC[
VQEQRG$GKPICVVGPFGFVQEQOHQTVGFGPEQWTCIGFTGCUUWTGFVQWEJGFJGNFCPFUVTQMGF²KPYC[U
VJCVCTGEQOHQTVKPIVQ[QW²EQPVTKDWVGUVQ[QWTYGNNDGKPI9KVJUWEJECTG[QWCTGOQUVNKMGN[VQHGGN
ITGCVUCVKUHCEVKQPCPFTGOGODGT[QWTDKTVJGZRGTKGPEGYKVJLQ[CUGPUGQHCEEQORNKUJOGPVCPF
CRRTGEKCVKQPHQTVJQUGKPXQNXGF*CXKPICFQWNCYKVJ[QWEQPVKPWQWUN[QPGYJQKUEQP¿FGPVGZRGTK
GPEGFCPFGZRGTVKPVJGWUGQHRCKPTGNKGXKPICPFNCDQTGPJCPEKPIVGEJPKSWGUKORTQXGUQWVEQOGU
CPFUCVKUHCEVKQPHQTDQVJ[QWCPF[QWTRCTVPGT
-PQYYJCVJCRRGPUKPNCDQTCPFJQY[QWECPKPETGCUG[QWTQYPEQOHQTV
6JTQWIJTGCFKPIXKFGQUEJKNFDKTVJENCUUGUCJQURKVCNVQWTCPFFKUEWUUKQPUYKVJ[QWTECTGIKXGTFQWNC
HCOKN[CPFHTKGPFUNGCTPCNNCDQWVNCDQTVJGWUWCNRTQEGFWTGUCPFEWUVQOUKP[QWTJQURKVCN
JQYCPF
YJ[VJG[CTGFQPGFWTKPINCDQTCPFCHVGTDKTVJCPFYJGVJGTVJGTGKUÀGZKDKNKV[KPTQWVKPGU
YKVJKPVJG
DQWPFUQHUCHGV[$[MPQYKPIVJGUGVJKPIU[QWECPCXQKFUQOGUWTRTKUGUCPFJCXKPIVQCFLWUVVQ
WPGZRGEVGFCPFUVTGUUHWNGXGPVU#NUQNGCTPJQYVQWUGVJGTGUQWTEGUQH[QWTOKPFCPFDQF[VQMGGR
VJGRCKPOCPCIGCDNGCPFCXQKFUWHHGTKPI/CP[QHVJGUGUGNHEQOHQTVKPIOGCUWTGUCTGFGUETKDGF
DGNQY
6CNMVQUQOGQPG[QWVTWUVCDQWVCP[HGCTUCDQWV[QWTWREQOKPIDKTVJ
/CP[YQOGPJQNFHGCTUVJCVVJG[FQPQVVCNMCDQWV²QHRCKPQHPGGFNGUQHOGFKEKPGUQHNQUKPI
EQPVTQNCPFOQTG$GKPICDNGVQVCNMCDQWVUWEJHGCTUYKVJCMPQYNGFIGCDNGVTWUVGFRGTUQPDTKPIUC
UGPUGQHTGNKGHCPFOC[CNUQJGNR[QW¿PFRTCEVKECNYC[UVQCXQKFQTFGCNYKVJUQOGQHVJQUGHGCTU
#UM[QWTECTGIKXGTHQTCFXKEGCDQWV[QWTEQPEGTPUCPFCRQUUKDNGTGHGTTCNVQCEQWPUGNQTYJQECP
JGNR[QWCFFTGUU[QWTHGCTUEQPUVTWEVKXGN[2TGRCTGC$KTVJ2NCPVJCVGZRNCKPUVQVJGUVCHH[QWTEQP
EGTPUCPFPGGFUCPFFGXKUGYC[UVQFGCNYKVJHGCTUVJCV[QWCPVKEKRCVG
&QYPNQCF5QWTEGYYYEJKNFDKTVJEQPPGEVKQPQTI
*QY6Q7UG%QOHQTV/GCUWTGU6Q/CPCIG2CKP#PF2TGXGPV
5WHHGTKPI+P.CDQT
(QNNQYKPICTGFGUETKRVKQPUQHUQOGJGNRHWNVGEJPKSWGUVJCVTGFWEG[QWTRCKPQTIKXG[QWCUGPUGQH
OCUVGT[FGURKVGVJGRCKP
4J[VJOKE$TGCVJKPIQT/QCPKPIYKVJ6GPUKQP4GNGCUG
/QUVYQOGP¿PFVJCVKVJGNRUVQDTGCVJGHWNN[
NKMGUKIJKPIKPCUNQYTJ[VJOFWTKPIVJGKTEQPVTCEVKQPU
/CP[OQCPCUVJG[DTGCVJGQWV6T[VJKUCPFHQEWUQPTGNGCUKPIVGPUKQPYKVJGCEJQWVDTGCVJ#NUQ
VT[DTGCVJKPIKPCPQVJGTJGNRHWNRCVVGTP²SWKEMGTUJCNNQYQTNKIJVDTGCVJUQTOQCPUCDQWVQPGGXGT[
VQUGEQPFU
VQRGTOKPWVG/CP[YQOGPWUGVJGUNQYDTGCVJKPIVJTQWIJGCTN[NCDQTCPF
DG[QPFVJGPCNOQUVKPUVKPEVKXGN[VWTPVQVJGNKIJVDTGCVJKPIKPNCVGNCDQTDGHQTGVJG[DGIKPRWUJKPI
/CUVGTKPIDQVJQHVJGUGDGHQTGNCDQTJGNRUGPUWTGVJCV[QWYKNNCXQKFDTGCVJKPIVQQHCUVQTJ[RGTXGPVK
NCVKPIFWTKPINCDQTCPFIKXGU[QWEQP¿FGPEGVJCV[QWECPJGNR[QWTUGNH
+PNCDQT[QWOC[¿PF[QWTUGNHEQODKPKPIVJGTJ[VJOKEDTGCVJKPIYKVJTQEMKPIUYC[KPIVCRRKPI
QTEQWPVKPI[QWTDTGCVJU6JKUMKPFQHTGURQPUGVQ[QWTEQPVTCEVKQPUQHVGPEQOGUKPUVKPEVKXGN[CPF
URQPVCPGQWUN[4J[VJOKUVJGGUUGPEGQHVJGUGEQRKPIVGEJPKSWGU-GGRKPICTJ[VJOOGCPU[QWCTG
EQRKPIYGNN
0QVGVQ[QWTRCTVPGTQTFQWNC;QWECPJGNRD[DGKPIKPJGTTJ[VJO
OQCPKPIYKVJJGTUVTQMKPIJGT
QTWUKPI³TJ[VJOVCNM´²VJCVKUOWTOWTKPIUQQVJKPIRJTCUGUNKMG³VJCV¶UVJGYC[´³LWUVNKMGVJCV´
³RGTHGEV´KPVJGTJ[VJOQHJGTDTGCVJKPI;QWOKIJVCNUQVQWEJQTRTGUUNKIJVN[QPCVGPUGCTGCQTC
RNCEGVJCVHGGNUIQQF
GIHQTGJGCFUJQWNFGTUNQYDCEMYKVJQPGDTGCVJCPFOQXGVQCPQVJGT
URQVYKVJVJGPGZVDTGCVJWPVKNVJGEQPVTCEVKQPGPFU+H[QWFQUQOGVJKPIVJCVKUPQVJGNRHWNVQJGT
FQP¶VDGJWTVKHUJGVGNNU[QWVQUVQR6CMGKVKPUVTKFGCPFFQVJKPIUVJCVFQJGNR
+HUJGNQUGUJGTTJ[VJO
CUUQOGVKOGUJCRRGPUFWTKPIVJGOQUVKPVGPUGRCTVUQHNCDQTJGNRJGT
TGICKPKVYKVJG[GVQG[GEQPVCEVUGVVKPICTJ[VJOHQTJGTCPFTGOKPFKPIJGT³-GGR[QWTTJ[VJO´5GG
VJG³6CMG%JCTIG4QWVKPG´DGNQY
/QXGOGPVCPF2QUKVKQPKPI
/QXKPIFWTKPIEQPVTCEVKQPUQTEJCPIKPIRQUKVKQPUDGVYGGPEQPVTCEVKQPUQHVGPCFFUVQ[QWTEQOHQTV
CPFKORTQXGUNCDQTRTQITGUU9CNMKPITQEMKPIUYC[KPICPFQVJGTOQXGOGPVUECPDGRCTVQH[QWT
TJ[VJOKETKVWCNHQTJCPFNKPIEQPVTCEVKQPU
9CNMKPI
&QYPNQCF5QWTEGYYYEJKNFDKTVJEQPPGEVKQPQTI
4QEMKPI
5YC[KPI
'ZCORNGUQHJGNRHWNRQUKVKQPUKPENWFGMPGGNKPIQXGTCDKTVJDCNNQTCRKNGQHRKNNQYUUVCPFKPICPFNGCP
KPIHQTYCTFUKVVKPIDCEMYCTFUQPCEJCKTUSWCVVKPICPFQVJGTU(GGNHTGGVQVT[VJGOCPFWUGYJCV
GXGTJGNRU
-PGGNKPIQXGTCDKTVJDCNN
5VCPFKPICPF
NGCPKPIHQTYCTFU
5KVVKPIDCEMYCTFU
QPCEJCKT
5SWCVVKPIYKVJCDCT
5SWCVVKPIYKVJCRCTVPGT
0QVGVQ[QWTRCTVPGTQTFQWNC;QWECPJGNRD[UWIIGUVKPIRQUKVKQPEJCPIGUKHNCDQTRTQITGUUJCU
UNQYGFKHJGTEWTTGPVRQUKVKQPKUXGT[WPEQOHQTVCDNGQTKHUJGJCUDCEMRCKP;QWECPJGNRJGT
EJCPIGRQUKVKQPCPFUWRRQTVJGTKPJGTPGYRQUKVKQPCUPGGFGF
&QYPNQCF5QWTEGYYYEJKNFDKTVJEQPPGEVKQPQTI
5JQYGTQT$CVJ
#YCTOUJQYGTCP[VKOGFWTKPINCDQTKUCOCTXGNQWUUQQVJGTCPFRCKPTGNKGXGTGURGEKCNN[KH[QWECP
UKVQPCUVQQNCPFFKTGEVCJCPFJGNFUJQYGTJGCFLWUVYJGTG[QWYCPVKV
QP[QWTHTQPVQTDCEM6JG
YCTOVJCPFUMKPUVKOWNCVKQPTGFWEG[QWTCYCTGPGUUQHVJGRCKP
$CVJKPIKPYCTO
QTFGITGGU(CJTGPJGKVYCVGTKUCITGCVYC[VQTGNCZCPFKVVGORQTCTKN[GCUGU
[QWTRCKP.CDQTQHVGPURGGFUWRCNUQ$GPG¿VUCTGITGCVGUVKH[QWYCKVWPVKNOQTGKPVGPUGNCDQTYJGP
EQPVTCEVKQPUCTGENQUGTVQIGVJGTDGHQTGIGVVKPIKPVQVJGDCVJ9QOGPYJQCTGJCXKPICUNQYRCKPHWN
GCTN[NCDQT
YKVJFKNCVKQPNGUUVJCPQTEGPVKOGVGTUCNUQIGVCDTGCMHTQOVJGFKUEQWTCIKPINCDQT
RCVVGTPYJGPVJG[IGVKPVQVJGVWD
0QVGVQ[QWTRCTVPGTQTFQWNC5WIIGUVCPFRTGRCTGVJGUJQYGTQTDCVJHQTJGT*CXKPICUYKOUWKV
CPFEJCPIGQHENQVJGUJCPF[CNNQYU[QWVQDGKPYKVJJGTQTENQUGD[-GGRVTCEMQHVJGDCVJVGORGT
CVWTGDGECWUGKHKVKUVQQJQVUJGECPIGVCHGXGTYJKEJUJGUJQWNFCXQKF#JKIJGTUJQYGTVGORGTC
VWTGKUPQVCUNKMGN[VQECWUGHGXGT
*GCVCPF%QNF
6T[CYCTOIGNRCEMJGCVGFTKEGRCEMJQVYCVGTDQVVNGQTJQVOQKUVVQYGNQP[QWTNQYCDFQOGP
ITQKPUNQYDCEMUJQWNFGTUQTFWTKPIVJGRWUJKPIUVCIGQP[QWTRGTKPGWO9CTODNCPMGVUHGGNIQQF
KH[QWCTGEQNF
&QYPNQCF5QWTEGYYYEJKNFDKTVJEQPPGEVKQPQTI
6JGCRRNKECVKQPQHEQNFVQCUOCNNRCKPHWNCTGCUWEJCU[QWTNQYGTDCEMKUXGT[JGNRHWNCPFECP
TGFWEGRCKP;QWECPWUGCPKEGDCIHTQ\GPIGNRCEMEQNFQTHTQ\GPOQKUVENQVJUCNCVGZINQXG¿NNGF
YKVJKEGEJKRUQTCEQNFECPQHUQHVFTKPMHQTVJKURWTRQUG%QQNENQVJUHGGNIQQFQP[QWTUYGCVKPI
DTQYHCEGEJGUVQTDCEMQH[QWTPGEM#EQNFEQORTGUUQP[QWTRGTKPGWOCHVGTVJGDKTVJTGFWEGU
RCKPCPFUYGNNKPI
0QVGVQ[QWTRCTVPGTQTFQWNC#UMVJGUVCHHKHJGCVQTEQNFECPDGWUGFCPFKHRQUUKDNGIGVVJGJQVQT
EQNFRCEM[QWTUGNH7UGVJGUGCUNQPICUVJG[UGGOVQJGNR%JGEMJGTUMKPRGTKQFKECNN[HQTUKIPUQH
FCOCIG
TGFPGUUDNKUVGTUQTXGT[RCNGUMKP+HVJGYQOCPJCUCPGRKFWTCNFQPQVCRRN[JGCVQTEQNF
QPCP[CTGCYJGTGUGPUCVKQPKUCNVGTGF
6QWEJCPF/CUUCIG
6QWEJOC[EQOGKPVJGHQTOQHUQOGQPGJQNFKPI[QWTJCPFUVTQMKPI[QWTEJGGMQTJCKTDTWUJKPI
[QWTJCKTQTRCVVKPI[QWTJCPFQTUJQWNFGT+VEQPXG[UTGCUUWTCPEGECTKPICPFWPFGTUVCPFKPI²CNN
QHYJKEJOC[JGNR[QWHGGNDGVVGTCUNQPICU[QWCTGEQOHQTVCDNGYKVJVJCVMKPFQHVQWEJ;QWT
EQORCPKQPOC[OCUUCIG[QWTJCPFUHGGVUECNRUJQWNFGTUDCEMQTNKODUKPVJGHQTOQHNKIJVQT
¿TOUVTQMKPIMPGCFKPIQTRTGUUWTGYKVJJCPFUQTCP[QHCXCTKGV[QHOCUUCIGFGXKEGU1KNNQVKQPQT
RQYFGTOCMGUUVTQMKPIUOQQVJGT/CUUCIGJGNRUYKVJRCKPCPFTGNCZCVKQPDWVKH[QWFQP¶VNKMGKV[QW
UJQWNFUC[UQDGECWUGUQOGVKOGUNCDQTKPIYQOGP¿PFUVTQMKPIFKUVWTDKPI
&QYPNQCF5QWTEGYYYEJKNFDKTVJEQPPGEVKQPQTI
#EWRTGUUWTG
³¿PIGTCEWRWPEVWTG´KURTGUUWTGD[VJWODQT¿PIGTQPQPGQTOQTGCEWRWPEVWTG
RQKPVUVQTGNKGXGRCKPCPFQTKORTQXGNCDQTRTQITGUU6YQRQKPVUQPGCEJUKFGCTGQHVGPWUGFKPNC
DQT²QPGKPVJGYGDQHUMKPCPFOWUENGDGVYGGPVJGDCUGUQH[QWTVJWODCPFKPFGZ¿PIGT
³*QMW´
RQKPVCPFVJGQVJGTCDQWV¿PIGTDTGCFVJUCDQXG[QWTKPPGTCPMNGDQPG
5RNGGPYKVJVJGRTGU
UWTGCRRNKGFKPCPFVQYCTFVJGHTQPVQH[QWTVKDKC
NQYGTNGIDQPG6JGRTGUUWTGKUCRRNKGFHQT
UGEQPFUCPFTGNGCUGFHQTUGEQPFUQPCPFQHHHQTWRVQOKPWVGU2TGUUWTGKU¿TODWVPQVRCKP
HWN5QOGVKOGUKEGKUCRRNKGFVQQPGQTDQVJ*QMWRQKPVUFWTKPIEQPVTCEVKQPU
0QVGVQ[QWTRCTVPGTQTFQWNC2C[CVVGPVKQPVQVJGYQOCP¶UTGURQPUGVQ[QWTVQWEJCPFOCUUCIG
CUMJGTKHUJGOKPFUYJCV[QWCTGFQKPIQTKHKVKUJGNRKPI.GCTPJQYVQIKXGOCUUCIGCPFRTCEVKEG
YKVJJGTVQ¿PFQWVJQYUJGNKMGUKV5JGOC[RTGHGTVJCV[QWWUGQPGQHVJGOCUUCIGVQQNU*GTRTGHGT
GPEGUHQTVQWEJQTOCUUCIGOC[EJCPIGCUNCDQTRTQITGUUGU.GCTPJQYVQNQECVGVJGCEWRTGUUWTG
RQKPVUQP[QWTUGNH²KVKUDGUVPQVVQRTCEVKEGVJGUGQPJGTDGHQTGNCDQTCUVJG[OC[ECWUGRTGOCVWTG
EQPVTCEVKQPU
6JG6CMG%JCTIG4QWVKPG
6JKUKUCYC[HQT[QWTRCTVPGTQTFQWNCOKFYKHGQTPWTUGVQJGNR[QWKH[QWJCXGNQUV[QWTTJ[VJOKP
DTGCVJKPIOQCPKPIQTOQXKPICPFHGGNQXGTYJGNOGFD[VJGKPVGPUKV[QHVJGEQPVTCEVKQPU;QWTJGNR
GTKU¿TOEQP¿FGPVCPFMKPFCPFCUMU[QWVQQRGP[QWTG[GUCPFNQQMKPVQJKUJGTG[GU;QWTRCTVPGT
VJGPIKXGU[QWCTJ[VJOVQHQNNQYD[DQDDKPIJKUJGTJGCFEQPFWEVKPIWRCPFFQYPYKVJCJCPF
CPFQTURGCMKPIVQ[QWYKVJ³TJ[VJOVCNM´#NN[QWJCXGVQFQKUHQNNQY9JGPVJGEQPVTCEVKQPGPFU
[QWOC[TGUVCPF[QWTJGNRGTTGRGCVUVJG6CMG%JCTIG4QWVKPGCUPGEGUUCT[6JKUOCMGUKVGCUKGTHQTC
YQOCPKPRCKPQTHGCTVQOCKPVCKPCTJ[VJO²VJGOQUVKORQTVCPVGNGOGPVKPEQRKPI
0QVGVQ[QWTRCTVPGTQT&QWNC4GOCKP¿TOEQP¿FGPVCPFMKPF#UMJGTVQNQQMCV[QW
[QWTHCEG
QT[QWTJCPFCU[QWIKXGJGTCTJ[VJOVQHQNNQY5JGOC[NQQMCYC[QTENGPEJJGTG[GUUJWV+PUKUV
ECNON[CPFMKPFN[VJCVUJGOCMGG[GEQPVCEVCICKP-GGRKPUVTWEVKQPUUKORNGCPFENGCT
&QYPNQCF5QWTEGYYYEJKNFDKTVJEQPPGEVKQPQTI
5RGEKCN6GEJPKSWGUHQT$CEMCEJGKP.CDQT
#DQWVYQOCPKPQTHGGNUJGTEQPVTCEVKQPUCUCUVTQPIDCEMCEJGYKVJQTYKVJQWVCDFQOKPCNRCKP
4GCUQPUHQTVJKUCTGPQVCNYC[UENGCTDWVOC[JCXGVQFQYKVJVJGRQUKVKQPQHVJGDCD[¶UJGCFVJG
UJCRGQHVJGYQOCP¶URGNXKUQTQVJGTECWUGU5QOGVKOGUDCEMCEJGKUCUUQEKCVGFYKVJCUNQYGTNCDQT
6JGHQNNQYKPIRQUKVKQPUOQXGOGPVUCPFVGEJPKSWGUJGNRTGFWEGDCEMRCKPCPFOC[JGNRTGRQUKVKQP
VJGDCD[UQVJCVRTQITGUUKORTQXGU
1RGP-PGG%JGUV
6JKURQUKVKQPOC[JGNRTGRQUKVKQPC³RQUVGTKQT´DCD[YJQKUHCEKPIHQTYCTFKHWUGFFWTKPIXGT[GCTN[
NCDQT+H[QWJCXGHTGSWGPVKTTGIWNCTRCKPHWNEQPVTCEVKQPUECWUKPIDCEMRCKPCPF[QWTEGTXKZKUPQV
FKNCVKPIVT[VJKU$GUWTG[QWTDWVVQEMUCTGJKIJKPVJGCKT6T[VQTGOCKPKPVJCVRQUKVKQPHQTOKPWVGU
1PEGVJGDCD[TQVCVGUVQCOQTGQRVKOCNRQUKVKQPVJGDCEMRCKPWUWCNN[UWDUKFGU
5KFG.[KPI
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5GOK2TQPG
.KGQP[QWTUKFGYKVJ[QWTNQYGTCTODGJKPFQTKPHTQPVQH[QWCPF[QWTNQYGTNGIUVTCKIJV(NGZ[QWTWR
RGTJKRCPFMPGGTGUV[QWTMPGGQPCFQWDNGFWRRKNNQYCPFTQNNUNKIJVN[VQYCTF[QWTHTQPV
*CPFUCPF-PGGUQT-PGGNKPICPF.GCPKPI(QTYCTF
4GUV[QWTWRRGTDQF[QPCEJCKTQTCDKTVJDCNN
CNCTIGRJ[UKECNVJGTCR[DCNN5QOGNCDQTDGFUECP
DGCTTCPIGFVQUWRRQTV[QWKPVJKURQUKVKQP
&QYPNQCF5QWTEGYYYEJKNFDKTVJEQPPGEVKQPQTI
5VCPFKPI5YC[KPI9CNMKPICPF5NQY&CPEKPI
6JGUGVCMGCFXCPVCIGQHITCXKV[CPFOQXGOGPVVQGPEQWTCIGTGRQUKVKQPKPICPFFQYPYCTFOQXG
OGPVQHVJGDCD[
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9CNMKPI
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6JG.WPIG
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MPGGCPFHQQVRQKPVKPIVQVJGUKFGYJKNG[QWTGOCKPHCEKPIHQTYCTF&WTKPICEQPVTCEVKQPYKVJQWV
NGCPKPI[QWTWRRGTDQF[UNQYN[³NWPIG´UKFGYC[UVQYCTFVJGEJCKTUQVJCV[QWDGPF[QWTTCKUGF
MPGG;QWUJQWNFHGGNCUVTGVEJQPVJGKPUKFGUQHQPGQTDQVJVJKIJU*QNFHQTCUNQYEQWPVQHVJGP
TGVWTPVQWRTKIJV4GRGCVFWTKPIEQPVTCEVKQPUHQTCVQVCNQHEQPVTCEVKQPU6T[QPGEQPVTCEVKQPNWPIKPI
VQVJGNGHVCPFQPGVQVJGTKIJVCPFEQPVKPWGKPVJGFKTGEVKQPVJCVKUOQUVEQOHQTVCDNG
&QYPNQCF5QWTEGYYYEJKNFDKTVJEQPPGEVKQPQTI
#DFQOKPCN.KHVKPI
9JKNGUVCPFKPIKPVGTNQEMVJG¿PIGTUQH[QWTJCPFUCPFRNCEGVJGODGPGCVJ[QWTDGNN[CICKPUV[QWT
RWDKEDQPG&WTKPIVJGEQPVTCEVKQPUNKHV[QWTCDFQOGPWRYJKNGDGPFKPI[QWTMPGGU6JKUQHVGPTG
NKGXGUDCEMRCKPCPFOC[KORTQXGVJGRQUKVKQPQH[QWTDCD[KP[QWTRGNXKU
6KRUHQT2CTVPGTUCPF&QWNCUQP%QOHQTV/GCUWTGUHQT$CEM2CKP
KP.CDQT
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CPFJQVEQORTGUUGUQPVJGDCEMOCUUCIGQHVJGDCEMCPFVJGUJQYGTQTDCVJ
GURGEKCNN[KHVJGVWD
KUNCTIGGPQWIJVQCNNQYVJGYQOCPVQOQXGCPFNGCPQXGTVJGUKFGQHVJGVWD+PCFFKVKQPVT[VJG
HQNNQYKPIOGCUWTGUVJCVCTGFGUKIPGFURGEK¿ECNN[HQTDCEMRCKP
%QWPVGTRTGUUWTG
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YKVJ[QWT¿UVQTVJGJGGNQH[QWTJCPFKPQPGURQVKPVJGNQYDCEMQTDWVVQEMUCTGC5JGYKNNJGNR[QW
MPQYYJCVURQVVQRTGUU²KVXCTKGUHTQOYQOCPVQYQOCPCPFYKVJKPVJGUCOGNCDQT6T[RTGUUKPIKP
UGXGTCNRNCEGUCPFUJGYKNNVGNN[QWYJGP[QWJCXGHQWPFKV
&QYPNQCF5QWTEGYYYEJKNFDKTVJEQPPGEVKQPQTI
&QWDNG*KR5SWGG\G
6JGOQVJGTMPGGNUCPFNGCPUHQTYCTF
QTQPJGTJCPFUCPFMPGGU(TQODGJKPFRTGUUQPDQVJUKFGU
QHJGTDWVVQEMUYKVJVJGRCNOUQH[QWTJCPFU#RRN[RTGUUWTGVQYCTFVJGEGPVGT
RTGUUKPIJGTJKRU
VQIGVJGT'ZRGTKOGPVVQ¿PFVJGRNCEGUYJGTGVJGRTGUUWTGHGGNUDGUV&QVJKUFWTKPIEQPVTCEVKQPU#R
RN[CUOWEJRTGUUWTGCUUJGPGGFU
4QNNKPI2TGUUWTGQXGTVJG.QY$CEM
#TQNNKPIRKPQTDGVVGT[GVCJQNNQYTQNNKPIRKP¿NNGFYKVJKEGQTEQNFECPQHUQHVFTKPM
MGGRCUKZRCEM
KPCDQYNQHKEGUQ[QW¶NNCNYC[UJCXGCEQNFECPTQNNGFQXGTJGTNQYDCEMKUUQQVJKPIFWTKPIQTDG
VYGGPEQPVTCEVKQPU
&QYPNQCF5QWTEGYYYEJKNFDKTVJEQPPGEVKQPQTI
6JKUCTVKENGJCURTGUGPVGFUWIIGUVKQPUHQTOCP[JGNRHWNPQPFTWIEQOHQTVOGCUWTGUVJCV[QWOC[WUG
KPNCDQT1HEQWTUGRCKPOGFKECVKQPUCTGCXCKNCDNGCPFOCP[YQOGPWUGVJGPQPFTWICRRTQCEJGU
CNQPIYKVJRCKPOGFKECVKQPUWEJCUKPVTCXGPQWUPCTEQVKEUQTCPGRKFWTCN$[FGNC[KPICPGRKFWTCN
WPVKNCEVKXGNCDQTUQOGWPFGUKTCDNGUKFGGHHGEVUQHVJGGRKFWTCNYJKEJKPETGCUGYKVJVJGFWTCVKQPQH
VJGGRKFWTCN
UWEJCUCHGXGTCPFKPETGCUKPIKPCDKNKV[VQOQXG[QWTNGIUCPFRCTVKEKRCVGKPRWUJKPI
OC[DGCXQKFGF1VJGTUYJQJCXGIQQFUWRRQTVMPQYNGFIGQHVJGUGOGCUWTGUCPGPXKTQPOGPV
UWKVCDNGHQTCEVKXGRCTVKEKRCVKQPD[VJGOQVJGTCFGUKTGVQCXQKFRCKPOGFKECVKQPUCPFCTGCUQPCDN[
PQTOCNNCDQTRCVVGTPYKNNPQVWUGCP[RCKPOGFKECVKQP
/GFKECVKQPUHQT.CDQT2CKP4GNKGH
6JKPIUVQ%QPUKFGT
6JGVYQOCKPOGFKECNCRRTQCEJGUVQNCDQTRCKPCTGKPVTCXGPQWU
+8PCTEQVKENKMGFTWIU
CPFTGIKQPCNDNQEMU
HQTGZCORNGVJGGRKFWTCN
+8PCTEQVKENKMGFTWIUIKXG[QWCUJQTVTGUV
HTQOVQJQWTUFGRGPFKPIQPVJGV[RGCPF
FQUCIGQHVJGFTWI6JG[CNNQY[QWVQTGUVNQPIGTDGVYGGPEQPVTCEVKQPUCPFUJQTVGP
VJG RCKPHWN RGCMU QH [QWT EQPVTCEVKQPU DWV [QW YKNN UVKNN HGGN RCKP $GECWUG VJG[ GPVGT
[QWTDNQQFUVTGCOVJG[CHHGEV[QWTDTCKPCPFOC[ECWUGWPRNGCUCPVOGPVCNTGCEVKQPU
ITQIIKPGUUJCNNWEKPCVKQPUQTCIKVCVKQP6JG[CNUQTGCEJVJGHGVWU5JQTVCEVKPITCVJGT
VJCPNQPICEVKPIFTWIUCTGOQTGNKMGN[VQYGCTQHHDGHQTGVJGDKTVJUQVJGDCD[¶UDTGCVJ
KPIOWUENGVQPGCPFCDKNKV[VQUWEMCTGNGUUCHHGEVGF
6JGGRKFWTCNVJGOQUVGHHGEVKXGHQTOQHRCKPTGNKGHHQTNCDQTECWUGUPWODPGUUCTQWPF
[QWTVTWPMHTQO[QWTDTGCUVUFQYPKPVQ[QWTNGIU5QOGUGPUCVKQPOC[TGOCKPKP[QWT
RGTKPGWO6GEJPKSWGCPFFTWIFQUCIGXCT[DWVDCUKECNN[CVJKPVWDGKURNCEGFVJTQWIJ
CPGGFNGKPLGEVGFDGVYGGPVYQXGTVGDTCKP[QWTNQYDCEMKPVQCURCEGQWVUKFG[QWT
URKPG/GFKEKPGWUWCNN[COKZQHDWRKXCECKPGCPFHGPVCP[NTWPUVJTQWIJVJGVWDG
6JGGRKFWTCNKUCEQORNGZCPFRQVGPVKCNN[TKUM[VGEJPKSWG6JGFQEVQTFKOKPKUJGUOCP[QH
VJGTKUMUYKVJVGEJPKSWGUQTKPVGTXGPVKQPUVQRTGXGPVQTVTGCVVJGRTQDNGOKOOGFKCVGN[
6QNGCTPOQTGCDQWVVJGUGCPFQVJGTCRRTQCEJGUVQEQOHQTVCPFRCKPTGNKGHKPNCDQT
CPFYC[UVQNKOKVQTCXQKFVJGFQYPUKFGUUGG%JKNFDKTVJ%QPPGEVKQP¶UKPFGRVJUGEVKQP
QPVJKUVQRKECVJVVRYYYEJKNFDKTVJEQPPGEVKQPQTICTVKENGCUR!%NKEMGF.KPMEM
CTGC
&QYPNQCF5QWTEGYYYEJKNFDKTVJEQPPGEVKQPQTI
4GUQWTEGU7UGFHQT6JKU2CRGT
*QFPGVV'2CKPCPFYQOGP¶UUCVKUHCEVKQPYKVJVJGGZRGTKGPEGQHEJKNFDKTVJ#U[UVGOCVKETGXKGY
#OGTKECP,QWTPCNQH1DUVGVTKEUCPF)[PGEQNQI[5
-NCWU/-GPPGNN,-NCWU26JG&QWNC$QQM*QYC6TCKPGF.CDQT%QORCPKQP%CP*GNR;QW*CXGC
5JQTVGT'CUKGTCPF*GCNVJKGT$KTVJ2GTUGWU2WDNKUJKPI%CODTKFIG
.QVJKCP,&G8TKGU%6JG1H¿EKCN.COC\G)WKFG)KXKPI$KTVJYKVJ%QP¿FGPEG/GCFQYDTQQM&GGR
JCXGP/KPPGUQVC
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5KOMKP2,WUVCPQVJGTFC[KPCYQOCP¶UNKHG!9QOGP¶UNQPIVGTORGTEGRVKQPUQHVJGKT¿TUVDKTVJGZRGTK
GPEG2CTV$KTVJ
5KOMKP2/GFKECVKQPU7UGFHQT2CKP&WTKPI.CDQTCPF$KTVJ%JKNFDKTVJ)TCRJKEU9CEQ6GZCU
5KOMKP2$QNFKPI#7RFCVGQPPQPRJCTOCEQNQIKECRRTQCEJGUVQTGNKGXGNCDQTRCKPCPFRTGXGPVUWH
HGTKPI,QWTPCNQH/KFYKHGT[CPF9QOGP¶U*GCNVJ
5KOMKP2#PEJGVC46JG.CDQT2TQITGUU*CPFDQQM'CTN[+PVGTXGPVKQPUVQ2TGXGPVCPF6TGCV&[UVQEKC
5GEQPF'FKVKQP$NCEMYGNN2WDNKUJKPI1ZHQTF
(QT/QTG*GNRYKVJ.GCTPKPI/CMKPI2NCPU#EJKGXKPI)QCNU
6JG%JKNFDKTVJ%QPPGEVKQPYGDUKVGJCUKPFGRVJUGEVKQPUVQJGNRRTGIPCPVYQOGPNGCTPOQTGCDQWV
UGXGTCNKORQTVCPVVJGOGUKPVJKUCTVKENGCPFVJGPENCTKH[CPFRNCPHQTCEJKGXKPIVJGKTIQCNU6JGVQRKEU
CFFTGUUVJGKORQTVCPEGQHECTGHWNCVVGPVKQPVQ
%JQQUKPICOCVGTPKV[ECTGIKXGT
JVVRYYYEJKNFDKTVJEQPPGEVKQPQTICTVKENGCUR!%NKEMGF.KPMEMCTGC
%JQQUKPICRNCEGQHDKTVJ
JVVRYYYEJKNFDKTVJEQPPGEVKQPQTICTVKENGCUR!%NKEMGF.KPMEMCTGC
#TTCPIKPIHQTEQPVKPWQWUUWRRQTVKXGECTGFWTKPINCDQT
JVVRYYYEJKNFDKTVJEQPPGEVKQPQTICTVKENGCUR!%NKEMGF.KPMEMCTGC
2NCPPKPIHQTEQOHQTVCPFEQRKPIYKVJRCKPFWTKPINCDQT
JVVRYYYEJKNFDKTVJEQPPGEVKQPQTICTVKENGCUR!%NKEMGF.KPMEMCTGC
&QYPNQCF5QWTEGYYYEJKNFDKTVJEQPPGEVKQPQTI