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This 2022 Healthline Stronger Scholarship winner believes integrative medicine will revolutionize the conventional understanding of health and disease.

From a young age, Rodrigo Bravo has felt frustrated with the limitations of Western medicine. He lives with nephrotic syndrome, a type of kidney disorder.

Doctors told Bravo at age 10 that his kidneys may never function properly and that his life may be shortened as a result of the condition.

Yet they could not tell him what caused the condition. Some doctors suspected that there was an environmental factor (like a toxin) involved, though the exact culprit is still a mystery.

Bravo eventually made a spontaneous recovery from the disease, but the experience stuck with him.

He realized that Western medicine needed to start taking into account other aspects of a persons life such as their nutrition, stress, environment, and even subconscious trauma in order to better understand disease and find new ways to promote healing.

Now a public health advocate and physician-in-training, Bravo hopes to gain an even deeper understanding of integrative medicine. The goal: help people better manage the health effects of climate change.

The 28-year-old will start his first year of graduate studies at Yale University this fall. He plans to launch a consultancy to help healthcare centers set up integrative medicine programs and one day run his own clinics.

I am an example of the radical healing that can occur as a result of mind-body unity, and I am so excited to bring this to everyone, he said.

We asked Bravo about his studies, goals, and obstacles. Heres what he had to say.

This interview has been edited for brevity, length, and clarity.

My lifelong passion for helping others heal was inspired by the illnesses I experienced in my early life.

Throughout my childhood and into my mid-20s, I endured a number of rare and chronic conditions that Western medicine could not resolve.

At age 10, I was told that my kidneys might never properly function and that my life expectancy would likely be reduced.

It wasnt until I looked into integrative and holistic medicine that I found life changing solutions for my own health. I quickly began asking questions about how we could improve the healthcare system for others in a similar position.

I grew up with a model of Western medicine that failed to consider the role of things like nutrition, lifestyle, stress, and the environment, all of which can affect diseases and overall well-being.

It also failed to take into account subconscious trauma, spiritual health, and the mind-body connection, which felt critical for me. These elements are the bread and butter of the rapidly evolving field of integrative medicine.

My goal is to help the allopathic (or Western) model of medicine better incorporate these aspects of health and wellness into patient care.

During and after my time at Harvard, I ran a marketing accelerator called BAST Marketing Lab, which helped start-ups that were focused on social and planetary good. It was later reborn as Bee Positive, an accelerator for integrative medicine initiatives.

I was in the middle of bringing reiki and biofield medicine (a type of complementary and alternative medicine) to the largest Veterans Affairs hospital in Georgia when COVID-19 hit, which unfortunately put the project in the backseat.

In the meantime, I started medical school and began exploring neurotechnology, neuro- and bio-feedback, and technology-facilitated mind-body medicine. I helped launch Supermind, a start-up focused on mental health. It uses neurotechnology to address psychological conditions through brainwave training.

In the future, I plan to launch Bravo Conscious Health, a consultancy to help healthcare centers expand their integrative medicine programs and clinics.

I will also debut my own sustainable clinics that will offer therapies based on the science of psychoneuroimmunology. Thats the study of how thoughts, beliefs, and emotions affect the functioning of the nervous and immune systems.

A new era of conscious medicine is trying to emerge in the United States as we catch up with older cultures that have understood and applied the power of the mind-body connection and transpersonal psychology for thousands of years.

It is trying to revolutionize the mainstream understanding of health and disease. It also comes with an agenda to resolve social and planetary injustices.

Concepts such as spiritual health, emotional health, and climate change are fundamental to understanding an individuals health. But theyve often been left out of the conversations people have with their doctors and healthcare team.

To inspire the next era of medicine, well need to educate people on what it means to include planetary, transpersonal, and emotional well-being in healthcare. Well also need to influence policy decisions and incorporate these ideas into modern healthcare.

Overcoming these obstacles will require a deeper understanding of current problems. Well also need cooperation among changemakers and leaders who want to see evolution in allopathic medicine.

Ive been interested in global health since I was young and living with nephrotic syndrome, a poorly understood condition that affects the kidneys.

No one knows exactly what caused my condition or why I eventually made a spontaneous recovery. However, doctors have considered the possibility of a connection to something in the environment, such as a toxin, an infectious disease worsened by the climate, or radiation exposure while my mother was pregnant with me in Bolivia.

My happy ending is not common, though especially among those living in places with limited access to nutritious foods and clean drinking water.

Now as a public health advocate and physician-in-training at one of the most sun-beaten places in the United States, I have already observed the effects of climate change on the community. Im seeing more instances of heat-associated conditions, like heat stroke and dehydration.

Its important to note that the changing climate can also affect mental health. My work at Supermind involves using neurotechnology to support mental wellness.

As we prepare for a future where mental illness will be exacerbated by extreme weather and natural disasters, I am driven to continue working at the intersection of climate change and medicine.

Our bodies reflect what is happening inside of us, as well as in our surroundings. Those who are already experiencing the health effects of climate change are instrumental in helping us achieve a course correction.

They are evidence that our current terms of engagement with Mother Earth are not working, and we need a change in science and policy.

I would encourage people to write to their elected officials and legislators about their policy concerns and ask them to prioritize environmental health. You could also include letters from your physicians explaining the relationship between your medical conditions and the changing climate.

Sharing personal stories on social media can also be a powerful way to support environmental activism. You can also find other opportunities to get involved through advocacy groups.

Lastly, I would encourage people to vote every chance they get and to urge their family and friends to vote in the direction of planetary and environmental health.

Excerpt from:
Rodrigo Bravo: Working at the Intersection of Climate Change and Medicine - Healthline

CDIs industry-leading non-invasive at-home hydrogen and methane breath tests for Small Intestinal Bacterial Overgrowth (SIBO) and Intestinal Methanogen Overgrowth (IMO) as well as fructose, lactose, and sucrose malabsorption are now available for ordering via Rupa Health platform.

We are thrilled to partner with Rupa Health and look forward to working together to deliver diagnostic care to patients when and where they need it, said Craig S. Strasnick, President and CEO of CDI. Making CDIs cost-effective diagnostic solutions available on the Rupa platform will provide greater access to naturopathic and integrative practitioners and their patients nationwide and help expedite treatments with more precise and timely results from our experienced lab staff.

Per the strategic partnership, Rupa will provide services including marketing support and order processing services for CDIs portfolio of industry-leading diagnostic solutions. Tests now available for ordering on the Rupa platform include non-invasive at-home hydrogen and methane breath tests for Small Intestinal Bacterial Overgrowth (SIBO) and Intestinal Methanogen Overgrowth (IMO) as well as fructose, lactose, and sucrose malabsorption.

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Follow the full story here: https://przen.com/pr/33472788

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Commonwealth Diagnostics International (CDI) Expands Access to Naturopathic & Integrative Medicine Community Through New Partnership with Rupa...

Getting sick from COVID is bad enough, but for many it doesn't just end there. Millions will experience a long list of lingering symptomslike brain fog, fatigue, headaches, shortness of breath, neurological symptoms and GI issues for weeks, months and possibly years after the initial infection. According to the Centers for Disease Control and Prevention, "New data from the Household Pulse Survey show that more than 40% of adults in the United States reported having COVID-19 in the past, and nearly one in five of those (19%) are currently still having symptoms of "long COVID." Eat This, Not That! Health spoke with experts who explain how COVID affects the gut and signs you have Long COVID. Read onand to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

Raphael Kellman, MD, a Physician of Integrative and Functional Medicine tells us, "Research is showing that the COVID virus can actually impact and adversely affect the microbiome, which then results in inflammation in intestinal permeability, and a host of consequences that occur when the gastrointestinal wall becomes more permeable than it should be to toxins, environmental chemicals, and byproducts of bacterial metabolites. That can then cause a number of problems in the body, including inflammation and even oral immunity. A component of the effects of coronavirus is its impact on the microbiome and that's even if you don't have gastrointestinal symptoms. So that's why improving the microbiome is a very important component in the healing of COVID. Also, dealing with vaccines in vaccine injury assists with prevention and the treatment of long haul COVID."

Jacob Teitelbaum, M.D., Integrative Medicine Physician, Researcher and Bestselling Author From Fatigued to Fantastic! adds, "In some people, COVID likes to make a persistent home for itself in the gut lining. As the gut makes more brain and mood controlling neurotransmitters than the brain itself, This can trigger the persistent brain fog and anxiety frequently seen in long haulers."6254a4d1642c605c54bf1cab17d50f1e

Dr. Teitelbaum says, "It is not uncommon to see people come down with persistent diarrhea and sometimes nausea as part of their Long Covid."

Dr. Kellman adds, "Many people who've had no gastrointestinal symptoms before they got COVID have developed gastrointestinal symptoms. There's no doubt about it. Certainly, if one has an autoimmune gastrointestinal disease like Colitis or Crohn's disease, they're more susceptible to exacerbation. People who have had no gastrointestinal disease, symptom or problem at all developed GI and COVID related problems. They could persist for quite a while."

Dr. Teitelbaum explains, "Although the research has been done actually showing persistent parts of the Covid virus in the gut lining, these tests are not available outside of research settings. But they look very different on colonoscopy and biopsy. The main tipoff? That the gut symptoms started with a viral infection didn't go away."

Dr. Kellman states, "Well, first of all if someone had Crohn's before they would know. But if it's a new onset with Crohn's, you could get mucus and/or blood in the stool, same thing with Colitis. This is not as common with COVID, but there's a lot of crossovers because COVID can induce autoimmunity as well. So, it can be a trigger for Colitis and Crohn's disease. COVID could really cause many problems. It's a really difficult disease, as it has many weapons to it."

Dr. Teitelbaum shares, "In those that I treat, I begin with ivermectin 20 27 mg a day (depending on the person's weight) for five days along with Pepcid 20 to 40 mg twice a day. Interestingly, Pepcid has been shown to have marked immune and anti-COVID activities in a good number of studies. A recent Yale study also showed reactivation of the Epstein-Barr (Mono) Virus in people with Long Covid, and we have known for decades that Pepcid stimulates your immune system in ways that are helpful for this as well. In addition, Our recently published studies showed that a unique form of ginseng very high in rare ginsenosides resulted in 67% average increase in energy in post viral chronic fatigue syndrome."

According to Dr. Kellman, "There are absolutely things that can be done and it relates to restoring the microbiome. COVID can adversely affect the health of the microbiome. It reduces its diversity and it can absolutely reduce percentages of certain healthy bacteria in the gut and overgrowth of some other bacteria. So, number one, reestablishing some balance of the microbiome and helping it to endogenously become healthier so that it could flourish. A very important component of treatments is the use of both probiotics and prebiotics. Prebiotics are the nutrients that are used to help a healthy gut microbiome to proliferate and become more diversified. Probiotics that have immune modulating and anti-inflammatory effects,.are important to incorporate to assist with relief. When the microbiome is adversely affected by COVID, it can lead to an immunological flare up, even autoimmunity. So, you want to use the types of probiotics that tend to modulate and reduce the overactive immune expression."

Dr. Kellman lists the following GI symptoms that can happen with Long COVID:

"Persistent abdominal discomfort and cramps is certainly one possible sign that COVID has affected your gut.

Constipation and/or diarrhea is another sign, some people actually have alternating constipation and diarrhea post COVID.

Bloating is another symptom that I've seen.

When there's gastrointestinal symptoms, invariably, there are other systemic symptoms as well, such as brain fog and difficulty concentrating anxiety. It's rare that you'll see someone with long haul COVID and that they only have gastrointestinal symptoms. It's quite common that it's associated with problems in the brain as well, including anxiety, depression, brain fog, poor memory and difficulty concentrating, which is very common."

Dr. Teitelbaum shares, "The main symptoms of long Covid are fatigue, brain fog, achiness, and insomnia. Although you may have symptoms localized just to the gut, the onset after Covid and the association of these other symptoms suggests that possible long Covid needs to be addressed."

Dr. Teitelbaum tells us, "The more often one gets COVID, the more likely they are to have more severe illness. But in an otherwise young healthy and low risk population, the risk is still low. What is most important is to maintain optimal health and immune function. This can be as simple as taking a good daily multivitamin with zinc 15 mg, vitamin D 1000 units and other key nutrients. I recommend either the Energy Revitalization System vitamin powder or a combination of Clinical Essentials plus Virapro. Remember, 40% of people who get the virus have no symptoms whatsoever. And only about 20% of people in a household where somebody has the virus catches it. So simple measures such as a good multivitamin, getting your eight hours of sleep a day, and staying hydrated can make all the difference in the world."

Dr. Kellman explains, "It's most important for people to realize that long haul COVID is a big problem. Some studies show as high as 30% of people who've had COVID develop some form of long haul COVID and sometimes symptoms can start months later. So, it's very tricky to diagnose and sometimes people don't see the connection.

It's very elusive but it could have significant adverse consequences, not only in the fact that many people feel so terrible, but it could have detrimental effects on the brain and other organs. Causing persistent inflammation, which can then lead to a number of different problems, including coronary artery disease, neurological problems and neurological inflammation, which can then lead to neurodegenerative disorders and poor cognitive function. It's important to understand that number one, it needs to be diagnosed and identified and people need to be more aware of this possibility that their symptoms may be due to long haul COVID and not just say aging or "I'm just not feeling so good these days." Make the connection that if you've had COVID and you're having these symptoms, this definitely could be long haul COVID. In fact, some people have long haul COVID who had very mild symptoms with COVID. And then a few weeks or a month later they have long haul COVID symptoms such as brain fog, difficulty concentrating, anxiety, poor memory, and common fatigue among others." And to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.

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Signs You May Have COVID in Your Gut After Infection Eat This Not That - Eat This, Not That

One simple breathing technique that takes just over a minute to complete could help you fall asleep faster and get a better night's rest overall, according to experts.

The technique, known as 4-7-8 breathing, was developed by Dr. Andrew Weila trained medical doctor and founder of the Arizona Center for Integrative Medicine.

Weil developed the technique, which is based on breathing exercises found in yoga, for the purposes of managing stress and anxiety.

But experts told Newsweek the technique can also be useful for people who are having trouble sleeping.

Sleep is crucial to our physical and mental health, enabling our body to recover and wake up feeling refreshed.

But large portions of the population don't get sufficient sleep, have poor sleep quality, or have trouble falling asleep as a result of sleep disorders, medical conditions or mental health issues.

According to the American Sleep Association, 50 to 70 million adults in the United States have a sleep disorder, with insomnia being the most common one.

Around 10 percent of adults suffer from chronic insomnia, while many more suffer short-term issues. Meanwhile around 25 million U.S. adults have obstructive sleep apneaa sleep disorder characterized by repeated obstruction to the airway during sleep.

In addition, 35 percent of adults report getting less than seven hours of sleep during a typical 24-hour periodless than the minimum recommend amount.

"The 4-7-8 breath that I teach is the most powerful relaxation method that I've discovered," Weil said in a video demonstration of the technique. "It's very simple, requires no equipment, takes very little time, costs nothing."

This is how to practise the technique correctly:

The speed with which you do the technique is not necessarily important. What is important is maintaining the 4-7-8 ratio between the counts.

According to Weil, this is a technique that you have to practise regularlyat least twice a dayto benefit from fully.

"You can do it more frequently than twice a day but never more than four breath cycles at one time," Weil said in the video.

According to Weil, it may take four to six weeks before you notice any physiological changes from the practise.

Over time he said it could help to lower heart rate, lower blood pressure, improve digestion, improve circulation, and to help people fall asleep.

"It is the most effective anti-anxiety techniques that I've found," he said. "I've taught it to patients with the most extreme forms of panic disorder, who eventually brought that under control, just relying on this breathing technique."

According to Patrick McKeown, a leading international expert on breathing and sleep, and author of bestselling books like The Oxygen Advantage, changing our breathing can have a profound impact on our physical and mental states.

"With breathing exercises one can down-regulate and up-regulate, giving us control over how our minds and bodies react to external stimuli," McKeown told Newsweek. "For sleep, breathing and mental health, functional breathing is instrumental.

"Knowing what exercises to practise can be life changing as we learn to change states. It's not about taking the deep breath. It's much more than that!"

According to McKeown, how a person breathes during the day will influence our breathing patterns during sleep.

"If our breathing patterns mean we are breathing through the mouth, with a faster rate and from the upper chest, (rather than from the diaphragm) this will increase the risk of sleep issues including insomnia, snoring and sleep apnea."

McKeown said that for people with functional breathing who are able to slow down their respiratory rate to around three breaths per minutelike during 4-7-8 exerciseextended exhalation will help activate the bodies relaxation response.

"When the rest and digest response is activated, one feels sleepy and experience increased watery saliva in the mouth," he said. "Slowing breathing rate also enables a better gas exchange to take place from the lungs to the blood.

"Practising this breathing technique before going to bed will not only help people fall asleep but will noticeably improve quality of sleep and when practiced regularly, will lead to a better quality of life all around."

Michael Breus, a clinical psychologist who is a diplomate of the American Board of Sleep Medicine and a fellow of the American Academy of Sleep Medicine, told Newsweek he is a "huge fan" of the 4-7-8 breathing technique.

According to Breus, the technique lowers the heart rate to the point it needs to be at night when some is trying to fall asleep.

"I have adopted this method, as both a 'help you fall asleep' but more of a 'help you get back to sleep' method," Breus told Newsweek. "Most people do not know this metric, but in order to get to a state of unconsciousness you need a heart rate of 60 or below, to get there. So, when you wake up in the middle of the night and your anxiety is high because you looked at the clock, this can help you get back to sleep."

In addition, Breus said there is plenty of data to show that diaphragmatic breathing helps to lower anxiety, which has been linked to difficulties falling and staying asleep.

"Most people are what we call 'shallow breathers' meaning that they do not use their full lung capacity, unless during full-on physical activity," Breus said. "This type of breathing requires more breaths per minute to get the required volume of air to live. More breaths per minute equals increased heart rateand we know we need to get to 60, which is usually down from where people tend to sit naturally (unless you are an athlete)."

Breathing for four counts in will slowly fill the lungs, holding for seven enables oxygen exchange to the fullest, and breathing out for eight pushes all the excess carbon dioxide out of the lungs and allows more fresh, highly oxygenated air to enter the system, and so the heart does not have to work as hard, according to Breus. This leads to a lowering of the heart rate.

McKeown said it is important to note that not everyone will be able to practise 4-7-8 breathing.

"People with poor breathing already experience a breathlessness that we call 'air hunger'. Slowing down the respiratory rate to three breaths per minute will be impossible for them to practise. It could even cause a disruption to their breathing," he said.

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The Breathing Trick That Could Help You Fall Asleep Almost Instantly - Newsweek

The Karnataka Health Vision Group, constituted by the state government in January 2021, released their report recommending various health system reforms, on Wednesday.

The report, titled 'Advancing peoples Health in Karnataka: Vision for Progress', recommends a sharp hike in the states investment in healthcare from 4.7% of GDP (in 2019), to 8% by 2025. This is in line with the 15th Finance Commissions recommendations, says the report.

Senior professor of epidemiology, Nimhans, G Gururaj, who headed the Vision Group, said the fundamental goal was to make public health services available, accessible and affordable to all. The report, to which 250 doctors had contributed, says that decentralised, district-level health systems should be strengthened. All citizens should be able to access all healthcare programmes including specialty services within a 50-km radius.

Read | Four years after launch, Ayushman Bharat reaches 30% of beneficiaries

The report also says that Karnatakas many health programmes and policies will be effective only if streamlined and routinely monitored, and recommends steps for these. The state should commission a pilot study in three districts to identify areas of investment in coming years.

The report adds that Karnatakas current disease surveillance system is weak, not only for non-communicable and occupational diseases, but also for communicable diseases. An integrated surveillance architecture should be set up to tackle this.

The report states that a life course perspective should be adopted, to address healthcare needs in various life stages - that is, for children, youth, middle-aged and elderly. For example, occupational health services should be integrated into primary healthcare for the benefit of the middle-aged.

It identifies less accessible areas like mental and neurological services, and also recommends setting up a state council for inclusion and rehabilitation of people with disabilities. Since many health interventions need multi-sectoral coordination, each district should have a committee headed by the district commissioner to oversee such programmes.

Recommendations

Districts should have data on healthcare institutions, including bed availability and cost; All institutions should undergo accreditation for quality improvement; Transparency in drug procurement; resolve issues of drug quality, storage; Create health IT policy, health IT cells to monitor programmes and provide services and State Health Council for Integrative Medicine and Healthcare to integrate AYUSH into health system.

Continue reading here:
Karnataka Health Vision Group recommends hike in healthcare investment to 8% of GDP - Deccan Herald

Manuela Bougueno collapses after finishing Buenos Aires Half Marathon

In just one minute, the life of Chilean young man Manuela Bougueno was changed forever. The 30-year-old girl came to run the Buenos Aires Half Marathon last Sunday. Once he crossed the finish line, he saw the time on his watch and collapsed. At that point, Dr. Roberto Campos, a cardiologist who was part of the prevention team assigned to the race, swung into action. In a conversation with Infobae, the doctor told how those 6 eternal minutes came to life again after Manuelas sudden death. He was lucky enough to faint right in front of the Red Cross post that we had set up upon arrival for the event, Campos explains. In less than two minutes we got to work on Pulmonary Cardiovascular Recovery (CPR) and a second attempt. We were able to save him.

Works at Campos Kynet Integrative Medicine, a runners health care company. Prior to the start of the race, all crews selected him as the person in charge to perform CPR in the event of an incident. Almost without thinking, I was working on Manuelas body. We used a defibrillator and luckily the athlete responded quickly. Those 6 minutes flew by for me. Once back in life, Bugueno was taken in the same ambulance to the Fernndez Hospital. just there, After 22 minutes he was able to express what he was feeling.

The last thing you remember is to look at the clock to see your time. And then he woke up in the Fernandez hospital bed, Campos explains. After stabilization, Bougueno was admitted to a German hospital. Studies now remain to find out the reasons for what happened to Manuela. If you have any heart disease or any genetic problems. In theory, you should wait to return to a high-intensity sporting activity like the half marathon .

Chilean runner Manuela Bougueno, 30 years old He disappeared while crossing the finish line after marking a time of 1h 28m, the competitions organization said in a statement. He was immediately treated and resuscitated by the organisations medical team. In coordination with the Urban Surveillance Center of the Government of Buenos Aires, the transfer of an ambulance to Fernndez Hospital was expedited, where his care was completed and he remained in direct contact with his family, the organizers added in the text.

According to data provided by Campos to Infobae, There are about 35,000 sudden deaths per year in Argentina. It gives about 100 per day highlights the doctor . Thats why its very important that we all know how to do CPR. This way many lives will be saved. Thats why it should be taught in schools and clubs.

Manuelas father spirit

The young Chilean was grateful to all the members of the Buenos Aires health system who saved her life. In addition, his father from Chile sent a video to the doctors to thank them for their work. Mario Bugueno highlighted in the video that as a family they will never have enough time to thank Manuela for everything they have done so that he can be with us again. Manuela is again the daughter of our whole family. We thank you for getting on as sister, cousin and granddaughter.

Manuela Bogueno, 30, was rescued at the hands of Dr. Roberto Campos. Cardiologist revived her in 6 minutes

How was the running of the race

Nandu Association, The races organizer highlighted that in 2018 it became the first competition in the country to receive cardioprotected status. Organizers stated that for the 21k in Buenos Aires, the device once again had a cardio-assistance plan designed by Emertem with the support of Emergencies Salad and Kynet in compliance with Law 27,159 (December 402/2022).

The health operations deployed at the Buenos Aires Half Marathon included: 27 automated external defibrillators (AEDs) and 14 cardio-defibrillators in mobile intensive care units, totaling 41 defibrillators throughout the circuit. Apart from the Central Medical Post (with Physicians, Cardiologists, Nurses and Technicians), there were 11 First Aid Posts, 14 UTIM Emergency Ambulances, 4 Motorized with Paramedical Personnel, 12 Motorcycles with AEDs, 15 Physiotherapists and 105 Lifeguards. An emergency coordination center.

Considering the enormity of the race, there were fewer attention numbers than we expected. In general, it was about some muscle problems, commented Pizzini, a university technician in civil defense and emergencies. and is the director of Amarteam.

read on

He died suddenly after running the Buenos Aires Half Marathon, he was without a pulse for about 6 minutes and survived

More than 20,000 people took to the streets to demonstrate at the Buenos Aires Half Marathon

Original post:
Doctor Who Saved Life Of Chilean Athlete Who Died Suddenly Says: "We Used Defibrillator And He Responded" - Nation World News

PAINWeek Pain Management Conference, September 6-9

MONTCLAIR, N.J. (PRWEB) August 24, 2022

Psychedelic medicine has been stigmatized and isolated from us for too long. Now is the time to revolutionize care for addiction, pain, and mental health using whatever tools we have, and psychedelic medicine is the most promising potential weapon in this battle, states Dr. Eugene Vortsman, who will be presenting at the PAINWeek National Conference, September 6-9, at The Cosmopolitan of Las Vegas, during the Psychedelics Track on Friday, September 9.

His presentation is Purple Haze: Mysticism & Science of Psychedelics, about which Dr. Vortsman said, to best understand the true potential of these powerful medicines it is important to understand the cultural and scientific history of hallucinogenics leading to the current landscape for future growth. Come on this psychedelic journey through time, space, and science. Together, we will explore the trippy world of hallucinogens. Eugene Vortsman, DO, FACEP, is Clinical Director of Addiction Medicine and Disease Management at Northwell Health, Long Island Jewish Medical Center in Queens, NY.

The psychological mechanism and insight gained during nonordinary states of consciousness is as important as the biological mechanism of the medication, says Dr. Michelle Weiner. Her presentation is K Especial: The Biopsychosocial Model of Personalizing Ketamine for Pain Management. She continued, practicing medicine during an opioid epidemic and mental health crisis has challenged physicians to evaluate if we are treating chronic physical and emotional pain effectively. Ketamines dose, route of administration, and setting can be personalized and integrated into the treatment plan. Michelle Weiner DO, MPH, is an Integrative Pain Management Physician at the Spine and Wellness Centers of America in Miami, Florida.

Dr. Sanjey Guptas presentation, The Glass Bead Game: Harm Reduction and Its Potential Impact on the Opioid Crisis, will discuss the combination of programs, policies, and practices that aim to reduce the negative social, health, and legal implication associated with drug use. He commented, we are pleased that PAINWeek is a leading source of education in harm reduction, as these initiatives are grounded in social justice and human rights. Sanjey Gupta, MD, MBA, is a Professor of Emergency Medicine at the Zucker School of Medicine at Hofstra/Northwell Health, Rockville Centre, NY.

PAINWeek will present 90+ CME/CE credit hours in tracks such as Behavioral Pain Management, Chronic Pain Syndromes, Health Coaching, Interventional and Integrative Pain Management, Medical/Legal, Neurology, Physical Therapy, and Pharmacotherapy. Master Classes, Special Interest Sessions, and sponsored courses complement the agenda, along with tracks presented by The American Society of Interventional Pain Physicians and the International Pelvic Pain Society.

For more information, click PAINWeek or go to painweek.org.

PAINWeek accreditation provided by Global Education Group:Global Education Group focuses on producing partnership-based CME for healthcare practitioners. The Global team works with a select group of medical education companies, associations, academic institutions, and healthcare facilities to develop and accredit live healthcare conferences and workshops as well as online activities. With each partnership or joint providership, Global brings accreditation expertise, project management excellence and grant funding intelligence. Based in Littleton, Colo., Global has accreditation with commendation from the ACCME and accredited with distinction from the ANCC. Global also holds accreditations to offer continuing education for nurse practitioners, pharmacists, dietitians, dentists, and psychologists. Global is a division of Ultimate Medical Academy.

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Explore the Trippy World of Hallucinogens at PAINWeek 2022, on Friday, September 9, at The Cosmopolitan of Las Vegas - PR Web

Tim HoganTimes correspondent

Health experts have been telling us to spend more time in nature for years. Maybe we haven't gone far enough.

According to a bevy of studies, baring at least your feet when running, hiking and walking can have profound benefits.

The practice studied is called "earthing," or "grounding, and it has been reported to assist with everything from reducing inflammation to improving mental health.

The basic idea is performing simple exercises such as walking or running barefoot to take advantage of the calming, or grounding, aspects of connecting with the Earth.

According to a 2020 meta-study of the practice in the journal Explore, Bodily contact with the Earth's natural electric charge stabilizes the physiology at the deepest levels; reduces inflammation, pain and stress; improves blood flow, energy and sleep; and generates greater well-being.

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I do it with my friends walk around barefoot, said Sara James, fitness coach at Anytime Fitness. It's so grounding; it's healing to do it.

To James and other practitioners, it's basically just walking barefoot outdoors. If you want to get fancy, you can use any inexpensive grounding system indoors or outdoors to restore a lost and needed electric connection with the Earth.

Such grounding mats can be found on websites including Earthing.com or Walmart, are generally available for $30-$70 and can be used for standing, sitting or stretching.

People ask me why I'm walking around barefoot, James says, And I tell them it feels grounding to me and healing.'

And it calms me," she adds.

James even suggests that her clients walk barefoot in the grass for a short time each day.

Dr. John R. Principe, a board certified internist and integrative medicine specialist who takes a holistic approach, likens earthing to an electric aspirin that you dont swallow.

Principe, who operates the WellBeingMD in Burr Ridge, Ill., and is affiliated with Advocate Christ Medical Center and Northwestern Medicine Palos and Central DuPage Hospitals, adds that studies have shown that earthing improves blood flow and reduces stress.

Michelle Kelleher, exercise specialist at Purdue Northwest Fitness, is another barefoot aficionado. It's a very beneficial, calming exercise, says Kelleher. Paired with common-sense precautions and deep breathing, she says it can calm the mind.

Most practitioners recommend that you start with 5-10 minutes of barefoot walking and gradually build to longer walks or higher intensity runs or hikes.

Staying safe is really about common sense.

Look to make sure the area is clear of potential hazards like broken glass or nails, says Kelleher. If you are more used to walking in shoes, walking without shoes can strain the Achilles tendon, so it's best to go gradual.

There is even minimalist footwear that can mimic the feeling of barefoot walking or running, says Kelleher, who also works at the shoe store Fleet Feet Sports in Schererville.

Principe adds that new earthers should be mindful of where they are walking barefoot. He suggests that besides watching for sharp objects, they should avoid lawns that have been treated with chemicals. And after every barefoot walk, they should check your skin for ticks.

He says many common used lawn herbicides can have "potential toxic effects," such as increased risk of cancer, kidney damage and birth defects.

Kelleher recommends pairing other exercises with earthing. Body weight exercises, as opposed to machine based, can also help you feel connected to the Earth, she says. They can complement the sense of feeling grounded and at peace.

When earthing, Principe gets a touch philosophical. As I live in the Midwest and cannot benefit from the warmth of a white sandy beach under my feet, I prefer to use a grounding mat at my desk on a daily basis for 20-30 minutes.

Like all the electrical appliances around me, I feel stable and balanced when I am energetically grounded.

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WATCH NOW: It can be calming and grounding to go barefoot in the park or elsewhere - The Times of Northwest Indiana

SPECIAL REPORT: PHYSICIAN WELLNESS PART 1

Although much attention has been paid to the idea of work-life balance, many of us were never taught or formally trained as to what that constitutes, how to achieve it, or how to maintain it. Moreover, prioritizing any sort of balance in our current medical culture often feels antithetical to the dedication to medicine that is expected of us.

We are often of the mind-set that dedication to our profession requires extraordinary sacrificesto our health, time with children and family, and anything else outside of work. Yet overworkingespecially in invalidating, exhausting, or even downright toxic environmentswithout the ability to refuel by tapping into enriching or meaningful personal areas of life is a fast track to burnout. And so many of us do this exact thing, tirelessly.

In addition, most of us do not have the ability to clock in and out and leave work completely behind. In fact, many colleagues report they bring work home, often finding themselves charting late into the night. Or they bring psychologically jarring elements of work (ie, difficult interactions or traumatic events) into their home lives without the ability to decompress or uncouple from those experiences. So how, then, do we achieve this elusive work-life balance?

Perhaps the initial step is to determine the components that require balance, including the nuances unique to psychiatric practices that make that achievement even more challenging (Figure). The second step might be to acknowledge that burnout can start quietly, creeping into our mental health, patient care, and relationships, and surreptitiously affecting us without our notice until we reach a crisis point. The reality is that achieving work-life balance must be emphasized and encouraged earlywith our trainees, our colleagues, and ourselves.

Redefining Work-Life Balance

A work-life balance refers to a sustainable and effective distribution of self between ones work and life obligations, suggesting a clear separation between work and life with minimal spillover of one into the other. It refers to the ability to effectively attend to ones work responsibilities and ones personal responsibilities, with adequate reserves to balance it all. But consider this: More than 40% of psychiatrists believe their careers in medicine are a calling. Thus, we tend to have a deep connection to our work.1 This may be both a blessing and a curse: Data suggest this viewpoint may play a protective role in our resilience. However, it may also be difficult to separate work from our other senses of self. When faced with the age-old question, Do you live to work or do you work to live? it seems many of us would reply affirmatively to both options.

The idea of creating and maintaining balance has always been difficult and even more so during the COVID-19 pandemic. The drawing of a line between work and home life became impossible as we were suddenly thrust into telepsychiatry mode, without any clear ways to apply our office-based approaches and boundaries. On top of that was the need to simultaneously manage distance learning for our children, negotiate infection control, deal with pandemic fears, and so on.

The corporate world has pushed to reconceptualize this as work-life integration rather than balance. The word integration lessens the need to separate oneself into disparate parts to address various areas of life. In addition, the emphasis of integration over balance suggests that you are a whole person, with an identity and sense of wellness spanning, affecting, and being affected by all areas of work and nonwork life. Because our profession necessitates maintaining clear boundaries for therapeutic and safety reasons, this integrative concept may best be applied in terms of how it affects our self-concept, by easing our need to find a way to split our identity. It also allows us the space to then prioritize ourselves and our health in all areas, knowing that when we are not feeling well in our personal lives, this greatly impacts our work life and vice versa.

No One-Size-Fits-All Approach Exists

Each individuals life elements, stressors, needs, health conditions, and so on are unique, so the approach to creating a sense of balance must also be individualized, and fluidity and recurring reassessments are needed. As work life (eg, changing workloads, switching electronic health record systems, staff turnover, etc) and personal life (eg, loss of a family member, birth of a child, a geographical move, etc) evolve, and as we face a constant flux of changing priorities as we age and grow, previous equilibriums and coping systems can be thrown off track. Indeed, when I ask physician-patients what is important to them in work and in life, they often note that what had mattered so greatly at one time matters far less now.

Unfortunately, no proven formulaic approach exists for work-life balance. We cannot easily quantify this balance. When working 50 active hours per week, it is not feasible to balance this by dedicating an equal 50 active hours to another priority, such as spending time with a partner. Instead, a more attainable goal involves emphasizing quality versus quantity; focus on creating a sense of connection, fulfillment, and meaning in the nonwork areas of life.

Reconsider the Need to Be a Relentless Worker

I am in awe of the extraordinary diligence and relentless work ethic of my physician-patients, who frequently push themselves beyond their limits. When asked why, many note they do not know any other way to be. After all, more is better, or so we are taught. A relentless, unsustainable work ethic is considered the gold standard by which we measure our abilities and success.

There is a uniquely American concept that someone who takes breaks is less dedicated to their profession. In fact, the average American worker works among the longest daily hours compared with their non-American peers. Even with paid vacation time, Americans only take about 54% of their allotted time per year.2 This notion extends to microbreaks; 39% of respondents rarely or never take breaks (including lunch) and 22% feel guilty when they step away for a lunch break.3 Overworking, it seems, is a romanticized American ideal that reaps few rewards and comes at an exceedingly high cost to us and our communities.

These work habits are even more pronounced in physician work culture. A 2018 study showed that most physicians work an average of 51.4 hours per week; the American Psychiatric Association reported that the average psychiatrist works 48 hours per week.4,5 Moreover, physicians are more likely to work through the very health ailments for which they would suggest medical leave for their patients.6 In addition to the charting and work tasks that easily bleed into our personal time, the emotional weight of our work can carry into our nonwork lives: As psychiatrists, we witness some of the most painful and traumatic experiences of humanity without the necessary downtime to decompress or process before moving on to the next patient in what has become a volume-heavy and productivity-based medical culture. It is thus no wonder that up to 50% of psychiatrists are experiencing burnout.7

Ironically, we know that working beyond emotional and physical limits is a violation of the healthy boundaries we set for ourselves as human beings. In fact, if we were advocating for a patient, we would likely prescribe a decreased workload so the patient could live healthfully and well. We would do the same for family and friends. Thus, we should not hesitate to set ourselves healthy boundaries, including reassessing what is doable within an acceptable time frame to protect our health reserves (Table 1).

Physicians, Families, and Balance

Most physicians (approximately 80%) are married and the majority also have children.8 Although our divorce rates may be lower than those of our nonphysician professional peers, this is not necessarily indicative of how fulfilled we are in our marriages and family lives.9 Data are mixed regarding marital satisfaction for physicians; in my practice, when discussing lack of balance, physician-patients often first and foremost cite their familial struggles.

The complexities of family life can be challenging, especially during seasons of intermittent sleeplessness and high levels of stress, and emotionally and physically taxing periods of raising children and caring for aging parents.

Although children can add to a sense of fulfillment, physicians disproportionately struggle with infertility, pregnancy complications, and pregnancy loss when compared with their nonphysician peers.10 Aforementioned work stressors as well as delayed family planning due to long years of training may contribute to reproductive challenges. It is therefore important to educate ourselves and colleagues about these statistics.11 In my practice, we incorporate this information into planning for the future, and I often recommend to physicians that they consult with our obstetrician-gynecologist and reproductive endocrinologist colleagues to learn about options if or when they are ready to take that next reproductive step.

Many of us lean heavily on our supports, including our partners, to cope with career stressors, but partnership and marriage presents their own challenges. After the demands of work, attending to our partners emotional and physical intimate needs can prove difficult. As such, many physicians express to me a feeling of isolation and loneliness within their marriages, thus resulting in feeling distanced from a spouse.

Many of my physician-patients have found benefit from deliberately setting aside time for connection and presence with their partners and families. We also must give ourselves permission to turn to a couples counselor when needed. Finally, by taking breaks and vacations, we allow ourselves time to foster partner and marital connections, which in turn allows time for decompression, reconnection, creating memories, and improving relationships.

Balance Through Building Oneself Outside of Work

A common issue among my physician-patients (including psychiatrists) post retirement is the feeling of grief and the sense that they are losing a large part of their identity. To make matters worse, this often occurs as grown children begin to leave the nest, and their parental identity is changing. Who are we if we are not practicing or actively tending to children? Did we allow ourselves a chance to nurture other aspects of our identity?

It is not unusual for highly driven professionalsincluding psychiatriststo define themselves unilaterally by their professional identities. With such a huge investment (both in terms of timeone-third of our livesand money), it is no wonder we identify so strongly with our work. Especially as the practice of medicine changes and as rates of burnout skyrocket, it may be time to focus on embracing the other elements of ourselves and building a more complex sense of self. Our worth spans far beyond perfectionism and high volume and patient satisfaction scores. Recognizing this is an imperative next step to achieving balance.

Findings from some studies have suggested there is a typical physician personalitya set of traits common among physicians, irrespective of chosen specialty or demographic (Table 2). These traits help us provide meticulous care to our patients. We can also use these assets to foster outside interests, such as supporting charitable endeavors or learning new skills or crafts.

Lastly, creating a sense of agencydetermining when and in which ways we are in the drivers seatin our work and home lives can be highly protective and give us a sense of control, confidence, and self-efficacy in everyday routines.

Balance Does Not Cure Systemic Burnout

Balance alone is not the answer. The current medical system is designed to incentivize overworking, and it tasks physicians to self-assess their well-being needs, which is a recipe for burnout. To address the root causes of burnout, which are buried within the medical system and culture, systemic changes are necessary. Unfortunately, creating a healthier, more sustainable medical culture will take time to implement. Until then, it is important that we stop blaming the victim.

Concluding Thoughts

Burnout may seem like an isolating experience, but no single physician is to blame for their situation. Instead, we must find ways to find some balance. Highly individualized and heterogenous paths can help establish balance and create a path for recovery. A sense of self outside of work and dedication to oneself and ones nonwork priorities are essential. Similarly, we must pay attention to mental and medical health. Finally, finding a sense of agency in all areas of our lives can help us to start our own healing journeys and keep ourselves balanced.

Dr Iyer works in a private practice in Frisco, Texas. She has a special interest in working with women who are pregnant and post partum, as well as in physician wellness.

References

1. Yoon JD, Daley BM, Curlin FA. The association between a sense of calling and physician well-being: a national study of primary care physicians and psychiatrists. Acad Psychiatry. 2017;41(2):167-173.

2. York J. Why its so hard for US workers to ask for time off. BBC. December 13, 2021. Accessed July 8, 2022. https://www.bbc.com/worklife/article/20211209-why-its-so-hard-for-some-workers-to-ask-for-time-off?

3. Grow your lunch business with Take Back The Lunch Break. Tork. June 29, 2022. Accessed July 8, 2022. https://www.torkusa.com/press-releases/tork-takes-back-lunch-break

4. The Physicians Foundation 2018 Physician Survey. The Physicians Foundation. September 18, 2018. Accessed July 8, 2022. https://physiciansfoundation.org/physician-and-patient-surveys/the-physicians-foundation-2018-physician-survey/

5. Choosing a career in psychiatry. American Psychiatric Association. Accessed July 8, 2022. https://psychiatry.org/residents-medical-students/medical-students/choosing-a-career-in-psychiatry

6. Physicians work when ill, even with confirmed flu. Relias Media. December 1, 2015. Accessed Jul 8, 2022. https://www.reliasmedia.com/articles/136776-physicians-work-when-ill-even-with-confirmed-flu

7. Bykov KV, Zrazhevskaya IA, Topka EO, et al. Prevalence of burnout among psychiatrists: a systematic review and meta-analysis. J Affect Disord. 2022;308:47-64.

8. Why doctors marry doctors: exploring medical marriages. American Medical Association. February 13, 2020. Accessed July 8, 2022. https://www.ama-assn.org/residents-students/resident-student-health/why-doctors-marry-doctors-exploring-medical-marriages

9. Ly DP, Seabury SA, Jena AB. Divorce among physicians and other healthcare professionals in the United States: analysis of census survey data. BMJ. 2015;350:h706.

10. Rangel EL, Castillo-Angeles M, Easter SR, et al. Incidence of infertility and pregnancy complications in US female surgeons. JAMA Surg. 2021;156(10):905-915.

11. Glauser W. Is the culture of medicine contributing to miscarriages among female physicians? CMAJ. 2019;191(44):E1229-E1230.

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Work-Life Balance: What Is It and How Do We Attain It? - Psychiatric Times

Health care can be daunting, but choosing a provider who partners with you on your journey to better health brings peace of mind. Together, youll take a comprehensive look at all aspects of your lifestyle body, mind and spirit to prevent illness and promote healing.

Integrative medicine also known as complementary medicine is the thoughtful, evidence-based combination of modern or conventional medicine with holistic medicine. We partner with you to achieve optimal health and personal balance. We offer the best integrative health services to provide you with the outstanding experience youve come to expect. Our integrative medicine physicians, nurse practitioners and physician assistants have fellowship training in integrative medicine.

Creating balance is essential for living a healthy fulfilled life. Thats why we treat more than just symptoms.

Cancer treatment can present its own physical and mental challenges. At Aurora, you have access to a range ofintegrative medicine therapiesdesigned to nurture your mind and body. Integrative therapies are made available to help manage your fatigue, stress, pain and nausea, and support your well-being. See how we can help treat your mind and body

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Integrative Medicine | Aurora Health Care

Functional medicine is a comprehensive approach to health and wellness incorporating lifestyle, diet, and specific diagnostic testing to help uncover root causes of illness. Diagnostic testing primarily focuses on hormone balance, including adrenal function, as well as digestive pathogens and food sensitivities.

Integrative medicine, like functional medicine, also incorporates lifestyle, diet, and diagnostic testing as an approach to health and wellness. In addition, integrative medicine expands on treatment and diagnostic testing to include environmental, nutritional, infectious, immune, and neurochemical evaluations for a wide array of health problems.Both approaches have similarities, but for some practitioners their desire may be to incorporate a few integrative medicine treatments into their practice such as targeted nutritional therapy or adrenal testing, and not pursue a total transformation of their practice which is often the goal of functional medicine.

Other terms often used to describe functional and integrative medicine are complementary or alternative medicine. There is a lot of crossover between these terms so for our purposes here, we will simply use Integrative Medicine to be inclusive of functional, complementary, and alternative medicine.

Neurological disorders are often chronic in nature. For example, Alzheimers disease is linked to biochemical imbalances now known to be linked to various inflammatory and oxidative stress problems. The use of convention medicine only works to slow the deterioration of this disease, but integrative medical approaches such as targeted nutrition and antioxidant therapies are often beneficial too in preventing Alzheimers cognitive deterioration.

Other brain and nervous system problems, including mental health issues, as well as autism-spectrum disorders, can be significantly helped with integrative medicine approaches such as testing for chronic infections, food sensitivities, and utilizing various nutritional therapies to deal with the underlying imbalances that are often at the root of these disorders.

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Integrative Medicine Academy

Newswise May 17, 2022 University Hospitals (UH) Connor Whole Health and Susan Samueli Integrative Health Institute (SSIHI) at University of California, Irvine have joined in collaboration to lead BraveNet -- the first and largest whole health, practice-based research network in the U.S. BraveNet is a nationwide consortium comprised of academic health systems conducting evidence-based research on therapies used in integrative medicine, which is now more often known as whole health. Together, these 17 research-based institutions offer whole health services to more than 100,000 patients a year.

Previously led by Albert Einstein College of Medicine, BraveNet will have shared leadership going forward. SSIHI will serve as the data coordinating center under Shaista Malik, MD, PhD, executive director of SSIHI. Jeffery Dusek, PhD, will serve as BraveNets principal investigator through his role as research director of UH Connor Whole Health (UH Connor). This new management structure will further BraveNets mission of advancing integrative medicine by providing clinical outcomes and cost benefit data that have previously not been available to the medical and scientific communities.

UH Connor is one of the largest integrative medicine clinical programs across the country and this appointment demonstrates our leadership and expertise in the field, said Dr. Dusek, who has served on BraveNets executive committee since 2017. This co-leadership opportunity provides us with resources to further research in this field. With two new entities leading the charge, this collaboration will have greater ability to document the power of integrative medicine and health, leading to better treatment for patients.

We are inheriting a program that is on course to generate important scientific evidence about integrative practices, thanks, in part, to the progress made by the Albert Einstein team during its tenure, said Dr. Malik. Combining the forces of two integrative health leaders to continue the BraveNet studies enables us to sustain and expand the academic medicine communitys involvement in further understanding the effectiveness of integrative treatments. The resulting science will help determine how the whole health approach is integrated into the health system and ultimately, give patients greater control over their personal health and well-being.

Since 2015, SSIHI has participated in the flagship BraveNet project, PRIMIER: Patients Receiving Integrative Medicine Interventions Effectiveness Registry, an integrative medicine database launched in 2013. Led by Dr. Dusek, PRIMIER is a multi-institution project designed to uniformly collect patient-reported outcomes and extracted electronic health record data into a large national registry that would help improve the health and well-being of patients. PRIMIER provides a framework that can be used for quality improvement and evidence-based research, as well as discovering best practices within integrative medicine.

Another example of collaborative research conducted under the BraveNet umbrella includes a randomized trial studying the effectiveness of using acupuncture in the emergency department (ED), which was funded by a prestigious grant to Case Western Reserve University from the National Institutes of Health. Three BraveNet members -- UH, Vanderbilt University Medical Center, and the University of California, San Diego -- are participating in the study, led by Dr. Dusek, who is serving as principal investigator with M. Diane McKee, MD, MS, chair and professor of family medicine & community health at UMass Chan Medical School. According to published studies, pain accounts for up to 78 percent of ED patient visits in the United States. The overall goal of this research is to determine if acupuncture can manage pain and ideally reduce the use and prescription of opioid medications in the ED.

At UH Connor we are passionate about pursuing non-pharmacologic treatments for pain in order to help mitigate the opioid epidemic impacting our communities, said Francoise Adan, MD, Chief Whole Health & Well-being Officer and the Christopher M. & Sara H. Connor Chair in Integrative Health, University Hospitals Health System and Director, UH Connor Whole Health. This study exemplifies how BraveNet is impacting our field. We have made many strides in the perception, understanding and acceptance of evidence-based integrative medicine in recent years, but we have more work to do. This new role provides UH Connor and SSIHI with a unique opportunity to collectively guide the evolution and expansion of integrative medicine across the U.S.

The first half of 2022 serves as a transition period. UH Connor and SSIHI will officially begin their leadership roles on July 1, 2022.

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About UH Connor Whole Health

UH Connor Whole Health is part of University Hospitals (UH), a comprehensive health system with annual revenues in excess of $5.0 billion, 23 hospitals (including 5 joint ventures), more than 50 health centers and outpatient facilities, and over 200 physician offices located throughout 16 counties.UHs goal is to be the most trusted health care partner in Northeast Ohio and UH Connor Whole Health furthers this objective by working to strengthen relationships between patients and providers to improve outcomes. The Whole Health approach prioritizes compassionate care centered on the patients entire well-being. The health care providers goal is to equip and empower each patient to take charge of their physical, mental, and spiritual health in order to live a full and meaningful life. Linking the patients larger purpose and life goals to their lifestyle allows clinical services, integrative medicine, and well-being programs to be delivered in a way that increases collaboration, motivation, and adherence to self-care and clinical needs. UH Connor Whole Health services include acupuncture, art therapy, chiropractic, expressive therapy (art, dance, and music), guided imagery, integrative medicine/lifestyle medicine consultations (adult and pediatric), massage therapy, meditation, mindfulness, stress management and resilience training workshops and yoga. For more information, visitUH Hospitals.org/ConnorWholeHealth. Follow UH Connor Whole Health on LinkedIn.

About University Hospitals / Cleveland, Ohio Founded in 1866, University Hospitals serves the needs of patients through an integrated network of 23 hospitals (including 5 joint ventures), more than 50 health centers and outpatient facilities, and over 200 physician offices in 16 counties throughout northern Ohio.The systems flagship quaternary care, academic medical center, University Hospitals Cleveland Medical Center, is affiliated with Case Western Reserve University School of Medicine, Oxford University and the Technion Israel Institute of Technology. The main campus also includes the UH Rainbow Babies & Children's Hospital, ranked among the top childrens hospitals in the nation; UH MacDonald Women's Hospital, Ohio's only hospital for women; and UH Seidman Cancer Center, part of the NCI-designated Case Comprehensive Cancer Center. UH is home to some of the most prestigious clinical and research programs in the nation, with more than 3,000 active clinical trials and research studies underway. UH Cleveland Medical Center is perennially among the highest performers in national ranking surveys, including Americas Best Hospitals from U.S. News & World Report. UH is also home to 19 Clinical Care Delivery and Research Institutes. UH isone of the largest employers in Northeast Ohio with more than 30,000 employees. Follow UH on LinkedIn, Facebook and Twitter. For more information, visitUHhospitals.org.

About UCI Susan Samueli Integrative Health Institute (SSIHI): SSIHI is part of UCI Health and the UCI Susan & Henry Samueli College of Health Sciences. The college, which was named in 2017 with a transformative gift from Susan and Henry Samueli that focused on interdisciplinary integrative health, is the first university-based health sciences enterprises to incorporate integrative health research, teaching and patient care across its schools and programs. Within the college, SSIHI is creating a model of clinical care that emphasizes an evidence-based, transdisciplinary approach to healing the whole person and transforms healthcare through integrative health that emphasizes clinical, research and educational excellence. SSIHI, formerly known as the UCI Susan Samueli Center for Integrative Medicine, was established in 2001 to explore the frontiers of complementary and integrative medicine. Among several SSIHI research programs that foster collaboration across UCI, the Cardiovascular Acupuncture Research Program has received continuous National Institutes of Health funding for more than 20 years. For more information on SSIHI, visit https://ssihi.uci.edu. Follow SSIHI on LinkedIn, Facebook and Instagram.

About the University of California, Irvine:Founded in 1965, UCI is the youngest member of the prestigious Association of American Universities and is ranked among the nations top 10 public universities byU.S. News & World Report. The campus has produced five Nobel laureates and is known for its academic achievement, premier research, innovation and anteater mascot. Led by Chancellor Howard Gillman, UCI has more than 36,000 students and offers 224 degree programs. Its located in one of the worlds safest and most economically vibrant communities and is Orange Countys second largest employer, contributing $7 billion annually to the local economy and $8 billion statewide.For more on UCI, visitwww.uci.edu.

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University Hospitals and UC Irvine Announce New Co-Leadership of BraveNet, a Practice-Based Integrative Medicine Research Network - Newswise

Aiming to educate patients on diet and nutrition, University Hospitals Conneaut Medical Center opened a Food for Life Market, part of a holistic approach to addressing food insecurity and medical conditions affected by nutrition and access to healthy food in rural areas and food deserts, according to a news release.

With food provided by the Cleveland Food Bank through a partnership with Country Neighbor in Orwell and local donations, the UH Conneaut Food for Life Market is stocked with a variety of nutritious foods, including whole grains, dairy, fresh and frozen produce, canned fruits, vegetables and meats.

The Ashtabula Foundation donated $48,200 to make opening the market possible. It's the first and only medically-based nutrition program in Ashtabula County, and it's UH's fourth market across Northeast Ohio, according to the release. UH's other markets are in Cleveland's Fairfax neighborhood (opened in October 2018 within the Otis Moss Jr. Health Center); the UH Portage Food for Life Market (opened in February 2021 and located in the lobby of the medical center) and UH Cleveland Medical Center's Food for Life Market (opened in August 2021 in the Bolwell Center).

The Food for Life program is a collaboration between UH's Office of Community Impact, Equity, Diversity, and Inclusion and Sodexo Nutrition Services, the release stated. Sodexo Healthcare has worked on behalf of UH to establish the markets across the system.

"The UH Food for Life Market focuses on the direct connection between food and a person's health," said Anne Leach, registered dietitian and director of clinical and community nutrition with Sodexo Healthcare, in a provided statement. "UH has implemented a preventive food as medicine model to address food insecurity, which we know, if prolonged or repeated, can have negative health consequences."

Through work with primary care providers, patients who identify as food insecure can receive a referral to the market for a family of four and may visit for up to six months with possible extensions as needed, according to the release. A dietitian works with patients as they're shopping to provide one-on-one consultations and healthy recipes.

Open by appointment on Tuesdays and Wednesdays, the UH Conneaut location is expected to serve 50 patients and their family members per month, according to the release.

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UH Connor Whole Health expands with $3 million gift from Connor family - Crain's Cleveland Business

While you may have heard the term cupping and seen celebs like Justin Bieber, Kim Kardashian, Lady Gaga, Kevin Gates, and Michael Phelps sporting the telltale circular marks, the attention-grabbing wellness treatment is hardly a fad. Its actually been around for thousands of years across multiple cultures, schools of thought, and religions. But what exactly is it? And can it really enhance your physical well-being?

During treatment, cups are placed on various parts of the body, creating a partial vacuum with negative pressure and suction that aids in pain relief, increases circulation, decreases swelling, and helps with a variety of health conditions, including allergies, migraines, high blood pressure, gastrointestinal issues, and more.

Mohammed Widdi, a cupping practitioner and owner of the Brooklyn-based mobile cupping company Soul Detox, says the suction causes tissue beneath the cup to be lifted and drawn up, increasing the oxygenated blood flow to the area. The enhanced blood flow draws impurities and toxins away from the nearby tissues towards the surface.

There are two types of cupping: dry and wet. With dry cupping, theres no bloodletting, Widdi says. Cupping can also be dynamic or static. I start all sessions dry or wet with gliding cupping. This helps increase the circulation and yields a better session, especially if were doing wet cupping.

During the last few minutes of a wet session, small superficial scratches are made before suction is applied again. Its called wet cupping and not blood cupping because other bodily fluids, like lymph or pus, can come out, Widdi says. What usually comes out is a very thick jelly thats full of wastes and stagnant blood.

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Cupping has an antioxidant, anti-inflammatory, and neuro immunomodulatory effect on the body, explains Dr. Elizabeth Trattner, an integrative medicine doctor and acupuncture physician. She says cupping can help with headaches, colds, congestion, coughs, stress, cramps, anxiety, athletic recovery, and facial rejuvenation. Trattner uses cupping regularly in her practice, and sometimes performs it concurrently with acupuncture by placing the cups over the acupuncture needles.

Dr. Joi Edwards, a physical therapist and licensed massage and bodywork therapist, says cupping is useful in reducing adhesions, improving flexibility, increasing range of motion, enhancing tissue mobility, and decreasing pain. She often incorporates movement into her treatment sessions and notes that cupping has been found in research studies to increase blood flow and localized internal temperatures in the body, which are beneficial in the treatment of arthritis.

Edwards believes the possibilities for cupping are broad because it can be combined with other treatments. The beautiful thing about cupping, she says, is that it can be used in conjunction with allopathic, osteopathic, homeopathic, and many other types of treatment to successfully and holistically help improve conditions in different patients.

So, why isnt cupping more mainstream in the West? In the United States, we have a different philosophy, Edwards says. A lot of people still believe in a quick fix and use of medication, and see naturopathic practitioners and cupping as gimmicky or taboo.

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Known as hijama, which means suction in Arabic, cupping is widely associated with both Middle Eastern and Eastern medicine. Different forms of cupping have been used across many cultures and religions, including all three Abrahamic religions.

Hijama actually predates Islam, says holistic wellness consultant and Aafiyah Healing founder Zuhair Girach, noting that the earliest records referencing cupping were left by ancient Egyptians and Chinese. The Ebers Papyrus, one of the first-known medical texts, mentions the use of cupping as a therapy.

Girach says the Prophet Muhammad was reminded of hijama and directed to use it by the angels during his Miraj, or night journey to Heaven. The use of the word remind is significant, according to Girach, because the knowledge was already there. It had already been passed down. He says regardless of which school of thought that introduces patients to cupping, they fundamentally believe the same thing: Stagnated blood blocks the energy flow in the body.

Widdi warns against dismissing practices heralded as ancient, preferring instead to call them timeless. This is not some archaic, dated technology, he says. It has a place in the practices of today. The vacuum and suction mechanism from cupping are what inspired the breast pump.

When applied to the face, cupping may help rejuvenate the skin by bringing circulation of blood to the face, improving the production of collagen and elastin, Trattner says, citing a 2016 study. She also believes facial cupping can help promote cellular repair and break up fascia in the face. When used consistently, facial supping can reduce fine lines and wrinkles as well help with acne.

Cups used for facial cupping may be made from glass, silicone, or ceramic, and are much smaller than the cups used on the body. Beyond beautification, Widdi says that he has seen facial cupping help those suffering from temporomandibular joint dysfunction, commonly known as TMJ.

Ive had lots of clients opt for facial cupping to help relieve facial pain, such as that caused by TMJ disorders, Widdi says. The negative pressure lifts the muscles up and loosens them, which can be really helpful for relaxing tense jaw muscles. This is evidence-based, because there are studies that show cupping is helpful for TMJ.

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Is cupping safe?

In the United States, theres no regulatory body or licensure board for cupping practitioners like there is for massage therapists or other professionals, so Edwards says its important to make sure whomever youre seeing has the proper training. Cupping is safe, she cautions, when performed by a qualified and well-studied practitioner.

Widdi says that besides checking for a practitioners training, its important to ask about hygienic practices. You want to make sure whoever youre going to is utilizing the highest sanitary precautions, he emphasizes. Widdi employs plastic cups for wet cupping so they can be disposed of after the session. Some practitioners will use glass cups, which are reusable, so asking about their sanitary practices is a must.

While cupping is generally considered safe, Trattner advises that patients on blood thinners, those with bleeding issues and sensitive skin should steer clear of cupping.

Azmia Ricchuito is an Orlando, Florida-based therapist, life coach, and writer who has contributed to Allure, Teen Vogue, and Glamour. Follow her on Twitter at @azmiaakamia.

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Fifty is the new 40 and soon that will probably change, too. After all, what is middle age anymore?

Just look to TV to realize the change. The Golden Girls were the same age as the women in And Just Like That but youd be hard-pressed to find many other similarities.

Women are doing more job, family, friends, fun, caring for aging parents. Theyre also twice as likely to use antidepressants, according to data from the National Center for Health Statistics. Add hormonal changes that start midlife and challenges can add up.

At midlife, women face a gamut of happy as well as difficult milestones, said Nancy Wise-Vander Lee, PhD, LP, psychologist at Avera Medical Group Behavioral Health Clinic. It takes a toll on their energy, confidence and perspective on the future.

Bren Brown calls this less of a crisis and more of a slow unraveling when your mind starts telling you, All of this pretending and performing these coping mechanisms that youve developed to protect yourself from feeling inadequate and getting hurt has to go. Your armor is preventing you from growing into your gifts.

She continues, It seems as if we spend the first half of our lives shutting down feelings to stop the hurt and the second half trying to open everything back up to heal the hurt.

In other words, its a time when people start realizing the courage to be their true selves and run after their passions.

As we age, its important to discover what really matters to you, which often includes pouring into and loving others," said Rebecca Hanzen, health coach with Avera Medical Group Functional and Integrative Medicine.

You may be disappointed in some things:

When negative emotions linger and arent challenged, there runs a risk of a midlife crisis, when impulsive decisions might devastate finances, families and futures.

Remember, youve had good moments, smiles, laughter and victories. And heres another positive: you can create a mindset and lifestyle to help you live your life gracefully.

Aging gracefully means vitality and health. Its a mindset that keeps on giving. You, your family and those around you blossom and benefit. Perhaps in the past, change, discord and setbacks stirred those negative emotions mentioned before.

However, when you practice infusing grace into every day, especially into lifes painful moments, you realize that every difficulty is an opportunity, every broken relationship is a chance to love, every setback is a growing opportunity.

You realize youre no longer helpless or hopeless, said Hanzen. In fact, you find theres so much hope and possibility that can come to fruition in your life.

You have the power to find your joy, and sometimes it starts by looking in the mirror.

Finding your joy and your purpose begins by accepting yourself right where you are, said Wise-Vander Lee. Life has thrown many obstacles at you, and even though you managed them the best you could, it leaves scars.

Some of the most prominent mental health conditions Wise-Vander Lee sees are depression and anxiety in women who are stretched thin from the demands of life. Sorting through the pain youre carrying, especially with the help of a professional, can help you move forward in freedom.

As you heal from unfinished pain, you start to focus on creating another chapter in your life that is beautiful and rewarding, said Wise-Vander Lee.

You learn how to recalibrate yourself to discover whats important to you and how you want to cultivate those areas in life because the best of you delivers the best to those around you. You might even find a way to assist others who are going through trials you once experienced.

Managing mental health means practicing wellness that is within your power. Hanzen believes it starts from the decisions we make day to day that promote overall wellness.

A person is made up of a body, mind and spirit, said Hanzen. Because the composition of a person is so entwined, you often cant treat one part without treating or affecting another part.

Here are some self-care tips recommended by Hanzen and Wise-Vander Lee:

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Managing Mental Health During Midlife and Beyond - Avera Health

In a medical emergency knowing your blood type can be a matter of life and death, but it can also provide valuable insight into your overall health. There's been several studies that indicate people with certain blood types are at greater risk for GI related cancers and Dr. Tomi Mitchell, a Board-Certified Family Physician with Holistic Wellness Strategies tells us, "It's essential to understand that your blood type is just one risk factor for developing cancer. So even if you have a family history of cancer and your blood type puts you at higher risk, there are still things you can do to lower your risk." Eat This, Not That! Health spoke with experts who explain what to know about your blood type and the association with cancer. Read onand to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

Dr. Mitchell explains, "There are four blood types: A, B, AB, and O. Each blood type has a different combination of proteins called antigens on the surface of red blood cells. These antigens determine which blood type a person has. A person's blood type is determined by which antigens are present on their red blood cells. Type O is the most common blood type, followed by Type A. Type B blood is less common, and Type AB blood is the least common."

Dr. Srikanth Nagalla, chief of benign hematology, Miami Cancer Institute shares, "There are sugars and then there's a protein, so carbohydrate and protein. So the protein that it's called is the H antigen, and to that, you add these different sugars. And depending upon that, you get a, that it's A,B, AB, or if you're completely lacking the sugars, then it's called the O because O doesn't have the sugars. So, what I'm trying to get at first is how do you get this classification? Okay, what is blood group B? So for that, if you imagine like the red blood cell, because for that red blood cell, you have an H antigen like the alphabet H and to that antigen, you add sugars. And finally, if you don't have any sugars added, that becomes O now the reason this is important to start off with this, because once you know this, you understand that this is present not only on the blood cells, on the red blood cells, it's present in the gastro tract, like the PT cells of the GI tract. That's your stomach pancreas. It's also present in your broncho reference in your bronco, the lungs, the pulmonary area, the bronco pulmonary area, it's in the genital urinary area."6254a4d1642c605c54bf1cab17d50f1e

Dr. Nagalla says, "There are a lot of retrospective studies that were done in the past, but the very well done study for us or prospective looked at, or two big cohorts called the Nurses Health Study. And then the Health Professionals follow- up study, which has roughly hundred seven patients or so not patients hundred seven people like health professionals. And then they were, they were followed and everything. What this study particularly showed was something to do with the risk of A, B or AB blood groups and pancreatic cancer. Meaning if you're not an O if you're non O blood groups, you could be a, you could be B or you could be a, then you get some increased risk of pancreatic cancer. Why is this happening?"

Dr. Mitchell adds, "According to a new study, if you have blood type A, B, or AB, you may be at increased risk for cancer. The study, which is the largest of its kind, looked at almost 140,000 people with cancer and found that those with blood type A or B were more likely to develop the disease than those with blood type O. The risk was even higher for women with blood type AB. While the exact link between blood type and cancer risk is unknown, the study's authors say that it could be due to differences in how blood type A and B cells bind to sugar molecules. This difference could make it easier for cancer-causing agents to attach to blood cells and cause mutations. The findings are preliminary and more research is needed to confirm blood type and cancer risk. However, if you have blood type A, B, or AB, it may be worth discussing your cancer risk with your doctor."

Dr. Michael Hirt, a Board Certified Nutrition from Harvard University and Board Certified in Internal Medicine and is with The Center for Integrative Medicine in Tarzana California explained, "Chronic inflammation has been linked to increased cancer risk. Blood types that are associated with increased inflammation (like A and B) have been linked to increased risk of cancers, while the 'O' blood type is associated with lower cancer risks because it is associated with less inflammation. This is the same reason that type 'O' blood had a small but statistically significant reduction in COVID-19 disease severity."

Dr. Nagalla says, "If you go into the hypothesis, right? The theories of that for example for people who have blood group A and others are more prone to get H Pylori infection. So they're more prone to those infections. What does it mean? Maybe because of that they have higher inflammation and higher inflammatory condition that is causing some of these cancers because blood, the other thing they found that is when you have these changes, when you have, um, these blood group, a people and other things, or when they, when they looked at normal cells versus the pancreatic cancer cells, normal pancreatic based, they found that the pattern of the protein, the sugars that I started saying to tell you about what makes A, B sugars, the pattern was likely different between the cancerous cells and the normal cells. Maybe these things are getting altered in the cancerous cells due to other mutations and took off of that. These cells might have an altered signaling because cells have to signal among each other and inside. And these cells might also escape immune surveillance. What is immune surveillance? Why doesn't everybody get cancer? Because the immune system is constantly looking for bad cells and killing them, or making sure that they don't grow. But when you have some of these alterations, apparently in some of these patients. It's possible that these cells are escaping the immune system and their cancer gets to grow. These are all hypotheses of why it may happen. So there's not a definite reason why certain blood types are more prone to a certain type of cancer."

Dr. Nagalla states, "We are not going to use blood groups and say, based on this, you need more screening because you have blood group A blood group, a B or blood group AB, you need to be more closely followed or screened. You are not gonna do anything different because there's no data for that. Because, and a lot of times there's a difference. This is just an association, meaning this just because you have pain, you're not getting pancreatic cancer. It so happens that a little bit more of blood group A patients are having pancreatic cancer compared to blood group O patients. It could be, this is just a marker of something else. And maybe some of the genes that are associated with the ABO gene are getting dysregulated. People with O might be reassured there's a little bit less risk, but it's not like people with A are all going to get cancer or something like that. It's just an association. The main thing we want to stress is that these are all associations. It doesn't mean much because overall the absolute number is still tiny. We don't have to do anything different just because of a blood type."

Dr. Mitchell reminds us, "Remember, cancer is a complex disease, and many factors can contribute to an individual's risk. While blood type is one important piece of the puzzle, many other controllable risk factors can significantly impact cancer risk. For example, I focus on lifestyle factors that prevent and decrease cancer risk in my clinical practice. These include diet, exercise, smoking cessation, and alcohol consumption. While blood type may be out of our control, there are many things that we can do to lower our cancer risk. By making healthy lifestyle choices, we can all play a role in cancer prevention.

Smoking is the leading cause of preventable death in the United States and is responsible for more than 480,000 deaths each year. Smoking causes more deaths each year than the following causes combined: human immunodeficiency virus (HIV), illegal drug use, alcohol use, motor vehicle accidents, and firearm-related incidents. Smoking is also a significant contributor to cancer death and disease. Smoking causes an estimated 90% of lung cancer deaths in men and almost 80% of lung cancer deaths in women. Smoking also causes cancer of the larynx, mouth, pharynx, esophagus, kidney, bladder, liver, pancreas, stomach, cervix uteri, and myeloid leukemia. Smokers are also at increased risk for pneumonia and other lower respiratory tract infections. For example, quitting smoking reduces the risk of smoking-related diseases and can add years to your life. In addition, people who quit smoking before age 50 have half the risk of dying from smoking-related causes as those who continue to smoke. Quitting smoking at any age can give back years of life that would be lost by continued smoking.

Though smoking remains the leading cause of cancer, lifestyle choices such as diet can significantly impact cancer risk. A healthy diet includes plenty of fresh fruits and vegetables, whole grains, lean protein, and healthy fats. It's also low in processed foods, salt, and sugar. Studies have shown that following a healthy diet can lower the risk of several types of cancer, including breast, colon, endometrial, and stomach cancer. There are a few possible explanations for why a healthy diet may reduce cancer risk. First, fruits and vegetables contain antioxidants that help to protect cells from damage. They also contain phytochemicals that can boost the immune system or prevent the formation of cancer-causing substances. In addition, a healthy diet is typically low in fat and calories, which may help reduce the risk of obesity-related cancers. Of course, no single food or group can guarantee cancer prevention. But following a healthy diet is a straightforward way to lower your risk. Combined with other lifestyle choices such as not smoking and maintaining a healthy weight, it could make a big difference in your health.

There are many ways that exercise can help to reduce cancer risk. For one, exercise helps to maintain a healthy weight, which is essential since obesity is a risk factor for several types of cancer. Exercise also helps to improve immune function, making the body better able to fight off cancer cells. Additionally, exercise boosts antioxidants and other protective substances in the body, which can help reduce oxidative damage and inflammation, both of which can contribute to cancer development. Research has shown that people who exercise regularly have a lower risk of developing cancer than those who are inactive. So, if you're looking for ways to reduce your cancer risk, adding some exercise to your routine is a great place to start.

Maintaining a healthy weight is one of the best things you can do to reduce your cancer risk. Obesity is a significant risk factor for cancer, and being overweight increases your chances of developing the disease. How exactly does obesity contribute to cancer? One theory is that obesity increases inflammation throughout the body, leading to the development of cancer. Additionally, obese individuals tend to have higher insulin and other hormones linked to an increased risk of cancer. Exercise is one of the best ways to maintain a healthy weight, and it has also been shown to reduce inflammation and improve hormone levels. Furthermore, exercise has been shown to boost the immune system, making it more likely to fight off cancer cells. In other words, maintaining a healthy weight through exercise can reduce your risk of cancer in multiple ways.

In addition, some helpful blood tests can give you more information about your specific risks. For example, the genetic test for Lynch syndrome can show whether you have an increased risk for certain types of cancer. For example, if you have a strong family history of cancer, talk to your doctor about these tests and how they can help you make informed decisions about prevention and early detection." And to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.

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Deepak Chopras demonstrates his artificial intelligence program

Deepak Chopra, speaking recently to Fox News Digital during the Milken Institute Global Conference in Los Angeles, said that his latest book, "Abundance: The Inner Path to Wealth," was inspired by a lyric allegedly written by Bob Marley.

The lyric, he said, notes that "some people are so poor, all they have is money."

True wealth, said Chopra, a holistic health expert and best-selling author, is hardly about dollars and cents and nothing else.

Ultimately, he said, it's about much deeper and more important issues such as "security and safety love and belonging."

DEEPAK CHOPRA: WE NEED A PANDEMIC OF JOY

Living with "abundance" is not just about one's personal or financial situation but extends to "all those with whom you interact," he said.

"Americans are used to spending money that they haven't earned, to buy things that they don't need, to impress people that they don't like," Chopra pointed out.

"That creates a lot of stress. So first of all stop doing that," he said bluntly.

"Be frugal in these times."

DAVE RAMSEY SHARES THE SECRETS OF MANAGING STRESS OVER RISING COSTS

He added, "Secondly, this is a time for opportunities, also."

Far too many Americans, suggested Chopra, are "used to spending money that they don't have, to buy things that they don't need, to impress people that they don't like." (iStock / iStock)

"Start looking at investments right now [including in] technologies that are actually changing the way we see the future of well-being."

Among the technologies he mentioned: digital therapeutics, robotic healing, robotic surgery and telemedicine.

"We are dedicated to creating NFTs that make a difference in the world."

"There are a lot of opportunities right now" in these and other areas, he suggested.

He discussed NFTs as well.

WHAT IS METAVERSE AND WHY ARE NFTS KEY TO ITS EXPLOSION?

"We have a company that has launched NFTs for social good," he said including those who can be considered "climate change refugees."

"Our company is dedicated to creating NFTs that make a difference in the world," he said.

In this photo illustration, the logo of NFT, short for Non Fungible Token, is seen on the screen of mobile phone with a stock chart on the screen of a laptop in the background. (Davide Bonaldo/Sipa USA)

He said that in these difficult times, "you have to be alert what people call good luck is just opportunity meeting preparedness Times of inflation and adversity," he added, "are actually times of opportunity."

In terms of jobs and ambition, Chopra said, "I think the old paradigm was all about competition, and it worked."

"But the new paradigm," he added, includes cooperation and a shared vision of success by all parties involved, he explained.

Chopra is founder of The Chopra Foundation, a nonprofit entity focused on research into well-being and humanitarianism, as well as Chopra Global, "a modern-day health company at the intersection of science and spirituality."

He is a pioneer in integrative medicine and "personal transformation" as well as the author of some 90 books translated into over 43 languages, including numerous New York Times bestsellers.

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His next book, due out in January 2023, is called, "Living in the Light: Yoga for Self-Realization."

Kelsey Koberg and Andrew Murray, both of Fox News Digital, contributed reporting to this article.

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Deepak Chopra on money and fulfillment: Times of 'adversity' are meant for 'opportunity' - Fox Business

These research programs reveal that OM has potential as a treatment for depression, anxiety and trauma.

"My colleagues and I are extremely grateful for the role of The Institute of OM Foundation in supporting this trailblazing research," said Dr. Prause, Ph.D. Prause and Dr. Siegle's study was published in the journal Sexual and Relationship Therapy in March of 2021. "Ultimately, this research is about exploring the use of sexual stimulation to improve general health," she said.

The Foundation also provided support for a recent study conducted by Dr. Andrew Newberg, research director of the Department of Integrative Medicine and Nutritional Sciences at Thomas Jefferson University in Philadelphia. Dr. Newberg's study used functional magnetic resonance imaging (fMRI) technology to analyze 20 couples as they engaged in OM, and found changes in the frontal, parietal and temporal lobes of the brain among both male and female participants. The study was published in the journal Frontiers in Psychology on Nov. 11, 2021.

"This study suggests the possibility of an important link between sexuality and spirituality," said Dr. Newberg. "It should also be emphasized that the findings may have implications for therapeutic applications in the future, helping with various neurological and psychological problems including emotional traumas, sexual dysfunction, and even depression."

In yet another study supported by the Foundation, researchers deployed a questionnaire developed to study "mystical experience" to determine how the practice of OM might trigger a substantial transcendent sensation in both participating partners, equivalent to a moderate dose of psilocybin, the hallucinogenic compound found in certain types of mushrooms. This study, published in July of 2021 in the journal F1000 Research, employed two different surveys.

The first survey included 780 participants who were asked to complete the questionnaire with "a single powerful OM in mind." The second survey included 56 couples, who were asked to complete the survey immediately following an OM session. Respondents to both surveys reported moderate mystical experiences.

"Given that OM apparently can trigger a mystical experience of similar power to psilocybin, and that psilocybin has shown promise in the treatment of mood and substance disorders, this study raises intriguing questions about whether OM might also be effective in the treatment of these disorders," said Vivian Siegel, Ph.D., the lead author of the study, and currently a lecturer in biology at MIT.

The Institute of OM Foundation is funded by gifts from several generous donors, including Ramani Ayer, a longtime practitioner of transcendental meditation and a retired executive from one of the nation's oldest insurance companies.

"I saw great changes in people as a result of their regular practice of OM, and I was inspired to support research exploring its potential health and wellness benefits," Ayer said. "I have always believed in science, and I am proud to support this research into a promising area where there has not been a great deal of prior research."

In addition to these published studies, the foundation is continuing to support additional scientific research, including an upcoming study exploring the potential impact of OM on dopaminergic function in participants with Parkinson's disease, and a study exploring the impact of OM as a potential aide in the cessation of smoking tobacco.

FOR MORE INFORMATION, PLEASE CONTACT:

Allyson Gonzalez, Institute of OM Email: [emailprotected]Phone: 1.888.604.6636

SOURCE The Institute of OM Foundation

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Make sure to talk to a healthcare professional about your individual needs and appropriate dosages before adding a supplement to your routine.

Meal replacement shakes have come a long way in the past few years, with a greater variety of options than ever before. Thanks to advances in exercise science, wellness and the medical community, the list of promising products from start-ups and lesser-known manufacturers continues to grow, and established products keep getting better. If youve never tried meal replacement shakes before, the sheer number of options can be intimidating. So were here to help by explaining everything you need to know before choosing the best options for your lifestyle.

Meal replacement shakes consist of macronutrients such as carbohydrates, proteins and fats that are coupled with micronutrients such as essential vitamins, minerals and various plant compounds. Together, these elements make up a complete, on-the-go meal. Meal replacement shakes can be a good option for those with busy lifestyles; whether you are dealing with a demanding work schedule, shuffling kids to and from sports practice, or traveling, it can be hard to find time for a sit-down meal. Still, that doesn't mean you need to neglect your health to fuel up. If youre looking to avoid the fast-food line but still want to consume something easy and quick, consider adding a meal replacement shake to your routine.

Because meal replacement shakes supply a full meal, it's important to understand your health goals and needs, then select an option best suited to helping you achieve them. In addition, it is always advised that you work with a trained medical professional when implementing new dietary choices and supplements.

For those looking to bulk up or maintain weight during periods of heavy exercise, meal replacement shakes offer complete macro and micronutrients. Some people use meal replacement shakes as sustenance between meals or as a pre-or post-workout, to satisfy the body's need for additional energy. That being said, its important to differentiate between meal replacement shakes and protein shakes or powders as they are not the same thing.

Protein powders tend to be heavier on protein and lighter on carbs, fats, fiber and some vitamins and minerals. They are designed to aid in muscle repair and muscle gain during pre-and post-workout sessions or to act as a high-protein source for those consuming a low- or no- animal protein diet (such as vegetarians and vegans). Meal replacement shakes and powders, by contrast, supply nutrients to help you attain adequate daily values of both macros and micros.

Not all meal replacement shakes are created equal and it can be difficult to find one that checks all the boxes. Here are the best meal replacement shakes, broken down by specific categories to make it easier to find exactly which is best for you.

Transparent Labs

Transparent Labs has gone the extra mile to create a complete lineup of powders and supplements to support every aspect of your health and wellness goals from muscle building to mental clarity to joint support. As the name suggests, Transparent Labs publishes a detailed lab breakdown, called a certificate of analysis, for every product, and certificates of composition for most products on its website. The Meal Replacement powder contains 24 grams of protein from whey protein isolate and concentrate, grass-fed beef bone broth, egg white protein and pea protein. This powder contains 7 grams of fat, mostly from MCT (medium chain triglyceride) oil. The 19 grams of carbohydrates are derived from natural cane sugar and quality sources like pea starch and oat bran fiber, which also provide 5 grams of natural fiber.

This balance of slow and fast-burning macros from quality sources makes Transparent Labs a great choice to keep your body moving through a busy schedule or a tough workout. If theres one drawback, its that Transparent Labs lacks a substantial array of vitamins and minerals from whole-food sources. A dose of vegetable or other plant-based powders would go a long way to make this meal replacement shake truly complete.

For those already eating a well-rounded diet full of vitamins, minerals and other plant-based compounds, Transparent Labs is a well-made meal replacement powder designed to increase muscle repair and building and provide lasting energy for an active lifestyle.

Transparent Labs Meal Replacement Powder ($59.99 for approximately 56 oz. of powder; $2 per serving)

Kaged

Kaged Clean meal replacement powder is packed full of dense nutrients from various whole food sources. But what makes this powder unique is the brands trademarked ioWhey protein isolate. According to Kaged, ioWhey technology increases the surface area of the protein molecules for up to 123% better bioavailability than traditional whey powders. This powder delivers 28 grams of bioavailable protein from both the ioWhey and organic quinoa, containing all nine essential amino acids. Quinoa is also a good source of natural antioxidants, carbohydrates, fiber and minerals.Complemented with 18 grams of slow-burning carbohydrates mostly derived from oat flour, this powder is designed to keep you fueled through a tough workout or a busy day. With the addition of MCT coconut oil powder, which provides 4.5 grams of healthy fats, Kaged is a well-rounded macronutrient powder. Kaged Clean Meal goes a step further by adding a blend of vegetable and plant powders to supply ample whole food-sourced vitamins and minerals.

This blend contains a few common veggies, like broccoli and spinach powders and a handful of less-common superfoods such as kelp and maitake mushroom powders. This shake is a bit low on fiber (only 2 grams) and does contain sucralose.

Despite these downfalls, if you're someone with a very active lifestyle that demands a higher macronutrient intake, this is an excellent choice.

Kaged Clean Meal Replacement Powder ($49.99 for 41.34oz of powder, $2.50 per serving)

Iconic Protein

Iconic's line is ready to drink and packs a substantial amount of goodness into a relatively small 11.5-ounce bottle. These drinks are free from gluten, soy, GMOs, lactose, hormones, pesticides, corn, and carrageenan. They even come in a BPA-free bottle. Iconic uses a grass-fed milk protein isolate that provides 17 total amino acids, including nine essentials, for a healthy dose of 20 grams of protein per bottle.

The brand uses natural flavors, including real cacao powder and Colombian coffee, to produce flavors that taste clean and authentic. Their products are sweetened only with monk fruit and stevia, making these a zero sugar beverage. The Cacao + Greens option includes a full daily serving of veggies from kale, broccoli and spinach powders.

Iconic Protein Drinks ($39.99 for a dozen 11.5 oz. bottles (also available in 24 and 36 packs); $2.90 to $3.30 per serving, depending on case size)

Garden of Life

Garden of Lifes ingredient list reads more like a grocery list, with the majority of the nutrients derived from whole foods. Additionally, these ingredients are sproutedthe seeds and legumes are soaked in water for 24 hours and then allowed to start growing, which removes the phytic acid, a compound found on all seeds and legumes that interferes with calcium, iron and zinc absorption. And since the ingredients are processed at low temperatures to maintain the "raw" designation, the 28 grams of proteins per serving remain intact. The brand claims that this makes them fully absorbable for maximum muscle building.

This meal replacement shake also serves up 8 grams of naturally-occurring plant fiber per serving and no added sugars for a total of 10g of carbs (2 grams net carbs). In addition to the basic macros and micros, Garden of Life has added some unique superfoods that it claims can boost overall health, such as cinnamon, which it says helps to stabilize blood sugar, and ashwagandha, which it says can help reduce the effects of stress.

In addition to the superfoods, this product also contains a raw probiotic and enzyme blend that contains two Lactobacillus strains and 13 enzymes that may aid overall digestion.

Garden of Life Raw Organic Fit ($39.19 for 14.4 oz. of powder or $49.59 for 32 oz. of powder, $2.50 per serving)

Field Work

Field Work Nutrition is new to the game, but it came ready to play. Co-founded by a premier endurance coach, it utilizes a substantial variety of whole foods and superfoods to make this meal replacement shake a powerhouse of vitamins and minerals. Two such thoughtfully added ingredients are curcumin and tart cherry, which the brand says can control and reduce inflammation in the body.

Field Work has also added a robust fruit and vegetable blend to supply micronutrients. These naturally occurring vitamins and the added natural sea salt supply a healthy dose of the minerals essential for electrolyte balance (sodium, calcium, magnesium, and potassium). A pre-and probiotic blend has also been added to support gut health and a digestive enzyme complex to support digestion and absorption of the nutrients in the smoothie.

To make this a complete meal replacement product, Field Work has included 20 grams of protein from grass-fed whey and milk protein concentrate as well as 5 grams of fat from coconut oil powder and 18 grams of carbohydrates. The majority of the carbohydrates come from high-quality sources like sweet potato, oats, amaranth, chia and quinoa, making them slow-burning for sustained energy.

This meal replacement shake is excellent for anyone who has difficulty consuming enough plant foods regularly or anyone looking for a superfood boost from a meal replacement shake.

Field Work Nutrition Primo Smoothie ($55 for 33 oz. of powder, $3 per serving)

Orgain

Orgain is the brainchild of cancer-survivor turned-integrative-medicine-specialist, Doctor Andrew Abraham.

This shake uses USDA organic ingredients and is free from artificial sweeteners, flavors, preservatives, soy, gluten, GMOs and carrageenan. Its also free from dairy and lactose, and is vegan-friendly. Instead of the grass-fed milk protein found in most of Orgains other products, the 20 grams of proteins in this powder come from organic peas, brown rice and chia seed. It also contains complex carbohydrates from a sprouted blend that includes various seeds and beans like amaranth, quinoa, garbanzo, flaxseed and pumpkin seed.

Orgain also included a greens blend and a fruit and vegetable blend, which it says ensures this meal replacement shake supplies adequate micronutrients and beneficial plant compounds. In total, these all add up to 25 grams of carbohydrates. Orgain makes a great product suitable for anyone with common food sensitivities or allergies.

Orgain Organic Meal Powder ($39.99 for 32 oz. of powder with discounts on subscription service; $2.50 per serving (or $1.87 per serving with a subscription)

Ample

Ample traded out the whey protein in its Original Meal Shake for pea protein to make this vegan-friendly meal replacement shake. And, perhaps knowing how difficult it can be for vegans to consume enough complete proteins and good fats due to dietary choices, Ample loaded this meal replacement shake with macros to support health and body functions.

For starters, there are 26 grams of fatderived mostly from coconut oil (with some from macadamia nut oil). The high fat content means you will likely feel more satiated with your liquid meal, allowing you to go a longer period of time between meals. It also means that your body is getting a healthy dose of the saturated fats essential for cellular health and hormone production that can be hard to consume in adequate amounts with a plant-based diet.

The remainder of the ingredients in this product are non-GMO and from whole-food sources. The 20 grams of protein in Ample V come mostly from organic peas. And this protein is a high-quality source of essential amino acids and one of the better choices for a vegan-safe protein, as it is a complete protein. The carbohydrates in Ample V come mostly from whole grain oat powder. This, coupled with the acacia fiber and vegetable powders, makes for a fiber-rich shake at 11 grams per serving.

Ample has also added a healthy dose of probiotics for gut health and a few vegetable powders to supply vitamins and minerals. Though, it could probably do with adding a few more plant powders to boost the overall nutritional content, but still this shake makes an excellent choice for vegans or anyone preferring plant protein.

Ample V ($4.50 to $6 per serving, depending on the package)

HLTH Code

For those who follow the high fat, low carb ketogenic diet, HLTH Code makes an excellent option.

HLTH provides 27 grams of protein from whey protein concentrate, grass-fed collagen and egg whites. The addition of collagen is particularly great because collagen is essential for maintaining the health of connective tissues (tendons and ligaments), joints and skin. An active lifestyle can stress connective tissues and joints, so a collagen boost is especially welcomed. HLTH also provides 27 grams of fat from coconut oil powder, olive oil powder, MCT powder, flaxseed, cocoa butter and grass-fed ghee far and away the most diverse and superior fat sources on our list of meal replacement shakes. HLTH has 13 grams of carbohydrates with 9 grams from soluble vegetable fibers, for only 4 grams net carbs to keep you within your daily carb limit.

HLTH also includes a significant amount of real, mineral-rich sea salt. This is valuable because people on the keto diet often have lower sodium levelstheyre generally not able to eat high-sodium packaged foods that are common in many peoples diets, and clearing ketones also causes the body to lose sodium. Despite containing none of the vegetable powders that we see in most meal replacement shakes, HLTH has still managed to create a powder thats rich in 25 vitamins and minerals due to the nutrient-dense ingredient list. This meal replacement shake is thoughtfully made and an excellent choice for those following the keto diet or anyone looking to lower carbohydrate intake and increase fat intake.

HLTH Code Complete Meal ($59.95 for a 42 oz. bag with a discount for the subscription service; $4 per serving ($3.33 per serving with subscription)

Your meal replacement shake should contain high-quality, complete protein from sources like grass-fed whey, egg whites, beans and seeds. Whey protein is one of the most popular protein sources in meal replacement shakes because it is highly absorbable and contains all nine essential amino acids. Pea protein, derived from yellow split peas, has become one of the leading sources of high-quality plant-based proteins commonly used in meal replacement shakes. Both whey and pea proteins contain all nine essential amino acids, making them complete proteins and highly effective for muscle repair and growth. The amount of protein you aim for will vary based on your overall diet and goals. A good starting point for many people is around 20-25 grams of protein per shake, which has been shown to stimulate muscle building.

You should avoid meal replacement shakes with protein from wheat. These are low-quality sources of protein that lack essential amino acids, rendering them mostly ineffective for muscle repair and growth.

Healthy fats, usually polyunsaturated and monounsaturated fatty acids, are found in certain vegetable oils, nuts and seeds among others, and can provide some benefits for the body such as decreasing your risk for disease. Its wise to avoid hydrogenated oilsthey contain trans fats, which can increase your risk of developing heart disease and other health problems.

Carbohydrates are great for supplying the body with energy. However, if they come from simple sources like corn, that energy is likely to burn out quickly, leaving you feeling like a car without gas. Complex carbohydrates such as oat powder, sweet potato flour and various bean or seed powders are digested more slowly by the body for a more sustained energy supply. These carbohydrates also contain fiber, which aids in digestion and helps you feel fuller for longer.

While it's important that your meal replacement shake tastes delicious, it's far more important that you don't compromise your health by settling for a powder loaded with sugar or artificial sweeteners. Traditional sugar may appear on the label in different names like dextrose, fructose or corn syrup solids. Beware that all of these sugars will cause your blood sugar to spike.

It's equally important to read the label for artificial sweeteners, such as aspartame and sucralose. These ingredients have been linked to cancer and other chronic diseases, supported by the Journal of Pharmacology & Pharmacotherapeutics. Instead, look for a meal replacement shake with low sugar content (4g maximum) from healthy sources, such as maple or coconut sugar or a version that uses a natural plant-based sweetener such as monk fruit to boost the taste.

Probiotics, often in the form of cultures similar to what you see in yogurts or other fermented products, are necessary to keep your gut microbiome healthy. Prebiotics are indigestible plant fibers that act as food and nutrients for your gut microbiome. Sources in meal replacement shakes often come from inulin (usually from chicory root fiber). A healthy gut is important for overall health and good digestion. When your gut is not functioning properly, it inhibits the absorption of both macro and micronutrients, rendering your food (and your meal replacement shake) virtually ineffective.

Vitamins and minerals are used as coenzymes and cofactors for many of the metabolic reactions in the bodymeaning, your body needs them to complete the processes that transform food into energy. This is why it is important to eat a wide variety of foods to ensure you are getting these micronutrients into your body through your diet. If necessary, a meal replacement powder with some added micronutrients can help you fill in some of the gaps where you might be deficient. A good rule of thumb is to check the ingredient list for vegetables, fruit, mushroom and other plant powders if you are looking to round out your meal replacement shake.

While some people have been diagnosed with food sensitivities or allergies, many people are unaware that they have any issues. If you commonly feel bloated, have gas or have other digestive issues, you may be sensitive to common allergens. If this is the case or if you have been diagnosed, you may want to steer clear of products containing lactose, gluten, wheat or soy. Keep in mind that most whey proteins contain lactose (some may contain trace amounts of gluten if they are not 100% pure). If you have true sensitivities or allergies, read the label closely for certified claims about being allergen-free. Look to see if the product was made in a facility that processes nuts, soy, or other allergens, and check for NSF Certified Gluten Free, Non-GMO Project Verified, and USDA Organic badges, depending on your sensitivities.

If you recognize most, if not all, of the ingredients, thats a good sign you have a quality product. Poorly made products contain food chemicals to improve the texture and stability of the shake. Some shakes contain synthetic vitamins as a cheap alternative to whole or real foods. Others contain fillers. These are products with little-to-no nutritional value but they act as bulk to add weight to the bottle. Thickeners are used in some meal replacement shakes to help create a more consistent texture once the liquid is added. Carrageenan is a very common thickener that, while derived from natural seaweed, has been linked to gastrointestinal damages, including "mucosal erosions and ulceration," according to Environmental Health Perspectives.

Its imperative that you have a clear vision of the health goals you are aiming to achieve, so you can select a product to help you hit the mark. Are you someone who is using a meal replacement shake to bulk up? If so, you'll want much higher macronutrients than someone trying to slim down or maintain weight.

Suppose you are using a meal replacement shake because you don't always have time or the ability to eat a meal. In that case, you'll want to choose a balance of macros and a healthy dose of micronutrients to act as a sound substitute for a meal. Know your goals and choose a powder accordingly. If you are uncertain about your goals, reach out to a health professional to learn more.

Unless you choose a ready-to-drink meal replacement shake, you'll want to invest in either a blender or a shaker bottle. Simply stirring your meal replacement powder into liquid will only leave you with a lumpy, inedible (or undrinkable) drink. Blenders are great for when you're at home and have an extra minute to mix your drink. You can always throw in some fresh greens or fruit and ice to make your meal replacement shake into a smoothie for added nutrition and flavor. But if youre on the go, a shaker bottle is an easy way to keep your drink blended and smooth.

The time you drink your meal replacement shake can vary based on what works best for your schedule. Most people replace just one meal per day with one of these shakesgenerally whatever meal is most convenient for you. However, If you are considering replacing multiple meals with a meal replacement shake then we strongly urge you to discuss it with your qualified health care provider.

You can drink a meal replacement shake between meals or before or after workouts to increase caloric and nutrient consumption (for those trying to increase muscle mass and body weight). If you just need something to fill in occasionally, you can keep a stash of meal replacement powder in your desk drawer or your gym bag and just add water when you find yourself in a bind and unable to eat a meal. Just keep in mind that the powder for these shakes could be affected by temperature and climate fluctuations such as humidity which can cause the powder to clump up.

While whole food meals are usually our best option, busy schedules dont always allow for this luxury. Whether you are trying to bulk up, lean out or just get through your busy day, you can consider a meal replacement shake to aid your health and fitness journey.

Well-made meal replacement shakes are more nutrient-dense and contain much more of the healthy ingredients your body needs than a lot of the alternative on-the-go options such as fast food or candy bars. Once you know what fuels your body and what meal replacement shake is best suited to meet your dietary needs, you can confidently choose the right product to help you reach your goals and keep you on the move.

Prices are accurate and items in stock at time of publishing.

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The Best Meal Replacement Shakes of 2022 - Sports Illustrated

Clients now view these services as essential for geriatric patients, canine athletes, and pets recovering from certain surgeries

Rehabilitation services are emerging in veterinary medicine in parallel with the specialty and formal training most recently recognized by the American Veterinary Medical Association, the American College of Veterinary Sports Medicine and Rehabilitation.

At the 2022 Fetch dvm360 conference in Charlotte, North Carolina, presenter Janice L. Huntingford, DVM, DACVSMR, MS-TCVM, CVA, CVPP, CCRT, also explained that clients now view these services as essential for geriatric patients, canine athletes, and pets recovering from certain surgeries.1 Along with this, she shared key reasons that integrating rehabilitation including a range of therapeutic exercise and modalities (eg, hydrotherapy, ulstrasound, etc) would be especially advantageous for your practice.

Rehabilitation provides a unique service because the goals of treatment are functional and created specifically for patients who need to improve their movement or quality of life where other methods solely may not prove effective.

Huntingford illustrated an example in a dvm360 interview: So if you have a dog who has difficulty walking, it's already had its cruciate repaired but it's still not walking, it may be because its muscles are painful. And rehabilitation allows you to take those dogs and and create a scenario where they're able to walk again, because you're really dealing with functional things like that.

According to Huntingford, rehabilitation is ideal for geriatric canine patients because they typically have various health problems and medication cant address all of them. Additionally, these dogs often have stomachs that are sensitive to drugssuch as non-steroidal anti-inflammatorieswhen they are in pain because of arthritis. Thus, you can use rehabilitation methods as nondrug therapies for them.

A small animal practitioner may want to start doing rehabilitation because it gives them more tools in their toolbox when treating dogs that are geriatric who have pain and mobility issues, Huntingford said, in the interview.

Because many of these dogs have problems taking conventional drugs, either they're vomiting or they get diarrhea or they have kidney disease, and they just can't take it but they still need to have their pain managed, they need help with mobility. So in that case, you can do rehabilitation techniques [such as] therapeutic exercises, joint mobilization, hydrotherapy, laser, acupuncture . . . so it allows you to continue to treat your patients, she added.

Furthermore, engaging in rehabilitation medicine bonds you with patients, but with clients as well. Huntingford said that pet owners are often grateful that you are treating their older patients, those recovering from surgery and all others in need of an alternate therapy. It is appreciated by them that you are helping their pets pain to be better managed.

Reference

Huntingford J. Integrating rehabilitation into a busy general practice.Presented at: Fetch dvm360 Conference; April 22-24, 2022; Charlotte, North Carolina.

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Benefits of integrating rehabilitation into your practice - DVM 360