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Exercise and Bone Health

How can exercise improve my bone health and help be age better?

One of the hallmarks of aging is decreasing bone density. You reach your peak bone density around the age of 30, and it decreases a certain amount every year after that. Our bones are always going through a renewal process involving removing old bone cells and regenerating new ones. Both of these processes are going on at the same time, but as you age, the process of regenerating bone decreases resulting in an overall decrease in bone density instead of maintaining or increasing bone density. The cells that regenerate bone make collagen and other non-collagen proteins. The collagen is what provides bone its strength and resistance to deformation. There are also changes in the structure of the collagen in the bone as we age that lead to increased stiffness and brittleness. Lots of other factors such as genetics, hormones, peak bone mass earlier in life, drugs or medication use, other medical conditions, nutrition, and yes, even physical activity can impact bone mass.

We all know that our bones get more brittle and are more likely to fracture as we get older which is why so many people shy away from physical activity as they get older because they don’t want to hurt themselves.

The question is, how do you prevent further excessive loss in bone mass as you age?

You can’t control all of these factors leading to where you are now, but you can do something moving forward!

Exercise is a great way to help increase bone density as you age. Certain kinds of exercise can help to stimulate the generation of new bone cells. Bone responds to something called “mechanical loading” (which is muscle contraction or bearing weight) by increasing bone formation. The increase in bone formation is proportionate to the amount of mechanical loading or strain put on the bone. Furthermore, including rest periods in-between the periods of time where strain is present (more of a dynamic workout situation) increases the bone formation even more. Exercises that induce strain that is unlike normal strain put on the bone (think multidirectional jumping or versus walking or running) induces the formation of bone. Another reminder, like all processes in the body, certain nutrients are necessary for optimal function. Therefore, adequate protein, calcium, and vitamin D is necessary to experience the full benefits of exercise for bone health. Furthermore, hormonal status and function is important to maintain good bone health. 

Here are some tips for maintaining bone health as you age:
– Maintain a healthy body weight: a body weight that is too high or too low can negatively impact bone health. Many don’t think about low body weight but that can negatively impact bone health as much as a higher body weight.
– Eat a healthy diet with adequate protein, calcium, and vitamin D. An adequate vitamin D status is required for optimum absorption of calcium in the gut, so it doesn’t hurt to eat both at the same time.
– Incorporate light weight-bearing aerobic activity: jumping, tennis, volleyball, hiking, etc. Remember to always start light and slowly increase.
– Incorporate light weight-bearing resistance training: Grab some small weights or use your body weight and do various exercises to increase your muscle strength and stability. Remember to always start light and slowly increase.
          – Here is a website with some great exercises for increasing strength while maintaining stability:

            https://americanbonehealth.org/exercises/
– Mix up your movement: Like we discussed above, dynamic exercise is best for increasing bone density. Create a workout plan with your doctors that changes up the types of exercises you are performing.

Remember to always talk to your doctor if you have or are at risk for a bone-related disease, are at risk for falling or fractures. It is always a good idea to run ideas past your doctor before trying to implement your own workout or diet plan.

Sources:
https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/bone-health/art-20045060
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3383520/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4402109/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5467150/#:~:text=At%20the%20apical%20surface%2C%20osteoblasts,proteins%2C%20including%20osteocalcin%20and%20osteopontin.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991386/
https://pubmed.ncbi.nlm.nih.gov/15984409/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6179512/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6323511/
https://pubmed.ncbi.nlm.nih.gov/16680498/
https://www.osmifw.com/sports-medicine/bone-density-and-weight-bearing-exercise/

Healthy Barbecuing

It’s that time of year again. Summer time. The sun is blazing and the kids are splashing through the sprinkler. Grilling a nice-sized steak fits really well into this picture.

Did you know that grilling/ barbecuing has the potential to create carcinogens, or cancer-causing agents?

These compounds/ chemicals result from high heat and open flame that causes charring on food. This can happen with a direct reaction between the proteins in the meat and high heat, or when the fat drips, burns and coats the meat with toxic compounds. Unfortunately, smoked meat can also create these compounds from the smoking process. It creates a yummy flavor but can also deposit harmful chemicals on the meat as well.

Time and high temperatures are the main factor here. The composition of the meat also impacts the formation of these toxic chemicals.

Here are some tips to make sure you’re grilling in a healthy way:
– Grill lean meats without skin and with excess fat trimmed off. The fat can drip off and burn.
– Clean the grill before every use with a non-metal bristle brush. Metal bristles have been known to break off and get stuck in your food and cause serious issues. Buildup of char on the grill can also deposit chemicals onto your food. 
– Put the meat on aluminum foil with holes punctured to protect the meat from the smoke and drain the fat but still get the yummy flavor.
– Grill more fruits and vegetables: Although char can still form on vegetables, it is less likely.
– Do not overcook your meat: Here are the temperatures for meat cooking. Remove the meat as soon as it’s done to prevent char formation. 
     – Poultry (chicken, turkey, etc.) = 165 F
     – Ground meats, pork, and sausage = 160 F
     – Steaks, roasts, and chops = 145 F
     – Fish and seafood = 145 F
– Scape off any char present on your meat or fruits/ vegetables. Do as best as you can, it doesn’t have to be perfect. 
– Marinating your meat and seasoning with things like pepper can help to decrease the formation of these toxic compounds.
– Do what you can to shorten the cook time: Cut meat into smaller pieces or pre-cook your meat.
– Make eating smoked meat a treat instead of a regular occurrence. 

All these things, you don’t have to stop grilling or smoking meat. Maybe just start thinking about these things when you are cooking your meat.

Sources:
https://www.cuimc.columbia.edu/news/:~:text=Grilling%20can%20create%20cancer-causing,increase%20the%20risk%20of%20cancer.
https://www.webmd.com/women/safe-grilling
https://pubmed.ncbi.nlm.nih.gov/7447916/
https://pubmed.ncbi.nlm.nih.gov/30642492/
https://ift.onlinelibrary.wiley.com/doi/epdf/10.1111/1541-4337.12527?saml_referrer
https://pubmed.ncbi.nlm.nih.gov/24915407/
https://www.aicr.org/news/five-steps-for-cancer-safe-grilling/
https://health.clevelandclinic.org/is-smoked-meat-bad-for-you/#:~:text=In%20fact%2C%20the%20World%20Health,its%20link%20to%20colorectal%20cancer.
https://www.foodsafety.gov/food-safety-charts/safe-minimum-internal-temperatures

Exercise and Chronic Pain

Does exercise help or hurt my chronic pain?

Chronic pain is defined as pain that lasts for longer than 3 months. This is the time period chosen because it is beyond when normal tissue healing should occur. In the United States in 2021, an estimated 20.9% of people experienced chronic pain. This is a general term as other forms of chronic pain cause actual continued tissue damage such as cancer or osteoarthritis. Since there are such a wide variety of chronic pain syndromes with different causes, we won’t be diving into any of the specifics of those diseases.

When you experience constant pain that doesn’t go away, it is only normal to question whether or not exercise would be helpful for you. This pain can even begin to affect your daily life. Pain is never fun; therefore, it is our natural response to want to decrease the pain. Our natural instinct is to move less in order to try and reduce pain. It is counter-intuitive that exercise can help improve chronic pain. However, inactivity can also lead to other issues such as muscle atrophy (your muscles get smaller because they’re not being used), poor posture and stability, and other health problems. Fear is a common emotion experienced with chronic pain. Avoidance of certain behaviors or movements that caused pain in the past can invoke more fear and it becomes a vicious cycle. Fear of pain can become debilitating and perpetuate inactivity.

On another note, one of the proposed mechanisms for chronic pain is some kind of local or systemic inflammation. Scientific literature is showing that exercise can decrease systemic inflammation and in contrast, a sedentary lifestyle can even increase or contribute to inflammation. Consistent exercise is the most important thing, even if the sessions are short and of a lower intensity. Additionally, exercise can influence certain neurotransmitters and endogenous opioids (made by our own bodies) which promote the decrease and control of pain through pathways in the brain. Studies are also showing improved neuron regeneration after exercise which could help our nervous system respond better to pain signals. There is also a sensation where exercising a body part that does not hurt can help to decrease the pain in the area that does hurt. In additional to all of these benefits, exercise also helps to reduce fatigue, reduce excess weight, improve sleep, reduce anxiety and improve mood.

This being said, please make sure to talk to your doctor before trying to complete exercises if you are experiencing chronic pain. Figure out a plan that works for you and your specific condition.

If you’re wanting to increase your movement, here are a few non-intimidating forms of movement that you can slowly (and progressively, as possible) try to incorporate into your life:
– Leisurely walks of increasing length: Start slow and increase. For example, walk for 5 minutes, and rest and repeat. Walk for 10 minutes, rest and repeat. Etcetera. 
– Stretching and yoga: Incorporating small amounts of stretching into your day can help to increase flexibility and mobility, especially at the beginning and end of the day and when you’ve been sitting for a while. 
– Light core strengthening: Try getting an exercise ball and use that for various exercises. There’s no need to jump right into an intense amount of crunches.
– Incorporate more activity into your daily tasks. When you get up off a chair, sit down and get up a few more times. When you’re going up the stairs, redo a few stairs at the end. Sweep the floor more often than you need to. 

Schedule an appointment online today with one of our doctors if you’re experiencing chronic pain!

Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5461882/
https://link.springer.com/chapter/10.1007/978-981-15-1792-1_16
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4530716/
https://www.cdc.gov/mmwr/volumes/72/wr/mm7215a1.htm#:~:text=During%202021%2C%20an%20estimated%2020.9%25%20of%20U.S.%20adults%20experienced%20chronic,(8.0%25)%20(5).
https://extension.usu.edu/heart/research/exercise-and-chronic-pain
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4993768/
https://www.va.gov/WHOLEHEALTHLIBRARY/docs/Moving-the-Body-in-Chronic-Pain.pdf

Exercise and the Brain

We all know that exercise can help us manage our weight, build muscle, and is generally good for us, right?

Did you know that exercise also helps improve your sleep, mood, thinking and judgment skills, and reduce your risk of some cancers, heart disease, neurodegenerative diseases, and other metabolic diseases such as diabetes and metabolic syndrome?

When we think of the benefits of exercise, improving brain health doesn’t usually come to mind. However, research is showing that regular aerobic exercise (otherwise known as “cardio”, the kind of exercise that gets your heart rate up) helps to improve memory and other learning process. In fact, it can preserve or even increase the volume of the areas of the brain involved with cognitive functions (particularly the hippocampus). Furthermore, exercise induces the creation of new neurons in the brain and more integrated neural networks. Muscle synthesis, as a result of exercise, can cause the release of certain molecules that modify neurotransmission in specific areas of the brain.

In addition to structural changes, exercise can also promote recovery after an injury and has anti-depressive effects. One reason for this could be is that exercise has been known to increase tryptophan (a type of amino acid) levels in the blood which is a precursor to serotonin. A lot of antidepressive medications attempt to increase serotonin as it has a relaxing, feel good effect. Exercise also increases blood flow to the brain and releases endorphins that help to improve mood by influencing pain and the body’s response to stress. Also contributing to this “feel good” effect is an increase in opioids made by the body as a result of acute exercise (a burst of exercise).

Acute, or short-term exercise, has also been shown to increase cognitive function and performance- more specifically motor skills and academic achievement. Studies show that exercise intensity greatly affects the responses that contribute to improved function.

You might be asking yourself this question, what is the best kind of exercise for my brain health?

The kind that you can get yourself to do regularly and enjoy. Sure, a mixture of aerobic (cardio) and resistance training (weight lifting) are beneficial in different ways, but if you absolutely hate both, maybe tennis is the way to go. Or biking. Or swimming.

Here are some tips for incorporating exercise into your life or finding ways of exercising that are enjoyable for you:
– Find an exercise buddy: Nothing is as fun if you’re doing it by yourself. Find someone else who is as committed to exercising as you are and will encourage you to exercise when you don’t want to. 
– Be willing to try something new at least two times: Maybe you decide to try a new fitness class at the gym or a friend invites you to try something out with them like rock climbing or hiking. Maybe something goes wrong and you absolutely hated it. Try it at least one more time. There are always things that can randomly go wrong so give something two chances before giving up on it.
– Try mixing up your exercise routine: Doing the same thing over and over again can increase the risk of injury. Try doing a different activity or exercise routine each time you plan to workout this week.
– Choose activities that you enjoy so that your workout routine is sustainable. If you’re having trouble finding something you enjoy, keep trying new things until something sticks. Just don’t give up.

Sources:
https://medlineplus.gov/benefitsofexercise.html
https://www.nia.nih.gov/health/real-life-benefits-exercise-and-physical-activity
https://neurosciencenews.com/fitness-neuroscience-23228/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6770965/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2680508/
https://pubmed.ncbi.nlm.nih.gov/2678895/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077351/#:~:text=Several%20lines%20of%20research%20suggest,function%20in%20the%20human%20brain.
https://pubmed.ncbi.nlm.nih.gov/22480735/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5928534/

Toxic Stress Overload

You’ve heard from everyone that stress is toxic and not good for you, but why is it not good for you?

When we encounter a stressful situation, our bodies have specific responses (we’ll call this a stress response) that allow us to adapt to the present physical or psychological stimuli. Our bodies were designed with this built-in defense mechanism to be able to respond to life or death situations and survive. This is where the “fight or flight” term comes from. Here is an example of what happens in our body during a stress response:

Stress hormones and other neurochemicals increase in the body which causes increased heart rate, blood pressure, and blood glucose- all with the objective of supporting the possibility of needing to expend energy to protect ourselves. The body even begins to shutdown or divert energy away from the body systems that are unnecessary at that moment like the digestive or reproductive systems. You don’t need to worry about procreating or eating a large meal when you’re running away from a bear, right? That’s the idea here.

                                                                       

Under normal circumstances, once the stressor is no longer present or even with a moderate amount of stress, your body is able to adapt and go back to more of a “normal” state where these stress responses are not as ramped up. However, when those stressors are chronically present, your allostatic load can increase. “Allostatic load” refers to the cumulative effects of strong, repeated, or prolonged stressful experiences (regular life situations, drastic life events, and/or consequences from unhealthy behaviors such as poor sleep, smoking, chemical toxicity, etc.) in one’s life. Allostatic “overload” or “toxic stress” occurs when an individual is no longer able to cope or adapt with these physical responses that the body has in response to the stressful experiences.

Our bodies are designed to be able to handle and even thrive on acute, or short-term stress. For example, the physical stress from a hard workout or nervousness that comes from a public speaking engagement or during an exam. Our bodies are able to make little adjustments to be able to cope with a particular situation as long as it is able to return to more of a normal state. However, when this stress becomes chronic and doesn’t ever die down, these hormones and physical responses begin to cause damage to the systems involved in the stress response and cause dysfunctional responses that can lead to things like heart disease, psychiatric disorders, digestive issues, weight gain, infertility, and much more.

Children are particularly susceptible to toxic stress because of their impaired ability to cope as their brains are in a sensitive period of development. Permanent changes in brain physiology and poor health outcomes like immune dysregulation, persistent infections, and various diseases as adults can happen as a result.

What can you do then to prevent toxic stress from occurring and limit your toxic load altogether?

Some situations cannot be controlled like a drastic life event or a stressful work situation. What can be controlled, however, are other lifestyle habits such as exercise, sleep patterns, and food choices.

Here are some tips for limiting harmful behaviors that could contribute to allostatic load:
– Establish consistent and sufficient sleep patterns: Most adults need at least 7 hours of good sleep per night. Try going to bed and waking up at the same times every day, put away the electronic devices one hour before bed and do something relaxing like take a shower or read a book before bed
– Eat a low-inflammatory diet rich in fresh fruits vegetables, fiber, and healthy fats and limit your added sugar and processed foods
– Exercise for at least 150 minutes of moderate activity or 75 minutes of vigorous activity per week
– Try to work with your doctor to decrease any other harmful activities such as excessive drinking or smoking
– Do what you can to limit your chemical toxicity like using cleaner products and ensuring you’re consuming clean water and fruits and vegetables
– Support your body’s own detoxification by eating more fiber, eating plenty of the necessary nutrients, eating plenty of protein, and consuming antioxidants

Although you cannot control the stressful situations that appear in your daily like like work or family, you can incorporate stress reducing practices in order to support your response to these stressful situations.

Here are some ideas for reducing stress in your life:
– Talk regularly with a trusted family member, friend, or counselor to work through normal or drastic life situations
– Adopt stress reducing activities such as: journaling at night to write down stress from the day, connect with other people, get outside as much as you can, and/ or stretch before bed to release muscle tension

Sources:
https://www.ncbi.nlm.nih.gov/books/NBK541120/
https://www.sciencedirect.com/science/article/pii/S0306453019301581
https://www.hsph.harvard.edu/nutritionsource/stress-and-health/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4928741/
https://pubmed.ncbi.nlm.nih.gov/32799204/
https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response
https://www.nationwidechildrens.org/family-resources-education/700childrens/2017/07/toxic-stress-how-the-bodys-response-can-harm-a-childs-development#:~:text=Children%20are%20especially%20vulnerable%20to,and%20sensitive%20period%20of%20development.
https://www.jneurosci.org/content/40/1/12
https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html
https://www.ifm.org/news-insights/toxic-exposures-cumulative-effect/
https://www.cdc.gov/emotional-wellbeing/features/reduce-stress.htm
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6770193/

Nutrition + Gut Health

How important is gut health and can diet really play a large role in my gut health?Your gut, also known as the entire human intestinal tract, is home to over 100 trillion microbial cells. That’s more than the estimated number of cells that the average man has in his entire body! This complex community of microbes can influence physiology, metabolism, immune function, and synthesize certain vitamins and essential amino acids. Consequently, they are also involved in modulating diseases such as type 2 diabetes, inflammatory bowel disease, cardiovascular disease, and cancer. It has been documented that drastic diet changes can induce large, temporary shifts in the gut microbiota in as little time as 24 hours.

What can happen when many factors such as poor nutrition, stress, heavy alcohol use, and heavy metal toxicity damage the intestinal lining? The junctions between the cells of the gut lining are supposed to be tight, but they begin to spread apart and allow microorganisms to pass through into the blood. This is known as leaky gut syndrome. Altered gut microbiota, otherwise known as dysbiosis, is linked with this increased permeability of the intestinal lining. Studies have also linked intestinal dysfunction and gut dysbiosis to traumatic brain injuries such as a concussion. It is not clear the exact correlation, but a correlation is present.

What can you do to improve your gut health?

  • Eat a diverse diet of fresh fruits and vegetables (these are rich in fiber and essential nutrients)
  • Opt for whole carbohydrate sources such as potatoes, whole grains, and root vegetables instead of eliminating carbs completely (rich in fiber and beneficial carbohydrates)
  • Avoid processed foods that contain simple sugars, inflammatory fats, and additives
  • Consume probiotic-rich foods such as yogurt with live cultures, sauerkraut, kombucha, and pickled vegetables
  • Consume probiotics and enzymes in supplement form to fill the gaps in your diet

Nutrition for Concussion Recovery

What can you do nutritionally to support concussion recovery?

 

Believe it or not, nutrition is not a part of traditional medical treatment for concussions. In fact, Mayo Clinic and Cleveland Clinic say that the main treatment is physical and mental rest, and pain management. No further recommendations are given beyond what is recommended as a healthy diet for all individuals. This blows my mind as the physiological events following a concussion involve a cascade of inflammation and a dramatic increase in the usage of certain nutrients in order to heal the subsequent damage.

Within the first 48 hours of the concussion, blood vessels which are stretched or even torn cause decrease blood flow to the brain which initially causes parts of the brain to become “excited”. This can cause brain cells to die and other injured cells begin to release chemicals that cause inflammation and swelling. Ionic abnormalities in the cells also lead to an increased need for energy in the brain, using almost 40% more glucose than normal in the brain. This increase in oxidative stress and inflammation also increases the need for antioxidants in the brain. These events result in a restructuring process called “brain plasticity”. This is why rest is so important- especially during this period of time following the injury.

 
Nutrients and other factors important for concussion recovery:
– Energy: Our body makes energy out of the food that we eat. Sufficient energy is needed in the form of calories to support recovery. Often, the symptoms (nausea, migraines, etc.) can cause a decrease in appetite and decrease in calorie consumption.
– Protein: Since there is damage to the tissue in the body, additional protein is needed to reconstruct and heal the damaged areas. Some studies suggest 25- 88% more protein is needed than normally recommended for adults.
– Gut health: Gut dysfunction is a hallmark issue with brain injuries. Concussions have been found to modify the bacteria in the gut as well as cause functional and structural damage to the gut.
– Omega 3’s: DHA specifically is the main omega 3 fatty acid in the brain. Omega 3’s are anti-inflammatory, help regulate brain plasticity, and are structurally and functionally important in brain cognition and development.
– Vitamin D: Vitamin D deficiency pre-concussion is linked to poorer recovery rates. It is also involved in regulating brain plasticity and offers neuroprotective effects.
– Magnesium: As a part of the initial ionic imbalance in the brain, acute magnesium deficiency occurs. Magnesium is an important mineral which is involved in enzymatic processes in the brain. Magnesium supplementation was shown to improve recovery.
– Zinc: Zinc plays a very important role in the body’s antioxidant systems, as well as offering anti-inflammatory properties.

Hormonal Health

How can I support my hormonal health? This is a very common question, and not just from women but men, too. Let’s go back to the basics of hormones.

Emerging Trends in Health: Hope for a Vibrant Future

It is no surprise that one of the fastest growing industries in the United States is the healthcare sector. As the baby boomer generation ages, there is a rise in both healthcare costs and need for those who care for health. Another sobering fact is that the current middle age generation is expected to have a shorter lifespan than their parent’s generation. This is the first time in centuries that this drop in life expectancy is predicted. As it becomes easier to access high-quality health treatments, treatments that are more sophisticated than ever before, the quality of health is in decline. Not only is the projected lifespan decreasing, the years of functional life are decreasing. What is functional life you may ask? Functional life is having the freedom to travel, develop relationships, do things that make memories, be free of the need for medications, surgeries, and other life-saving interventions.

 

Why is functional lifespan so important? Is there hope in emerging care models to improve functional lifespan? Can you expect to both outlive your parents and have the freedom into retirement to make memories and truly enjoy a life of freedom? The hope can be found in several scientific “discoveries” and the development of newer models of healthcare.

 

For years, we have been told that the best way to be healthy is through diet and exercise. This is intuitive for most people. However, most individuals don’t know, with absolute certainty, that the top causes of death and decreased quality of life are determined by lifestyle choices. The recent work that has been done in mapping out the human genome was a start to this certainty and understanding in the scientific community. Further advances in understanding that human genes can be turned “on” and “off” has given more proof that conditions such as heart disease, diabetes, and others are both preventable and predictable. An example of genes being expressed can be found in exercise. When you exercise, the DNA for making muscle protein gets switched on. When you spend the day sitting at work, on the couch, or being sedentary, the DNA gets turned off. This field of study is called epigenetics and is a fascinating new understanding of how the human body functions. The study of epigenetics also gives us hope and certainty that with the proper diet and exercise, proper for the human genome, you can express health instead of disease.

 

With the emergence of understand how human DNA expresses itself based on lifestyle choices, a new model for healthcare MUST emerge. The current model in the USA is mostly based on diseases from centuries past, diseases with very low risk due to advances in science. The current model of healthcare is based off of treating symptoms and disease after they impact a person’s health. This is primarily symptom-based care. Models of care that are emerging are, and must be, based on prevention. These models fit with the scientific understand of health and causes of chronic diseases. We must ask ourselves, “Where can we find both healthcare providers and modern models of healthcare?”

 

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