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Archive for the ‘Health Center’ Category

A baby born in the U.S. in 2004 will live an average of 77.9 years. That life expectancy ranks 42d in the world, down from 11th twenty years earlier.

- Source: Census Bureau and National Center for Health Statistics

BLAME-STORMING THE HEALTH CRISIS

Who is responsible for the health crisis in America? Is it the government? The state of the economy? Parents? Schools? What about you and me? Restaurants? Grocery stores? Or is it our busy schedules? How about those get-togethers and parties you attend? Maybe the presented food choices are to blame. Yes! “Blame.” That is the word I was looking for! We are looking for someone or some institution to blame for our health crisis.

IS THERE A GOVERNMENT CONSPIRACY?

Is there a government conspiracy? If so, just who are the conspirators? Let us get one thing straight. You and I do not need anyone’s help in creating a health crisis. There is a reason for this. You and I are the greatest conspirators of our own lives. We have received more than enough information to let us know what to do to enhance our health and yet we, in many cases, do not act and make the changes. I think that clarifies the conspiracy theory in a nutshell. When I speak of this health crisis, I am not talking about medical insurance or medical costs or treatment. True, this is an important issue. However, this issue only touches on the surface of the problem. How we think, eat and live is the real cause. So who or what is responsible? Do you have an idea? Who is the villain or culprit?

YOU ARE RESPONSIBLE FOR YOUR HEALTH

You are personally responsible for all the decisions you make. Do not blame any institution or anyone else for your poor choices that lead to disease, illness and poor health.

WHY AMERICANS RANK LOW ON LONGEVITY

What has caused America to fall so far behind the statistics on longevity in the world? The ranking went from 11th to 42d. Americans do live longer, but not as long as 41 other countries, according to National Center on Health Statistics. Why is one of the richest countries in the world not able to keep up with other countries? Some say it is because the United States has no universal health care. I do not see that as the primary reason since we have never had universal health care. Here is what I think are some of the primary reasons for this trend:

Adults in the United States have one of the highest obesity rates in the world. One third of U.S. adults 20 years and older are obese and about two thirds are overweight, according to the National Center for Health Statistics. Americans are extremely sedentary in their lifestyles. Americans do not exercise at all or very little. Americans eat too much and they eat too much processed foods, sugar and fat. As long as the health care debate is limited to insurance, the health of Americans will not improve.

SAM MADE ME DO IT

Kids sometimes will do the craziest things. Once upon a time, there were two brothers. We will call them Sam and Jake. As school-aged brothers, Sam challenged Jake to climb a tree, and so he does. Then Jake is challenged, on a dare, to go farther out on a long, thin branch of the tree. He gets about half way out before the limb breaks, and he comes falling to the earth with a thump. Jake broke his nose and got some cuts and bruises. Both kids report to their mother and of course Mom asks Jake, “How did this happen?” Jake responds, “Sam made me do it!”

There are many complaints I hear about all that enticing processed food in the grocery stores. There are remarks about the special challenge of eating out: The portion sizes are too big, and there are all those irresistible, unhealthy “choices” available. I see no difference between Jake’s response and these complaining adults’ reactions to their plight – or, should I say, dilemma. Jake said, “Sam made me do it.” Translation: Sam is responsible for Jake’s poor decision to go out on a limb. That is nonsense. Jake is responsible for his own decision to go out on a limb. We adults are too frequently “going out on a limb” with our health by making poor choices while laying the blame on external circumstances or institutions — whether commercial, social, or governmental. Cease fire with such thoughts of blaming external circumstances or other people. Take charge. Be accountable for your own actions.

INSTITUTIONAL RESPONSIBILITY

Are our institutions off the hook when it becomes to responsibility? No, they are not. I use the term “institution” in a broad sense, to include the following:

Federal, state and local governments Political parties and politicians Teachers and school boards Physicians, dentists, nurses Journalists, press and media CEO’s and corporate shareholders Restaurateurs, marketers School cafeterias Workplace cafeterias Clergy, little league coaches Parents and caregivers Law enforcement officers, parole officers Military leaders (from the squad leader upward)

INSTITUTIONS ARE RESPONSIBLE TO LEAD BY EXAMPLE

What kind of leadership responsibility do institutions have when it comes to healthy eating and exercise? Institutions, as well as all leaders, have a heightened level of responsibility beyond rules and regulations of the organization. Our institutions have the special responsibility to “walk the talk,” clarify the goals of health and fitness, and assume a more visionary role to set and implement standards for a solution to our health crisis. Our institutions are morally obligated to set the example by living by the higher standard required of them as leaders. This can be accomplished through legislation, executive orders and both internal and public policy making. Our institutions need to deal with the problem directly and use their special influence to save lives and prevent suffering.

HEALTH INSURANCE DOES NOT EQUATE TO A HEALTHY LIFESTYLE

Health insurance will not accomplish this. Are you looking for true medical insurance? Make your premium payments in the form of living a healthy lifestyle void of dependence on a home pharmacy of medications. Most of our medications are prescribed because of our lifestyles, not because we simply got sick. I am talking about the overwhelming rule and not the exception.

There are exceptional cases where, despite a healthy lifestyle, serious disease or illness happens. Would you cease to drive a car simply because someone had an automobile accident? In addition, you certainly should not cease to lead a healthy lifestyle just because someone you know lived to be 100 years old as a smoker. That would be a fatal error in thinking. It is just this type of thinking that is killing and maiming Americans. Ban this type of thinking from your mind.

Take the educational institutions for America’s young people. Schools are primarily focused on delivering on educating our youth with an approved curriculum. Schools need to go beyond mere curriculum, to consider the whole child, setting improved fitness and healthy eating as a priority. Fitness and healthy eating should be a part of the curriculum, as they play a major role in the development of a child.

TEACHERS ARE ROLE MODELS

Teachers are role models and leaders when it comes to eating and exercise habits and how they portray their attitudes about fitness and health in school. John Maxwell defines leadership as “influence – nothing more, nothing less.” Moving beyond the position of the teacher to assessing the ability of the teacher to influence others as a leader is essential. This refers to those who would consider themselves followers, and those outside that circle.

Leadership builds character, because without maintaining integrity and trustworthiness, the capability to positively influence will disappear. There are many other definitions of leadership. They all point to a leader having influence on others and providing to them the guidance and direction necessary to envision a long-term view of the future.

POINT OUR CHILDREN IN THE RIGHT DIRECTION

Policy is made from the top down through legislation, executive order, mission and policy statements. Where there is a void in such top-down leadership, the initiative must begin from the ground up. Educational institutions by virtue of their access to vast blocks of our children’s time, have a unique responsibility to go beyond mere curriculum to consider the whole child. By offering and stressing healthier choices, they are setting precedent for the rest of that child’s life.

Early in America’s pioneer history, schoolteachers were expected to be morally beyond reproach in every detail of their own lifestyle. This reflected how those communities wanted to influence their children’s future and the future of the country as a whole. Today’s America likewise needs today’s schoolteachers to be wholeheartedly health conscious for the same reason. Our future depends on it.

That is not to say that all schoolteachers should be fashion-model thin or good-looking or in any way shaped by the media’s image. An overweight teacher who is working to improve her fitness would be preferable over the Size 4 who is proud to eat candy bars and drink sodas in front of her pupils. Institutions are role models in all that they say and do or do not say or do. Their policies and actions set the standards.

WE ARE KILLING OUR CHILDREN

Look at some statistics on childhood obesity in America. About 15 percent of children and adolescents ages 6-19 years are seriously overweight. The percentage of children and adolescents who are defined as overweight has nearly tripled since the early 1970s.

Over 10 percent of preschool children between ages of two and five are overweight. Another 15 percent of children and teens ages 6-19 are considered at risk of becoming overweight. Researchers found that lowered self-esteem was associated with being overweight in girls as young as five. One in five children in the U.S. is overweight. Children ages 10-13 who are obese are expected to have a 70% likelihood of suffering from obesity as adults.

Centers for Disease Control and Prevention’s (CDC), 1999-2000

National Health and Nutrition Examination Survey (NHANES)

CHILDHOOD OBESITY ONLY AN INDICATOR AND NOT THE REAL PROBLEM

Childhood obesity is only the indicator of an underlying problem of a sedentary lifestyle and unhealthy eating habits. Address these underlying issues, and childhood obesity will be significantly reduced.

SCHOOLS, TEACHERS AND PARENTS HAVE A HEIGHTENED LEVEL OF RESPONSIBILITY

Our schools, teachers and parents have a heightened level of leadership responsibility to address the statistics that are just a few of many indicators of the direction of the state of health of our children. Once these children become adults, they, too, will pass on their lifestyles to their children and will in all likelihood perpetuate poor eating and exercise habits. The consequences will manifest themselves as learning disabilities, increased crime, and socioeconomic problems which our children’s generation cannot afford to inherit.

THE MOTHER OF ALL INSTITUTIONAL EXCUSES

What is the number one excuse institutions use for not doing more to fight the poor state of health of Americans?

Answer: It is each individual’s own decision as to how he or she wants to live, how he or she wants to eat and exercise or not. This is the mother of all institutional excuses. An institution using this excuse relinquishes its leadership responsibility as a visionary to lead and guide by example and exercise that institutional influence it possesses. The institutions need to ask the visionary question of what can they do to influence, guide and inspire each individual to make healthy lifestyle choices.

WHY PYRAMIDS AND DIETARY GUIDELINES DON’T WORK

Dietary guidelines, pyramids and charts have all failed to make Americans healthier. Why are they not working? Institutions are made up of individuals who are a cross-section of society who are therefore personally dealing with the same lifestyle issues about eating and exercise, as are all consumers.

Dietary guidelines do not work, because the vast majority of the food and beverage industry does not incorporate them into food choices and portion sizes we see on the shelves. Remember, this is from the perspective of the institution and its responsibility and in no way diminishes the personal responsibility of every individual to take charge of their own lifestyle and choices. Our children need special guidance to learn what personal responsibility means. That guidance must come from adults.

GOVERNMENT SETS THE STANDARD AS A LEADER

Emission controls in the automobile industry have resulted in smaller, cleaner, and more fuel-efficient cars; though more work remains to be done. These successes were accomplished through government regulation through the Clean Air Act and similar initiatives. We have another just as pressing form of pollution going on in America: health pollution.

HEALTH POLLUTION

We have a health pollution crisis on our hands in America, and – as with automobile emission regulations – the food and beverage industry needs to be regulated to meet improved standards for healthy eating through strict labeling, reduced portion sizes, and regulation and disclosure of unhealthy ingredients in our country’s food supply.

The free market society needs some governmental fine-tuning in order to save American lives and prevent suffering. The cost of not doing so is enormous. Heart disease, cancer, stroke, and diabetes (the four leading causes of death in the U.S.), and obesity, hypertension, and osteoporosis are all linked to diet and exercise. Americans and their children are the most over-fed and under-nourished group of people in the world.

One out of two Americans is overweight. One-third of Americans are obese. Being overweight is the second leading cause of preventable death in the U.S.

ILLNESS AND DISEASE IS COSTING AMERICA BIG BUCKS

The total cost of stroke to the United States is estimated at about $43 billion per year. $28 billion per year direct costs for medical care and therapy. $15,000 is the average cost of care for a patient for up to 90 days after a stroke. $35,000 for 10% of patients, the cost of care for the first 90 days after a stroke.

*Statistics compiled from the Pennsylvania Health Care Cost Containment Council “Hospital Performance Report: 28 Common Medical Procedures and Treatments” (December 2002)

FOOD AND BEVERAGE INDUSTRY

The food and beverage industry as well as the health and wellness industry have a leadership responsibility to clean up their marketing. Misinformation and misleading claims are rampant. Observe carefully and you will detect the emotion-laden words, which are associated with poor choices and portion sizes:

Convenient (over-processed) All natural (so is lard and corn syrup) Lite or light (lots of added sugar) Quick and easy (huge amounts of sodium) Simple (check the label; not so simple, unpronounceable ingredients.)

In addition, the list goes on:

Fun, exciting, easy, time saver, feels great, low-carb, no sugar, no fat, healthy, look great.

Will the food and beverage industry have an economic price to pay for such changes? Yes, the transitional period will have some associated costs, in the short term. In the end, the food and beverage industry as well as consumers and our country as a whole will all benefit from a healthier America with healthier food choices. In fact, this will result in innovation and new areas of revenue for the food and beverage industry, all while actively contributing to making Americans and America healthier and stronger.

THE PUBLIC’S BASIC RIGHT TO KNOW

Disclosure is the law for government in Florida and many other states and federal entities. The Sunshine Law of Florida establishes a basic right of access to most meetings of boards, commissions and other governing bodies of state and local governmental agencies or authorities. It has led to not only a more informed public, but also actually better government.

Full disclosure on food labels would likewise inform the public and result in healthier foods being produced and marketed. True full disclosure for the average consumer must be in the form of a simple “level of healthiness” and “level of nutrients” grade. The factors determining the simple, easy-to-understand grade must be clearly defined in easily understandable language.

HEALTH POLLUTION A NATIONAL SECURITY ISSUE

The present health pollution of America is a national security issue because the consequences go much farther into sociological issues, such as increased crime and poor learning ability. An unhealthy America cannot perform or think as well.

LOOKING FORWARD

Whatever challenges our country faces will be better met if we are healthier in mind and body. Sick and unhealthy Americans are living longer and living with meds. These Americans need to be weaned back to health and off the meds, where possible. In most cases, lifestyle changes will result in improved health, independent of meals. Our physicians are challenged with a special institutional leadership role in strategizing to prescribe lifestyle-based changes and not just medication so that they and not just medication so that they truly can take on the role of healers, not only for the patient but also for the nation. Keep America strong. The medication mindset without healthy eating and exercise is killing Americans.

We have what it takes to change our culture for the betterment of all by taking personal responsibility for our lifestyles we lead. Our institutions have an equally important role model responsibility to set the tone and standard necessary to keep America healthy. Regardless of political affiliation, there should be complete agreement about personal and institutional responsibilities.

Many massage therapy health centers offer numerous services to accommodate the growing demand of their clients. Aside from offering the usual massage services, many health and wellness centers are now expanding their services to attract more clients. This is also one way to keep regular clients from going to other centers.

Aside from massage, what are other popular services offered by massage therapy health centers? What make them the ideal place to relax, unwind, and reenergize? Here are the popular services these centers often have in common:

Massage therapy
What is a massage therapy health center without offering massages? This is their primary service that is available in different ways and techniques. Massage therapy is a very effective way of relieving stress and aids the circulation of blood in the body at the same time. It is recommended for patients suffering from arthritis and those who are under therapy.

Skin care treatments
Many massages health centers also offer services for your skincare needs. A qualified dermatologist is readily available to assist you and give you the proper treatment for your skin. Facials, peeling, waxing, and bleaching are some of the most common treatments.

Body spa treatments
Body spa treatments are also an added feature to most massage therapy health centers. Most health centers offer unique styles for their body spa treatments. You can have a body scrub in a forest setting or even enjoy having your whole body moisturized by expert hands with scented candles all around the room. For a more romantic and relaxing feel, you and your partner can avail of these treatments together.

Reflexology
This added service for massage therapy health is a methodical massage that’s very beneficial to your body. Reflexology focuses in stimulating the reflexes of the hands and feet that relate to a specific area in your body. In just a short reflexology session, you will feel more relaxed and relieved of your body pain.

Acupuncture
Many massages health centers now provide this type of service. Acupuncture is originated in Asia and is now widely practiced in many parts of the world. Acupuncture is a very complicated yet effective process that must be performed by a qualified professional. That is why massage therapy health centers offer it to clients.

Sauna
Sauna is common in many massages health centers that cater to individuals who want to shed those extra pounds easily and instantly. This type of service is available in two modes. One is the public sauna wherein a space is provided for customers who want to try it and the other is a private sauna for those who want a more peaceful ambiance. The sauna is also effective in keeping the skin moisturized and young looking.

Massage therapy health centers offer services that help promote wellness and better health. The services they offer are all designed to benefit the human body. Further, they only hire experienced professionals to deliver their services. There are many spas and wellness centers today that all you have to do is visit them and see which ones appeal to you most.

MNAP Oncology Center has opened its doors in June 12, 2004. It offers a state of the art facility that allows patients to undergo radiation therapy treatments in the privacy of a friendly, comfortable and soothing outpatient center. In October 25, 2004 the center made available for patient cutting edge technology, IMRT (Intense Modulated Radiation Therapy) that allows for maximum delivered dose to the cancer area while sparing the healthy tissues surrounding the cancer site and have the ability to provide radiation protecting agents. All patients receive personalized care.

At MNAP Oncology Center the personnel offers a variety of innovative prevention programs, state-of-the-art diagnostic and treatment cancer care techniques, and a dedicated team of physicians and other medical professionals. The stuff invites people to explore the medical specialties and discover why MNAP is synonymous with serious care and leading edge medicine throughout Northeastern Philadelphia Community.

The board of certified Radiation Oncologists are experts in the field of fighting cancer and, together with the Radiation Oncology team, they work with each patient to develop a comprehensive treatment program. From the moment of the first appointment to the completion of the patient’s care, they are there to support the patient, answer all of the questions, and ensure that their experience reflects the highest standard of care. The radiation oncologists are experts in treating all types of cancer. They are actively involved in developing and conducting clinical trials to test new ways to use radiation therapy to fight cancer, including studies sponsored by the National Institutes of Health. The center is fully accredited and certified by RTOG (The Radiation Therapy Oncology Group), funded by National Cancer Institute for several clinical trials for Prostate Scan and Breast Cancer protocols. Clinical trials provide patients with access to the latest advances in and research on radiation therapy before they are widely available. The unmatched range of Diagnostic Center equipment includes the latest strategies to treat tumors aggressively, while reducing or eliminating some of the side effects that accompany radiation treatment. The treatment machine is the Siemens Linear Accelarator, the premier Intensity Modulated Radiation Therapy (IMRT) beam delivery vehicle. By using the most current treatment planning technology available to “map” tumors, the radiation oncologists can design treatments with pinpoint accuracy, ensuring that tumors get the most effective dose while healthy tissues and organs are spared. XiO Treatment Planning Software combines the latest technology and advanced dose calculation algorithms in an intuitive and efficient platform. The unparalleled speed of latest generation processors provides superior 3D rendering and manipulation in real time! In addition, Oncology Department is an official clinical education center to receive from Cooper Health System – School of Radiation Therapy for Clinical Practice.

Finding a good gynecologist is one of the most important health concerns for any woman who has entered adulthood. It is commonly advised that a woman begin consulting with a gynecologist when she first becomes sexually active. However if you are 18 years old or over and have some health concerns or are even just concerned with maintaining good health, it would be beneficial for you to start an early professional relationship with a qualified gynecologist.

There are many ways to find a gynecologist. You can find out from your insurance company if they have a listing of reputable doctors in your area, they usually do. College students can check with their local health center if they can recommend a physician and some colleges even have a resident gynecologist on staff. You can also check the local yellow pages of course, but most people are more comfortable consulting with a gynecologist who comes recommended by someone they know. In fact like in all other medical concerns, the best resource is your family and friends; they can recommend you a gynecologist with whom they have already established a long medical history and they can give you insight on their working methods and professional demeanor.

For many young women choosing a gynecologist for the first time can be a source of considerable anxiety. In fact even after many years of consultation with the same doctor many women still feel a sense of unease. This negative association with annual gynecological exams and possibly even the particular gynecologist may get in the way of the patient receiving the best possible medical attention.

After narrowing your choices down to a few doctors, make your decision based on how comfortable you are with your doctor. Gynecologists may either be male or female, it is your choice and there should be no reason to feel uncomfortable with a male gynecologist. Being comfortable with your gynecologist encourages open communication; remember this is a health concern and being too embarrassed to share details with your physician may prevent your doctor from giving you the best health care possible.

Ask your friends for recommendations on a good gynecologist. If you go with a gynecologist who comes personally recommended by someone you can trust, you may find a doctor who is able to address some of your personal anxieties and not just treat you as a patient with an illness.

It is very important that you choose a doctor you are comfortable with EVERY TIME you enter the doctor’s office. If for any reason you are not comfortable with a particular gynecologist, you are well within your rights to look around for someone else.

The weight loss center Chicago locals need can be just around the corner. However, not all of them are the same so in choosing a weight loss center Chicago residents want, consider the following tips:

Consider the fees

Be wary of informercials or newspaper ads of some weight loss centers because they claim to offer free consultations but in reality, they are going to charge you just for one phone call. In some cases, they can even talk you into signing up with them on the spot. So the next time you want to find a weight loss center Chicago-based, make sure that you are aware of the fees that you need to pay for prior to signing up. Furthermore, make sure that you are getting the best value for your money when you sign up with them. Remember that higher fees do not necessarily mean that the services are better.

Mind the location

The weight loss center Chicago-based you should be looking for must be conveniently near your office or home. If it is going to take you a 45-minute commute or drive to the weight loss center, there is a big chance you can miss out on your sessions just in case you run into some traffic. In choosing a weight loss center, be mindful of the location so the sessions can fit right into your schedule and you won’t have problems regarding the time and how you are going to get there.

The people running the place

A reputable weight loss center does not only provide you all the right plans and programs you are going to need to lose weight but their staff and the people working in the center should also be able to provide emotional support, counselling and guidance. Losing weight can turn into an emotional journey especially if you are not allowed to eat your comfort foods or if you are having self-esteem and self-image issues. Consider signing up in a weight loss center with counselling services or a support group.

One least understood alternative healing therapy and the effective medicinal benefits it provides is aromatherapy. When asked what it is, the average person offers a vague and unclear definition, oftentimes referring to aromatherapy as something that smells like lavender or something you receive in a spa. The classic definition of aromatherapy is usually defined as the use of pure essential oils to promote physical, psychological and spiritual health that can be administered in many ways.

The use of essential oils for health and well-being cannot be dismissed. Aromatherapy plays a huge role in an age when a preponderance of individuals are over-stressed, exhausted and unsure of their future – and it is an excellent holistic therapy that delivers the goods. In body care treatments such as massage, essential oils can be used very effectively to help reduce maladies such as stress, tension, shock, headaches, grief and pain. In facial treatments, essential oils are an excellent choice because they help to regulate the activity of capillaries and restore vitality to the tissues. Essential oils used in a bath have deep psychological actions on the nervous system if you are using them to reduce stress, calm your nerves or to help you sleep.

Aromatherapy is used in conjunction with other therapies by chiropractors and acupuncturists and has success as a holistic therapy, but there still is just not a lot of public awareness about the actual medical benefits it has on health issues such as sports injuries, burns, herpes, shingles, the lymphatic system and respiratory conditions to name but a few.

However, scientific research in aromatherapy continues to be done and this research verifies that the benefits of aromatherapy on wellness on the physical and emotional levels are valid and not to be ignored. There is so much being done in the medical aromatherapy movement today that most people are unaware of what is going on behind the scenes. Dr. Kurt Schnaubelt, the Scientific Director and Founder of the Pacific Institute of Aromatherapy in San Rafael, California has spent a lifetime of research in this field. Dr. Schnaubelt is a chemist and a pioneer in the science behind aromatherapy. In his book, Medical Aromatherapy: Healing With Essential Oils, he offers an explanation to the reader about aromatherapy as a “self-care therapy that returns power to the patient, lessening dependency on the authority of the medical establishment.”

There also seems to be little awareness that aromatherapy is actually being practiced in hospitals today by doctors and nurses. Incredibly enough, I discovered that aromatherapy is actually being supported and used by some hospitals in Santa Clara County, but not enough public information is known about their programs and which hospitals are supporting this therapy. In this country, it took years for essential oils to even be available in health food stores. This is amazing considering that aromatherapy and essential oils are a part of everyday life in Europe as a whole and essential oils are sold in pharmacies and in hospitals.

Most people in this country are still pretty unfamiliar with how effective essential oils really are and exactly what to do with them unless they are working with a professional in this field. However, in European countries when essential oils are purchased by a lay person, they know exactly what, how and why they are using them medicinally. What is lacking in this country still is more education and public awareness that aromatherapy and essential oils can be and should be as well-known as an acceptable alternative and medical health treatment as say acupuncture for example.

When researching this article, I discovered Michaela Boldy who is a nurse and a certified aromatherapist. She sells her aromatherapy blends at El Camino Hospital in Mountain View. The hospital absolutely supports Michaela and the use of aromatherapy and essential oil treatments on women in labor in the maternal child health center. Michaela has two aromatherapy blends that the patient purchases and is used during the birth by the mother’s birthing partner. Both of these blends – the Labor blend first stage, and the Labor blend second stage are sold in the Maternal Connections store at El Camino Hospital. You don’t even have to be a patient at the hospital to purchase these aromatherapy blends – they are available to the public or on Michaela’s website. You can get more information by going to http://mbaromatherapy.com.

Stay tuned for part 2 and more exciting information about the future of medical aromatherapy, the people behind this movement and so much more that you were unaware of until now. You won’t want to miss this amazing and informative story!