Topical Pain Medication: A Safer Path to Chronic Pain Relief

Living with chronic pain can be an overwhelming and persistent challenge, impacting various aspects of daily life. While there are numerous approaches to managing chronic pain, the rise of opioid-related concerns has led the medical community to explore safer alternatives. One such alternative gaining attention is topical pain medication. Let’s explore how topical pain medication is changing the landscape of chronic pain treatment, providing effective relief with a reduced risk of addiction and adverse effects.

 

The Opioid Dilemma in Chronic Pain Management

 

  1. Risk of Addiction and Misuse Opioid medications, often prescribed for chronic pain, come with a significant risk of addiction and misuse. The potential for dependence on these medications poses a serious concern, leading healthcare professionals and patients alike to seek safer alternatives.
  2. Life-Threatening Consequences Opioids can have life-threatening consequences, including respiratory depression and overdose. The alarming rise in opioid-related fatalities has prompted a reevaluation of pain management strategies to prioritize patient safety while still addressing the root causes of chronic pain.

 

The Rise of Topical Pain Medication

 

  1. Targeted Relief with Fewer Side Effects Topical pain medications, applied directly to the skin over the affected area, offer targeted relief with minimal systemic absorption. This localized approach reduces the risk of systemic side effects commonly associated with oral medications, providing a safer option for chronic pain sufferers.
  2. Minimized Risk of Dependency Unlike opioid medications, topical pain relievers have a lower risk of dependence or addiction. The reduced likelihood of developing a tolerance to these medications makes them a favorable choice for long-term pain management.
  3. Diverse Formulations for Different Needs Topical pain medications come in various formulations, including creams, patches, gels, and ointments. These diverse options allow for customization based on the type and location of pain, providing a tailored approach to individual patient needs.
  4. Applicability to Various Conditions Topical pain relief is suitable for a range of conditions, including arthritis, muscle pain, neuropathic pain, and localized injuries. This versatility makes it an attractive option for individuals dealing with different forms of chronic pain.


Explore Topical Pain Medication Options with T&F Pharmacies

 

At T&F Pharmacies, we understand the challenges of chronic pain and the importance of finding effective, safe solutions. If you or a loved one is seeking alternatives to traditional pain management approaches, consider exploring topical pain medication options available at our pharmacy locations.

 

Our experienced healthcare professionals are ready to guide you through the selection of topical pain relievers tailored to your specific needs. Contact us at one of our pharmacy locations to learn more about how topical pain medication can provide the relief you deserve without the risks associated with traditional pain management approaches. Let’s work together to redefine your journey towards a life with less pain and more comfort.

The Importance of Planning for Your Family’s Long-Term Care

As our lives evolve, so do the needs of our loved ones, especially as they enter the later stages of life. Long-term care planning is a crucial step in ensuring the well-being of your family members, and choosing the right facilities and services is paramount. To help you understand this more, we’re going delve into the importance of planning for your family’s long-term care, with a focus on the role of long-term care pharmacies and specialized services. T&F Pharmacies is here to guide you through this journey and offer support at every step.

 

The Importance of Long-Term Care Planning

 

  1. Preserving Quality of Life: Long-term care planning involves anticipating and addressing the potential health and lifestyle needs of your loved ones. This proactive approach ensures that they can maintain a high quality of life as they age, even if they require specialized care.
  2. Financial Preparedness: Long-term care facilities and services can incur significant costs. Planning ahead allows you to make informed financial decisions, ensuring that your loved ones have access to the care they need without causing financial strain on the family.
  3. Peace of Mind for Everyone: Knowing that your family members have a well-thought-out long-term care plan in place provides peace of mind for both you and them. It alleviates stress during challenging times and allows your loved ones to age with dignity and grace.

 

The Role of Long-Term Care Pharmacies

 

  1. Medication Management: Long-term care often involves complex medication regimens. Long-term care pharmacies specialize in managing medications for individuals in assisted living or skilled nursing facilities, ensuring accurate dispensing, monitoring for interactions, and providing education on proper administration.
  2. Personalized Care Plans: Long-term care pharmacies work closely with healthcare providers to create personalized care plans for residents. This includes tailoring medication regimens to individual needs, considering any allergies or sensitivities, and addressing specific health conditions.
  3. Convenience and Accessibility: Long-term care pharmacies offer convenient services like medication synchronization and delivery to the facility. This streamlines the medication management process for both residents and facility staff, enhancing overall efficiency and ensuring that medications are readily available.

 

 

Choosing the Right Long-Term Care Services

 

  1. Evaluate Facilities Carefully: When selecting a long-term care facility, consider factors such as the quality of care, available services, staff expertise, and resident testimonials. Ensure that the facility aligns with the specific needs and preferences of your loved ones.
  2. Research Specialized Care Services: Depending on your loved one’s health condition, seek facilities that offer specialized care services, such as memory care for individuals with dementia or Alzheimer’s disease. This ensures that their unique needs are addressed with the utmost expertise and compassion.
  3. Plan for Future Needs: Choose a long-term care facility that has the flexibility to adapt to changing health conditions. This future-focused approach ensures that your loved ones can seamlessly transition to different levels of care if necessary.

 

At T&F Pharmacies, we understand the importance of comprehensive long-term care planning for your family. If you’re considering or currently navigating the process of choosing a long-term care facility, our experienced team is here to assist you. Get in touch at one of our pharmacy locations to discuss how we can support your family’s long-term care needs. Together, let’s ensure that your loved ones receive the specialized care and attention they deserve in the years to come.

Getting Ready for Hiking in the Fall and Winter

We are pleased to welcome Tom Willemann, Physical Therapist and Owner of Apex Orthopedic Rehabilitation in Wyckoff, New Jersey, as a guest blogger. Tom brings over 25 years of experience helping people meet their goals to remain active and independent through exercise. For additional guidance on resuming an active lifestyle following an injury, or for inquiries related to orthopedic and sports-related injuries, please feel free to reach out to him at tomw@apexorthopedicnj.com. Learn more about Tom and his clinic, and find links to his various informative social media channels, on Apex’s website: www.apexorthopedicnj.com. 

 

How to Get Ready for Hiking in the Fall and Winter 

 

For many, regular exercise can be viewed as a chore; dreaded by many, but necessary for everyone to maintain a healthy lifestyle.  The benefits are numerous, as outlined by the Mayo Clinic’s article, Why Exercise? Know the Benefits. The APTA released guidelines on exercise that basically state we all need to move a little more than we currently do. (Read more of the APTA’s current guidelines in more detail here: American Physical Therapy Association.) 

 

Health Benefits of Hiking 

 

As the weather begins to cool and many are starting to hibernate at their local indoor gyms to walk on a treadmill or ride a stationary bike, why not start a new exercise habit? Despite the dropping temperatures, get outside instead! The reasons to start hiking year-round are clear: From controlling blood pressure to improving endurance to increasing strength and maintaining bone density, hiking offers a multitude of physical health benefits that can help you lead a more active and fulfilling lifestyle. With the proper gear, clothing, mindset and physical preparation, you can happily hike throughout the fall and winter. Autumn in North Jersey is a great time to take advantage of the beautiful foliage and venture out for a long walk in the woods. There are a ton of options for great hikes that are just a short drive from our Wyckoff clinic alone, ranging from easy gravel roads to more challenging hikes that require hiking sticks during certain times of the year.

 

 

Local Hikes to Start Exploring 

 

I’ve been on many incredible hikes in our area over the years, but my two favorite local hikes will always be Van Slyke Ruins (off Skyline Drive) and High Mountain State Park. Both locations are in close proximity to Wyckoff and provide the additional advantage of offering a sense of being distanced from suburban life while still being linked to New York City. They boast views of the city skyline, and weather permitting, you can enjoy panoramic views of most of Manhattan in the distance. (Don’t forget to pack binoculars!) Fun fact: While hiking Van Slyke Ruins, fans of The Hunger Games might recognize the little island on Ramapo Lake, off the Fire Road, from the opening scenes. 

 

Equipment Recommendations for the First Time Hiker 

 

So, how do we make this hike a positive experience for all? The answer is: Preparation, preparation and more preparation. 

 

Hiking is a great way to start a cardiovascular program that is paired with getting out in the woods, away from the stresses of the world. Before we even start to plan our hike, we first have to consider the best equipment. Necessary hiking gear includes: Proper clothing, appropriate footwear, a light backpack, a water bottle and adequate nutrition, walking sticks, and, depending how long you are out for, a downloadable or printed map. Over the years, I have stocked up on hiking equipment locally at both Campmor and REI. Both have physical locations in Paramus and have staff that truly live and breathe the outdoors; they are typically great sources of hiking information, from tents to water filtration to the right hiking boots. Additionally, I encourage you to do a bit of research before you head out to get a sense of the location’s degree of difficulty. An appAPP I’ve used, and recommend, is All Trails, which gives you a quick description of distance, difficulty level and type of terrain. 

 

Exercise Plan for Your First Hike

 

While it’s necessary – and quite fun – to accumulate all of your hiking equipment, of utmost importance is being physically ready. This is especially recommended if you are not currently walking, cycling or doing some form of cardiovascular exercise. We suggest that beginners start with a simple exercise program, preferably four to six weeks prior to your inaugural hike, that encompasses the following components: 

 

  • Cardiovascular Conditioning 
  • Flexibility and Mobility Work 
  • Strength Training 
  • Balance Exercises 

 

First, head to the local high school track to get an understanding of how far you can walk without feeling like you’re pushing the limit of your ability. Most high school tracks are a quarter mile and, of course, flat. Record your start and end time on your watch, and track your distance. This will serve as a baseline for your fitness program and give you an idea of what length hike you should start with. Keep in mind that many variables have to be considered when determining if you can do the hike comfortably. A useful rule, which I made up and coined “The 50% Rule”, is: For every one mile you can walk on flat surfaces with minimal grade, assume you can do 1/2 mile easily in the woods. This serves as a rough guide; adjust accordingly once you have a few hikes under your belt. Please note: If you carry a heavy backpack or bring along a stubborn child who refuses to walk any further, that equation will most likely not work! 

 

Second, try to walk outside at least three times per week, with a day of rest in between, for four to six weeks prior to going on your first hike. If you plan a hike with hills, pick walks that simulate the demands of your first hike. Another alternative is to join a local gym and hop on a treadmill; many simulate hills as well as your desired pace. 

 

 

Next, consider your flexibility and mobility issues. It is always easier to manage rocks, low branches and various inclines deep in the woods with good baseline flexibility. Every sport or activity has its specific demands; a gymnast has very different demands than a powerlifter. If you are really interested in improving general mobility and flexibility, taking yoga a couple times a week is a nice alternative leading up to your first hike. For many, the demands of hiking, especially ones of relatively modest hills or very little in the way of obstacles, much focus in this area may not be necessary. 

 

I’m going to highlight a few basic stretches that should take only 10 minutes daily. One of the keys to effective stretching is daily stretches at a long duration, at least 30-60 seconds in length, at the end of the available range of movement. You should feel pressure at the end of the stretch, but not pain. If you do find it to be slightly uncomfortable, it should be mild and dissipate within a few minutes. Remember: You should feel good at the end. I prefer stretching after being up and active for at least 15 minutes or after a 5-10 minute walk. Each stretch should be performed a minimum of three times for 30- 60 seconds each day. 

 

Here is a list of the stretches I recommend for a return to hiking:

 

  • Gastro Calf Stretch 
  • Hamstring and Lower Back Stretch 
  • Lumbar Extension Stretch 
  • Hip Flexor Stretch 
  • Quadriceps Stretch 
  • Warrior Yoga Stretch 

 

Here is a list of the top strengthening exercises for hiking: 

 

  • Heel and Toe Raises 
  • Bodyweight Squats 
  • Bulgarian Squats 
  • Prone Planks 

 

All exercises should be done in three sets of eight reps with two minutes of rest in between sets. If you can easily do more, we will show you ways to increase the difficulty of dumbbell weights. In the early stages, don’t worry about weight, but going forward, once you can do over 15 reps, you should add weight in order to make strength gains. 

 

The last piece worth adding to your program is balance exercise. If you are interested in finding out how good your balance is, try the Unilateral Stance Test. This is how we do the test in the clinic: With eyes open and hands on hips, the patient stands on one leg unassisted; time begins when the opposite foot leaves the ground; time stops immediately when the opposite foot touches the ground and/or when hands leave the hips. If unable to stand for five seconds or less, you are at a greater risk of injury from fall. The “Single Leg Stance, With or Without Leg Swing” is a simple exercise based on the balance test just discussed. 

 

Keep in mind, most of this advice is for the beginner hiker and more sedentary person who wants a good entry point to becoming more active. For more active individuals, you may already be strong enough to perform and are ready to venture out into the woods! Exercising out in nature is one of my favorite things to do, whether it be mountain biking, hiking or downhill skiing. I hope you find this blog to be inspiring and these tips to be helpful. Best of luck! 

 

To contact Tom Willemann, Owner and Physical Therapist from Apex Orthopedic Rehabilitation, please visit the clinic’s web site at www.apexorthopedicnj.com, call the clinic at 201-251-2422, or email the clinic at info@apexorthopedicnj.com. 

 

Medical Disclaimer: The information provided by Tom Willemann from Apex Orthopedic Rehabilitation in Wyckoff, New Jersey is for informational purposes only and is not intended as a substitute for advice from your physician or other healthcare professional. You should not use this information for the diagnosis or specific treatment of any health problem or for prescription of any medication or other treatment. You should consult with a healthcare professional before starting any diet, exercise, or supplemental program, before taking any medication, or suspect you might have a health problem. You should not stop taking any medication and/or should not discontinue any prescribed treatment or exercise without first consulting your physician. The opinions expressed by Tom Willemann from Apex Orthopedic Rehabilitation are of the author and the author alone.

Staying on Track with Healthy Eating during the Holiday Season

The holiday season is a time of togetherness, warmth, and sumptuous feasts. With Thanksgiving and Christmas fast approaching, it’s important to strike a balance between savoring the culinary delights and maintaining a healthy lifestyle.

 

It’s important to recognize the significance of healthy eating during the holiday season, and we’ll provide you practical tips to ensure you stay on track without sacrificing the joy of the festivities. We’ll also talk about how T&F Pharmacies can help you on your journey to a healthier you with our nutritional health consultation services.

 

The Importance of Healthy Eating During the Holidays

 

Prioritize Your Well-Being: Embracing healthy eating during the holiday season is not about depriving yourself but about prioritizing your health and well-being. Choosing nutritious options ensures that your body receives the essential vitamins and minerals it needs to function at its best.

 

Maintain Control: Holiday meals tend to be indulgent and calorie-rich. By practicing moderation and making conscious choices, you can prevent overindulging and the discomfort that often follows.

 

Boost Immunity: The holiday season coincides with colder weather, making your immune system more vulnerable to illnesses. Opting for nutrient-dense foods can bolster your immunity and reduce the risk of getting sick.

 

 

Tips to Ensure You Stay on Track

 

Plan Ahead: Before attending holiday gatherings, strategize. Consider what you’ll eat, how much, and when you’ll eat it. Setting expectations for yourself will make it easier to resist unplanned indulgences.

 

Choose Nutrient-Rich Foods: During holiday feasts, opt for healthier options like roasted vegetables, lean proteins, and whole grains. These items can help you feel full and make it easier to control portions of richer, calorie-dense dishes.

 

Practice Portion Control: If there are dishes you can’t resist, go ahead and enjoy them, but in moderation. Utilize smaller plates, take smaller servings, and savor every bite. Slow, mindful eating can help you savor your food and prevent overeating.

 

Stay Hydrated: Drinking ample water throughout the day and during the meal can help control your appetite and prevent overindulging.

 

Contribute Healthy Dishes: If you’re attending a potluck-style gathering, consider bringing a healthy dish that you love. This ensures you have a nutritious option to enjoy.

 

Avoid Continuous Snacking: Constantly nibbling on snacks or leftovers can lead to overconsumption. Set specific times for meals and snacks, and stick to them.

 

Enjoy Treats Mindfully: Sweets and treats are an integral part of the holiday experience. Rather than avoiding them entirely, enjoy your favorite desserts in small portions, savoring each bite.

 

Sustain Your Activity Level: Continue your regular exercise routine during the holiday season. Regular physical activity can help offset the extra calories and maintain your overall well-being.

 

As the holiday season approaches, remember that healthy eating is about finding harmony, not restriction. By making mindful choices, planning ahead, and prioritizing nutrient-rich options, you can relish the holiday feasts without compromising your well-being. Celebrate the season with loved ones while staying on track with your health and nutrition goals.

 

At T&F Pharmacies, we understand the importance of healthy living. If you’d like expert guidance on your journey to better nutrition, we invite you to get in touch at one of our pharmacy locations for a nutritional health consultation. Our experienced professionals are here to support you in achieving your health and wellness objectives during the holidays and beyond.

Stay Ahead of Flu Season: Why You Need the Flu Shot

As the temperatures drop and the leaves change color, we all know that flu season is just around the corner. While the changing seasons bring a sense of coziness, they also bring an increased risk of falling victim to the flu.

 

This article discusses why getting a flu shot is crucial, how it can help, and how you can take action to protect yourself and your community by booking a flu shot or a flu clinic with our trusted pharmacy.

 

The Importance of the Flu Shot

 

Preventing Illness

 

The flu is a contagious respiratory illness that can lead to a range of symptoms, from mild discomfort to severe complications. By getting a flu shot, you significantly reduce your chances of contracting the virus. It’s a simple yet powerful step to keep yourself healthy during flu season.

 

Protecting Others

 

Getting vaccinated isn’t just about your own health; it’s also about protecting those around you. Some people, such as young children, the elderly, and individuals with compromised immune systems, are more vulnerable to severe flu-related complications. By getting vaccinated, you contribute to the overall immunity of your community and help safeguard those who are most at risk.

 

How the Flu Shot Works

 

The flu shot contains inactive flu viruses that stimulate your immune system without causing illness. When you receive the vaccine, your body produces antibodies against these viruses. If you’re exposed to the flu later on, your immune system is already prepared to fight off the infection. This means a milder illness, fewer complications, and a faster recovery if you do get sick.

 

Booking Your Flu Shot or Flu Clinic

 

At T&F Pharmacies, we are committed to helping you stay healthy and flu-free this season. Here’s how you can take action:

 

 

Individual Flu Shots

 

We offer convenient individual flu shots at all of our pharmacy locations. Simply schedule an appointment or drop by during our flu shot clinic hours. Our healthcare professionals will administer the vaccine safely and answer any questions you may have.

 

Company Flu Clinics

 

If you’re a business owner or manager, consider organizing a flu clinic for your employees. This proactive step can help keep your workforce healthy and productive during flu season. Contact us to arrange a flu clinic at your company location, and our team will make it a seamless and efficient process.

 

Don’t let the flu catch you off guard this season. Protect yourself and those around you by getting a flu shot. It’s a small but significant way to stay healthy and help build immunity in your community. Whether you’re an individual looking for a quick vaccination or a company interested in organizing a flu clinic, T&F Pharmacies is here to support you. Book your flu shot or flu clinic with us today, and let’s make this flu season a safer and healthier one for everyone.

Boost Your Metabolism and Stay Energized this Fall: The Role of Vitamin D and More

As we transition into the crisp and cozy fall months, maintaining a healthy metabolism becomes even more crucial. A well-functioning metabolism not only helps you maintain your energy levels but also supports overall health.

 

In this article, we’ll explore effective ways to boost your metabolism, with a particular focus on the role of Vitamin D. Plus, we’ll introduce you to the benefits of nutritional consultations and invite you to book one with us to optimize your health this season.

 

Boosting Your Metabolism

 

Stay Active, Even in Cooler Weather

 

As the temperature drops, it’s tempting to stay indoors, but don’t let that be an excuse to be sedentary. Regular physical activity, such as brisk walks, hikes, or indoor workouts, can help rev up your metabolism. Exercise not only burns calories but also builds lean muscle mass, which can increase your resting metabolic rate.

 

Prioritize Protein in Your Diet

 

Protein is an essential macronutrient that supports muscle growth and repair, which, in turn, boosts your metabolism. Include lean protein sources like chicken, fish, beans, and tofu in your meals to help your body maintain its energy-burning muscle mass.

 

Hydrate Wisely

 

Staying well-hydrated is crucial for a healthy metabolism. Drinking enough water helps your body efficiently process calories and can even temporarily boost metabolic rate. Consider herbal teas or warm water with lemon as comforting fall beverage choices.

 

The Role of Vitamin D

 

 

Sunlight and Vitamin D

 

 

As the days grow shorter and you spend more time indoors, your exposure to natural sunlight decreases. This can impact your body’s ability to produce Vitamin D, which plays a significant role in metabolism regulation. Vitamin D is vital for the functioning of various metabolic processes, including insulin secretion and fat metabolism.

 

Dietary Sources of Vitamin D

 

In addition to sunlight, you can get Vitamin D from dietary sources such as fatty fish (e.g., salmon and mackerel), egg yolks, fortified dairy or plant-based milk, and supplements. Discussing your Vitamin D intake with a healthcare professional can help you ensure you’re getting the right amount for your needs.

 

Book a Nutritional Consultation

 

If you’re looking to make the most of the fall season by optimizing your metabolism and overall health, consider booking a nutritional consultation with our experienced healthcare professionals. During the consultation, we can:

 

  • Assess your current diet and lifestyle.
  • Create a personalized nutrition plan to meet your goals.
  • Discuss the importance of Vitamin D and other essential nutrients in your diet.
  • Offer guidance on supplements if needed.
  • Provide ongoing support and adjustments to your plan as needed.

 

Fall is a season of change, but it’s also an excellent opportunity to take proactive steps towards a healthier you. By staying active, focusing on protein-rich foods, and maintaining optimal Vitamin D levels, you can boost your metabolism and maintain your energy levels throughout the season. Don’t hesitate to reach out and book a nutritional consultation with us to receive personalized guidance and support on your journey to better health this fall. Your well-being is our priority, and we’re here to help you make the most of the season ahead.

 

Unlocking Stress Relief: Exploring CBD, Exercise, and Sleep for Your Well-Being

In our fast-paced world, stress can creep into our lives unnoticed and take a toll on our physical and mental health. As your trusted regional pharmacy, we understand the importance of maintaining overall well-being. 

 

We’ll explore effective strategies for destressing, including the role of CBD, the benefits of exercise, and the importance of quality sleep. We also encourage you to take the next step in prioritizing your health by booking a general health consultation with us.

 

Understanding Stress

 

Before we delve into ways to destress, let’s first understand what stress is. Stress is your body’s natural response to perceived threats or challenges, whether they are real or imagined. It triggers the release of stress hormones like cortisol, which can lead to a wide range of physical and mental health issues when not properly managed.

 

Destressing Strategies

 

CBD: A Natural Stress Reliever

 

CBD, short for cannabidiol, is a compound found in the cannabis plant. Unlike its cousin THC, CBD is non-psychoactive and does not produce a “high.” It has gained popularity for its potential to reduce anxiety and stress. CBD interacts with the endocannabinoid system in your body, helping to regulate mood and stress responses.

 

When considering CBD, it’s essential to consult with a healthcare professional to determine the right dosage and form (e.g., oils, capsules, or topical creams) for your specific needs. At our pharmacy, we offer guidance on CBD products that meet your requirements.

 

The Power of Exercise

 

Regular physical activity is a potent stress buster. Exercise releases endorphins, which are natural mood lifters. It also helps lower cortisol levels and improves overall cardiovascular health. Incorporating just 30 minutes of moderate exercise into your daily routine can make a significant difference in stress reduction.

 

Whether it’s walking, jogging, swimming, or yoga, find an activity you enjoy and make it a habit. If you’re unsure where to start, consider consulting with our healthcare professionals to create a personalized exercise plan.

Prioritizing Quality Sleep

 

Adequate sleep is essential for stress management and overall well-being. When you sleep, your body and mind recharge, repairing the damage caused by daily stressors. Lack of sleep can lead to increased stress levels, irritability, and a weakened immune system.

 

Create a sleep-friendly environment by keeping your bedroom dark, quiet, and cool. Establish a regular sleep schedule and avoid screens before bedtime. If you’re struggling with sleep issues, don’t hesitate to discuss them during your general health consultation with us.

 

Take Action: Book a General Health Consultation

 

At T&F Pharmacies, we are committed to helping you achieve your best state of health. If you’re feeling overwhelmed by stress or simply want to prioritize your well-being, we encourage you to book a general health consultation with our experienced healthcare professionals. During your consultation, we can discuss your unique needs, recommend personalized strategies for stress management, and answer any questions you may have about CBD or other health-related topics.

 

Stress is a part of life, but it doesn’t have to control your well-being. By incorporating strategies like CBD, regular exercise, and quality sleep into your daily routine, you can take proactive steps to manage stress effectively. Remember that seeking guidance and support from healthcare professionals is a crucial part of your journey to a healthier, stress-free life. Take the first step today by booking a general health consultation at any of our locations and invest in your well-being.