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Wednesday, November 3rd
Practice Management Workshop: Launching and Growing a Successful Age Management Practice
Many attendees of the AMMG conferences are attracted to the field of Age Management Medicine, but do not feel qualified, or empowered with the necessary tools, to successfully transition from the well-established structure of disease-based medicine or from the traditional insurance-based reimbursement system into a system which relies to a significant degree upon direct pay. This workshop is for those physicians and management staff. Attendees will be guided through the process of evaluating their professional goals, and then be helped to create a successful strategy to achieve those goals. Our goal is for the attendee to be equipped with the basic tools for making the decision whether to consider moving into an Age Management Medicine practice, and if so, to create a successful transition into this exciting field.
Non-CME Course
Time |
Presentation |
|---|---|
| 9:00 – 9:45 am | What Does Direct Pay Practice Ownership Mean? Overview on the Requirements and Recommendations to Start Your Own Practice Kenneth Janson, M.D., FACS Chief Medical Officer, Precision Health by Science Understand what a direct pay practice is, learn what the best practices for this type of practice are and transcend the fear of moving from insurance-based to direct pay practice. Attendees will be asked to envision the ideal Age Management Practice they wish to develop. |
| 9:45 – 10:30 am | Defining Your Medical Services and Procedures Planning Process Kent Rilling, PA-C Chief Executive Officer, Precision Health by Science Practice Business Models – Business Plan and Pro Forma Development: Strategies for pricing and staying compliant plus a discussion of the legal and operational considerations you don’t want to get wrong. |
| 10:30 – 10:45 am | Break |
| 10:45 – 11:30 am | What a Successful Practice Workflow Looks like: The Systematic Efficiencies Needed to Maximize Patient Experience Liz Huertas, BS Patient Services Manager, Precision Health by Science Creating Practice Efficiencies: Reproducible Methods that Create a Raving Fan Patient Experience. |
| 11:30 am – 12:15 pm | Practice Location, Labs, Pharmacy, and Ancillary Testing Partnerships that Can Make or Break Your Practice Cynthia Rilling, M.A. Chief Operating Officer, Precision Health by Science There are several decisions that are critical in launching and growing an Age Management medical practice. These include: choosing your location, establishing a relationship with compounding Pharmacies and laboratories, deciding on your services to include body composition scans, neurocognitive testing, and other treatment considerations. Learn about the importance of adding these, and others, at the right time. |
| 12:15 – 1:00 pm | Lunch Break Sponsored lunch provided by DEXAPLUS |
| 1:00 – 1:45 pm | Developing the Branding and Internal Marketing of Your Practice Cynthia Rilling, M.A. Chief Operating Officer, Precision Health by Science A culture of excellence starts with the right team and brand. How your patients perceive your practice is essential to developing trust, thus increasing referrals and patient retention. Learn how to engage your team in creatively promoting, not selling, your services to current patients and prospects. |
| 1:45 – 2:45 pm | Speaking to Your Patient’s Subconscious: How to Influence and Motivate Your Patients to Achieve the Results They Are Looking For Kent Rilling, PA-C Chief Executive Officer, Precision Health by Science In the process of transitioning from sick-care to preventive health care you don’t want to sound like a salesman. Learn the exact words to use to speak to your patient’s subconscious and help them get the results they want to achieve. Bonus: Learn how to influence your patients to recruit highly motivated patients for you. |
| 2:45 – 3:00 pm | Break |
| 3:00 – 4:00 pm | WATCH OUT! Practice Landmines to Avoid Kenneth Janson, M.D., FACS Chief Medical Officer, Precision Health by Science Kent Rilling, PA-C Chief Executive Officer, Precision Health by Science Cynthia Rilling, M.A. Chief Operating Officer, Precision Health by Science Liz Huertas, BS Patient Services Manager, Precision Health by Science
|
| 4 – 5:00 pm | Open Forum Q and A |
Thursday, November 4th
Advanced Workshop: Sexual Dysfunction in Men and Women
Sexual dysfunction is a common problem among both men and women, particularly in the aging patient. It can be caused by physical problems and medical conditions, such as heart disease and hormone imbalances, or by psychological problems, like anxiety, depression and the effects of past trauma. Age Management Physicians will be confronted with these issues; in fact sexual dysfunction may be a primary motivator for patients to seek out treatment. This workshop will focus on sexual dysfunction, diagnosis and treatment modalities that can be used in an Age Management Practice.
Time |
Presentation |
|---|---|
| 7:00 – 7:45 am | Complimentary Breakfast Open to all attendees. Provided by the Age Management Medicine Group (AMMG) |
| 8:00 – 8:45 am | Love and Libido: Gender Differences in Sex Angela DeRosa, D.O., MBA, CPE Founder & President, Hormonal Health Institute, Scottsdale, AZ Men and women are very different species when it comes to many things, but none more relevant than the differences in not only how one thinks about sex, but also the physiologic response to sex. Women are held to a different standard and have many more biases that need to be addressed and overcome in order to have a healthy intimate relationship. Men have been given a larger freedom to “spread their seed” without remorse. The 21st century with various heralding events, drove a social acceptance regarding women and their sexual needs, but it also created an opportunity to understand the differences between the two sexes. As providers it is important to understand these differences as we address the needs of our patients when it comes to not only safe sexual practices, but also how to properly treat sexual dysfunctions and the drivers in each sex of these concerns. |
| 8:45 – 9:15 am | Medical and Psychological Causes of Sexual Dysfunction in Men & Women Angela DeRosa, D.O., MBA, CPE Founder & President, Hormonal Health Institute, Scottsdale, AZ Men and women are very different species when it comes to many things, but none more relevant than the differences in not only how one thinks about sex, but also the distinct causes of sexual dysfunction and how to properly evaluate and address.As providers it is important to understand these differences as we formulate a proper work up and treatment protocol so that we can assist our patients in having happier, healthier sexual intimacy |
| 9:15 – 10:00 am | Patient Assessment and Diagnosis of Sexual Dysfunction in Men: Beyond Prescribing 5-alpha-Reducatase-Inhibitors Kathy Maupin, M.D. Founder and Medical Director, BioBalance Health Male sexual dysfunction is much more than ED and must be approached diagnostically by evaluating multiple physiologic systems, ruling out lifestyle and medication etiologies, anatomic abnormalities, and in some cases relationship counseling. The initial evaluation is complex and doesn’t begin with a prescription of a 5-alpha-reductase inhibitor but by diagnosing the physiologic dysfunction. Proper evaluation includes blood laboratory analysis of hormonal adequacy, diagnosis of contributing vascular and other medical diseases, which often requires radiologic tests, and relationship counseling. The optimal treatment plan is prioritized by normalizing all hormonal deficiencies, primarily by treating men with bioidentical testosterone, then treating medical diseases concomitantly, then adjusting medications that may worsen sexual performance and libido, defining and improving contributing lifestyle choices, and finally adding 5-alpha-reductase inhibitors, prostaglandin injections or referral for penile implantation if the result is not as robust as the patient desires. Patients appreciate the complete evaluation and treatment plan that this approach offers. |
| 10:00 – 10:15 am | Break |
| 10:15 – 11:00 am | Nutrition Plan to Reduce Incidence of ED and Increase Heart Health Paul Thompson, M.D. Medical Director, Thompson Clinic Chief Medical Officer, Launch Medical Advisory Board, Organicell Vascular disease is epidemic in size, Metabolic syndrome has become a way of life and everyone is looking for the MAGIC pill to fix their problems. The leading cause of death in the US is far and away cardiovascular in nature and sexual dysfunction is rampant. The common numbers are 50% of 50-year-olds, 60% of 60-year-olds, etc., suffer from sexual dysfunction. The answer today, pop a pill and fix your problem. The fallacy is that by doing so you are correcting the problem freeing you up to continue your habits that led to the problem. The worst part is, as you go along your merry way you are still highly likely to become a victim of a lethal cardiac event. While being a vegetarian seems like a drastic step there are many benefits including decrease in vascular inflammation, reversal of plaque, improved sexual function and a decrease in hypertension and many of the things that are associated with the metabolic syndrome. This lecture will point out the benefits of reducing animal protein and sticking with a plant-based diet. |
| 11:00 am – 12:00 pm | Evidence Based Treatment for Sexual Dysfunction in Men Using Hormones, FDA Approved Peptides and Other Common Modalities John C. Carrozzella, M.D., MSMS Director & Founding Physician, CEO, Florida Center for Hormones and Wellness Sexual Dysfunction in men is far more common than conventionally thought. Several studies suggest that almost every man will experience some degree of sexual dysfunction in his lifetime. From lack of desire, to poor physical performance, to a complete inability to have a sexual encounter, the extent of sexual dysfunction in men is wide. Since the introduction of Testosterone Therapy in the 1950’s and Sildenafil in 1998, the number and variety of remedies for sexual dysfunction have expanded dramatically. In this presentation, the attendee will learn about the root causes of sexual dysfunction in men. Then the presenter will discuss a number of Evidence Based treatments that have been well studied and shown to be medically effective. |
| 12:00 – 1:30 pm | Lunch Break |
| 12:00 – 1:00 pm | Hormones and the Microbiome – The Estrobolome and How it Influences Estrogen Metabolism Presented by Keri Anania, PA-C Open to all attendees and includes a complimentary lunch Non-CME symposium sponsored by Biocidin |
| 1:30 – 2:15 pm | Use of Non-Hormone Clinical Interventions for Sexual Dysfunction: Shockwave Therapy, P-Shot Michale Barber, M.D. CEO & CMO, Better Life Carolinas, Charleston, SC & Charlotte, NC Over the past decade the use of unique therapies for erectile dysfunction have emerged. This lecture will explore the science and effectiveness of Low intensity extracorporeal shock wave therapy for treatment of ED. A review of the literature will be presented to assess the physiology of shock wave therapy, suggested protocols for treatment and effectiveness and possible adverse effects. The use of platelet-rich plasma (PRP) for treating ED will also be discussed with a focus on up to date literature for use in erectile dysfunction. The literature will be reviewed for results including improvement in subjective patient scores, intracavernous pressure, analysis of penile tissue and other pertinent clinical data. Possible risks and contraindications will also be discussed. |
| 2:15 – 3:00 pm | Patient Assessment and Diagnosis of Sexual Dysfunction in Women: Unravelling the Mystery and Treating the Problem Kathy Maupin, M.D. Founder and Medical Director, BioBalance Health Secondary sexual dysfunction in women over 40 has a history of being misdiagnosed, ignored, treated with the wrong hormone, obstructed from treatment through governmental agencies and generally categorized as a psychiatric condition. Sexual function is a real physiologic, hormonal, psychological condition that affects many women after age 40. Sexual function and dysfunction involve many components of what we consider sexual function: libido, arousal, engorgement, comfort, orgasm, and emotional engagement. This complexity makes it more important to delineate what component is involved as each may require various treatments. Because sexual function is very complex in nature, the diagnosis and treatment of sexual complaints should be approached in an organized and complete fashion. Gynecologists generally rule out anatomic abnormalities which are rare in the mature patient but should not be overlooked. Hormonal deficiencies, medical illnesses and poor lifestyle choices are the most common causes of female sexual dysfunction. The fact that testosterone is necessary for female sexual function and the FDA has not approved a testosterone replacement for women, offers us an opportunity to use non oral bioidentical testosterone to treat the most common cause of female sexual dysfunction in mature women. I will offer case studies from my practice to illustrate the multifaceted problem of poor sexual function in mature women, and offer treatment protocols that work well. |
| 2:30 pm | Exhibits Open |
| 2:30 – 3:00 pm | Break / Visit Exhibits |
| 3:00 – 3:45 pm | The Use of Hormones & FDA Approved Peptides as an Evidence Based Treatment for Sexual Dysfunction in Women Carolyn DeLucia, M.D., FACOG Womens Intimate Health Clinic, NYC, NY Member and Instructor, American Aesthetic Association & American Cosmetic Cellular Medicine Association Fellow, American College of Obstetrics and Gynecology We will explore the literature on use of hormones both bioidentical and pharmaceutical grade products for sexual wellness. We will analyze the use of Peptides that are still FDA approved and available. The pertinent literature will be reviewed. The FDA’s impact on bioidentical hormones will be discussed and scrutinized. |
| 3:45 – 4:15 pm | The Use of Vylessi and HIFEM Technology in the Treatment of Pelvic Floor Muscles as a Cause of Female Sexual Dysfunction (Men & Women) Carolyn DeLucia, M.D., FACOG Womens Intimate Health Clinic, NYC, NY Member and Instructor, American Aesthetic Association & American Cosmetic Cellular Medicine Association Fellow, American College of Obstetrics and Gynecology HIFEM technology is the first to market of its kind to treat sexual medicine. Its value as opposed to traditional physical therapy and biofeedback techniques will be analyzed. The resent literature published and studies underway exploring HIFEM in the treatment of sexual dysfunction will be reviewed. The value of a noninvasive, operator independent, painless simple procedure will be appreciated. |
| 4:15 – 5:30 pm | Sexual Dysfunction Complex Case Discussion (Men & Women) Neal Rouzier, M.D. Director, The Preventive Medicine Clinics of the Desert, Palm Springs, CA A 60 y/o male presents for evaluation of hormone replacement that he has been receiving from a physician colleague. His chief complaint is loss of libido, erectile dysfunction, and weight gain. He also notes worsening of weight and body fat after being placed on anastrozole (Arimidex) for high estrogen levels that resulted from testosterone injections. Since then, he c/o increased fat and sexual dysfunction that he did not have before. Although he is on HRT, he wonders if you can offer something else as his friend who you treat does not complain of any of the side effects or problems that he is experiencing.Carolyn DeLucia, M.D., FACOG Womens Intimate Health Clinic, NYC, NY Member and Instructor, American Aesthetic Association & American Cosmetic Cellular Medicine Association Fellow, American College of Obstetrics and Gynecology A case of a woman with anorgasmia will be reviewed. What approach was taken and what else should be explored will be debated. Can every aspect of the orgasmic system be evaluated and treated? |
| 5:30 – 7:00 pm | AMMG Welcome Reception Open to all conference attendees, spouses, and guests Held in Conference Networking and Exhibits Center |
Thursday, November 4th
Workshop: IV Nutrient Therapies for Age Management Medicine
IV Therapies or intravenous treatment of nutrients infused directly into the bloodstream are exceptional powerful because they circumvent issues with oral administration and some of the adverse reactions of orally administered nutrients such as stomach upset and absorption issues. IV Therapy has become more mainstream in the past several years and we find our physicians are requesting more information on their clinical use for patients who require this type of treatment and for patients who are requesting this for a variety of reasons. This workshop will provide physicians with the evidence basis for use, and describe the medical necessity and the clinical procedures for administration.
Time |
Presentation |
|---|---|
| 7:00 – 7:45 am | Complimentary Breakfast Open to all attendees. Provided by the Age Management Medicine Group (AMMG) |
| 8:00 – 8:40 am | History, Indications and Scientific Evidence-Based Rationale for the Clinical Use of IV Nutrient Therapy Edwin N. Lee, M.D. Assistant Professor of Internal Medicine, University of Central Florida College of Medicine It is estimated that the human body consists of somewhere between 100-200 trillion cells conducting an excess of 500 billion chemical reactions each second. Our cells form the basic building blocks of life. For our cells to function properly one of the most basic ingredients that our cells need is nutrition. IV nutrition is the most effective way for our cells to receive nutrients. In addition IV nutrition is a powerful tool for regenerative medicine that can repair the body at a cellular level. Modern IV therapy has been around for about 50 years although the first IV infusion has been dated from 1665. A short history of IV nutrition, the science and indications for IV nutrition will be reviewed. |
| 8:40 – 9:10 am | Components of IV Nutrition: Equipment and Set up Dr. Payam Zand, N.D. Associate Physician, LIVV Wellness, San Diego, CA IV nutrient therapy can be a powerful tool in patient care. This will provide a comprehensive framework for understanding the apparatus needed for initiating IV treatments safely and effectively as well as the nutrients that can be utilized in practice. IV nutrition components will consist of IV preparation equipment, IV administration equipment and protocol, and safe discontinuation and disposal of IVs. |
| 9:10 – 9:40 am | Assessing the Patient & Development of an IV Nutrition Treatment Plan Payam Zand, N.D. Associate Physician, LIVV Wellness, San Diego, CA Assessment of each individual patient and the development of a specific IV protocol is dependent on several factors including patient symptoms, medical history, laboratory testing of nutrient status, and presence of methylation SNPs. These factors will then be utilized to develop a treatment plan with a specific duration and frequency for the patient’s individual need. Specific IV treatment protocols and research will be covered in de-tail. |
| 9:40 – 10:10 am | Implementation of IV Nutrient Therapy Payam Zand, N.D. Associate Physician, LIVV Wellness, San Diego, CA The implementation of IV nutrient therapy will take into consideration the space, time, and personnel needed for IV therapy. This will also be a review of IV safety, calculation of IV osmolality, choosing a proper IV drip rate, overview of various |
| 10:10 – 10:20 am | Break |
| 10:20 – 11:00 am | Post IV Nutrient Care and Maintenance Derrick DeSilva, Jr. M.D. Teaching Faculty, JFK Medical Center, Edison, NJ Co-Chair, Department of Complimentary Medicine and Senior Attending Staff, Raritan Bay Medical Center, Perth Amboy, NJ The after care with IV vitamins can be as critical as the infusion of the IV nutrients themselves. All nutrients work together to provide the body with the cellular energy and various co-factors so that the cells function at optimal levels. In order for an engine to perform at it peak the correct fuels must be introduced into the engine to achieve maximum results. The role that probiotics, CoQ10, Vitamin D, B vitamins and various other nutrients play in order to sustain cellular function will be discussed during this presentation. Preserving cellular energy is one of the keys to optimal aging and longevity. Cellular energy is also a critical component for maintaining hormonal balance and supporting the thyroid, adrenals etc. The body is a “cellular unit” and not a group of independently functioning organs. Let’s support the body’s systems by supporting the cellular functions of the body on the cellular level. |
| 11:00 am – 12:00 pm | Clinical Use of Nicotinamide Adenine Dinucleotide (NAD) IV Therapy Theresa Ramsey, NMD Medical Director, Revitalize Functional Medicine, Paradise Valley, AZ NAD (nicotinamide adenine dinucleotide) is part of basic biochemistry primarily involved in energy production and its activity is related to an increased sirtuitin response preserving DNA. In this way it is related to longevity. NAD levels can affect chronic conditions such as diabetes (insulin resistance), cancer, and neurodegenerative conditions. Severe niacin deficiency results in pellagra. The first studies using NAD by intravenous injection were with alcoholics and drug addicts. It was found that in 90% of patients elevating levels with continued IV infusion over 10 days decreased cravings for alcohol and drugs. There have also been studies revolving around hyperlipidemia with a response to NAD treatment better than drugs and with minimal side effects. NAD metabolism will be reviewed and clinical indications of deficiency discussed. Treatment with NAD will be reviewed as far as rejuvenation, which in my experience is preferable with intravenous and subcutaneous injection rather than oral supplements. We learned about NAD in middle school biology. This was reviewed again in medical school in a little more depth. We did not learn about the clinical usage of NAD in medical school or residency training. |
| 12:00 – 1:30 pm | Lunch Break |
| 12:00 – 1:00 pm | Hormones and the Microbiome – The Estrobolome and How it Influences Estrogen Metabolism Presented by Keri Anania, PA-C Open to all attendees and includes a complimentary lunch Non-CME symposium sponsored by Biocidin |
Thursday, November 4th
Workshop: Senotherapeutics for Age Management Medicine
Cellular senescence is one of the main driving forces for aging and organ dysfunction. As such, the field of Senolytics is poised to become the next big niche in Age Management Medicine. It is important for practitioners to understand how to assess body senescence burden and how to employ adequate senolytic strategies. This half-day workshop will teach healthcare practitioners the fundamentals for properly integrating senolytic treatments into their clinical practices. We will cover everything from the basic biology of cell senescence to testing and treatment protocols. Practitioners will leave the workshop with the necessary tools and knowledge required to start offering senolytic therapies in their practice.
Time |
Presentation |
|---|---|
| 1:30 – 2:15 pm | Understanding the Fundamentals of Cellular Senescence: Why it Happens and How it Affects Health Jin-Xiong She, Ph.D. Professor, Augusta University. Founder & CEO, Longevity Testing, Jinfinti Precision Medicine This lecture will review the biological mechanisms of cellular senescence. We will discuss cellular quiescence, geroconversion and final steps towards irreversible senescence. Additionally, we will describe the senescence associated secretory phenotype (SASP) and its impact on cellular microenvironment. |
| 2:15 – 2:50 pm | Testing for Cellular Senescence Luis Martinez, M.D., MPH President, XanoGene Clinic, San Juan, Puerto Rico President, Regenera Global, Ponce, Puerto Rico Recent advances have made testing for cellular senescence a more available and applicable test for physicians to incorporate in their Age Management Practice. This lecture will cover all the biomarkers and laboratory testing methods currently available for clinicians. The pros and cons of different testing approaches will be discussed. Additionally, an integrated model for assessing cellular senescence will be presented. |
| 2:30 pm | Exhibits Open |
| 2:50 pm – 3:30 pm | Break / Visit Exhibits |
| 3:30 – 4:00 pm | Senolytics- What Are They and Do They Work Luis Martinez, M.D., MPH President, XanoGene Clinic, San Juan, Puerto Rico President, Regenera Global, Ponce, Puerto Rico Senolytics, and more broadly senotherapeutics, can now be offered in clinical settings. This lecture will discuss the mechanisms of action by which senolytics work. We will list the different senolytics currently available for clinical use. Additionally, we will discuss other senotherapeutic strategies such as senomorphics, geroprotec-tors and SASP inhibitors. |
| 4:00 – 4:45 pm | Senolytic Treatment Protocols Luis Martinez, M.D., MPH President, XanoGene Clinic, San Juan, Puerto Rico President, Regenera Global, Ponce, Puerto Rico These lectures will review treatment protocols for incorporating senolytics and senotherapeutics into clinical practice. A review of clinical studies for the different treatments will be presented. Finally, specific case studies will be shown with an evidence-based approach for treatment selection. |
| 4:45 – 5:30 pm | Case Discussion and Review of Protocols Luis Martinez, M.D., MPH President, XanoGene Clinic, San Juan, Puerto Rico President, Regenera Global, Ponce, Puerto Rico Clinical Cases will be presented and include a review and discussion of the protocols used for treatment |
| 5:30 – 7:00 pm | AMMG Welcome Reception Open to all conference attendees, spouses, and guests Held in Conference Networking and Exhibits Center |
Thursday, November 4th
Workshop -Traumatic Brain Injury: A Clinical Approach to Diagnosis and Treatment
This full day program, TBI–A Clinical Approach to Diagnosis and Treatment, will provide to the attendees overwhelming information culled from peer-reviewed articles on Traumatic and Non-Traumatic Brain Injuries as causative factors for personality changes, cognitive impairment and mood disorders leading up to suicide. The attendees will be walked through the literature discussing the effects of primary traumas and the secondary effects of inflammation and oxidative stress on functionality. The rising cases of post-Covid neurological complications will also be discussed as a new entry into non-traumatic brain injury due to the “Cytokine Storm”. This program will prepare you for the treatment.
Course Faculty (all sessions in this track)
Mark L. Gordon, M.D.
Medical Director, Millennium-TBI & The Millennium Health Centers, Encino, CA; CBS Studios;
USC, Keck School of Medicine, Department of Family Medicine, Los Angeles, CA
Medical Director of Education, Access Medical Laboratories, Jupiter, FL
Member, AMMG Conference Planning Committee
Life Member, AMMG
Time |
Presentation |
|---|---|
| 7:00 – 7:45 am | Complimentary Breakfast Open to all attendees. Providede by the Age Management Medicine Group (AMMG) |
| 8:00 – 9:00 am | An Introduction to Traumatic Brain Injury A 60-minute overview of trauma and non-traumatic brain injuries and the social and medical impact and the need for a paradigm shift in evaluation and treatment. |
| 9:00 – 10:15 am | The Laboratory of Traumatic Brain Injury The assessment of neurotrauma using trophic, neurosteroids, and neuroactive steroids as markers for hormonal deficiencies that are caused by both the primary and secondary injuries associated with neurotrauma (TBI). The literature supported view that the “standard reference” ranges and “normal” reference ranges are not relative to the patient. Interpretation of the lab results using the Median Theory of optimal levels. |
| 10:15 – 10:30 am | Break |
| 10:30 – 11:30 am | Traumatic Brain Injury and Neurobehavior The impact of neurosteroid deficiencies on both personality and mental abilities is clearly discussed in peer-reviewed articles. Those same articles provide support for mood and anxiety disorders developing from loss of the regulatory effects of many of the neurosteroids that are produced in the brain. |
| 11:30 am – 12:00 pm | Neuroinflammation and Oxidative Stress, the Foundation for Treating Traumatic Brain Injury, Part I The major impact of trauma is the production of secondary injury precipitated by free radicals and oxidative stress. The use of specific anti-oxidants and the regeneration of the glutathione system in the brain can help to regain a neuro-permissive environment that can allow for cellular repair and regeneration. |
| 12:00 – 1:30 pm | Lunch Break |
| 12:00 – 1:00 pm | Hormones and the Microbiome – The Estrobolome and How it Influences Estrogen Metabolism Presented by Keri Anania, PA-C Open to all attendees and includes a complimentary lunch Non-CME symposium sponsored by Biocidin |
| 1:30 – 2:30 pm | Neuroinflammation and Oxidative Stress, the Foundation for Treating Traumatic Brain Injury, Part II Continuation of the 5th lecture with specific application and treatment of traumatic brain injury. A number of cases will be discussed. |
| 2:30 – 3:30 pm | Putting it All Together with Case Studies 10 comprehensive cases will be dissected and presented with attendees’ participation as a means of consolidating the information that will be shared throughout the day. |
| 2:30 pm | Exhibits Open |
| 3:30 – 4:10 pm | Break / Visit Exhibits |
| 4:10 – 5:30 pm | Case Studies & Q&A Continuation of the cases with attendee participation and Q&A. The goal of these cases is to allow the audience an opportunity to work out with the lecturer the initial evaluation of the patient, laboratory testing, interpretation of the test results, and selection of an optimal treatment protocol. |
| 5:30 – 7:00 pm | AMMG Welcome Reception Open to all conference attendees, spouses, and guests Held in Conference Networking and Exhibits Center |
Friday, November 5th
General Session Curriculum
Time |
Presentation |
|---|---|
| 7:00 – 7:45 am | Update On Growth Hormone and Secretagogues Presented by Mark Gordon, M.D. Open to all attendees and includes a complimentary breakfast Non-CME symposium sponsored by University Compounding Pharmacy |
| 8:00 – 8:15 am | Opening Remarks |
| 8:15 – 9:15 am | Testosterone and Prostate Cancer: Latest Concepts and Advances Abraham Morgentaler, MD, FACS Associate Professor, Harvard Medical School Staff, Beth Israel Deaconess Medical Center For decades the greatest obstacle preventing wide adoption of testosterone therapy was the fear that it would cause aggressive prostate cancer or cause rapid prostate cancer progression. This lecture will review the origins of this erroneous belief and review the latest evidence, including results of testosterone therapy in men who have undergone prior treatment for prostate cancer with surgery or radiation, and in men on active surveil-lance. The limited data regarding testosterone therapy in men with more advanced disease will be reviewed as well. Guidance will be provided for attendees as to when it may be safe to offer testosterone therapy to men at risk for prostate cancer, or with a history of prostate cancer. |
| 9:15 – 10:00 am | Break / Visit Exhibits |
| 10:00 am – 11:00 pm | Keynote Lecture: Testosterone, Science, and Human Dignity Abraham Morgentaler, M.D. Associate Professor, Harvard Medical School Staff, Beth Israel Deaconess Medical Center In this lecture I will share lessons I have learned over 30 years of research and clinical work using testosterone therapy. Those lessons include understanding why testosterone use was almost non-existent for more than 60 years, why it continues to be mistrusted by mainstream medicine, and how study results showing efficacy and safety are distorted by the media. Most importantly, by sharing several unique cases from my practice I will show how the key to being a great healthcare provider is by optimizing quality of life for individual patients. |
| 11:00 am – 12:00 pm | Controversy: Clinical Use of Estrogen In Men Neal Rouzier, M.D. Director, The Preventive Medicine Clinics of the Desert, Palm Springs, CA Recent studies have demonstrated that elevated estrogen (estradiol) levels in men are associated with an increased risk of heart disease. A plethora of data supports this contention. Unfortunately, these are only observational studies that do not prove that elevated levels of estrogen cause any increase in harm, rather it is only an association and does not prove causation. In order to prove causation, interventional trials must be done in order to establish causation. There are a multitude of studies that prove high estrogen levels are protective and beneficial and certainly not harmful as we have been falsely misled to believe. The purpose of this lecture is to review the most recent literature that proves high levels of estradiol are protective against cardiovascular disease, cancer, and osteoporosis. This is in contrast to current recommendations to keep estrogen levels low in men. Various observational studies will be compared to interventional trials to gain a better understanding of the difference in pow-er between the two and the importance of not relying on just observation to prove causation. Observing that high baseline levels of estrogen are harmful in men and extrapolating that to indicate that raising estradiol levels by giving testosterone is also harmful is entirely incorrect and can lead to harm if estrogen is blocked. So much of the beneficial effect of testosterone is in the conversion (aromatization) into estradiol. Over 70 years of studies where testosterone is prescribed to men, that simultaneously raise estradiol levels, have proven beneficial. Not one study shows harm when estradiol is raised via aromatization of testosterone. The importance of estrogen in men will be reviewed as well as the harm of blocking the aromatization into estradiol. No study has ever demonstrated benefit to lowering estrogen levels. Every study demonstrates harm in blocking estrogen aromatization with aromatase inhibitors. Unfortunately, most physicians remain unaware of this data and continue to prescribe aromatase inhibitors to block estrogen formation. |
| 12:00 – 1:30 pm | Lunch Break / Visit Exhibits |
| 12:00 – 1:15 pm | The Gut-Brain Axis Connection Presented by Trupti Gokani, MD Open to all attendees and includes a complimentary lunch Non-CME symposium sponsored by Microbiome Labs |
| 1:30 – 1:45 pm | Why Undergo Certification in Age Management Medicine Derrick DeSilva, Jr., M.D. Teaching Faculty, JFK Medical Center, Edison, NJ Co-Chair, Department of Complimentary Medicine and Senior Attending Staff, Raritan Bay Medical Center, Perth Amboy, NJ |
| 1:45 – 2:30pm | Gender Bias in Medicine: Lazy Science and Bad Medicine Benjamin Gonzalez, M.D. Medical Director, Atlantis Medical Wellness Center, Silver Spring, MD This is a powerful discussion of how our current medical system ignores women. The system believes women are done with life at the age of 52. There is a built-in gender-bias that has shaped the health care system and educated generations of physicians. You will learn how for generations women were kept out of medical studies, how men were used in primary studies for uterine cancer, how women were left out of long-term studies on aging, and how the medical system chooses bandaids over prevention in the management of aging women. This discussion will teach you how to recognize gender bias in medicine and begin to be the solution for decreasing the rate of the top 5 killers of women. You will learn how to transition from this built-in gender bias in the post graduate medical education system to evidence-based, gender-focused care of your female patient. |
| 2:30 – 3:15 pm | Surgical and Post Surgical Implications for Transgender Patients Jonathan Keith, M.D., FACS East Coast Advanced Plastic Surgery Clinical Associate Professor, Rutgers New Jersey Medical School Population studies suggest that 0.5 to 1% of the population identifies as transgender or gender non-conforming. As availability and insurance coverage of surgical procedures to treat gender dysphoria expands, it is important for medical professionals to understand the surgical indications, procedures and consequences of gender affirming surgery. This lecture will introduce important concepts in modern gender affirming surgery. Perioperative considerations for top surgery (chest) and bottom surgery (genital) for male to female, female to male and gender non-conforming/non-binary patients will be discussed. Indications, complications and outcomes for specific procedures such as facial feminization, chondrolaryngoplasty (tracheal shave), chest masculinization, breast augmentation, phalloplasty, metoidioplasty and robotic vaginoplasty will be described. Physicians and clinicians will gain invaluable insight into the perioperative care of the transgender patient and their role in the multidisciplinary approach to modern gender affirmation. |
| 3:15 – 4:00 pm | Break / Visit Exhibits |
| 4:00 – 4:45 pm | Gender Affirming Hormone Therapy for the Aging Transgender and Gender Nonbinary Patient Dana Delgado, FNP Primary Care Medical Provider, CAN Community Health, Essex, NJ Gender affirming hormone therapy helps transgender and gender nonbinary individuals feel congruent, and reduces the intensity of gender dysphoria. The lack of trained providers to address the specialized medical needs of this community, including the need for medically necessary gender-affirming hormone therapy, maintains the health disparities that affect this population. To close this gap, attendees will receive an overview of gender-affirming hormone therapy (GAHT) and will learn common dosing regimens based on the present clinical guidelines. The benefits and risks associated with providing GAHT, as well as aging-related considerations, will be discussed. |
| 4:45 – 5:30 pm | Treatment and Management of the Transgender Patient. Case Presentation of a Clinician’s Approach Cesar Pellerano, M.D., P.A. Member, AMMG Planning Committee The transgender patient is becoming more prevalent in our society. Yet few if any of us, have had any formal training in the management of these patients. These individuals often seek help from physicians that do not feel competent or comfortable in their management. As a result, these patients often are left to fend for themselves. In this case presentation I will show how with no training in transgender medicine but with confidence in my age management skills and excellent communication with the patient, I was able to successfully manage and help a transgender woman. I hope that this lecture will inspire the audience to do the same when given the opportunity. |
| 5:30 – 7:00 pm | AMMG Reception for Members & Faculty Open to all AMMG Members and Conference Faculty. Held in Lalique Ballroom. New Members who sign up onsite are welcome to attend. |
Saturday, November 6th
General Session Curriculum
Time |
Presentation |
|---|---|
| 7:30 – 8:15 am | Complimentary Breakfast Provided by the Age Management Medicine Group (AMMG) Open to all attendees. |
| 8:00 – 9:00 am | Evidence Based Use of Hyperbaric Oxygen Therapy (HBOT) to Increase Stem Cells, Balance Hormones and Reduce Inflammation Jason Sonners, D.C., Ph.D., DCBCN, DIBAK, CHP Board Member, International Hyperbaric Association Faculty, Medical Academy of Pediatric Special Needs (MAPS) & International Board of Undersea Medicine Owner & Clinic Director, Core Therapies Family Wellness Center, New Jersey HBOT, Hyperbaric & Function Medicine Clinic, HBOT USA In the United States hyperbaric oxygen therapies (HBOT) have been used very effectively for a short list of severe conditions ranging from osteomyelitis, osteonecrosis, gangrene, non-healing wounds, diabetic neuropathy, crush injuries & radiation burns. This therapy is relatively noninvasive, safe and effective for improving patient’s recovery and healing times from these acute and severe conditions. Chronic inflammatory illnesses on the other hand, which affect 6/10 Americans and are the driving force behind the $3.8 trillion health care costs in the US, destroy our quality of life and reduce our ability to be contributing members of society. Some of these conditions include autoimmunity, neurodegenerative, musculoskeletal degenerative, cancer and many others. Initial studies on hyperbaric therapy point to specific mechanisms of action at work when used for 14 traditional insurance based hyperbaric indications. There is evidence which suggests that the mechanisms for these “on label” acute and severe cases would be similar or even identical to the mechanisms required by most chronic illnesses to also improve their outcomes and recovery times. Hyperbaric can be delivered a number of ways, from mild pressure to high pressure and lower oxygen levels to higher oxygen levels. The exact amount of pressure, oxygen and frequency of dives required for improvement is not known for the majority of hyperbaric indications. Current hyperbaric research also shows that intermittent and relative hyperoxia-hypoxia is a strong stimulator of many cell signaling and epigenetic signaling cascades used for the promotion of healing and adaptation to an accelerated regenerative response. Hyperbaric has the ability to help rebalance hormones, improve healing times, stimulate stem release and is finally finding its place within the field of regenerative medicine. |
| 9:00 – 10:00 am | How Prescription Medication Accelerates Aging Derrick M. DeSilva, Jr., M.D. Teaching Faculty, JFK Medical Center, Edison, NJ Co-Chair, Department of Complimentary Medicine and Senior Attending Staff, Raritan Bay Medical Center, Perth Amboy, NJ Over 60% of the US population over the age of 50 is on at least one prescription medication. A significant number of children are also on various medications, from asthma drugs to digestive aids. There is no question that prescription medications play a definite role in health but at what “cost”. As a result of the nutrient depletion from the prescription medication various disease states may be accelerated. For example, the depletion of magnesium from proton pump inhibitors (PPI) could predispose individuals to cardiac arrhythmias and then cause an entire cascade for the use of other drugs that many deplete more nutrients and potentially accelerate the aging process. Being aware of these depletions and correcting the depletions ahead of time plays a critical role not only to the predisposition of other disease but also improving the quality of life for our patients. During the presentation we will discuss the role of prescription medications, along with helping resolve some of the “confusion” about the key role that supplements play in our health. |
| 10:00 – 10:30 am | Break / Visit Exhibits |
| 10:30 – 11:15 am | Low Dose Naltrexone William Clearfield, D.O., FAAMA, DABMA, FAARFM Medical Director, Clearfield Family Medicine, Reno, NV Executive Director, American Osteopathic Society of Rheumatic Diseases Naltrexone, an FDA-approved drug indicated for relief of addiction to opiate drugs, such as heroin or morphine, inhibits inflammatory pathways that involve Toll-Like Receptors. In 1985, spurred by the AIDS crisis, and with little else to treat the horrendous infections developing in their patients, several enterprising physicians surmised that naltrexone’s anti-inflammatory properties could be harnessed at a more local level diluting its potency, thereby shortening its duration of action. The result? A powerful new anti-inflammatory agent was born. Diluted at first to 10%, then eventually as low as 2% of its original potency, “low dose” naltrexone proved to be a boon to chronic fatigue, multiple sclerosis, CFS/ME, autoimmune thyroid diseases, and various cancers. Seasoned clinicians might be skeptical about how a single entity could exact benefit from such a wide range of pathologies. Still, a careful study of LDN’s properties reveal it is effective against dozens of inflammatory intermediaries such as interleukin (IL)-1β, IL-1Ra, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12p40, IL-12p70, IL-15, IL-17A, IL-27, interferon (IFN)-α, transforming growth factor (TGF)-α, TGF-β, tumor necrosis factor (TNF)-α, and granulocyte-colony stimulating factor (G-CSF). This lecture will explore the history, indications, mechanism of action, dose schedules, side effects, and evidence-based studies using low-dose naltrexone. The audience participant will have a firm grasp of the appropriate uses of low-dose naltrexone and its contraindications and idiosyncrasies. We will briefly touch on ultra-low-dose naltrexone for use in specialty situations. Lastly, we will explore a case study to highlight LDN’s usefulness as a therapeutic modality. |
| 11:15 am – 12:00 pm | Envisioning Self-Care as a Gateway to Authentic Health for Us Doctors and Our Patients Beatriz Olson, M.D., FACP Private Practice, Integrative Endocrinology and Healthy Aging Past Clinical Faculty, Yale University The experiential course will create awareness, inspiration, and education for participants to develop or evolve structures for lasting personal change that creates authentic and sustainable health.The 45 minute session will be a new and different professional and personal experience for AMMG participants. The focus is about our own self care as AMMG health practitioners who aim to enhance health span in the lifespan of others. Dr. Olson will lead a discussion on what is authentic health and invite you to reflect upon and live in the questions. This self inquiry experience will create calm awareness and expand the sense of wholeness you can own and bring to patients / clients. |
| 12:00 – 1:30 pm | Lunch Break / Visit Exhibits |
| 12:00 – 1:00 pm | Evidence Based Clinical Uses of Full Spectrum Hemp Oil Presented by the Derrick DeSilva, Jr., M.D. Open to all attendees and includes a complimentary lunch. Non-CME symposium sponsored by Med 7 |
| 1:30 – 2:15 pm | Sarcopenia Jeff Life, M.D., Ph.D. Founder, CEO, CMO, The Life Center for Healthy Aging, South Charleston, WV Sarcopenia, the age-related loss of skeletal muscle mass and function, is believed to be a normal and inevitable consequence of aging. Evans and Rosenberg, in their book Biomarkers published in 1992, consider it to be the most important variable determining the quality of an individual’s life. They list muscle mass and strength as the top two biomarkers of the aging process. Loss of muscle mass and strength are major factors in the placement of individuals in a nursing home. This talk describes the many causes of sarcopenia along with its progression and consequences as people age. The devastating impact of sarcopenia on our current and future healthcare system is also discussed. |
| 2:15 – 3:00 pm | Brain Health for Patients Over 50 Elliot Dinetz, M.D., ABFM, ABAARM Timeless Health, Miami, FL With Alzheimers being the 6th leading cause of death and cognitive decline affecting 1 in 9 people over age 45, brain health is rapidly becoming a leading health concern as we strive to live healthier and longer. While current medical guidelines offer little hope in terms of treatment, newer evidence points towards different sources of inflammation at its root cause. In targeting such, this may help both halt and even reverse cognitive impairment. We will explore the literature and fascinating clinical cases involving hormone balance, genetic risk factors that can be suppressed, and how nutrients & nutraceuticals may form a comprehensive approach to helping provide better answers for those who are at risk or struggling today. |
| 3:00 – 3:45 pm | Break / Visit Exhibits (exhibits close 3:45 pm) |
| 3:45 pm – 4:45 pm | Insulin Resistance: We Need To Do Better Benjamin S. Gonzalez, M.D. Medical Director, Atlantis Medical Wellness Center, Silver Spring, MD A detailed look at how at how Heart Disease, Dementia, High Blood Pressure, Obesity, Pediatric Type II Diabetes, Sarcopenia, Arthritis, Fatty Liver, Stroke, Erectile Dysfunction, and many other disease processes have one thing in common: Insulin Resistance (IR). Dr. Gonzalez discusses how IR is a true disruptor of the endocrine system and how IR is the primary contributor to major disease processes. You will learn how to recognize IR early and what tools to use in the prevention of the top 5 Killer-Diseases in the U.S. You will leave with a better understanding of why you, as a medical provider, should be focusing on the early recognition and management of Insulin Resistance in treating all disease processes. |
| 4:45 pm – 5:30 pm | Enteroimmunology & Endocrinology: How Dysbiotic Gut Inflammation Leads to Hormone Imbalances, and How Reversing Them is the Key to Resolving Chronic Illness Dushyant Viswanathan, MD, ABIM, ABoIM, AACE Chief Medical Officer, The Columbia Center for Integrative Medicine (CCIM) Gut dysbiosis is associated with inducing a chronic inflammatory state that affects every organ and is implicated in the pathogenesis of multiple chronic conditions in the scope of internal medicine. Here we articulate relevance, diagnostic/therapeutic concerns of translational mucosal immunology (“Enteroimmunology”) and articulate the impact on measured cortisone secretion patterns as demonstrated by 24 hour salivary cortisol test-ing. Inflammatory cytokines stimulate cortisol secretion, and over time, an endocrinopathy develops: dysfunctional diurnal cortisol secretion, depletion of beneficial hormones such as testosterone, DHEA, progesterone, pregnenlone, thyroid hormone, and sometimes estrogens (although elevations of estrogens due to impaired excretion is more common) occur. These physiologic events are implicit in the process of aging. We will de-scribe treatment approach and cases featuring gut microbiome repair and restitution of optimal hormone levels as essential to lessening physiologic/cellular aging and inflammation. We will review case studies including treatment of Crohns inducing remission, reversal of autoimmune inflammation, and reversal of prostate dis-ease. |
Sunday, November 7th
General Session Curriculum
Time |
Presentation |
|---|---|
| 7:30 – 8:15 am | Complimentary Breakfast Provided by the Age Management Medicine Group (AMMG) Open to all attendees. |
| 8:00 – 9:00 am | Continuous Glucose Monitoring (CCGM) in Precision Medicine: Leveraging Real-Time Data to Detect and Reverse Metabolic Abnormalities Florence Comite, M.D. Comite MD, New York City, NY Precision Medicine is bolstered by longitudinal ‘N-of-1′ data that enables the optimization of an individual’s health trajectory. While CGMs were initially intended for diabetes management following a diagnosis, they can be further utilized to detect and predict early signs of disease decades prior to emerging symptoms. The lecture will illustrate the various insights garnered from CGM analysis. We have harnessed these insights to extend our patients’ healthspans to match their lifespans today and into the future. |
| 9:00 – 10:00 am | Aerobic Performance & Body Composition in Precision Medicine Christopher Arboleda, MS, ACSM-CEP, NSCA-CSCS Manager Clinical Operations, Performance Lab Manager & Clinical Exercise Physiologist, ComiteMD, New York, NY Periodic surveillance of aerobic performance and body composition enable age management teams to track and assess intervention efficacy to lengthen the healthspan. The importance of maintaining op-timal cardiovascular fitness, muscle mass, and fat mass with age cannot be overstated. This presenta-tion highlights the role of these tests in Precision Medicine by examining patient data compiled into 12 sex-age groups. We conclude by summarizing the recommendations utilized to continually improve test scores. Audience members will learn how to introduce these techniques into their clinical practic-es, gaining valuable insights that can increase patient longevity and quality of life. |
| 10:00 – 10:15 am | BREAK |
| 10:15 – 11:15 am | The Role of Therapeutic Plasma Exchange (TPE) in the Prevention and Treatment of Age-Related Conditions Dobri Kiprov, M.D. Founder and President, Global Apheresis, Inc. Member, Board of Directors, International Society For Apheresis (ISFA) Abstract TBD |
| 11:15 am – 12:00 pm | Clinical Application of N-of-1 Precision Medicine Ashley Madsen, PA-C Comite Center for Precision Medicine & Health Precision medicine enables clinicians to predict and detect disease in early stages, thereby preventing disorders of aging. In this presentation, we will discuss the case of a 50-year-old Caucasian male presenting with occasional gastrointestinal discomfort and low energy. Using Advanced Precision Diagnostics, we uncovered various, previously undetected conditions and modifiable risk factors. Additional patient snapshots will emphasize how N-of-1 techniques can be harnessed to treat and reverse disease decades before symptoms emerge. Audience members will learn the benefits of precision medicine, an approach that has never been more important given the current health landscape and cost of healthcare. |
| 12:00 – 12:45 pm | Hair Regrowth Without Surgery William Clearfield, D.O., FAAMA, DABMA, FAARFM Medical Director, Clearfield Family Medicine, Reno, NV Executive Director, American Osteopathic Society of Rheumatic Diseases By age 60, 65% of men and 80% of women, 56 million in the US alone, experience noticeable hair loss. Conventional wisdom dictates that the vast majority of hair loss is due to genetics. Nevertheless, as we have seen with so many other accepted scientific myths (does testosterone cause prostate cancer ring a bell?), what is accepted science many times just is not so. We begin with what is “normal,” the natural lifecycle of a single hair. From there, we extrapolate root causes of the three types of hair loss. 1. Androgenic alopecia, by far the most common, is typically thought of as “male pattern bald-ness.” 2. Alopecia areata is the loss of hair in discrete circular to oval areas in the scalp. 3. Telogen effluvium patients lose their mane from the metabolic components, thyroid disease, hormonal imbalances, other androgens, infections, immune-compromised hosts, stress, medications, or crash dieting. We review the patterns, including how to recognize them. We then propose treatment solutions for each hair type. We reveal what to do with the 30% “mixed” types. These are hair loss types that over-lap patterns. Lastly, we review diet and lifestyle changes we can enact to improve our chances of re-growing hair. |
| 12:45 – 1:30 pm | The Biopsychosocial Model: Treating an Aging Population with Touch Jodi Scholes Certified Massage Therapist In 1977 Dr. George Engel wrote an article entitled, The Need for a New Medical Model: A Challenge for Biomedicine. In this article, he introduced the concept of the Biopsychosocial model. Dr. Engel was concerned about the alarming amount of treatment plans that excluded patient feedback, focused only on data points and lab results. Questions about mental stress or social pressures (family expectations, work deadlines) that could be affecting the patient seemed to be irrelevant. The results of such a singular focus? Treating just one aspect of a disease. Dr. Engel, who enjoyed appointments in the Dept. of Psychiatry and the Dept. of Medicine at the University of Rochester Medical Center, advocated for a more integrated approach: Examine the biology, but also consider the psychology and the social pressures of the patient. Dr. Engel called this the Biopsychosocial Model. It’s standard operating procedure to examine the biology. However, we also have the opportunity to ask questions about the mental state of the patient. Questions like, “Is there any unusual stress in your life?” Here’s the key: then we listen. During the pandemic many dentists caught on to this. Cracked molars indicate new and higher tension levels than normal. Tempromandibular Joint Pain can be a sign of stress related jaw clinching. Yes, a night guard is a good start. But what else is going on? Dr. Abraham Verghese in his TED talk says, “It may be heresy to say this at TED, but I’d like to introduce you to the most important innovation to come in the next 10 years and that is the power of the human hand, to touch, to comfort, to diagnosis and to bring about treatment.” Touch. Let me ask, do you have physical contact with your patients? In treating patients, how can we incorporate Dr. Engel and Dr. Verghese’s point of view? Using a more integrated approach, diagnosing the physical symptoms and being aware of the psychological and behavioral stressors that could be contributing to the con-dition. A client dealing with increased mental stress may respond well to more intentional directives to relax. Using a hot tub, attending a beginner meditation class, experiencing an all levels yoga class or even recommending a walk in nature…one study tells us. |