Browsed by
Category: Preventative Healthcare

The Key to More Independence in Your Senior Years? Start Walking Now!

The Key to More Independence in Your Senior Years? Start Walking Now!

Will you be able to maintain your independence as you reach your golden years? Recent research indicates that the answer to that question may actually depend on how you answer another question: “Can you comfortably walk a quarter of a mile?”

If your answer is “No” you’re not alone. 24 million older Americans have trouble walking that far, and 13 million more can’t walk a quarter-mile at all. According to a new article published in the Journal of the American Medical Association (JAMA), this puts these people at a huge risk of becoming disabled and losing their independence.

In recent years, inactivity (leading a sedentary lifestyle) has been found to be a major risk factor for serious conditions like cancer, heart disease, diabetes, and stroke. In fact, the U.S. Centers for Disease Control and Prevention released a report suggesting that inactivity is now killing more people every year than smoking. Inactivity is an even larger problem for older people because without exercise they begin to lose muscle mass and their sense of balance deteriorates more quickly. This puts them at increased risk of injury from falls—the leading injury-related cause of death among seniors.

In the JAMA study, researchers in eight states worked with people in their 70s and 80s who reported that they had developed a sedentary, inactive lifestyle. At the beginning of the study, these people were (on average) active less than 20 minutes a week. As a result, they were considered at high risk of becoming disabled due to lack of strength in their legs.

The study participants met twice a week to perform simple exercises to strengthen their legs and walk in a group, and were also asked to walk more at home. The goal for all participants was to engage in 150 minutes of activity each week and to become fit enough to walk a quarter of a mile without any outside assistance (other than using a cane). Interestingly, the quarter-mile distance wasn’t chosen by researchers at random. Rather, this distance is significant because city planners use it as a “livability” reference point. A city is considered “livable” if all the goods and services you need for day-to-day life are attainable within a quarter-mile of the closest public transportation stop. This means that if you can’t easily walk a quarter-mile, you may have effectively lost your ability to lead an independent life.

At the end of the 2.6-year JAMA study, all participants were able to comfortably walk that distance, and all felt that their general health and mobility had improved. Even more important, a significantly smaller percentage of them had become temporarily or permanently disabled, compared to people of the same age who had maintained a sedentary lifestyle.

The clear message from this study is that you can (quite literally) take steps TODAY to improve your own odds of staying healthy, happy, and independent in the future. Developing a new walking habit is a great way to ensure that you’re getting enough exercise while maintaining your mobility. Plus, it doesn’t cost anything and it doesn’t require any equipment more elaborate than a comfortable pair of shoes. And—maybe best of all—walking is an activity that you can do either socially as part of a group or on your own. Many local communities around the country even have seniors clubs that organize walks on a regular basis.

The key to aging well is to stay healthy, stay active and stay engaged. Building good habits now can make all the difference years from now. If you’d like to learn more about how you can keep your musculoskeletal system in good working order, just call or visit our office at Oblander Chiropractic today! Our phone number is 406-652-3553.

Taking Responsibility for Your Health

Taking Responsibility for Your Health

We had to share a great blog post today from elsewhere on the web! We hope you will read and enjoy!

No one else is responsible for your health and your body, except for you.  No-one knows your body like you do.

You simply cannot delegate your health to anyone else and still expect to stay vibrantly well and healthy.

If you don’t take personal responsibility for creating your health, here is a very frightening, but real possibility… the results you get in your health are going to make someone else happy, but not you!

Food companies want you to become addicted to their highly refined, highly processed fake foods.  Diet companies want you to eat their diet foods. Big pharma wants you to be on prescription drugs.

These profit-driven companies are very happy to take your money but they will not take responsibility for the quality of health that you experience. If you hand over your health to them, in the hope that their illusory advertising promises are real, you may be faced with the possibility of living out a life filled with disease, food addiction, frustration, stress, anxiety, and unhappiness…

Taking responsibility for your health gives you food freedom.

You can create an incredible sense of ‘freedom around your food’, when you begin to look at your diet and your health.  When I awoke to the concept of taking responsibility for the food I ate and the thoughts I had, I started making vastly different choices for myself. I started reading food labels and studying them. I started getting proactive; asking different questions, shopping differently and eating differently.

Here are three things you can do today to begin taking responsibility for your creating your health.

1. Create an enjoyable and sustainable relationship with food.

When I began to heal my body, I knew I was going to make some changes to the way I ate, along with the way that I treated myself.   I spent time dedicated to finding a way of eating that would be sustainable for me, based on my goals, food preferences, and lifestyle.

I asked myself the question, “Can I see myself eating like this tomorrow, next week and even next year?” When I found a style of eating that worked for me, I kept it and continued to refine it as my health journey progressed.  With a few minor adjustments along the way, it is still the way I eat today – almost 12 years later!

Take care to eat foods that are as close to their natural state as you can, (with minimum intervention by man or machines and no ikky added chemicals).  Primarily I ate a plant-based diet, high in whole grains, vegetables and fruits diet that were local, seasonal and organic where possible.

Along with eating sustainably, another thing that worked for me was moving away from the idea of deprivation. Since I loved food, I knew that I needed to change my focus from the rhetoric of dieting dogma and the idea of total elimination to something far bigger and more exciting.

2. Integrate my little-known but powerful ’80-20 Rule’.

While I was searching for a way to eat that allowed me to enjoy my food and still be healthy I stumbled upon the concept of ‘the 80:20 Rule’ and I decided to apply it to what I was learning about food.

Simply put, I began to eat about 80% real, natural foods and 20% lightly processed foods. This allowed me the flexibility to enjoy healthier versions of all of my favorite foods. I loved eating nutritious food that was good for me, tasted delicious and fulfilled and satiated me.

Today I wouldn’t want to eat or live any other way!

3. Take responsibility for detoxifying your body gently.

Another key distinction was that I started paying attention to the quality of food.  I started to notice that some food was more processed and higher in toxicity than others.  I began to favor food that was less processed and therefore had fewer toxins in it. As I reduced the toxic load I was ingesting, it allowed my body to begin its’ own natural process of detoxification and self-healing.  As I began the process of gentle detoxification, my energy levels surged and to my delight, my waistline began to reduce…

Over time, I stopped eating all fake foods. This included processed and manufactured foods such as fast-foods, artificial flavorings, colorings, preservatives, additives, processed and refined white flour, white sugar, high corn fructose syrup (HFCS) or glucose-fructose syrup and all dangerous trans-fats.

You don’t have to make radical changes overnight (in fact I recommend that you don’t!).  Instead, take your time to explore and find healthier substitutes for your favorite “fake foods.”  Make your changes slowly but surely.  Take baby steps to begin cleaning up your diet.

How to get started.

You do not have to be a medical doctor or a dietician to know how to get healthy or to take positive steps in the direction of taking responsibility for your wellbeing.

There are so many easy things, that anyone can do, that can radically transform your life, just like it did mine.  Remember that claiming back your health is journey. Just take one more step, and then another. Make the choice to take responsibility to find what foods work for your body and enjoy the process of carving out your personal path to vibrant health and wellbeing.

I did it, and I know that you can too.

Today’s post was written by Katrina Love Senn and has been shared from the following website: http://www.katrinalovesenn.com/index.php/articles/natural-health/82-who-is-responsible-for-your-health

4 Best Exercises for Improved Posture

4 Best Exercises for Improved Posture

Let’s face it. Good posture isn’t exactly a high priority for many Americans. Like most things related to our health and wellness, we don’t notice it until it’s gone. 

Most of us live in a sitting culture—we sit at work, we sit at school, and we sit at home. The hard truth is that most of us sit too much and sit incorrectly. Beyond this, our love affair with mobile devices is amplifying the post problem by encouraging us to bend over, hunch our shoulders and crane our necks to look at small screens. Given our lifestyle choices, poor posture may seem almost inevitable. But it doesn’t have to be that way. For anyone with a bit of mobility, motivation and time, there are exercises you can do to improve poor posture. Here are four of the best types of exercises to help you improve your posture. 

Exercises to Strengthen Your Core

A strong core is essential for good posture. Your core includes your abdominals, lower back, obliques, and hips. Strong core muscles don’t just give you an attractive “six-pack” to show off at the beach. In fact, they help hold your body up straight, improve your balance, and provide you with greater muscle control and efficiency. They’re also critical to maintaining back health and provide some measure of protection against injury. When your core muscles aren’t strong, other muscles have to compensate, which results in reduced mobility as well as weakness and even pain. So, to help avoid or reduce low back pain, try regular core training. Some core training exercises include basic crunches (but not full sit-ups), side planks, crunches with a twist, standing side bends, and plank holds. Doing Pilates is another great way to work out your core muscles, as are back extensions and slow swimming. 

Exercises to Correct Your Rounded Shoulders

Because so many people spend their day hunched over while driving, sitting at a desk while working, using a laptop, or even watching television, rounded shoulders are extremely common—but they are in fact a postural abnormality. When you spend a lot of time in these forward-reaching positions, the muscles in your chest, shoulders, and hips become shortened and tight, and at the same time, your upper and middle back muscles lose strength. In order to help avoid and ease rounded shoulders, you can do exercises that strengthen the weak upper back muscles and stretch the tight muscles in the chest, shoulders, lats, and hips. As the upper back becomes stronger and the chest becomes more flexible, the shoulders naturally pull back, which improves your posture significantly. You can strengthen the upper back with exercises such as reverse dumbbell flys as well as rows with a resistance band, while you can stretch your tight muscles by doing standing chest stretches, torso stretches, and standing quad stretches. 

Exercises to Neutralize Your Tilted Hips

Hips should be neutral and level when viewed from the side—however, some people have postural abnormalities stemming from their hips’ tendency to slant forward. This is called the anterior pelvic tilt, and it negatively affects posture. Lordosis (also known as “swayback”) is a common indication of this tilt. Seen very often in people who sit for hours every day with their legs bent, this abnormality is caused by weakness in the hamstrings, glutes, and abs as well as tightness in the hip flexors and thighs. Exercises to correct this tilt include the core exercises mentioned above as well as bridges, leg curls with a ball, and single leg hamstring flexions with a ball. Exercises that stretch tight hip and quad muscles include standing quad stretches and kneeling quad and hip stretches. 

Exercises to Retract a Forward Head

Unfortunately, you can easily develop poor posture by tilting your head forward for hours every day. This happens when you drive, when you use a laptop or tablet, or when you watch television. When you fail to retract your head while performing everyday tasks, this tightens the front and side neck muscles and weakens the deep and rear muscles of the neck. The muscles at the front of your neck have to be strong enough to hold your head directly above—not forward of—the shoulders. Not only does this abnormality contribute to poor posture, but it also causes chronic neck pain. In order to retract a forward head, elongate the back of your neck by gently pulling your chin straight in. The highest point of your body should be the top back of your head. This works against the penchant to slip into a forward head posture. You can also work on this issue while driving: practice pulling your chin in and pushing your head into the headrest behind you for a few seconds at a time, then releasing. If you have a high-backed chair that you sit in at work, you can do this at your desk as well.  

Chiropractic Patients Less Likely to Suffer Drug Reactions

Chiropractic Patients Less Likely to Suffer Drug Reactions

 

Most people experience back pain, and many of these patients use drugs for pain relief. A 2014 study1 found that of older adults with chronic back pain, 72% of them were using some kind of analgesic to help cope with the pain. Another study2 found that 32% of back pain patients in their analysis were using prescribed opiates for relief.

It’s unfortunate that so many patients depend on drugs for musculoskeletal aches and pains, especially when chiropractic is an effective and safe way to not only relieve pain, but also prevent future pain episodes.

Now a new study3 shows that chiropractic also is linked to a lower risk of adverse drug reactions in patients with back pain. In this study, the authors looked at the medical records of over 19,000 adults in New Hampshire who had at least two doctor visits for back pain. 9.810 of these patients used chiropractic care; 9,343 patients used regular medical care. The researchers analyzed the number of adverse drug effects (ADEs) experienced by the two groups.

The authors found:

  • Younger patients were more likely to use chiropractic care.
  • Non-chiropractic patients tended to have more health problems, in general, when compared to those who used chiropractic.
  • Chiropractic patients experienced 51% fewer adverse drug reactions (.4% vs .9%) compared to medical patients.
  • 15 non-chiropractic patients were diagnosed with drug withdrawal, while zero chiropractic patients had drug withdrawal.

This study had some limitations, as the study data didn’t included details about the types of drugs the patients were using or how frequently they were using medications. But the authors conclude that the “utilization of chiropractic care may be associated with reduced risk of ADEs; however, no causal relationship has been established.”

Another study by the same group of researchers found that chiropractic patients were 55% less likely to be prescribed opiates for their pain and had lower health care bills.

With the opiate epidemic in the US, it’s critical that we find non-opiate approaches to back pain treatment. Chiropractic is about restoring health without the use of drugs. By helping the body heal naturally, chiropractic can help you stay well and help you avoid unnecessary adverse drug reactions, too!

  1. Enthoven WT, Scheele J, Bierma-Zeinstra SM, Bueving HJ, Bohnen AM, Peul WC, van Tulder MW, Berger MY, Koes BW, Luijsterburg PA. Analgesic use in older adults with back pain: the BACE study. Pain Medicine 2014 Oct;15(10):1704-14. Doi: 10.1111/pme.12515.
  2. Ashworth J, Green DJ, Dunn KM, Jordan KP. Opioid use among low back pain patients in primary care: Is opioid prescription associated with disability at 6-month follow-up? Pain. 2013 Jul;154(7):1038-44. doi: 10.1016/j.pain.2013.03.011.
  3. Whedon JM, Toler AWJ, Goehl JM, Kazal LA. Association Between Utilization of Chiropractic Services for Treatment of Low Back Pain and Risk of Adverse Drug Events. Journal of Manipulative & Physiological Therapeutics 2018 May 26. pii: S0161-4754(17)30136-7. doi: 10.1016/j.jmpt.2018.01.004.
Are You Sedentary?

Are You Sedentary?

Did you know that you need to walk at least 7000 steps a day? If you walk less than 7000 steps a day, you are considered sedentary! Today, we are sharing a video from www.primalplay.com. It helps to quickly show the results of living a sedentary lifestyle. Primal Play is a great website to check out if you want to incorporate more movement into your day in a fun and easy way! Have a wonderful “Moving” day!

Chiropractic Patients Recover Faster, Spend Less Money

Chiropractic Patients Recover Faster, Spend Less Money

Back pain is an expensive health problem for both patients and businesses. A 2012 study reported that we spend about $635 billion on pain every year, with a significant amount of that spent on back pain. Over the years, quite a few studies have shown that chiropractic care is more effective for back pain than medical care, plus chiropractic patients spend less money on their care than medical patients do.

Because back pain is such a common problem, a group of Canadian researchers recently investigated the role that the type of primary caregiver has on financial compensation.

This was a large study of 5,511 patients who experienced a work-related back injury in Ontario, Canada. The patients saw the following providers for their first visit:

  • 85.3% saw a medical doctor
  • 11.4% saw a chiropractor
  • 3.2% saw a physical therapist

The authors set out to “compare the duration of financial compensation for back pain” among patients from each care group.

The study found that chiropractic patients had the shortest amount of time receiving compensation for their pain and also were less likely to have a recurrence.

In addition, chiropractic patients didn’t need to see other healthcare providers for their pain. 75% of chiropractic patients saw no other provider, while 58.6% of physical therapy patients also saw a medical doctor.

The authors conclude:

“The type of healthcare provider first visited for back pain is a determinant of the duration of financial compensation during the first 5 months. Chiropractic patients experience the shortest duration of compensation, and physiotherapy patients experience the longest.”

Blanchette M, Rivard M, Dionne CE, et al. Association between the type of first healthcare provider and the duration of financial compensation for occupational back pain. Journal of Occupational Rehabilitation 2016 Sep 17.

Today’s article was written by Michael Melton and is shared from the following website: https://www.chironexus.net/2016/09/chiropractic-patients-recover-faster-spend-less-money/

The Human Longevity Project – Such Good Information and So Much Beneficial Information!

The Human Longevity Project – Such Good Information and So Much Beneficial Information!

This is not a short video but it has such important information! We hope all of you will take the time out of your busy lives to watch it! We will continue to share this series of videos as it is released. The information shared here is vitally important to understand for positive physical and mental health!

Does Having Young Children Really Build Your Immune System?

Does Having Young Children Really Build Your Immune System?

Maybe it’s just wishful thinking, but many moms and dads believe that having a young child or two around the house boosts their immune system.  It’s easy to see why this idea has some popular appeal.  After all, young children typically have lots of contact with other young children, often in environments where lots of germs can be spread. They then bring these same germs home, where parents’ immune systems need to fight them off over a sustained period of time. The thinking goes that this, in turn, helps make parents more resistant to them.

But what does the science actually say about this? Although there is at least one strong study and a lot of related or anecdotal evidence that suggests that the idea may be sound, more research needs to be done to see if this theory is valid.

The “strong study” is from Norway, and was published in the journal Science & Medicine. It’s important to note that the study did not specifically evaluate the immune response of parents and non-parents. Rather, this particular research was aimed at understanding the relationship between parenthood and overall health. The investigators looked into detailed medical records of more than 1.5 million men and women born between 1935 and 1968, and found that there was a strong negative correlation between being a parent and the risk of developing cancer, heart disease, becoming an alcoholic, and even dying in a car crash. The study found that the people most at risk of dying from any of these causes were those who were childless. The researchers theorized that this may be because the individuals felt less of a need to take care of their health.

Fascinatingly, the study also found that the positive health benefits or parenthood seemed to depend on the numberof children. Having only one child or having more than three children actually slightly increased the risk of dying from any of these factors, whereas having two children was “just right.” As researcher Emily Grundy of the London School of Hygiene & Tropical Medicine, says: “Four-plus children might have adverse effects arising from stress, socio-economic disadvantages and lifestyles, off-setting, or even outweighing, social benefits of parenthood.”

In terms of other evidence, the strongest suggestions that having children might strengthen their parent’s immune system come from related studies that have consistently shown that having pets in the home strengthens and builds the children’s immune systems and helps to keep them healthy. For example, a 2012 study from the journal Pediatricsshowed that children who lived with dogs and cats during the first year of life tended to be significantly healthier than those who did not. The researchers theorized that the pets exposed children to a wide variety of “good germs,” some of which are beneficial for developing immunity to the “bad germs.” We may be able to infer that parents might also benefit from being exposed to a variety of germs, both from the pets and from their own children, as children pick them up at school and bring them home.

There is certainly anecdotal evidence of the latter to be found in the “common wisdom” imparted to people becoming new kindergarten and elementary school teachers. When one woman started teaching in California, her school board warned her that she should probably plan her finances for the first year of teaching based on being out sick more than her allotted number of “sick days,” and thus not being paid for them. The woman, who had always been remarkably healthy, laughed at this advice, but then spent 25% of her first year at home sick, because of all the germs she picked up from kids in the classroom.

However, this same schoolteacher rarely ever got sick again. Her exposure to a wide variety of germs transmitted by the kids did seem to boost her immune system over time, and enhanced her ability to be exposed to them in the future without getting sick herself. We can possibly infer that the same thing happens with small children in the home—they pick up germs at school and bring them home where the parents are exposed to them. This exposure then buildsimmunity over time rather than diminishing it. Dr. Jordan S. Orange, chief of immunology, allergy and rheumatology at Texas Children’s Hospital explains the simple mechanics of this “early exposure” process this way: “When you get it [immunity], you have it. So, if you get it earlier, you’re going to be immune earlier.”

Related studies have indicated that many people feel happier when they have kids. If this is actually true, then their positive mental state can also certainly contribute to staying healthy. Besides, as all parents know, there are so many other joys associated with having kids that even if there aren’t a huge number of studies proving that they keep parents healthier, they’ll feel healthier.

Playground Safety Checklist: Basic Design and Maintenance

Playground Safety Checklist: Basic Design and Maintenance

If you’re a parent, you may have noticed that hard asphalt and sharp edges are on their way out at playgrounds around the country. In large part, these changes are due to concerns over injuries and law suits. Over 200,000 children in the US are treated each year in hospital emergency rooms for playground-related injuries. That’s a lot of opportunity for enterprising attorneys, especially in cases where parents or guardians lack health insurance.  

Accident and litigation concerns aside, it is important for children to get outside in the fresh air and exercise. This is particularly true considering the increasing rate of childhood obesity. Playgrounds can be ideal areas for kids to socialize while getting the exercise they need. By checking the playground for safety hazards and following some simple guidelines, there is no reason why your kids can’t take advantage of all a playground has to offer. 

The most important element to playground safety is adult supervision. Kids need to be supervised whenever they are using playground equipment so an adult can intervene when a child is not using the equipment properly or is acting in a dangerous fashion. Kids like to test their limits, and sometimes young children cannot properly judge distances and may try something that is likely to cause injury. 

The playground surface is important in reducing the number of injuries from falls. Asphalt and concrete are obvious surfaces to avoid, but so are grass and packed soil surfaces. None of these are able to cushion a child’s fall appropriately. Instead, look for playgrounds that have safety-tested rubber surfacing mats or areas of loose fill 12 inches deep made from wood chips, shredded rubber, mulch, sand or pea gravel. The cushioned surfacing should extend at least 6 feet from any equipment, and sometime farther, depending on the particular piece of equipment (such as a high slide or a long swing). 

Children should always play in areas of the playground that are age-appropriate. Playgrounds should have three different clearly designated areas for different age ranges of children: those younger than 2 years old, children 2 to 5, and children 5 to 12 years of age. Children under 2 should have spaces where they can crawl, stand and walk, and can safely explore. Kids age 2-5 should use equipment such as low platforms reached by ramps and ladders, flexible spring rockers, sand areas and low slides no higher than 4 feet. Kids age 5 to 12 can use rope climbers, horizontal bars, swings and slides, in addition to having open spaces to run around and play ball. 

Following are a few basic guidelines to ensure playground equipment safety: 

  • Seesaws, swings and any equipment with moving parts should be located separately from the rest of the playground. 
  • There should be no openings on equipment between 3.5 inches and 9 inches where parts of a child’s body may become trapped (such as rungs on a ladder). 
  • The top of a slide should have no open areas where strings on clothing can get caught and cause strangulation. 
  • There should be only two swings per bay, and should be placed 24 inches apart and 30 inches from any support. 
  • Equipment should not be cracked, splintered or rusty, and hardware should be secure. 
  • Sandboxes should be checked for loose debris such as broken glass and sharp sticks and should be covered overnight to prevent animals soiling it. 
Chiropractic Care Can Improve Respiratory Function

Chiropractic Care Can Improve Respiratory Function

Chiropractic Can Help Asthma, COPD and More…

The World Health Organization reports that some of the most common chronic respiratory diseases include asthma, chronic obstructive pulmonary disease (COPD), and pulmonary hypertension, the last of which is high blood pressure in the arteries connecting the heart and lungs.

Though some of these conditions can be passed down through genetics, lifestyle factors play a role as well, with risks rising with increased exposure to cigarette smoke, high levels of air pollution, and chemicals and other toxins found in various work or home environments. Obviously, your genes are your genes and removing these types of environmental toxins can go a long way to avoiding the development of lung-based diseases. Find out how Chiropractic care plays a positive roll.

A Study Shows Regular Chiropractic Visits Can Help!

One study has discovered that another way to keep your lungs breathing easier is with regular chiropractic visits. In September of 2016, the Journal of Physical Therapy Science published a study involving 30 subjects between the ages of 20 and 38 who were not currently being treated for any type of respiratory issue, nor were they experiencing any pain in their thoracic region. One-half were randomly assigned to an experimental group, which is the group that received actual spinal manipulation therapy. The remainders were assigned to the control, receiving sham treatments instead.

Procedure:

At the onset of the study, each subject’s respiratory function was tested and recorded. Approximately ten minutes later, depending on which group they were in, they either received high-velocity, low-amplitude manipulation directed to the thoracic area of the spine or sham chiropractic. Follow-up respiratory testing occurred immediately following the actual or sham treatment session.

After studying the lung-function data collected, researchers noted that the experimental group, which is the group that received actual chiropractic, had “significantly increased” their forced vital capacity and forced expiratory volume in one second. The group that received the sham treatments experienced no difference in their respiratory function at all.

Findings:

These findings suggests that chiropractic care likely plays a more important role in healthy lung function than most people realize. This information may be helpful to patients who are already experiencing chronic respiratory issues and looking for relief, but it may also work to reduce the likelihood of lung-related diseases in the first place.

As the COPD Foundation states, generally speaking, “once lung function is gone, it is gone for good.” That’s why they recommend engaging in activities which can maximize lung capacity. These include: getting some type of regular exercise, performing physically demanding exercises during the times when it’s easier to breathe, and staying indoors when extreme temperatures are expected or pollution is high.

 

Reference

Shin, DC, Lee, YW.. The immediate effects of spinal thoracic manipulation on respiratory functions. Journal of Physical Therapy Science; 28(9):2547-2549. doi:10.1589/jpts.28.2547