Quote for the Day

I just received this email from William and I feel it summarizes our greatest wish for not only ourselves but also our students and clients. So go ahead and be extraordinarily your limitless Self.

Dear Shmuel,

This is one of my most favourite quotes – I think I’ll use it daily from now on:
William
When you are inspired by some great purpose, some extraordinary
project, all your thoughts break their bounds: your mind transcends
limitations, your consciousness expands in every direction and you find
yourself in a new, great and wonderful world. Dormant forces, faculties and
talents become alive, and you discover yourself to be a greater person by far
than you ever dreamed yourself to be.
Patanjali

The Ebb and Flow of the Soul-The Cranial Wave

Cranial Wave/Fluid-Energetic
Background: In all my years in the healing arts, I have found the CranioSacral Rhythm or Cranial Wave to be the most accurate indicator of the client’s overall health and well being on the physical, emotional, psychological, and spiritual planes.In addition,we  each  have an individual cranial wave pattern that is uniquely imprinted on each and everyone one of us.
In ASP1, we learned that  there are 4 parameters in which we measure the CSR. These parameters of CSR are Symmetry, Quality, Amplitude, and Rate (SQAR).
Symmetry: We assess the in the skeletal system left vs right side. In the C-S System, we assess not only the difference in the paired bones (eg.parietals, temporals ), but also the singular bones (occiput, frontal,sphenoid) may exhibit many times an asymmetry in the movement in the bone itself.
In addition, there exists  a Neutral Zone in the CSR which is a brief pause between the end of the flexion phase of cranial motion as it returns toward the center range and before it enters the extension phase of cranial motion. There are 2 neutral zones per cycle. In normal conditions the extension and flexion cycles should also be symmetric. This assessment is vitally important when we are evaluating the Spheno-Basilar Joint.

Quality: While more difficult to assess , the CSR should have a smooth, liquid feel to it. It should feel like a gentle wave flowing up and down in a rhythmic pattern.

Amplitude:The greater the amplitude, the greater the vitality of the area being assessed. It also indicates a greater potential for healing. Vibrant , positive people have a greater amplitude in their CSR.

Rate: The CSR ebbs and flows at a rate of 6-12 times per minute.

In addition, to the active ebb and flow yang phase of the CSR, ,  throughout the course of the day,  stoppages of the CSR occur. This pause in the Cranial Wave can last anywhere from a few seconds to a few minutes and is called a Still Point.These pauses in the normal CS cycle are the body’s attempt to recalibrate and reorganize itself. It is the time when the body/mind / spirit comes to a state of deep relaxation and rest. It is a time of nourishment , peace, tranquility and a return to ones soul. As a rule, the healthier the individual, the more and deeper Still Points he will experience.
As Hugh Milne describes so eloquently and poetically, “Still points are to the cranial wave as sighs are to the breath-autonomic releases that ‘let off steam’. They also allow a return to natural rhythm after a period of overload, or trauma. During the still point the dreambody makes profound physiological recalibrations… The still point is much more than a physiological pause…

The still point is spaciousness.
It is timelessness.
The still point is close to death, and
deathlessness, both.

When the still point occurs in the “yoga of daily life’, this apparently spontaneous cessation of the cranial wave is a moment of satori, of spiritual oneness, even ecstasy.”

Origin of the Cranial Wave:
Sutherland believed that the origin of Cranial Movement was the contractile properties within the brain itself. The brain cells , he believed, pulsated was the driving forc behind the rhythm. Scientific research has since proved this untenable.
In 1970, Dr. Upledger, while assisting in surgery to remove calcification of the dural tube in the cervical region, felt the rhythmic ebb and flow of the cerebral spinal fluid in the dural tube which was the same rate of  movement of the Cranial Bones. using his palpatory skills, keen intelligence and intuition, and years of research with Zvi Karni and others from 1975- 1978 at
Michigan State University, he developed the Pressurestat Model. In short the driving force of the wave is the inflow and outflow of  CSF through the water proof and relatively inelastic Dura Mater. The regulatory system for the rate of fluid is the stretch receptors located at the sagital suteres which communicate with  the choroid plexuses which control production of the CSF at its blood brain barrier. Upledger  was the first to link the movement of the cranial bones  with the dural membranes and hydrostatic pressure of CSF.

However, the BioMechanical Model that Upledger presented cannot explain the nonlocal spiritual properties of the Cranial Wave. Milne developed his Visionary CranioSacral Therapy with the understanding that cranial bone motility is the movement of the fluctuating field…”This fluctuating field is the spirit. It is a field of information and of intelligence, a single unified system of energy, whose fundamental texture is expressed in the quality of feeling we call love… The spirit is a quantum field of energy.”
The ancient Chinese depicted the fluctuating field with the symbol of yin and yang energy dancing around a still center, the two perfectly overlapping. The ancient Hindus depicted the same dance as two serpents ascending intertwined of the kundalini. The Kabbalists recognized this dance as the intertwining of the male heaven energies intertwined with the female earth energies.
Fritz Smith provides us the energetic model of these universal energies through the bones and joints and brings together his Zero Balancing and gives structure to energy and brings energy to structure.
CranioBalance  sees the Cranial Wave as the sum total of energy movement through the bones, fascia, and into all the cells, molecules and atoms.  The electromagnetic field that is produced by the energy movement in the body is the Cranial Wave. The Cerebro Spinal Fluid, as the highest known element of the human body (A. T. Still) , is able to contain the ebb and flow of the cranial wave. In the words of the Spiritual Osteopaths, “The Soul swims in the Cerebral Spinal Fluid.” In a similar way, the blood contains within it the ebb and flow of the spirit and the health of the organs. Like the Chinese Master who is able to pick up imbalances in the body/ spirit through a pulse diagnosis, the CranioBalance practitioner can tune in to the Cerebral Spinal Fluid and feel the state of being of his client.

Cranial Wave Contact: The 25 micron amplitude ( half the thickness of writing paper) of the cranial wave is so minute that we need different parameters to sense , feel, experience, and affect it. The Cranial Wave can best be felt in an expanded , meditative state of consciousness. In that state, we can “see” the movement of the cranial wave, we can “hear” the inner  voice of the spirit being expressed, and feel the individual imprint of the soul flowing through the body.
The optimal contact is about 5 grams of pressure.
Be in passive , listening  mode.
Allow the wave come in to your hands.
Blend in with the fluid component.
Be still, be silent , and be one with the core of the client.

Cranial Balance Therapy: A New Paradigm in Healing

CRANIAL BALANCE  THERAPY

What is Cranial Balance Therapy?

CBT is a highly unique variation of osteopathic and chiropractic medicine, where a therapist gently places his/her hands on your body and feels for the cranial rhythm (or, pulse) — that small degree of movement that the bones and soft tissue naturally express throughout life. This is a highly subtle motion of the membrane encasing the cerebrospinal fluid in the brain and spinal cord down to the sacrum, the bone at the bottom of the spine. The therapist gently manipulates the tissues to bring them back into proper alignment. It feels like a very gentle massage, but CBT is a potent healing therapy for a wide variety of disorders, including chronic pain, headaches, carpal tunnel syndrome, fibromyalgia, learning disabilities, depression, post traumatic stress disorder, vertigo, whiplash injury, TMJ, herniated disc pain and musculoskeletal problems. While surprising and somewhat inexplicable, even many skeptics acknowledge that “sometimes it just works.”

A New Life Paradigm

Shmuel Berger has created a new life paradigm derived from the works of many esteemed mentors, principally among them – John Upledger, Fritz Smith, Jean-Pierre Barral. This new paradigm recognizes the cranial pulse (or, rhythm) as the living expression of the soul in the body. Learning to listen to this pulse is to listen to the soul of the patient. Listening to the soul of the patient enables the therapist to access the core issue of the patient on any or all of the physical, mental, emotional and spiritual levels, and to efficiently and harmoniously assist in resolving it, thus restoring balance and health. Together with William Livingstone, Shmuel has developed a 6 level curriculum for students incorporating cranio-sacral, zero balance, and visceral therapies, and integrating the western Descartian medical model, together with eastern energetic and Jewish kabalistic and spiritual foundations. This is a profoundly unique course, going way beyond what our teachers have taught us, into the realms of the energetic and spiritual aspects of the soul and its journey here on earth.

How to learn Cranial Balance Therapy

Cranial Balance Therapy is taught in various locations in Israel in a 6 level program over a period of 3 years by the Centre for Health in Israel (CHI). The modules are self-contained, each enabling the graduate to successfully work at each level, and to progress at his or her own comfortable rate. A certificate of competence is awarded at the successful conclusion of each module.

Why learn Cranial Balance Therapy, and why choose CHI as a seminar provider? At CHI, we recognize that healing first and foremost comes with the integration and harmony of the mind/body and soul. That being said, we emphasize not only proper and specific techniques to promote health, well-being and healing but we also help develop personal growth and spiritual development in our students and patients. This combination of the physical and spiritual makes CHI unique and stands out among all other systems.

And specifically …

* Our instructors are hand-picked and trained by both Shmuel Berger and William Livingstone, who, together, have over 50 years combined experience in teaching and practicing holistic therapies, including Naturopathy and Natural Nutrition, Osteopathy, Cranial Soul Therapy, Visceral Manipulation, Zero Balancing, Physiotherapy, Transcendental Meditation, Kabalistic Healing, Reflexology, Martial Arts, Bach Flowers, Laughter Therapy, and more. Both Shmuel and William have taught at many and various colleges at both university and college level. Both are highly experienced, world renowned and recognized therapists.

* All of our instructors take personal interest in each and every student. Giving them all they know from the level of the heart, and representing a source of inspiration and power, they do all in their expertise to enable each student to excel and become master therapists.

* Our courses take the best therapies and techniques and present them in a coherent, integrated and unified system.

* We emphasize and train our students how to work within the Client/Therapist relationship –dealing with both the energetics and the boundaries involved. * We emphasize and train our students in the importance of personal growth and development.

* All of our graduates become a part of a Family and Network of like-minded practitioners.

* CHI offers on-going study groups, retreats, and further courses in order to assist and internalize knowledge and experience, and to continue training.

CST – The 6 Level Modules

1. The Art of Subtle Palpation Level 1 – ASP 1

ASP 1 introduces the concept of the 3 major tissue types of the body 1) Skeletal (bone and joints) 2) Soft Tissue (fascia and organ) 3) CranioSacral. The participant will learn for each tissue type:

* the anatomy and physiology

* the type of palpation needed to access them

* their energetic properties

* techniques to balance and correct them

In addition, the participant will learn

* the basic energetic model that shows how energy moves through the different tissue types of the body.

* how to create a safe healing space by learning skills of grounding energy and building boundaries, while maintaining an essential touch connection.

2. The Art of Subtle Palpation Level 2 – ASP 2

ASP 2 deepens the student’s understanding of the CranioSacral System and the Energetic connection within the body tissues. The student will learn the anatomy and physiology of the Cranial system, which includes the Cranial bones and the Cranial Membrane system. Powerful techniques will be taught, such as: * frontal lift * parietal lift * spheno-basilar releases * temporal release * opening up the avenues of expression, through mouth work. The “Energy Cyst” model will be presented and techniques to locate and release these cysts will be learned. Furthermore, students will learn to locate and treat fascial restrictions with techniques such as “fascial glide” and “facilitated segment”.

3. Journey to the Core – JTC 1

We now enter the SomatoEmotional Level. The student will learn the connection between the organs and their energetic and emotional components. We begin with the concepts of Motility and Mobility of the organs of the Liver, Stomach, Intestines, Gall Bladder, and Kidneys. The student will also learn the connection of the organs with the Meridian system, and learn to open up these channels thus releasing and balancing the organ systems. After a review and treatment of the entire body, the student will delve into Dialog and SomatoEmotional Release. The concept of the CranioSacral Rhythm and the Significance Detector will be presented and integrated into the treatment methods. The Inner Wisdom, levels of consciousness, and Resistance will be discussed and practiced in the course.

4. Journey to the Core – JTC 2

The Kabalistic Model of 5 Worlds, 5 Levels of the Soul, the 10 Sefirot, Tzelem Elokim, Ein Sof, and Male/Female forces will be presented and integrated into a broader understanding of treatment, wellness, and health. With our knowledge of the CSR and body/mind/spirit connection, the student will explore biological processes of conception, birth, puberty, adulthood, and death. Past Life trauma imprinted on the body’s matrix will be discussed and demonstrated. Also deeper archaic wounds imprinted on the ancestral level will be explored.

5. Inner Space and Beyond – ISB 1

The Student, under the careful guidance of the Instructor will enter into the world of Altered States of Consciousness, Angels, Spirit Guides, Ancestral Guides, and learn to navigate and integrate them into the world of healing and Tikkun. The student will also be introduced to Kabalistic Healing Methods such as Pidyon Nefesh, Shinui Shem, Neged Ayin HaRa, Neged Ruach Ra. Acceptance to this seminar will be at the discretion of CHI.

6. Inner Space and Beyond – ISB 2

This course is the continuation of ISB1 with emphasis on refining one’s skills in subtle palpation as well as clearing and balancing out one’s energy field and body. Advanced healing methods such as distant healing, and clearing energetic cords in relationships will be taught and practiced. Acceptance to this seminar will be at the discretion of CHI.

Integration of CranioSacral Therapy and Zero Balancing:A Perfect Match

Dear Students of ASP1,

I have been asked why  bring in the works and theories of Fritz Smith (Zero Balancing) and not directly begin with CranioSacral Therapy. After many years of study, instruction, and treatment, I have come to the conclusion that in order to fully understand and feel the CranioSacral Rhythm one must first have a working model of energy and structure.

Our work and teachings in ASP go beyond the physiologic model of Dr Upledger and take it to the dimension of energy and the soul. Zero Balancing simply clarifies and understands the worlds of matter and spirit and beautifully integrates the two.

The following is my summary and explanation of why Zero Balancing prior to touching upon the works of Dr Upledger and CST.

Looking forward to working together and exploring the infinite world of the Human Body through touch.

Shmuel

Lecture: Zero Balancing: The Art of Balancing Energy and Structure through touch

I begin the theoretical background with Fritz Smith and Zero Balancing for several reasons .First, he has taken eastern model of energy and has integrated it into the western understanding of physiology and structure .Second, his understanding of foundation and semi foundation joints, and the curves and shape of the skeleton provide the missing link between the life force(soul)or energy of the individual and the origins of the CranioSacral Rhythm(as being the pulse of the soul).Third , when building our healing system, we should start with the foundation and deepest levels which are the bone and joints. Forth, he defines most clearly the different types of energetic relationships of touch (blending, interface, streaming and channeling). Fifth, he describes clearly the working signs of the body when energy is affected in the body. Sixth, his model provides the basis to explain Kabalistic concepts. We can use his model and terms as a spring board to develop our paradigm and integrate it together with our rooting OSCAR meditation. Seventh, energy becomes real and palpable and not something esoteric. In general, I  intersperse many energy /structure exercises into the lecture. That way the lecture is broken down into component parts and the students can feel on themselves and others these concepts.

Exercises:1) Feeling different structures at different depths of the body

2) Feeling as if bone bending with 2 hands on forearm

3) Feeling difference between interface, blending, streaming, channeling

4) Basic OSCAR Meditation/Guided Imagery using Smith Model of Universal Lines of Energy, Energy Flows through the Bones and Spine and Connecting to the Earth Energy (Grounding)

Testimonial: Pain Free after One Session!

I just received an email from a patient of mine with severe neck and shoulder pain with muscular weakness:

I scheduled an appointment with Stuart for an extremely painful sensation in my neck.  The pain was both frightening and debilitating.  Stuart very gently and thoroughly examined me, then treated me for about one hour.  The treatment itself was relaxing and positive, but I had trouble believing that one hour of what felt like some kind of massage would have a significant impact.  It did.  Within 24 hours I was much better, with the pain diminished to a very manageable level.  Several days later, strength came back to my shoulder and neck area.  The improvement was dramatic and much faster than I would have thought possible.  I am keeping Stuart’s phone number close by.  I hope I won’t need it, but as I continue to age (better than the alternative), at least I know someone who can ease my body through this process.  Thank you Stuart for a professional and effective treatment.

S.R.

Jerusalem

Free Choice, Inner Wisdom, and CranioSacral Therapy

Several days ago a friend asked me if I had any regrets about any life decisions I made. After pondering the question for a moment, I took a deep breath, sighed, and said quite honestly, No.

Granted, many of my personal, professional, and financial decisions did not usually turn out the way I expected and from a superficial point of view may be seen as failures. However, I can truly say that every decision I made was the best decision  based on the information that was available to me at the time .  With many years of wisdom and experience behind me, I certainly would not make the same choices I made, lets say 25 years ago.

Life in general is made up of a series of seemingly infinite choices. From the mundane such as what time to get up in the morning, which clothes to wear for the day, what should I eat for lunch, to the emotional such as will I get angry at my boss, spouse, kids,etc, will I choose to be optimistic or defeatist, and finally to life altering decisions, such as whom to marry, where to live, and what profession to choose.

Our goal and purpose as evolving human beings is to make the highest choices possible that resonate with our souls and enhance  our overall physical/emotional/mental/spiritual well being. As we grow and mature we are given more Free Choice.

Thankfully, the Universe gives us the tools we need to make the best choice possible. It can be the advice of a teacher, Master, or friend. Or perhaps it comes from the wellspring of cumulative experience that we gather.

However, the most profound tool for me to reach major decisions comes from my ability to quiet my mind and body and listen to the still, gentle Inner Wisdom that I believe we all possess.  For me the CranioSacral Pulse is the manifestation of that Inner Wisdom or the Higher Self in the body. According to  Spiritual Cranial Osteopaths, “The Soul swims in the Cerebral Spinal Fluids”. When I can feel the ebb and flow of the Cranial Rhythm, my body/mind comes to a standstill and I feel as if I am Peace and at One with myself and the Universe. In the words of the IChing,”in that place of Tao, there are no mistakes”. Or  in the words of the Kabbalists, Shivit Hashem L’Negdi Tamid( I place G-D before me , always.)

Quieting the mind and body allows us to connect to our Soul and return to our Source. It allows us to tap into that part of us that is Infinite and Eternal. From my experience the best and easiest way to feel that is through CranioSacral Therapy because the CranioSacral System is the Gateway to the  Higher Self and the Soul.  For those of you that are in transition, need to make life changing decisions or just want more clarity in their daily lives, I strongly recommend getting CranioSacral Therapy and learn to tap into your Inner Wisdom.

CranioSacral Therapy and MS

I would like to know your opinion on the safety of use of CST with a pt. with active demyelinating disease in the left frontal lobe, supratentorial, and infratentorial regions as well a the cervical spine ans optic neuritis. I am an OT treating a pt. with MS with the above MS exacerbations after recently suffering a miscarriage. I am concerned about safety and adverse effects but feel a trial of CST may be indicated. I would like your opinion. Thank you for any help you can give me!, Lori

From New CranioSacral Therapy Workshop in Israel, 2008/11/20 at 12:34 PM

Dear Lori,

Thank you for question regarding the use of CST with MS. First of all, what is your level of expertise and experience? In general,  I believe that if you go lightly and truly listen to the inner wisdom of the patient , you cannot do any harm. However, be aware that in cases such as MS there is a very powerful somatoemotional component that has often been suppressed for many years. If you are uncomfortable with SER, I recommend that you either refer the patient out to a more experienced CST or be in close contact with me and perhaps I can help guide you along.

As a general rule, always be present, nonjudgmental, grounded,  always follow the fascia and  know at all times what the craniosacral rhythm is doing. Be aware of sudden stoppages (significance detectors) to help bring the patient to a deeper healing place.

Just to let you know, I have treated MS patients in the past with varying degrees of success. The most profound case was a woman in her 40’s who came to me with crutches. After a series of treatments, which delved into early childhood trauma, she felt much  better and required only a cane to walk long distances. Several months later, I received a call from her. With tears of joy, she informed me that the doctors at the MS center in Houston could no longer find any trace of her MS and she

was walking fine. Spontaneous Healing? Miracle Cure? Misdiagnosed? Or just good CST?
She came to Israel several years later on a trip and visited me, no crutches and no looking back.

Best of Luck and keep in touch,
Stuart(Shmuel)

A Challange to all Pediatricians

In the name of scientific inquiry, truth, and health for future generations, I call upon all pediatricians to conduct a long term study of the benefits of the present method of vaccinations versus treating infants with CranioSacral Therapy and Homeopathy. In my 15 years of treating children, I have seen such a startling difference in the overall health of children treated with gentle and natural means versus the Conventional Medical approach of vaccinations and antibiotics.

Doctors who are truly interested in the health of their patients should take an honest look at the two different methods. Comparisons should be made of the following:

1) Incidence of SIDS (sudden infant death syndrome)

2)Levels of Autism and PDD

3)Levels of ADD/ADHD and LD

4)Incidence of Chronic Ear Infections

The results I am sure would be shocking and any Doctor that is truly guided by evidence based scientific research would be forced to reexamine the efficacy of Vaccinations and would turn to CranioSacral Therapy and Homeopathy. The guiding principles of “First Do No Harm”, and “Foster the Body’s Inherent Healing Capabilities” should override all other considerations.

Holistic Medicine-A Case Study

Several weeks ago, a colleague of mine asked me to check out her knees. Without any specific trauma, she told me that she  began to experience severe pain upon walking distances and going up steps. She is young, athletic, and in very good condition and couldn’t understand why  all of a sudden she felt  limited in her daily life.

Interestingly enough, all her physical tests, x-rays, etc revealed no pathology and all seemed normal. From a Western Medical perspective, she was perfectly healthy and the doctor gave her some pain medication and told her it should pass within a week or two. However, with the passage of time, the pain did not subside , but rather intensified when she finally approached me.

However, from a CranioSacral Holistic perspective , I noticed a restriction of her fascial system from her pelvis through her dural tube affecting the Lumbar region and the nerves connecting to the muscles in her thighs and also her kidneys. She also seemed a bit stressed and her breathing patterns were shallow and restricted. This caused a lowering of her CranioSacral rhythm at the area of her diaphragm and also in her neck region. With all this information  given to me through her body, I sensed the Inner Wisdom was speaking to us as pain and restriction of the CranioSacral system and that there was something out of balance in her life.

From a mind/body understanding, I know that pain  in the knees could be a symptom of a fear of not being able to move forward in one’s life. While checking her CranioSacral Rhythm, I asked her if she has been undergoing any stresses in her life, or any major life decisions that have come up and have not yet been resolved. She looked at me with both wonderment and relief and said that yes, she has been overwhelmed with her three major life decisions about where to live, where to work and whom to marry. The emotional stresses simply had been somatized in her body in her tissues and caused a physical manifestation as pain in her knees.

As I helped her clear the body resrtrictions,  she understood  her life situations and she was better able to make decisions and move forward with her life.

How is she doing now? No knee pains, she decided to leave her job, go back to the states for a visit and confident that one day her soulmate will be there .

This my friends is an example of the power of  Holistic CranioSacral Therapy.

The Western vs Holistic Model of Healing

Several years ago, a gentlemen in his late 70’s came to me for treatment following a stroke. The CVA left him with weakness in the right side of his body, loss of balance, but he was cognitively intact. During one of our sessions, he recalled with great fondness the treatments he had for many years with his long time Chiropractor. “Whenever I would get a severe headache, I would just make an appointment with the Doc and he would adjust me and my headaches would miraculously disappear.”

I wondered out loud , “when did you get those severe headaches?” He answered without a pause, “Always at work.” “What kind of work did you do?” I asked. ” I was an accountant, and I hated every minute of it. I always wanted to do something in the arts or music, I was a talented musician but due to family and financial pressures, I settled for a job that would be secure, so I chose accounting. But boy, was I miserable all those years.”

How sad, I thought. For years, he was denying the voice of his inner wisdom that came out as headaches that was telling him something was out of balance in his life. “I am angry, I am frustrated, I am doing something I don’t want to be doing. I am forced to lead my life in a way I would not ideally chose.” Like the warning lights coming on when the oil is low in a car and needs to be added before the engine burns out, the body sends a warning light in the way of pain, discomfort, or dis-ease. (The word disease says it all-when the body /mind/spirit is not at ease, there is tension, restriction, tightness which leads to the disease.) Now who in their right mind would just cut the wires and turn off the the warning lights in his car allowing the engine to burn out. However , this is precisely what we do when we take a pill, get an adjustment, go for surgery, etc and try to take away the dis-ease instead of looking at the root cause of the illness. The western Medical model is based on suppression of symptoms and taking away pain rather than identifying root causes whether they be physical, emotional, psychological, or spiritual.

In the Holistic CranioSacral Model, the Therapist helps the Client find the root cause by helping him get in touch with the Inner Physician , or Inner Wisdom that everyone one of us possess. In the words of Dr John Upledger, “surgery is often a way of silencing the voice of the Inner Wisdom of the body.”

In my next post, I will explain how the CranioSacral Holistic Model works and how we can use this as a new paradigm in Healing and Health Care.