Friday, September 21, 2018

Simple Home Upgrades That Can Help Seniors Age in Place

 

For seniors, being able to age in place plays a critical role in staying comfortable, safe, and secure. Aging in place simply means being able to stay in your own home as you get older. It’s a simple idea that can keep you happy later in life. If you are looking for ways to comfortably age in place in your home, you should carefully consider making these important upgrades.

 

Be Careful in Bathrooms 

 

When it comes to preventing injuries at home, the one area seniors need to focus on most is the bathroom. Thousands of injuries happen in the bathroom every year. Slippery floors and elevated edges on tubs can make everyday bathing extremely risky for aging adults. If you have mobility issues, the risk can be even worse. Luckily, there are some simple fall prevention ideas that can help you improve the safety of your bathroom. These fall prevention projects could even save your life. Small adjustments, such as adding grab bars in the tub or a shower seat, can give you more stability when surfaces are slippery. Have a big tub that’s difficult to get into? Consider replacing it with a walk-in/zero-entry shower. Preventing bathroom slips is the simplest way for seniors to stay safe in their homes.

 

Reduce Fall Hazards Throughout Your Home

 

Preventing falls in bathrooms is a good first step for senior safety at home, but you need to be sure the rest of your house is safe as well. Falls account for the majority of serious injuries to seniors, and most seniors are injured when falling in their own homes. Falls can even be deadly. Take a look around your house to make sure your floors are safe for you to walk on. Carpet may be your best bet at preventing serious injuries if you do happen to fall. Be careful of any rugs you have and make sure they are tacked down securely. Also, be aware of any uneven surfaces, cords, or furniture that could trip you up when walking around. Shorter items, like stools and baskets, should be tucked away safely so you won’t trip over them.

 

Install a Ramp or Lift

 

If you have stairs around your home, they could limit your ability to get around safely. Those with mobility issues or wheelchairs should consider alternatives to steps and stairs to make life safer at home. For steps outside and ledges around your home, ramps can make getting around much faster and safer. If you’re in a wheelchair you may even be eligible for Medicare coverage for ramps. If you have larger staircases inside, a lift or elevator may be a good option to consider. Installing a chair lift or elevator in your home generally ranges from $2,545 to $6,220. But installing one of these helpful options can add value to your home and quality to your life.

 

Use Technology to Stay at Home 

 

Technology can help seniors age in place as well. For seniors living alone, or those who are at home alone for extended periods of time, an in-home monitoring system can be an easy, economical way to stay safe. Getting help quickly in the case of a fall, injury, or illness could mean the difference between life and death, and you may not be able to reach a phone in your time of need. These days, there are quite a few in-home monitoring systems to choose from. Some options may require WiFi, while others work off your cellular phone network. There are also contracts and other elements to consider. Research your options and find a system that works for you and will help you feel safer at home.

 

By being able to age in place, seniors can maintain their independence and control over their own life. Ensuring a safe, comfortable environment in your home can add years to your life and add joy to those years. So, make sure your home is set up so you can enjoy the best years of your life in safety, comfort, and happiness.

 

Photo Credit: Pixabay

The following post Simple Home Upgrades That Can Help Seniors Age in Place Find more on: http://americanchiropractors.org/



from American Chiropractors Directory - Feed http://www.americanchiropractors.org/chiro/simple-home-upgrades-that-can-help-seniors-age-in-place/

Friday, June 22, 2018

Tips for Buying a Mattress (And Sleeping Well)

The following blog post Tips for Buying a Mattress (And Sleeping Well) is courtesy of ACC

 

Consider the importance and value of a good night’s sleep (beyond the price tag) when you are looking for a new mattress. Your back will thank you!

Lack of sleep can have a significant impact on your quality of life, social interactions, and even your mood1. Sleep deprivation can also cause a decrease in your work productivity, the greater number of sick days used, and result in increased injury rates due to poor response time and accuracy.

A 2011 study by the British Chiropractic Association (BCA) reports that 41% of women and 36% of men claimed their back pain was exacerbated by a poor night’s sleep2. The pain can often be attributed to the firmness, size, or the offered back support of the mattress. If you’ve ever woken up with a sore neck or back, you may want to evaluate the quality of your mattress. Your mattress can play an important role in maintaining your musculoskeletal (MSK) health. Here is what to keep in mind when making a purchase.

When to replace your mattress

iStock_50438648_web

Waking up from slumber with a sore back on repeated occasions can be a sign that it is time to switch to a newer mattress. Typically, it is said that after 10 years, the bed will begin to deteriorate, which is the best time to consider buying a new one.

Current research suggests that1:

  1. Medium-firm mattresses can be beneficial for individuals with chronic mechanical low back pain and are considered more comfortable compared to soft mattresses. They also have been shown to improve sleep quality by 55% and decrease back pain by 48%.
  2. The standing posture of an individual’s spine should be similar to their sleeping posture. Since standing posture varies from individual to individual, mattresses that are custom made may be more beneficial in reducing pain.
  3. Using an adjustable bed based on individual preferences is associated with increased sleep quality.
  4. Mattresses that promote skin warming may improve sleep quality by reducing early morning awakening and enhancing deep sleep.
  5. Soft mattresses decrease excessive compressive forces on your joints, however, mattresses that are more firm help to maintain proper sleep posture as they prevent sagging of the hips.

Take time to try out the bed before you buy and see if it’s right for you. There are many options to consider when it comes to purchasing a mattress. Make sure to take the time to explore and do your research, especially if you are looking for specific features to meet your needs. A good night’s rest is important for your MSK health and ensures you can continue doing your daily activities. Consider these tips for your next mattress—your back depends on it!

 

References

1 Radwan A, Fess P, James D, Murphy J, Myers J, Rooney M, Taylor J, Torii A. Effect of different mattress designs on promoting sleep quality, pain reduction, and spinal alignment in adults with or without back pain; systematic review of controlled trials. Sleep Health: Journal of the National Sleep Foundation. 2015 Dec 1; 1(4):257-67. 
2 UtBritish Chiropractic Association, Mind Your Posture When Buying a Bed, https://www.chiropractic-uk.co.uk/gfx/uploads/member%20area/New%20posture%20sheets/Mind%20your%20posture%20-%20buying%20a%20bed%20-%20sleep.pdf


from American Chiropractors Directory - Feed http://www.americanchiropractors.org/chiro/tips-for-buying-a-mattress-and-sleeping-well/

Thursday, June 14, 2018

5 Stretches and Exercises for Better Posture

5 Stretches and Exercises for Better Posture was first seen on http://americanchiropractors.org

5 Stretches and Exercises for Better Posture

How many hours a day do you spend looking at a screen with your head tilted forward? Think about it. Chances are if you own a cell phone, tablet, laptop or desktop computer, you’ve spent hours viewing these devices. Other instances where you might tilt your head forward include watching television, driving and even reading a book. This constant state of having your head tilted forward causes postural alterations, often leading to faulty movement patterns, which increases the stress placed on the neck, shoulders, as well as the head.1

Upper cross syndrome is described as a muscle imbalance pattern located at the head and shoulder region.2 It is most often found in individuals who work at a desk or who sit for the majority of the day and continuously exhibit poor posture.2 The term ‘upper cross’ can be broken down into two components. ‘Upper’ simply refers to the head and neck region, as there is a lower cross syndrome for the low back and pelvic regions as well. ‘Cross’ refers to the distribution of tight or overactive muscles, which crosses with weak or underactive muscles. Primarily, tightness of the upper back muscles crosses with the tightness of chest muscles, while weakness of the neck muscles in front crosses with the weak muscles of the mid back.2 Common signs and symptoms of upper cross syndrome include forward head posture, rounding of the shoulders, hunched upper back, headaches, as well as pain in the shoulders, upper back and neck.3

The good news is that work station adjustments and appropriate exercises and stretches often improve posture and muscular coordination.1

Below are some of the following stretches and exercises that you can do to help improve your posture:

Stretches:

  • Trapezius Stretch
    • In a sitting position, slowly and with ease, draw your right ear towards your right shoulder. You may place your right hand over your head and let it rest on your left cheekbone for slightly more pressure. Hold for 20-30 seconds. Repeat on other side. Perform 3-4x throughout the day.

  • Levator Scapulae Stretch
    • Similar to the trapezius stretch, the above stretch can be modified by gently pulling your head and directing your nose to your underarm region. Hold for 20-30 seconds. Repeat on other side. Perform 3-4x throughout the day.

  • Chest Stretch (Brugger’s Position of Relief)
    • Sitting on the edge of a chair with legs slightly wider than shoulder width apart, have your palms face upwards and lift the chest up. Hold for 20-30 seconds. Perform 3-4x throughout the day.

Strengthening Exercises:

  • Chin Tucks
    • While seated, look forward and bring your head backwards, as if you were making a double chin. Make sure not to tilt your head down. Hold this for 8 seconds. Repeat 5 times and that’s one set. Perform 3-4 sets throughout the day.

 

  • Shoulder Blade Squeeze
    • Sitting comfortably on a chair with arms relaxed by your side, squeeze shoulder blades together without raising them. Hold for 8 seconds before releasing. Repeat 5 times and that’s one set. Perform 3-4 sets throughout the day.

 

In addition to these stretches and exercises, read our office ergonomics guide for further tips to optimize your work station: https://www.chiropractic.ca/wp-content/uploads/2015/05/office-ergonomics.jpg

Should you wish to pursue more information regarding upper cross syndrome or further exercise instruction, please consult with a chiropractor today!

 

References:

  1. Dawson-Cook, S. (2011). How’s Your Posture? American Fitness. (3), 24.
  2. Upper Crossed Syndrome. Muscleimbalancesyndromes.com. Retrieved 25 January 2017, from http://www.muscleimbalancesyndromes.com/janda-syndromes/upper-crossed-syndrome/
  3. Upper Crossed Syndrome: 4 Steps to Correct Rounded Shoulders and Hunchback Posture. (2015). Darwinian Medicine. Retrieved 25 January 2017, from http://darwinian-medicine.com/upper-crossed-syndrome-4-steps-to-correct-rounded-shoulders-and-hunchback-posture/


from American Chiropractors Directory - Feed http://www.americanchiropractors.org/chiro/5-stretches-and-exercises-for-better-posture/

Wednesday, May 23, 2018

MSK 101: An Overview of Musculoskeletal Conditions

MSK 101: An Overview of Musculoskeletal Conditions is courtesy of ACC

MSK 101: An Overview of Musculoskeletal Conditions

msk 101Musculoskeletal (MSK) health is an important part of your daily life. That’s why educating Canadians on the benefits of a healthy MSK system is an important priority for the CCA. As we have discussed in previous blogs, there are many ways to help prevent MSK conditions, and the more you know, the more you can do to enhance your overall health and wellbeing.

This post will give you some brief insight about MSK conditions.

What is the MSK system?

The musculoskeletal (MSK) system is a complex network of muscles, bones, joints, tendons, and ligaments that offers us the ability to perform our daily activities. The MSK system supports literally everything we do, and provides structure, protection and function to the body. As you can imagine, without a healthy MSK system, it becomes very difficult to do the activities you love.

What is an MSK condition?

Musculoskeletal conditions include a wide range of disorders that can impact the bones, muscles, tendons, ligaments, joints and connective tissue. It may result from physical trauma, or other causes such as overuse. Injuries are considered acute, subacute, chronic or recurrent depending on the duration or pattern of presentation. MSK conditions commonly affect body parts such as the head and neck, shoulders, mid-back, low back and pelvis, elbows and hands/wrists. Unfortunately, if not managed promptly, MSK injuries may become chronic and result in debilitating pain and dysfunction. Due to the high prevalence of these injuries, MSK conditions are the second greatest cause of disability worldwide!

How Can MSK Conditions Impact Your Health?

MSK conditions can impact Canadians of all ages! Yet, the prevalence of these conditions tends to increase with age and may complicate the ability to complete simple and essential daily tasks. Inevitably, aging is a risk factor for developing MSK injuries due to, for example, the progressive loss of muscle mass (sarcopenia) and a decline in muscle strength that increases the likelihood of injury from sudden falls1. Unfortunately, data suggests that falls have increased significantly and can result in fractures and even hospitalizations2. Therefore, to ensure healthy aging, Canadians are urged to keep moving and maintain a healthy MSK system to ensure mobility and independent living for many years to come.

How To Prevent MSK Conditions Moving Forward?

Healthy aging is a key priority for everyone. There are certainly ways to help enhance our chances, including maintaining an active lifestyle. Physical activity and exercise not only are a great way to maintain a healthy weight, prevent chronic conditions and manage stress, they also help maintain strength, endurance and mobility as we age. These can be critical components to preventing falls which can lead to developing an MSK condition and pain. We have many other tips to help you prevent injury or pain from occurring. Most of these tips are centred on an active lifestyle, and taking extra precautions when being active.

How Can a Chiropractor Help?

Visiting a chiropractor to discuss how you can prevent injuries or manage any pain or dysfunction may be a great start to healthy aging. Chiropractors not only treat MSK conditions, but they can help guide you with preventative measures as well. You may not be thinking about back pain now, but it’s important to always keep the future health of your back in mind. Visiting a chiropractor for guidance and treatment can be key to prevention.

Remember, we have your back and we want everyone to enjoy life feeling happy and healthy. Learn more about how a chiropractor can help you with preventative and MSK care.

1. https://www.phac-aspc.gc.ca/seniors-aines/publications/public/injury-blessure/seniors_falls-chutes_aines/index-fra.php
2. International Life Sciences Institute, Healthy Lifestyles, Diet, Physical Activity, and Health: Europe Concise Monograph Series, https://www.ilsi.org/Europe/Publications/ILSIcm11-004_Diet08.pdf.


from American Chiropractors Directory - Feed http://www.americanchiropractors.org/chiro/msk-101-an-overview-of-musculoskeletal-conditions/

Sunday, April 29, 2018

What causes muscle soreness after working out?

The blog post What causes muscle soreness after working out? was first published to http://www.americanchiropractors.org

What causes muscle soreness after working out?

You may have heard the expression, “no pain, no gain” when it comes to embarking on a fitness journey, but have you ever wondered why certain forms of exercise result in pain in the form of muscle soreness?

The technical term for muscle soreness after exercise is DOMS, which stands for delayed-onset muscle soreness. Besides feeling sore, this term also encompasses experiencing reduced range of motion and muscle strength. You will usually experience this 24-48 hours after you try new activities/exercises or increase the intensity of your workout. While DOMS can seem similar to trigger points, trigger points are different in that they are a type of muscle soreness that are the result of an overused muscle and feel more like a “knot” in the muscle.

There is a myth that DOMS is caused by lactic acid build-up. However, lactic acid lasts in your muscles only 1-2 hours after finishing a workout, so that’s not the likely cause. Resistance training causes micro-tears of muscle fibers, which draws increased blood flow and inflammation to the area (you may even notice some mild swelling), which stimulates the pain receptors in the muscle cell and makes them more sensitive to movement. The muscle damage is temporary, and as the muscle rebuilds itself as a response to this process, it gets stronger and can handle heavier loads.

How to deal with DOMS?

Although DOMS is a natural process that indicates that your body is getting stronger, there are some things you can do at home to reduce the discomfort. Here are some tips:

  • Prevent DOMS by doing longer warm ups before your resistance training.
  • Take an Epsom salt bath. Epsom salts are high in magnesium, which help promote muscle relaxation and improved circulation.
  • Do a gentle workout such as light cardio or stretching and yoga the day or two after an intense workout. Pick up the intensity again after the pain is gone.

Did you know your chiropractor can help you with injury prevention? See your community chiropractor to learn more.

References

1Everything you need to know about delayed onset muscle soreness (DOMS). Lifecare Cottesloe Physiotherapy. https://www.cottesloephysiotherapy.com.au/blogs/2017/10/24/everything-you-need-to-know-about-delayed-onset-muscle-soreness-doms . Published October 24, 2017. Accessed March 1, 2018.

2What causes muscle soreness after exercising. Today I Found Out. http://www.todayifoundout.com/index.php/2010/08/what-causes-muscle-soreness-after-exercising-note-its-not-lactic-acid/ . Published August 6, 2010. Accessed March 1, 2018.

3Feeling sore 2 days after working out? Here’s why. Fitbit Blog. https://blog.fitbit.com/delayed-onset-muscle-soreness/ . Published November 6, 2015. Accessed March 1, 2018.


from American Chiropractors Directory - Feed http://www.americanchiropractors.org/chiro/what-causes-muscle-soreness-after-working-out/

Wednesday, April 25, 2018

Phase 1 | The 10-Day Cleanse

The following article Phase 1 | The 10-Day Cleanse is republished from www.americanchiropractors.org

Fibromyalgia treatment, restless leg syndrome treatment, diabetes treatment, how to treat diabetes, how to lose weight, how to treat fibromyalgia, Columbus fibromyalgia, Columbus diabetes treatment, treat inflammation in Columbus, Columbus inflammation clinic, Get healthy in Columbus, Columbus health clinic, Columbus wellness clinic, heartburn treatment in Columbus, dr trent mozingo, dr moz, chiropractor in Columbus, Columbus chiropractic, chiropractic care in Columbus
When The New-Start Solution started to take shape back in 2014, it was designed around a weight loss strategy. That is what most people wanted so I set out to learn how weight loss happened, and why weight gain is at the epidemic level that is. Every bit of research led me back to one organ, The Liver. It soon dawned on me, weight loss, improved health, and increased energy levels are all in the same basket.

Every single adult in America should know the basics about the liver. Alcohol is bad for the liver. The liver is in the abdomen. The gallbladder is attached to the liver. Well, that is about it for basic knowledge. BUT, the liver is so much more. Let's dive a little deeper.

In the shortest terms i can come up with, "The Liver is in the Center of IT ALL!"

Every food we eat, every drink we drink, every cigarette we smoke, every medication we inject, every pill we take, EVERY thing we put in our body has to be processed by the liver. Through a system of blood supply, the liver is the main filter for all of the crap we expose our bodies to. If you eat a Snickers, the liver has to deal with it. If you drink a Coke, the liver has to deal with it. As you can imagine, during the last 20 years and the spike in processed pseudo-foods that we eat on a wildly regular basis, the liver has became overworked. 

This is the key to weight gain. We eat crap. We expose our liver to things like artificial sweetener, pop tarts, high fructose corn syrup, alcohol, and deep fried potatoes ALL THE TIME. Every single day. And that might be alright if the only job the liver had to do was filter out the bad stuff. Sorry, this is not a perfect world, because everything we eat plays a roll in our metabolic rate, and guess who is there to sort out our metabolic rate. The good ole liver. But how?

This is where it gets tricky. The liver has blood supply from both the heart and the digestive system. Actually 75% of the blood supply to the liver is actually the blood that drains from the digestive system called the Portal Vein. Ok, so every food we eat that gets digested, meaning, not regurgitated, goes into the stomach, small intestine and then large intestine. Every vitamin, mineral, nutrient, and calorie that is taken into the body from our digestive system pours into the portal vein and is taken to the liver for processing. So, instead of just filtering the toxins, the liver also has to set the standard for your metabolism. 

Oh, it gets even better. 

See, the liver is also responsible for controlling the amount of thyroid hormone that flows in the usable form. Common knowledge is that the thyroid sets our body temperature thus controlling our metabolism. We all know someone that has hypothyroidism, right? Let me guess, they are overweight? It is true, the thyroid hormones do control our body temperature, BUT the liver is what makes the thyroid hormone active.

Ohhhhh, more to come.

So, that Portal Vein we just discussed that brings all of the nutrients from our digestive system to the liver, well it has one other organ that dumps into it. THE PANCREAS. Yes, the pancreas is the hormone associated with diabetes. Insulin is released from the pancreas into the portal vein and take directly to the infamous liver. The liver has to monitor your incoming diet, inform the pancreas and brain of the sugar coming in, also monitor your already flowing blood and direct how much insulin needs to be released into the blood to stabilize the incoming sugar. 

Fibromyalgia treatment, restless leg syndrome treatment, diabetes treatment, how to treat diabetes, how to lose weight, how to treat fibromyalgia, Columbus fibromyalgia, Columbus diabetes treatment, treat inflammation in Columbus, Columbus inflammation clinic, Get healthy in Columbus, Columbus health clinic, Columbus wellness clinic, heartburn treatment in Columbus, dr trent mozingo, dr moz, chiropractor in Columbus, Columbus chiropractic, chiropractic care in Columbus
I do not like to play favorites, and every organ in the human body has a reason to be there and a job to perform. BUT, the liver is the center of it all. The master processing plant. The coordinator. The liver is so important that it is actually the ONLY ORGAN IN THE HUMAN BODY THAT CAN REGENERATE ITSELF!! Yes that is how important it is. You can surgically remove 75% of your liver and it will grow back. Try that with a finger or spleen. You will have 25% of your finger, FOREVER. 

When I really dug deep into my research of how the body works, why weight loss happens, and how to make it happen, it came back to one thing has to happen first. YOU HAVE TO CLEANSE THE LIVER. The liver is exhausted in the vast majority of Americans, and it is not surprising that the overweight level is hitting 60%. 

The good news is. The liver is remarkable. It can heal itself. You just have to give it the material to do the work. Cut the crap food. Drink your water. Flood your system with antioxidants. The first 10-Days of The New-Start Solution has ALWAYS included this remarkable 10-Day Cleanse, and that wont be changing as long as our body continues to work like it does.  Click here to get yourself on the right track. You can start this week. It is only 10 days.



from American Chiropractors Directory - Feed http://www.americanchiropractors.org/chiro/phase-1-the-10-day-cleanse/

Sunday, April 22, 2018

What The New-Start Solution was Missing!?!?

The following post What The New-Start Solution was Missing!?!? Read more on: www.americanchiropractors.org

Over the last 4 years, I have spent endless hours critiquing The New-Start Solution (NSS) to cover every basis that I know of health. With a strong backbone in biochemistry, The NSS is designed to restore you body’s functions by flooding it with the necessary nutrients that are found in wholesome foods. Through the laws of nature, this design of healthcare restores your health in the same way that it grows.

With great success, The NSS has changed the lives of many patients, and I have taken feedback from each one to continue critiquing this program, giving me the foundation to write a book about it, called How Health Comes Apart. 

New start solution Trent mozingo, dr trent mozingo, katelyn weissert, personal trainer online, online personal trainer, online fitness plan, free fitness plan, diet plan, online diet plan, online weight loss, lose weight online, lose weight, how to lose weight, how to work out, workout plan katelyn weissert Columbus, trent mozingo new-start, new-start solution, newstart solution, newstart weight loss plan, weight loss plan, thyroiditis, hashimotos treatment, diabetes treatment, how to treat diabetes, obesity epidemic, how to treat obesity, food elimination diet, paleo diet plan, how to eat paleo, how to eat to get healthy. diet for blood type, nutritional plan, exercise made easy, annastacia nuffer, anna nufferAnnaStacia Nuffer

​Recently, I had an eye opening meeting with AnnaStacia Nuffer that helped me bring to light the one facet of health that The NSS was missing, emotion. AnnaStacia is a Certified Holistic Health Coach, Reiki provider, and mother of three little girls. One conversation with AnnaStacia helped me understand that in the world of holistic health, I have a lot to learn. I have always been under the impression and understand that it is wholesome foods, nutrients, vitamins, and macronutrients are what are needed to nourish our health, but she brought a new understand of what “food” for our health really is.

AnnaStacia taught me the simple difference between “primary” and “secondary” food. See, the food that we eat, and The NSS focuses on is just our secondary food that fills the void of our body. As it is vital to remain full of nutrients from our diet, our “primary” food source is a symphony of our experiences, relationships, music, art, self-esteem, self-satisfaction, and more. She went on to explain how a person that is satiated with their primary food will be more resistant of giving in to emotional eating, or indulging in secondary foods that hurt our health.

I will always be a student of health, trying to learn as much as possible to translate into a healthcare model to pass along to patient care. AnnaStacia agreed to come on-board at New-Start Health Center to help me bring a well-rounded health care system to each and every patient we can. I am excited to have her help bring The NSS into a full spectrum wellness program, covering physical, chemical, and emotional standpoints of health.
​
Building New-Start Health Center has given me the greatest gift of all, meeting new and exciting people to grow this practice into its own. After only one session with AnnaStacia, I could feel my mind expanding to a whole new realm in holistic health I am confident that her approach to wellness is the final touch that The NSS needed to be complete. Stay tuned for more information regarding the bridge between biochemistry and emotional health. 


Weight loss Columbus Indiana, weight loss Columbus, lose weight in Columbus, how to lose weight, nutritional advice in Columbus, Columbus Indiana nutrition, Columbus Indiana weight clinic, weight loss clinic in Columbus, wellness coach in Columbus, wellness, health clinic in Columbus, new-start, newstart, newstart health center, new-start Columbus, wellness in Columbus, annastacia nuffer, anna nuffer, annastacia


from American Chiropractors Directory - Feed http://www.americanchiropractors.org/chiro/what-the-new-start-solution-was-missing/