Access to all articles, new health classes, discounts in our store, and more!
Four laws of ecology: (1) everything is connected to everything else, (2) everything must go somewhere, (3) nature knows best, (4) there is no such thing as a free lunch.
– Barry Commoner
Many have come to understand that – for all the complexity and diversity it expresses – the earth’s biosphere is one interrelated, indivisible whole. We cannot sustainably seek solutions to human health challenges by limiting our view to human physiology or genetic coding. We cannot view contamination of our soils and waters and air as somehow separate from the poisoning of our animal bodies, which depend on these basic elements for life. We cannot devastate brilliantly balanced systems in our “outer” environment and think there is no consequence for the elegant, interdependent, dynamic systems that maintain the health of our “inner” ecology.
It seems increasingly obvious that when we speak of the earth’s health or human health, we must take a systems view. This is holistic medicine as seen through a wide aperture. Deterioration of the earth’s balance of systems equals deterioration of human health-supporting systems. It doesn’t take much imagination to realize this is true, and yet there has been huge resistance within our medical and scientific communities to embrace it as so. Our sciences, for the most part, have continued to view the world through restricted viewfinders, even as those exploring fields such as quantum physics, psychoneuroimmunology, and evolutionary microbiology are showing us the way toward seeing the dazzling, unified whole.
But collectively we have not yet made the shift toward this understanding. We still argue among ourselves as to the truth of interrelatedness, as to whether consequence follows action. We still make the question of how this remarkable planet came to be a social litmus test – intelligent design or evolution? So much of our attention gets bound up in these polarizing intellectual debates. Meanwhile, we’re busy poisoning and killing each other and deconstructing our life-support systems at a feverish pace. As disease processes rage – both physical and psychological – we wonder at their prevalence and await the next pharmaceutical “cure.” Of course, all the while, we take pride in asserting the primacy of human “intelligence” and invention over other forms of life.
Our human minds and hearts are capable of perceiving the truths that underlie the incredible miracle of life on Planet Earth, but an essential humility and gratitude are needed to take us there. Many have opened to the exquisite beauty of the mutable equilibrium that pervades our nature. To do so, we must dissolve the membrane of separation and enter into the saturating light of awe and wonder, from which any possibility may emerge, including continued survival of the human species – although this assuredly seems unlikely from a purely rational point of view.
Meanwhile, as humans struggle mightily to resist the fact of their mortality and their interdependence with other species – perceiving “health” in a blindered, piecemeal manner – other kingdoms of life continue to demonstrate basic strategies and principles that underpin organism survival and evolution. There is much we might learn, should we open to the truth of what they teach.
Human life is not a given but a miracle of symbiosis within the whole. Our existence is dependent upon favorable circumstances and functioning systems of regulation and adaptability, detoxification and renewal – both within and without. The very idea that some boundary exists is, perhaps, the ultimate pathogen. The whole of the planet embodies a unity, a dynamic relationship of self-regulating systems. As conditions change, species either adapt or die.
The details keep presenting themselves to our understanding, but the collective awakening to what is possible when we comprehend our place in things awaits the critical mass needed to take group mind to the next wave of potential. Our capacity to shift our awareness is the medicine we have been seeking. Surely, clear awareness will lead us to wonder why it has taken so long to recognize what is in plain sight.
We live in a world dominated by microbes. They populate our soils, our waters, and our animal bodies. Without their ubiquitous presence, life as we know it would not exist.
Systems within systems
As many within the deep ecology community have been pointing out for decades, thinking in terms of systems is essential to understand the complex self-regulating dynamics that govern the existence of biological life within the earth’s living matrix. Disease is a predictable and observable consequence when organisms overpopulate or spoil their habitat. It can also be a mechanism for restoring more sustainable dynamics within an ecosystem. As renowned scientist Lynn Margulis notes, “Runaway populations of bacteria, locusts, roaches, mice and grass always collapse.”
The impact of rainforest and other old-growth forest devastation echoes throughout layers of systems: on planet-wide systems of self-regulation and restoration; on patterns of air, water, and migration; on the diverse communities of biological life integral to those habitats; on the teeming jungle of symbiotic organisms within the soil. The full consequence of such widescale soil disturbance has not yet been felt. Erosion, loss of fertile topsoil, choking of rivers – yes, these are predictable results. But such vast habitat destruction also liberates potential pathogens into the larger planetary system.
Climate changes obviously also play a role. A report by the Wildlife Conservation Society (WCS) listed 12 diseases and pathogens that may spread to new regions as a result of changing temperatures and precipitation patterns. Some of the diseases and pathogens on the WCS list include: avian influenza, Ebola, plague, parasites, cholera, Lyme disease, tuberculosis, and yellow fever.
Such news is coming steadily now. We have ignored simple truths at our peril. Yet, other principles evidenced by nature show us that positive change can happen rapidly when enough of us are ready.
Bacteria as ancestor and progeny
We live in a world dominated by microbes. They populate our soils, our waters, and our animal bodies. Without their ubiquitous presence, life as we know it would not exist. We are dependent upon bacteria for our nutrition, immunity, adaptability, detoxification, recycling, and waste management. Some bacteria prove pathogenic, for sure, but even in this it can be said that they – like viruses and fungi – are serving a role within the whole.
Fear or phobia of disease-causing bacteria or other pathogens only serves to dampen our innate aliveness and immune capacity. Our efforts should aim to achieve peaceful co-existence with the microbes, to engage some version of right relationship. Through doing this, we shall strengthen our own vitality.
A sterile world is a barren world.
The oldest fossils known are interpreted as the remains of bacteria. Found in southern Africa, these “microspheres” are dated at over 3.5 billion years old. According to Lynn Margulis, “Neither plant nor animal appeared on Earth until bacteria had undergone at least 2000 million years of chemical and social evolution.”
She notes, “We animals, all thirty million species of us, emanate from the microcosm. The microbial world, the source and well-spring of soil and air, informs our own survival. A major theme of the microbial drama is the emergence of individuality from the community interactions of once-independent actors.”
Nonetheless, Margulis observes, “The more balanced view of microbe as colleague and ancestor remains almost unexpressed. Our culture ignores the hard-won fact that these disease ‘agents,’ these ‘germs,’ also germinated all life. Our ancestors, the germs, were bacteria.”
Some basic understandings
Our resident bacteria
The human body is host to a world of bacteria. As is true in the soil, the forest, and other natural systems, bacteria are an essential part of a healthy human ecosystem. They are symbiotic with us.
It has been estimated that our bodies contain approximately a hundred times more microbial genes than human ones. The skin hosts an estimated 100 billion resident bacteria, with perhaps 100 trillion in the colon. Four hundred to 500 types of bacteria line the human digestive tract, distributed over its entire length in predictable geographic arrangements. Researchers believe that they have co-evolved with us.
Our resident bacteria generally exist in a state of ecological balance, which when disturbed, can lead to distress – such as colon inflammation (caused, for example, by Clostridium difficile), stomach ulceration (often due to Helicobacter pylori), or other health challenges. However, potentially pathogenic bacteria do not manifest as disease in everyone.
Gut and skin bacteria provide our first level of interface with the external environment. By incorporating DNA found in their environment into themselves, bacteria assimilate genetic traits and evolve. This is their way of responding fluently to changing circumstances. It is one of the mechanisms pathogenic bacteria use to develop drug resistance. Because the gut is so rich with microflora, and because so much bacterial information travels through it with our food, it is a place of both communication and literal internalization of new information.
Gut and skin bacteria provide our first level of interface with the external environment.
Bacteria and microfungi are ubiquitous. Everything we touch, every breath we take, every food we eat contains microorganisms. These organisms are masters of transformation; without them, the arisal and decay of form would not transpire. Like their relatives the soil rhizobacteria, the gut microflora are alchemists – able to transform inorganic substances into organic, bioavailable nutrients, and able to act upon toxins to render them more benign. This is a remarkable contribution. Healthy populations of intestinal flora provide us with a first level of detoxification and immune defense, promoting resistance to infectious disease, modulating immunity, and reducing or preventing cancer process.
Friendly microflora such as Lactobacillus acidophilus and bifidobacteria prevent the establishment or overgrowth of disease-causing microbes such as Candida, Salmonella, Escherichia coli, Helicobacter pylori, and Yersinia pseudotuberculosis. They also manufacture nutrients such as the B-complex vitamins and vitamin K; improve the absorption of minerals such as calcium, magnesium, and iron; maintain the integrity of the intestinal mucosa, thus preventing the syndrome known as “leaky gut”; and more.
Disruptors of ecology: both inner and outer
At the level of the individual, maintaining the health and integrity of the gut microbiota, the mucosal lining of the intestinal tract, and the diverse skin ecology is of foremost importance in supporting the health and resilience of the body as a whole. Here are some common disruptors of our microbial balance and gut health:
Nonsteroidal anti-inflammatory drugs (NSAIDs). Regular use of NSAIDs, such as aspirin, ibuprofen, and naproxen, can damage the intestinal lining. Other substances that are detrimental to the digestive tract and its inhabitants include alcohol, chlorine and fluoride (often found in tap water), oral contraceptives, steroid drugs, tobacco smoke, and a wide array of manufactured chemicals.
Antibiotics in the food supply. Animals, including fowl, are routinely administered antibiotics in factory farms, providing a flow of resistant microbes into the human milieu. This situation is compounded by the troubling consequences of antibiotic-tainted runoff from these farms into groundwater and streams.
Broad-spectrum pharmaceutical antibiotics. The indiscriminate or prophylactic use of broad-spectrum antibiotics should be avoided, as it effectively sterilizes the gut and stresses the liver, leaving the host vulnerable to pathogens from foods and the environment – and compromises basic strategies for survival. On both the individual and collective levels, this practice manifests as loss of microflora diversity and promotion of bacterial mutation toward resistance.
Antibacterial soaps and germ-free toys. The widespread use of such antibacterial products can ultimately weaken immunity and promote resistant strains of pathogens. Triclosan – a chemical now banned in soaps but still added to toothpaste, mouthwash, and other personal care products – can trigger multidrug resistance in E. coli, Salmonella, Shigella, and other intestinal bacteria. Triclosan and related chemicals persist in treated wastewater and, over the past 20 years, have become pervasive in groundwater, well water, and freshwater lakes and streams across the US.
The “hygiene hypothesis” being explored by researchers suggests that constant exposure to microbes in infancy and childhood promotes a healthy and responsive immune system in adults – and that our current lack of early exposure to diverse bacteria because of hyper-antimicrobial practices affecting our food/water supplies and home environments has contributed toward a dramatic increase in asthma, allergies, and eczema.
What we can learn from bacteria
Here are some lessons from our bacterial teachers, in a nutshell: What doesn’t kill you makes you stronger. Change can happen rapidly. Evolution requires adaptability. There is strength in diversity. Together, anything is possible.
Oh, and: Don’t kill the messenger.
Quorum sensing. In the late 1960s, researchers discovered that a marine bacterium (Vibrio fischeri) produced light, or bioluminescence, when its population reached a critical mass. Somehow, the bacteria were able to sense others of their kind and turn on this particular behavior when sufficient numbers were present in a given vicinity. This phenomenon became known as quorum sensing.
Then, in the 1990s, molecular biologist Bonnie Bassler and her research team at Princeton showed that a pathogenic Vibrio species (V. cholerae) released toxins via quorum sensing. The bacteria were able to defer expression of their virulence until enough had gathered to overwhelm the efforts of the host’s immune response. Quorum sensing has been seen to control gene expression in dozens of bacterial species, including Bacillus anthracis, E. coli, Salmonella, Staphylococcus aureus, and many other pathogens known to promote human distress.
Quorum sensing, then, involves the production, release, and subsequent detection of signaling molecules and allows bacteria to regulate gene expression in response to changes in population density. When a threshold is reached, the group responds with a collective alteration of its behavior. It’s the hundredth monkey principle on the micro scale!* In addition, other bacterial species mixed into a soup with the transforming group have been seen to express this adaptation.
Bassler’s team found that every bacterium they tested had its own chemical signaling molecule to communicate with others like it – a sort of dialect for a given species. In addition, studies show that other signaling molecules allow bacteria to communicate between species – a universal bacterial language Bassler calls “bacterial Esperanto.”
Quorum sensing allows bacteria to coordinate their behavior in order to survive and thrive. It allows them to change their behavior in unison to adapt to changing circumstances or to carry out processes that require many cells acting together to be effective. It allows them to adapt to availability of nutrients, defend against competing microorganisms, avoid compounds potentially toxic to them, and coordinate their virulence so as to overwhelm the immune system of the host. Bassler’s work shows that quorum sensing allows bacteria to act as multicellular organisms.
Diversity. The survival and health of systems is promoted by diversity. It has been shown that the diversity of species required for healthy human microflora depends on a continual introduction of new bacteria into the body. Experiments have shown how germ-deprived study animals became sick and died when introduced into a normal, bacteria-rich colony of fellow rats. Without bacteria, the intestinal tract cannot develop appropriately. In addition, in the 1960s, NASA studies showed that a steady diet of dehydrated and irradiated space food resulted in altered intestinal microflora and immune depletion in astronauts. This affirms the global traditions of naturally fermented foods and drinks, which are discussed later in this article.
Interdependent coexistence. Once again, nature’s models point us toward understanding health and wellness as the cultivation of dynamic coexistence and adaptation among diverse organisms within an ecological whole, the indivisible web of relationships. Within the body, as with microscopic life in the soil of intact ecosystems, everything has its role and its place. It is when these ecosystems are ravaged or distorted that untold consequences ensue as the web responds.
Dynamic equilibrium. A healthy ecosystem is, by definition, in a state of dynamic equilibrium, not a static state. Information is constantly circulating within the biosphere as well as human physiological systems. The ability to adapt nimbly and effectively to this information and respond to feedback is a basic feature of living systems and a requirement for their persistence.
Collaboration, (genetic) communication, and sharing of resources. Once resistant strains of disease-causing microbes appear, their resistance seems to spread rapidly. In fact, the presence of antibiotics has been seen to stimulate DNA transfer. Bacteria have an assortment of ways to pick up new traits. Genetic material from survivors – drug-resistant bacteria – literally begins to circulate even across species and genera, promoting multidrug resistance. Bacteria can swap genetic material, collect new genes from the environment, or have them delivered by a type of virus called a bacteriophage. In this way, bacteria relate as one organism with shared focus and resources toward survival.
Consequences of ignorance
MRSA and beyond
The rampant and ill-considered prescribing of pharmaceutical antibiotics – and the excessive use of antibacterial agents in daily life and in agriculture – has contributed to the rapid evolution of some bugs that are quite determined to survive. MRSA is a clear example of this.
MRSA refers to a strain of Staphylococcus aureus that has become resistant to the broad-spectrum antibiotics that have commonly been used to treat it. The acronym stands for methicillin-resistant Staphylococcus aureus. Infection with MRSA can be fatal.
Staph bacteria are typically found on the skin or in the nose of an estimated one in three people; a person can be “colonized” without manifesting symptoms. Healthy people who are colonized can pass staph on to others, however.
In the past, staph could be successfully treated with antibiotic drugs. But, for an assortment of reasons, it has become resistant to its pharmaceutical nemesis, methicillin. This occurred first in settings such as nursing homes and dialysis centers, and the resistant strain was dubbed HA-MRSA for healthcare-associated MRSA. It has been found that treatment with fluoroquinolones (ciprofloxacin, ofloxacin, or levofloxacin) or cephalosporin antibiotics can increase the risk of HA-MRSA.
Elders, with potentially less vigorous gut microbiota and immune function, are particularly at risk for this, as are others with weakened immune systems. Healthcare-associated infections are said to affect one out of every 22 hospital patients, totaling 1.7 million infection cases each year and 99,000 deaths subsequent to infection (though there may be other contributing causes), according to the US Centers for Disease Control and Prevention.
Every new antibiotic seems to be an agent promoting bacterial evolution toward resistant strains.
More recently, another form of MRSA has shown up, among otherwise healthy people in the community. This form is called CA-MRSA, or community-associated MRSA. It has been found among younger people, particularly athletes involved in contact sports, where the bacteria spreads through cuts, skin-to-skin contact, and the sharing of towels, uniforms, or equipment. In addition, it is expressing among those living with HIV/AIDS, those in prisons, and those in close contact with healthcare workers.
MRSA can manifest as a serious skin and soft tissue infection, as well as a challenging form of pneumonia, and can evolve into a life-threatening situation.
An extremely toxic antibiotic, vancomycin, has been successfully used against MRSA in some cases. Its toxicity, however, is concerning, as it can cause kidney damage and hearing loss. Beyond that, some hospitals are already observing bacteria that are resistant to vancomycin – so-called VRE, vancomycin-resistant Enterococcus, which first showed up in US hospitals in 1988. Vancomycin-resistant Staphylococcus aureus (VRSA) was first seen in Michigan in 2002. VRSA can manifest as unstoppable staph-related pneumonia, blood infection, meningitis, and so on.
Every new antibiotic seems to be an agent promoting bacterial evolution toward resistant strains.
Food for thought
Cannabinoids have been found active against MRSA and extremely drug-resistant Mycobacterium tuberculosis (XDR-TB). Investigators at Italy’s Universita del Piemonte Orientale and Britain’s University of London School of Pharmacy assessed the antibacterial properties of five cannabinoids against various strains of multidrug-resistant bacteria, including MRSA.
“All compounds showed potent antibacterial activity.… Activity was exceptional against some of these strains,” the researchers determined. In their study, they noted that cannabinoids demonstrated “potent” antibacterial activity against EMRSA-15 and EMRSA-16, the major epidemic MRSA strains occurring in UK hospitals.
The authors concluded: “Although the use of cannabinoids as systemic antibacterial agents awaits rigorous clinical trials…their topical application to reduce skin colonization by MRSA seems promising.” They observed that Cannabis sativa “represents an interesting source of antibacterial agents to address the problem of multidrug resistance in MRSA and other pathogenic bacteria.”
Honey has been used for thousands of years as an antiseptic wound dressing. Its antibacterial activity is due mainly due to its delivery of hydrogen peroxide. Researchers found that “the antibacterial potency of honey of average level activity is well in excess of that needed to stop the growth of MRSA and VRE.” Additionally, New Zealand manuka honey (produced from the nectar of the flowering tree Leptospermum scoparium) contains plant-derived antibacterial components. The antibacterial activity of manuka honey proved about twice as great as the hydrogen peroxide activity of other honey against VRE, but was similar to the activity of other honey against MRSA.
Strengthening the terrain
Just as the health of the soil and the diversity of the lifeforms it supports influence the health of the plant that draws its sustenance from them, so also the vitality of our inner ecology is key to our own well-being. This brings us to the understanding that even the germ-warrior Louis Pasteur was said to have expressed on his deathbed: that it is less the microbe that is the cause of disease than the state of the host, “le terrain.”
Bolstering our innate resilience, vitality, and immunity is the place to focus our attention. Healthful living foods, such as cultured dairy, grain, and vegetable products, can support immunity and encourage proper intestinal ecology. Beneficial botanical allies such as adaptogenic herbs and medicinal mushrooms can strengthen our regulatory and immune functioning. Other supportive foods are described below.
Probiotics are living microorganisms found in fermented foods that, when eaten regularly, encourage equilibrium of the intestinal flora and hence have assorted positive effects on the host. Probably the best known probiotics are the lactic acid bacteria and bifidobacteria, which are used to culture dairy products such as yogurt and kefir. Probiotics inhibit the growth of pathogenic bacteria in the intestines. For instance, healthy bacterial populations have been shown to successfully compete with Clostridium difficile for necessary nutrients such as simple carbohydrates. They fill an ecological niche by adhering to intestinal walls. Probiotics in cultured dairy products also generally lessen symptoms of lactose intolerance.
Bolstering our innate resilience, vitality, and immunity is the place to focus our attention.
These foods can be purchased ready made and, when well prepared, confer benefit. Better yet is the home fermentation of such foods, an ancient tradition across the globe to preserve both food and health. This also offers profound interspecies communion. Author and noted fermentationist Sandor Katz describes it elegantly: “By fermenting food and drinks with wild microorganisms present in your home environment, you become more interconnected with the life forces of the world around you. Your environment becomes you, as you invite the microbial populations you share the earth with to enter your diet and your intestinal ecology.”
Prebiotics provide sources of energy for the gut microflora. These are nondigestible carbohydrates sourced from certain foods that selectively encourage the growth of beneficial intestinal bacteria. They may be found in such foods as burdock root, dandelion root, Jerusalem artichoke, onion, garlic, endive, leek, asparagus, beans, and peas. Fermented soy foods – such as tempeh, natto, and miso – are sometimes termed synbiotic, in that they are created when probiotic bacteria ferment prebiotic-rich (oligosaccharide-rich) soybeans.
Even small amounts of prebiotic foods have been shown to increase populations of colonic bifidobacteria, with a resulting decrease in pathogenic bacteria such as Clostridia. Other benefits of regular consumption of foods considered prebiotic include improvement of calcium absorption, cholesterol metabolism, and chemical dynamics that support the prevention of disease, particularly of the colon and liver.
Sufficient hydrochloric acid in the stomach provides a deadly barrier to pathogenic bacteria, while acid-loving friendly flora remain intact. Routine ingestion of antacid medications is a questionable practice. Plant medicines such as dandelion root, when taken before meals, encourage secretion of HCl.
At some point, perhaps, humans shall be wise enough to unhesitatingly enlist the intelligence of the bacterial (and fungal) world to guide us toward balance and healing. Bacteria are clearly inventive and nimble in responding to changing circumstances and environments. They seem to be infinitely adaptable and able to communicate their adaptations across apparent barriers of space and kind.
Their strategies for promoting success of the group point us toward the evolutionary imperative for humankind. Realizing that we are “individuals by incorporation” and recognizing this pattern throughout the manifest world are the magical keys to awaken the group mind to its true nature.
As Lynn Margulis eloquently states, “The tendency of ‘independent’ life is to bind together and reemerge in a new wholeness at a higher, larger level of organization. I suspect that the near future of Homo sapiens as a species requires our reorientation toward the fusions and mergers of the planetmates that have preceded us in the microcosm…. Now and throughout Earth’s history, symbioses, both stable and ephemeral, have prevailed.”
Adapted from Conscious Caregiving: Plant Medicine, Nutrition, Mindful Practices to Give Ease by Carol Trasatto (Greenwild Publishing LLC, June 2018).
Price-Pottenger members can read hundreds of additional articles on our website.
To become a member, click here.
About the Author
Carol Trasatto has been practicing and studying herbal medicine since the late 1970s. A community herbalist in the Pacific Northwest, she teaches, writes, consults, and promotes a holistic systems approach to the way we think about health and healing – on the personal, bioregional, and planetary levels. Carol is the author of Conscious Caregiving, a valuable resource for anyone going through intense illness, medical treatments, or dying – as well as those who support them. The book is available at caroltrasatto.com, amazon.com, and independent booksellers.
* The “hundredth monkey principle” refers to a phenomenon whereby when a critical mass or tipping point is reached, a perceptual and behavioral shift occurs within the group consciousness, both locally and non-locally. Evolutionary biologist Rupert Sheldrake explores these organizing principles as “morphic fields” and “morphic resonance.” See his book A New Science of Life for examples of such evolutionary shifts as demonstrated by animal experiments.
- Commoner B. Closing the Circle. New York: Knopf; 1971.
- Margulis L. Symbiotic Planet: A New View of Evolution. New York: Basic Books; 1998.
- Roos R. Wildlife group lists diseases that global warming may spur. Center for Infectious Disease Research and Policy, University of Minnesota. October 8, 2008.
- Sachs JS. Good Germs, Bad Germs: Health and Survival in a Bacterial World. New York: Hill and Wang; 2007.
- Macfarlane GT. Probiotics and prebiotics: can regulating the activities of intestinal bacteria benefit health? BMJ. 1999; 318:999-1003.
- Holloway M. Talking bacteria. Scientific American. 2004; 290(2):34-35.
- Centers for Disease Control and Prevention. Preventing healthcare-associated infections. CDC at Work. 2008. https://www.cdc.gov/washington/~cdcatwork/pdf/infections.pdf.
- Appendino G, Gibbons S, Giana A, et al. Antibacterial Cannabinoids from Cannabis sativa: a structure-activity study. J Nat Prod. 2008; 71(8):1427-1430.
- Allen KL, Hutchinson G, Molan PC. The potential for using honey to treat wounds infected with MRSA and VRE. Presented at the first World Wound Healing Congress, Melbourne, Australia. September 2000.
- Katz SE. Wild Fermentation: The Flavor, Nutrition, and Craft of Live-Culture Foods. White River Junction, VT: Chelsea Green; 2003.
- Nadeau DA. Intestinal warfare: the role of short-chain fructooligosaccharides in health and disease. Nutr Clin Care. 2008; 3(5):266-273.
Published in the Price-Pottenger Journal of Health and Healing
Spring 2018 | Volume 42, Number 1
Copyright © 2018 Price-Pottenger Nutrition Foundation, Inc.®
All Rights Reserved Worldwide