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Over 600 Rural Hospitals at Risk of Closing

Throughout the nation many rural hospitals are on the brink of closure, citing physician shortages and lack of adequate funding to keep their doors open.  A report from the Center for Healthcare Quality and Payment Reform (CHQPR) revealed that more than 600 rural hospitals – nearly 30% of all rural hospitals in the country – are at risk of closing in the near future.

These hospitals are not just emergency rooms, many are the anchor for primary care, rehabilitative therapies, labs and x ray departments and maternity care. If the hospital closes many , if not all, other rural healthcare services in the area will also disappear.

Lack of adequate revenue

Rural hospitals and clinics are forced to operate many times at a loss- not because they are inefficient but because they have the same overhead as their urban counterparts.

 ER staffing 24/7- Urban hospitals have more patients coming through their doors than their rural counterparts. Even though both require adequate round the clock staffing, the volume of patients in urban areas offsets the overhead.

There are over 1,000 small rural hospitals, representing more than 25% of all the short-term general hospitals in the country, but they receive only 2% of total national hospital spending.

Insurance reimbursement disparity

A recent report by Center for Healthcare Quality and Payment Reform (www.CHQPR.org):

“A common myth about rural hospitals is that most of their patients are on Medicare and Medicaid. In fact, about half of the services at the average rural hospital are delivered to patients with private insurance (including both employer-sponsored insurance and Medicare Advantage plans). Low margins or losses on patients with private insurance, combined with losses on Medicaid and uninsured patients, can force small rural hospitals to close.”

Physician shortage

According to NHRA (National Rural Health Association)

“Ease of access to a physician is greater in urban areas. The patient-to- primary care physician ratio in rural areas is only 39.8 physicians per 100,000 people, compared to 53.3 physicians per 100,000 in urban areas. This uneven distribution of physicians has an impact on the health of the population.”

Some reasons cited for the rural physician shortage are long hours, lower reimbursement of insurance compared to urban areas, aging population of physicians that are nearing retirement, managing patients with higher proportion of chronic illnesses (diabetes, coronary heart disease) and lifestyle of rural living.

Rural hospitals and clinics serve farmers, ranchers, and others that provide food and services for the entire nation. Many of the nation’s natural resources- coal mines, oil and natural gas production are in these areas. Rural hospitals and clinics also provide care for visiting tourists to national parks and outdoor recreation if an emergency arises. If this population can’t continue to live and work in rural areas because of lack of medical services, the entire nation will suffer.

Solutions

  • Match reimbursement with cost of doing medicine

Current insurance reimbursements are below cost of delivering care. Saving Rural Hospitals states that increasing spending to meet cost of services (total would be 4 billion annually) could help offset the financial losses. This sounds like a lot of money, however this amounts to only 1/10 of 1% of total national healthcare spending, which is more than $1.3 trillion spent on all urban and rural hospitals in the country.

  • Telemedicine

 Rural communities could benefit from telemedicine, which solves the problem of rural patients having to drive long distances (sometimes over 70 miles) to see a doctor or consult with a specialist. Telemedicine can treat chronic conditions and provide a preventative approach to healthcare not usually found in rural areas.

  • Establish more rural residency programs and mentoring opportunities. As more rural physicians enter retirement age they are ideally positioned to mentor and support new physicians in rural medicine.
  • Utilize midlevel providers to offset the long hours the physician faces along with providing care more economically. Midlevel providers- nurse practitioners and physician assistants- are a more economical way to support the physician and can provide relief from long hours faced by rural physicians.

Until such a time that above solutions can be implemented, anyone living in rural areas should consider the very real possibility that their local hospital could be shut down in the near future. Are you prepared for such an event?

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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Silent Pandemic – Antibiotic Resistance

A dire warning from health leaders across the world are calling the silent pandemic- antimicrobial resistant (AMR) infections. According to the World Health Organization AMR is one of the top ten leading global threats to health facing humanity in the world.

CDC estimates about 47 million antibiotic courses are prescribed for infections that don’t need antibiotics, like colds and the flu, each year. That adds up to approximately 28% of all antibiotics prescribed. In addition, A study published in the Lancet found that antimicrobial resistance was the direct cause of 1.27 million deaths worldwide.

An ever-increasing number of bacteria, fungi and parasites are becoming resistant to commonly prescribed antibiotics, with some resistant to many different antibiotics.  In some cases, antibiotics are not effective, leading to impossible to treat infections. This is a chilling scenario we are facing.

Antibiotic resistance (AMR) occurs through either genetic mutation or by acquiring resistance genes- where the antibiotic resistance genes are transferred to the next generation.

Some of the most widespread and common examples include:

  • methicillin-resistant Staphylococcus aureus (MRSA) (The most common)
  • vancomycin-resistant Enterococcus (VRE)
  • multi-drug-resistant Mycobacterium tuberculosis (MDR-TB)
  • carbapenem-resistant Enterobacteriaceae (CRE) gut bacteria

Broad spectrum antibiotics- The good and the bad

Broad spectrum antibiotics are being used in more and more AMR cases. These are antibiotics that act on the two major bacterial groups, gram-positive and gram-negative or any antibiotic that acts against a wide range of disease-causing bacteria. They are lifesaving when no other antibiotic therapy is working.

 They do come, however with their own set of whole set of detrimental, long lasting health effects. Some of these include resistance to pathogens, altered gut microbiota and immune system dysfunction. This is especially detrimental in young children. Broad spectrum antibiotics can alter gut microbiota which in turn will disrupt and affect immune function and growth of the child.

Promising research to fight antibiotic resistance

A protein in antibiotic resistant bacteria called DsbA helps fold resistance proteins into the right shapes to neutralize antibiotics. This was discovered by researchers, including experts from Imperial College London, led by Dr Despoina Mavridou assistant professor in Molecular Biosciences at the University of Texas at Austin. By disrupting the DBsA protein the team was successful in neutralizing the antibiotic resistant protein. In addition the pathogen was more sensitive to common antibiotics. As of this writing, research has been limited to outside the human body. The team now plans on finding an inhibitor that can be safely used in humans providing the same effect.

How to prevent AMR

Until research can successfully develop therapies for AMR, staying healthy and using antibiotics only when necessary are our options. Also, avoid crowds during outbreaks. And if sick, stay home!

The most effective way to prevent AMR is to boost immune system through:

  • Quality sleep- Sleep is when the body actively heals and restores health. Practice sleep hygiene
  • Exercise- At least 30 minutes several times a week of active walking or other form of exercise can help boost immune system, regulate mood and decrease appetite
  • Avoid sugar-Sugar and refined carbohydrates help feed pathogenic bacteria
  • Vitamin D (with k2)- Vitamin D supports a strong immune system. Talk with your healthcare provider about vitamin D supplementation and checking vitamin D levels to make sure you are reaching optimum vitamin D levels
  • Avoid and manage stress- Deep breathing exercises can help when unable to avoid stressful situations.
  • Practice personal hygiene- wash hands after going to store, before eating, and any time your are exposed to anyone who is ill.

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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You recently made the proactive decision to purchase the Jase Case and some add-ons. This investment is a hedge against interrupted medication supplies due to natural disasters, travel to medically underserved regions of the world, and world events leading to extended...

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Our mission is to help you be more medically prepared. Join our newsletter and follow us on social media for health and safety tips each week!

Prepared Equals Peace of Mind

Prepared equals peace of mind

What is labeled “prepping” or being a “prepper” used to be how everyone lived as recent as 50 years
ago. Our just- in- time supply chains weren’t around back then. Amazon, and online shopping didn’t
exist. Back then, if you wanted something you had to either call the company and place an order or mail
a check in.

The Sears catalog, along with many other catalogs would arrive and you and your family would spend
hours poring over the pages. These pages were filled with almost anything you may need or want, from
bed sheets to tools for the shop. In essence, those catalogs were the modern-day equivalent of Amazon.
Sometimes it would take a month or so for the much-awaited order to arrive. This was normal. Back
then, if you wanted something you had to plan for it.

Just in time supply chain

Fast forward to today. With all the wonderful technology, the same day deliveries, and almost any item
at our disposal within a few days, we have become complacent. Don’t get me wrong, we have used this
system to receive much needed items, in some cases almost immediately. This is the wonder of our
technological age. But it comes at a price. We take for granted that these supply chains will always be
running smoothly. Our world economy, for the past several decades has made life more convenient and
opened our lives to new experiences and time saving devices.
Technology- double edged sword

Our global world is a double-edged sword. The convenience we so much rely on, can and has been in the
process of failing over the past few years. The consequences to our healthcare system have been
devastating. Medical supplies such as contrast dye and drugs, have been in short supply or altogether
unavailable with no end in sight. This illustrates how fragile our medical system is. We are only one
natural or manmade disaster, pandemic, political or civil unrest from the complete shutdown of life
saving drugs and medical supplies.

Pharmaceuticals outsourced

The last major pharmaceutical manufacturing operation closed its doors and left the United States in
2004. Since then, nearly all the active ingredients for antibiotics and chronic medications – even
vitamins – are produced overseas, mainly in China and India.
Take, for instance the current amoxicillin shortage.

Across the country many pharmacies have reported a limited or not available supply of amoxicillin.
Amoxicillin is one of the first antibiotics used to treat strep throat, ear infections, urinary tract infections
and many other infections. The shortage includes amoxicillin in pill form, powder to mix with water to
make a suspension, and chewable tablets.

The American Society of Healthcare Pharmacists maintains a database of drug shortages and
manufacturers. They have listed amoxicillin manufacturers who have reported shortages or no
availability.

• Aurobindo, with facilities located throughout the world, refuses to provide availability
information.
• Hikma, based out of the UK, did not provide a reason for the shortage.
• Rising, based out of New Jersey has amoxicillin capsules and tablets available, but doesn’t state
whether they have amoxicillin powder available
• Sandoz, headquartered in Switzerland did not provide a reason for the shortage.
• Teva, which is based out of Israel did not provide a reason for the shortage.

However, the FDA states the only shortage is amoxicillin in powder form. This is because if even one
manufacturer can supply the necessary drug there is no perceived shortage.

This is very disturbing. All it takes is that one manufacturer to declare either a shortage or the drug
not available at all and the US supply is dried up.

Augmentin, (amoxicillin / clavulanate) is one of the antibiotics included in the Jase Case (see below how
to order a Jase Case). This can be substituted for amoxicillin if amoxicillin isn’t available.

Generics less likely to be manufactured

An analysis conducted by the US Pharmacopeia, a group that sets standards around the world for
medicines, found that antibiotics are 42% more likely to be in shortage in the US compared to other
types of drugs. Most antibiotics are now generic.

According to an analysis by the FDA Report “Drug Shortages: Root Causes and Potential Solutions”
identified three root causes of drug shortages.

1. Lack of incentives for manufacturers to produce less profitable drugs. (Generics aren’t very
profitable)
2. The market does not recognize and reward manufacturers for “mature quality systems” that
focus on continuous improvement and early detection of supply chain issues; and
3. Logistical and regulatory challenges make it difficult for the market to recover from a disruption.
The fragile global supply chains mean that if a pharmaceutical factory is down in China, you may not be
able to find your prescription at the neighborhood pharmacy. Lifesaving antibiotics are at risk of running
out faster than any other medicine. Medicines that are now available could easily run out. This could
lead to dire consequences.

Jase Medical is on a mission

JASE Medical is a telemedicine company with a singular focus to change all of that. This platform offers
access to basic emergency preparedness medications for every family in America.

And how will they do that? Well, it won’t happen overnight. But JASE Medical has done its homework
and established a nationwide network of physicians trained to evaluate individual needs, assess
conditions, and prescribe appropriate prescriptions for emergency preparedness purposes. From there,
licensed pharmacists fill your prescription, and the Jase Case is sent to your home.

These are the medications that will become lifesaving for you and the people you care about. And it’s all
done online through the JASE Medical portal.

How it works

When you log on to the platform and begin your consultation, you will find a simple and user-friendly
experience. The consultation takes little over five minutes to complete. After a licensed Jase healthcare
provider has reviewed your health history and any allergic reactions to medications, your prescriptions
are filled, and your Jase Case is shipped to your front door.

What’s in the JASE Case?
The kit contains the following antibiotic medications:
 Amoxicillin/Clavulanate.
 Azithromycin.
 Ciprofloxacin.
 Doxycycline.
 Metronidazole.
(Substitutions are made if allergic to one of the antibiotics)

All medications carry a level of risk, but these five antibiotics were selected for their effectiveness and
optimal patient safety. Guidance from the CDC says it best: “Antibiotics … save lives, and when a patient
needs antibiotics, the benefits usually outweigh the risks of side effects and antibiotic resistance.”

Some of the infections a Jase Case can treat
 Anthrax, plague and tularemia (resulting from bioterror).
 Bite wounds.
 Cellulitis.
 Diverticulitis.
 Intra-abdominal infections.
 Tooth infections.
 Ear infections.
 Pneumonia.
 Sinusitis.
 Strep throat.
 Urinary tract infection.
 and more.

When access to your healthcare provider isn’t possible (you are on vacation, etc.) your Jase case
includes a symptom and antibiotic use handbook titled the “Emergency Antibiotic Guide “with easy-to-
follow instructions to ensure proper use of the antibiotics if indicated.
What about chronic conditions?

Soon, the JASE Medical platform will provide emergency preparedness medicines for those with chronic
medical conditions (such as blood pressure and other chronic conditions). JASE Medical’s same
physician network will assess your condition and the need for appropriate preparedness medicines.

Ongoing support

As part of its mission to prepare you medically, JASE Medical provides unlimited ongoing support from
their physician network for questions about any of the medications prescribed.

What about shelf life?

The good news about antibiotics is that they last longer than you think. The FDA’s Shelf-Life Extension
Program found that 88% of the drugs studied maintained their potency and safety beyond the published
expiration date. The extended usability of these medications ranged from 5.5 years to as many as 23
years beyond their printed expiration!

The JASE Case antibiotics all carry the FDA’s required expiration dates. JASE Medical endorses those
dates.

Value and peace of mind

At the end of the day, this is all about peace of mind and knowing that you are ready for the
unexpected. Knowing that you have found a solution, priced at a fraction of what it would otherwise
cost you, adds to that peace of mind.

Go to JaseMedical.com and secure your emergency medications, an emergency antibiotic guide,
unlimited physician consultation and a team of professionals who are on a mission to keep you and your
loved ones prepared and safe during these uncertain times.

- Brooke Lounsbury

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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How Should I Store My Jase Case and Add-ons?

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You recently made the proactive decision to purchase the Jase Case and some add-ons. This investment is a hedge against interrupted medication supplies due to natural disasters, travel to medically underserved regions of the world, and world events leading to extended...

Join Our Newsletter

Our mission is to help you be more medically prepared. Join our newsletter and follow us on social media for health and safety tips each week!

Maintain or Attain a Healthy Weight

When you maintain a healthy weight, your overall health and ability to care for the sick and injured is enhanced. Preparedness isn’t just first aid and readiness during adverse weather events and home safety. 

According to the CDC:

  • The US obesity prevalence was 41.9% in 2017 – March 2020. (NHANES, 2021)
  • From 1999 –2000 through 2017 –March 2020, US obesity prevalence increased from 30.5% to 41.9%. During the same time, the prevalence of severe obesity increased from 4.7% to 9.2%. (NHANES, 2021)
  • Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer. These are among the leading causes of preventable, premature death.
  • The estimated annual medical cost of obesity in the United States was nearly $173 billion in 2019 dollars. Medical costs for adults who had obesity were $1,861 higher than medical costs for people with healthy weight.

It is my belief that post covid the above rate of obesity will reveal a much higher rate.

Diseases linked to obesity:

  • Diabetes
  • Fatty liver disease
  • Sleep apnea
  • Premature death
  • Certain types of cancer (breast, colon, prostate, and esophageal cancers)

Obesity, and even being overweight puts a severe strain on the body. Plantar fasciitis, excess wear on hip and knee joints, low back pain and even sleep apnea can be a result of excess adipose tissue. 

A vicious cycle can set up in the body, where the hormones ghrelin and leptin are out of balance.

At least that is what happens in an ideal world.

Ghrelin is called the hunger hormone and is secreted by the stomach when the stomach is empty. It regulates:

  • Blood glucose levels through reduced insulin secretion and regulates the synthesis and breakdown of glucose and glycogen.
  • It reduces heat production to conserve energy.
  • It reduces sympathetic activity.
  • It plays a role in regulating bone growth 
  • It is also highly expressed in metastatic cancer cells

Leptin is called an appetite suppressant hormone and is secreted by adipose tissue and balances the ghrelin hunger hormone. Leptin regulates:

  • Satiety
  • Metabolism- energy regulation
  • Immune function
  • Stable mood
  • Mental sharpness

Leptin deficiency can lead to:

  • Recurrent bacterial infections
  • Severe obesity
  • A condition called leptin resistance

What is leptin resistance?

During a normal feedback loop:

High levels of leptin signal your body that there are adequate stores of fat so you eat less and burn more fat. When leptin levels are low, this signals your body (brain)that you need to eat more and hold on to fat reserves in the body.

Leptin resistance happens when leptin which is stored in fat cells isn’t acknowledged by the brain. This results in increased appetite and slower metabolism.

There are many reasons believed for leptin resistance. Genetics, poor sleep habits, processed food, insulin resistance and lack of exercise are believed to contribute to this.

There are no easy solutions.

Anyone who has struggled with weight has already heard the following-

  • Eat more vegetables,
  • Increase activity
  • Avoid processed foods
  • Stabilize blood sugar
  • Etc. etc. etc.

However. There is much more physiology and psychology involved to this than previously thought. If it was that easy, we would all be able to easily lose weight. Emotional eating, when bored, snacking between meals and lack of meal planning can contribute to weight gain. 

Solutions

Check with your primary care provider before initiating any lifestyle changes

- Brooke Lounsbury

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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How Should I Store My Jase Case and Add-ons?

How Should I Store My Jase Case and Add-ons?

You recently made the proactive decision to purchase the Jase Case and some add-ons. This investment is a hedge against interrupted medication supplies due to natural disasters, travel to medically underserved regions of the world, and world events leading to extended...

Join Our Newsletter

Our mission is to help you be more medically prepared. Join our newsletter and follow us on social media for health and safety tips each week!

Other Types of Accidental Poisonings and Exposures

Other Types of Accidental Poisonings and Exposures

Accidental poisonings cover a broad spectrum of populations and exposures. From the toddler ingesting something they found in the yard to medication errors to insect bites, the routes and exposure to toxic are almost endless. Some types of poisonings may not be apparent, and can cause irreparable damage if not caught in time.

As stated in the previous post on household chemical emergencies, poison control center is the fastest way to find out about what to do if you suspect any sort of exposure. Their online tool can help identify if there is a poison emergency and what to do They even have an app you can download for your phone to expedite the process.

According to The National Poison Control Center:

In 2020, the 55 U.S. poison control centers provided telephone guidance for over 2.1 million human poison exposures.

 That’s about: 

  • 6.4 poison exposures/1000 population,
  • 37.9 poison exposures in children younger than 6 years/1000 children,
  • 1 poison exposure reported to U.S. poison control centers every 15 seconds

Adults comprised almost half of all exposures (47%), followed by children younger than 6 (39%), then teens (8%).

Types of exposures

Our previous post on household chemical exposures details what to do if you or your loved one is exposed to common household chemicals. Below are some other types of accidental poisonings:

The most common types of poisonings in children:

  • cosmetics and personal care products
  • cleaning substances and laundry products
  • pain medications, both prescription and over-the-counter (OTC)
  • foreign bodies such as toys and toy parts, coins, and thermometers
  • topical preparations like rash creams
  • vitamins and supplements
  • antihistamines
  • pesticides
  • plants
  • antimicrobials like antibiotics

Most dangerous types of poisonings for children:

  • Medications– Over the counter and prescription medications- Remember, there is no such thing as a child proof container. Store all medications out of the reach of children. Do not store medicine in any container other than its original packaging. 
    • Carbon monoxide poisoning Not all poisons are swallowed; some are inhaled, or breathed in. Carbon monoxide gas is in fact an invisible killer. It has no color or odor. Take it seriously. Make sure there’s a carbon monoxide alarm in every sleeping area of your home.
    • Button batteries (sometimes called disc batteries) can be found in musical greeting cards, remote controls, key fobs, and other small electronic devices. Be especially mindful of the 20 mm lithium coin cell battery. When swallowed by a child, especially one younger than 4 years, it often lodges in the esophagus causing burns within just 2 hours. A hole in the esophagus may develop and the burn can extend into the trachea or aorta. More than 60 children have died from ingesting button batteries.
  • Iron pills  are very dangerous for children to ingest. A child can start throwing up blood or have bloody diarrhea within an hour of ingestion
  • Cleaning products (covered in previous post)
  • Nail glue and primer (used in artificial nails, etc)
  • Hydrocarbons: This is a broad category that includes gasoline, kerosene, lamp oil, motor oil, lighter fluid, furniture polish, and paint thinner.
  • Wild mushrooms: Many types of mushrooms grow in many areas of the country. Some are deadly to eat.
  • Alcohol: When children swallow alcohol, they can have seizures, go into a coma, or even die. This is true no matter where the alcohol comes from. Mouthwash, facial cleaners, and hair tonics can have as much alcohol in them as alcoholic beverages.
  • Drain cleaners and toilet bowl cleaners: These caustics cause devastating burns to the mouth, throat and stomach. Drain cleaners may be strongly alkaline and toilet bowl cleaners may be strong acids. If swallowed, they must be diluted immediately to limit the damage that rapidly occurs.
  • Topical anesthetics: These medicines can cause seizures or a condition called methemoglobinemia which keeps the blood from carrying oxygen to the tissues. Be especially careful with teething gels, hemorrhoid preparations, anti-itch creams, and sunburn relief agents.

The most common types of poison exposures in adults:

  • pain medicines, both prescription and over-the-counter (OTC)
  • sedatives, hypnotics, antipsychotics
  • antidepressants
  • cardiovascular drugs
  • cleaning substances (household)
  • alcohols
  • pesticides
  • bites -ticks, spiders, bees, snakes)
  • anticonvulsants
  • cosmetics and personal care products

What to do if suspected poisoning:

If unconscious, vomiting, seizures, or other signs of distress immediately call 911, then contact via phone, app or online tool the poison control center for guidance. Do not immediately try to induce vomiting until you contact them. Some chemicals are caustic and can cause damage to the esophagus if vomited. 

Action Plan:

On the refrigerator or other conspicuous place:

  • Keep an envelope with a list of medications and allergies for each family member
  • Keep a list of medications and allergies on refrigerator for each family member
  • Post poison control center phone number 1-800-222-1222
  • Post primary care provider name and number
  • Speak with primary care provider about keeping syrup of Ipecac on hand to induce vomiting.

 

- Brooke Lounsbury

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

Recent Posts

Keeping you informed and safe.

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Ivermectin for Scabies- and More

Discovered in the late 1970s and approved as a commercial product for animal health in 1981, ivermectin, an antiparasitic drug was initially used by veterinarians to treat mite and heartworm infections. In 1988, ivermectin was approved to treat Onchocerciasis (known...

How Should I Store My Jase Case and Add-ons?

How Should I Store My Jase Case and Add-ons?

You recently made the proactive decision to purchase the Jase Case and some add-ons. This investment is a hedge against interrupted medication supplies due to natural disasters, travel to medically underserved regions of the world, and world events leading to extended...

Join Our Newsletter

Our mission is to help you be more medically prepared. Join our newsletter and follow us on social media for health and safety tips each week!

New Jase KidCase now available!

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