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T*
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T*
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2.036 0 TD
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[(qualities)-365.3(suggest)]TJ
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[(that)-389.5(the)-389.5(biomedical)-383.8(model)-386.2(draws)-385.5(heavily)-388.1(from)-387.2(the)-383.1(biologic)]TJ
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[(logic)-437.2(outcomes,)-432(underscoring)-441.1(limitations)-430.6(of)-433.2(the)-433.7(biomedical)]TJ
T*
[(framework.)-358.3(For)-349.3(example,)-354.6(psychologic)-354.9(states)-357.1(including)-354.2(well-)]TJ
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[(being,)-631.9(anxiety,)-629.6(and)-625.5(depression)-636.8(are)-626.1(well)-628.2(associated)-630.3(with)]TJ
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[(multisystemic)-785.6(physiologic)-789.1(dysregulations)-782.1(and)-783.6(abnormal)]TJ
T*
[(levels)-287.1(of)-287.8(circulating)-290.9(biologic)-283.5(markers)-288.6(and)-284.1(cytokines.)]TJ
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(48,49)Tj
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[(close)-367.2(association)-365.2(between)-363.7(the)-364.2(mind)-361.6(and)-366.3(the)-357.8(body)-362.4(processes)]TJ
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T*
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T*
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(52,53)Tj
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T*
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(54,55)Tj
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T*
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T*
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T*
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T*
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T*
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[(a)-486.4(h)0(o)19.1(l)15.4(is)20.4(t)12.2(i)0(c)-477(u)0(n)20.6(d)0(e)22.4(r)0(s)23.3(t)0(a)19(n)0(d)25.2(i)0(n)18.4(g)-485(of)-471.1(he)22(al)22.2(th)21.4(,)-483.5(o)0(n)19.1(e)-486.8(m)15.1(u)0(s)16.3(t)-481(in)18.4(t)12.2(e)12.8(gr)20.2(a)13.1(t)0(e)-474.6(a)0(n)22.4(d)]TJ
0 -1.2266 TD
[(tr)17.8(a)13.1(n)0(s)20.6(c)0(e)19.8(n)0(d)-341.5(t)12.2(he)-338.4(ob)18.1(j)14(e)12.8(ct)19.2(iv)21(e)-347.7(a)0(n)22.4(d)-350.8(su)16.3(b)14.6(j)0(e)20.4(c)13.4(ti)21.3(ve)-342.1(di)25.1(ch)16.3(ot)22.1(om)25(y)-352.2(i)0(n)-335.7(o)0(r)15.5(d)16(er)-342(t)12.2(o)]TJ
0 -1.2203 TD
[(gr)20.2(a)13.1(s)0(p)-476.9(t)0(h)15.1(e)-486.8(un)20.6(d)16(e)0(r)18.4(l)0(y)23.7(i)0(n)18.4(g)-485(dy)24.2(na)22.4(mi)17.9(c)-486.1(p)0(r)23.2(o)0(c)23.2(e)0(s)17.8(s)0(.)-478.4(O)15.9(ur)-476.3(un)20.5(de)22.4(rs)17(t)12.2(a)13.1(nd)18.9(in)18.4(g)]TJ
T*
[(of)-547(h)15.6(e)0(a)19.6(l)0(t)21.3(h)-553.5(a)13.1(s)-557.7(a)-549.6(c)13.4(om)18.6(pl)20.4(e)12.8(x)-552.2(ph)20.6(e)12.8(n)0(o)19.1(m)0(e)21.5(n)0(o)19.1(n)-553.5(su)22.6(g)14.6(g)0(e)21(s)0(t)17.2(s)-551.4(t)12.2(h)0(a)22.4(t)-556.9(he)22(a)13.1(l)0(t)21.3(h)]TJ
T*
[(an)16.1(d)-382.4(d)0(i)18.8(s)0(e)24.1(a)0(s)18.1(e)-385.6(st)17.2(a)13.1(t)12.2(es)-380.6(e)12.8(m)0(e)21.5(r)0(g)20.2(e)-385.6(f)12.2(r)0(o)21.8(m)-389.6(dy)24.2(na)16.1(m)15.1(i)0(c)22.5(a)0(l)22.2(l)0(y)-381(i)15.4(nt)21.4(er)18.4(a)13.1(c)0(t)19.2(i)0(n)18.4(g)-383.8(a)13.1(n)0(d)]TJ
0 -1.2266 TD
[(ho)19.1(li)18.2(st)23.5(ic)-496(sy)19.6(st)23.5(e)12.8(m)0(s)]TJ
6.7246 0 0 5.9768 122.1165 488.6361 Tm
[(9,)25(2)19.5(1)]TJ
8.9663 0 0 8.9663 138.1606 484.6676 Tm
[(c)13.4(a)0(l)22.2(l)0(i)18.2(n)0(g)-494.7(f)12.2(or)-496.7(in)18.4(t)12.2(e)0(g)21(r)0(a)18.8(t)12.2(iv)21(e)-505.7(l)0(e)21.9(v)0(e)18.3(l)15.4(s)-507.1(o)0(f)-496.4(a)0(n)16.1(a)13.1(ly)23.7(si)20.4(s)]TJ
-8.7446 -1.2203 TD
[(wh)20.3(er)18.4(e)-328.7(f)0(a)19(c)0(t)19.2(o)0(r)21.8(s)-330.1(co)16.9(m)15.1(b)0(i)17.3(n)15.6(e)-335(i)0(n)-323.1(m)0(u)20(l)15.4(ti)21.3(pl)20.4(e,)-325.3(no)19.1(n)15.6(a)0(d)22.8(d)0(i)18.8(t)12.2(iv)21(e,)-325.3(a)13.1(n)0(d)-322.5(r)0(e)24.7(c)0(i)16.2(p)0(r)23.2(o)0(-)]TJ
T*
[(ca)20.2(l)-326(\()12.2(b)14.6(i)0(d)18.8(i)0(r)21.1(e)12.8(ct)19.2(io)25.3(na)16.1(l)15.4(\))-322.9(wa)17.8(y)14.6(s)0(.)]TJ
6.7246 0 0 5.9768 152.4472 466.7527 Tm
[(60)30.5(,6)25(1)]TJ
/F4 1 Tf
8.9663 0 0 8.9663 59.7543 435.3448 Tm
[(The)-338.2(Global)-335.6(Health)-332.8(Framework)]TJ
/F6 1 Tf
1.1128 -1.8336 TD
[(The)-328.8(Global)-328.7(Health)-329.3(Framework)-327.8(addresses)-332.4(the)-332.5(challenge)-326.7(of)]TJ
-1.1128 -1.2203 TD
[(conceptualizing)-360.3(health)-357.9(based)-355.9(on)-353.9(the)-357.8(current)-353.6(state)-355.7(of)-357.3(knowl-)]TJ
T*
[(edge)-253.8(in)-247.2(different)-252.1(scientic)-254(domains.)-254.3(Our)-245.4(goal)-250.5(is)-251.4(to)-249.8(structure)-252.1(a)]TJ
0 -1.2266 TD
[(perspective)-261.4(of)-249.8(health)-256.8(re)24.7(sp)16.3(e)12.8(c)13.4(ti)21.3(ng)-235.4(k)14.6(e)12.8(y)-244.7(p)0(r)23.2(i)0(n)18.4(c)13.4(ip)20.4(le)21.9(s)-241.6(i)0(d)25.1(e)0(n)22(t)0(i)15()16(ed)-230.5(f)12.2(r)0(o)15.5(m)]TJ
0 -1.2203 TD
[(mu)20(lt)21.3(ip)20.4(le)-591.5()16(e)0(l)15.5(d)16(s)-602(o)0(f)-591.3(r)0(e)24.7(s)0(e)17.8(a)13.1(rc)19(h)-597.7(a)0(n)16.1(d)-597.4(di)25.1(sc)18.4(ip)20.4(li)24.6(ne)22(s.)-592.3(Th)18.9(e)-600.6(p)0(r)23.2(o)0(p)21.2(o)0(s)21.2(e)12.7(d)]TJ
T*
[(fr)17.8(a)13.1(m)0(e)21.5(w)0(o)20.9(r)0(k)-473(\()0(1)19(\))-487.3(a)13.1(c)0(c)20.4(o)0(u)21.2(n)0(t)21.4(s)-488.2(f)12.2(o)0(r)-477.7(c)13.4(om)18.6(pl)26.7(ex)-476.3(as)18.1(so)21.2(c)13.4(i)0(a)22.2(t)0(i)21.3(o)0(n)19.1(s)-488.2(a)13.1(n)0(d)-474.3(b)0(i)23.7(d)0(i)18.8(-)]TJ
T*
[(re)18.4(c)13.4(t)0(i)21.3(o)0(n)19.1(a)13.1(l)-553.6(r)0(e)18.4(l)0(a)22.2(t)12.2(io)19(ns)20.6(hi)24.7(ps)-546.4(li)24.5(nk)17.5(i)15.4(n)0(g)-545.3(h)0(e)22(a)13.1(lt)21.3(h)-553.5(d)0(o)19.5(m)0(a)21.9(i)0(n)18.4(s)0(,)-541.7(w)0(h)20.3(i)15.4(ch)-546.4(c)13.4(o)0(n)19.1(-)]TJ
0 -1.2266 TD
[(ce)19.8(pt)17.1(ua)24.4(ll)24.6(y)-225.7(p)0(o)21.2(s)0(i)20.4(t)12.2(io)19(ns)-213.4(he)22(al)22.2(th)-218.8(do)25.8(ma)21.9(in)18.4(s)-222.6(a)0(n)22.4(d)-224.3(th)15.1(e)12.8(i)0(r)-212.9(a)13.1(ss)16.3(o)16.2(c)0(i)16.2(a)13.1(t)12.2(e)0(d)-217.9(f)12.2(a)13.1(c)0(t)19.2(o)0(r)21.8(s)]TJ
/F7 1 Tf
0 -1.2203 TD
[(he)18.8(t)12.2(e)0(r)17.6(a)13.4(rc)19.6(h)13.1(i)0(c)18.4(a)13.4(ll)21.5(y)13.1(/)0(h)19.6(o)0(l)17.8(a)13.4(rc)19.6(h)13.1(i)0(c)18.4(a)13.4(ll)21.5(y)]TJ
/F6 1 Tf
11.2738 0 TD
-.0206 Tc
[(a)-7.5(m)-20.6(on)-5(g)-353.8(e)-20.6(ac)-7.2(h)-359.1(o)-20.6(th)-20.6(er)-20.6(;)]TJ
6.7246 0 0 5.9768 233.2913 335.2251 Tm
0 Tc
[(62)30.5(,6)25(3)]TJ
8.9663 0 0 8.9663 251.0362 331.2566 Tm
-.0122 Tc
[(\(2)-12.2(\))-334.7(p)-12.2(o)9(s)-12.2(i)8.2(t)-12.2(i)9.1(o)-12.2(n)6.9(s)]TJ
-21.3335 -1.2203 TD
0 Tc
[(se)17.8(lf)21.3(-)12.2(p)0(e)17.7(r)0(c)25.3(e)0(p)17.7(t)12.2(io)19(n)-566.1(o)0(f)-559.7(h)0(e)22(a)13.1(lt)21.3(h)-572.4(a)13.1(s)-570.4(a)13.1(n)-572.4(i)15.4(mp)20(or)21.8(t)12.2(a)0(n)16.1(t)-563.2(fa)19(c)13.4(t)0(o)15.7(r)-563.4(li)18.2(nk)23.8(ed)-559.3(t)12.2(o)]TJ
0 -1.2266 TD
[(he)15.7(a)13.1(l)0(t)21.3(h)-395.4(do)19.5(m)15.1(a)0(i)22.3(n)0(s)20.6(;)]TJ
6.7246 0 0 5.9768 122.6267 313.3416 Tm
(3)Tj
8.9663 0 0 8.9663 129.5433 309.3164 Tm
[(\()12.2(3)0(\))-385.7(i)0(n)18.4(c)13.4(or)21.8(po)21.2(ra)18.8(t)12.2(e)12.8(s)-399.7(w)0(e)23.8(l)0(l)18.2(-)12.2(e)12.7(s)0(t)17.2(a)13.1(b)14.6(l)0(i)18.2(s)0(h)20.6(e)12.8(d)-395(e)0(p)17.7(i)15.4(de)16.1(m)15.1(i)0(o)19(-)]TJ
-7.7835 -1.2203 TD
[(lo)19(gi)23.7(ca)20.2(l)-288.1(a)13.1(nd)-278.3(cl)16.2(i)15.4(n)0(i)18.4(c)13.4(al)-281.2(va)25(ri)21.1(a)13.1(b)0(l)17.3(e)12.8(s)-292.2(\()12.2(e)12.8(.)0(g)18(.)16(,)-287.4(b)0(i)17.3(o)0(l)25.3(o)0(g)18.1(i)15.4(c,)-280.4(ph)20.6(ys)19.6(i)15.4(o)0(l)19(o)0(g)24.4(i)0(c)16.2(,)-287.4(so)21.2(c)13.4(i)0(o)19(-)]TJ
T*
[(ec)19.8(on)19.1(om)25(ic)16.2(\))-373.5(a)13.1(ss)16.3(oc)23.2(ia)22.2(t)12.2(e)0(d)-369.6(w)0(i)26.5(t)0(h)-370.6(d)16(is)20.4(ci)22.5(pl)20.4(in)18.4(e)12.8(-)0(b)20.4(a)13.1(se)17.8(d)-376.1(d)0(o)19.5(m)15.1(a)13.1(i)0(n)18.4(s)0(;)-364.6(a)13.1(nd)-366.8(\(4)19(\))]TJ
0 -1.2266 TD
[(in)18.4(c)13.4(l)0(u)20.4(d)0(e)22.4(s)-323.8(t)12.2(r)0(a)18.8(n)0(s)20.6(d)0(i)25.1(s)0(c)18.4(i)0(p)20.4(l)0(i)24.6(n)0(a)22.4(r)0(i)21.1(t)0(y)-314.7(a)13.1(s)-323.8(a)13.1(n)-325.9(o)0(r)21.8(g)14.6(an)16.1(i)15.4(z)0(i)22.2(n)0(g)-311.3(p)0(r)16.9(i)15.4(nc)16.3(i)15.4(p)0(l)20.4(e)0(.)]TJ
6.7246 0 0 5.9768 271.5023 280.4597 Tm
[(2,)25(64)]TJ
8.9663 0 0 8.9663 69.7323 265.4929 Tm
[(These)-690.4(important)-692.6(principles)-694.4(operate)-693.8(among)-690.5(ve)-686.5(main)]TJ
-1.1128 -1.2203 TD
[(health)-440.1(domains:)-431.3(biologic,)-431.8(psychologic)-437.1(\(affective)-434.7(and)-435.9(cogni-)]TJ
T*
[(tive\),)-393.7(social,)-392.2(behavioral,)-394(and)-391.6(spiritual)-388.4(\(Fig.)-395.1(1\).)-388.6(The)-392(range)-387.3(of)]TJ
0 -1.2266 TD
[(biologic)-549.1(factors)-548.3(include)]TJ
/F7 1 Tf
11.2738 0 TD
[(higher-order)-547(biologic)-549.7(processes)]TJ
/F6 1 Tf
13.3034 0 TD
(\(e.g.,)Tj
-24.5772 -1.2203 TD
[(circadian)-694.6(rhythms,)-697(appetite)-695.7(regulation\);)]TJ
/F7 1 Tf
19.3418 0 TD
[(physical)-696.5(function)]TJ
-19.3418 -1.2203 TD
[(and)-344.6(mobility)]TJ
/F6 1 Tf
5.4756 0 TD
[(\(e.g.,)-342.3(activities)-347.4(of)-344.7(daily)-342.8(living,)-344.5(exercise)-341.8(capacity,)]TJ
-5.4756 -1.2267 TD
[(cardiovascular)-640.7(function\);)]TJ
/F7 1 Tf
11.9187 0 TD
[(physiologic)-640.3(functions)]TJ
/F6 1 Tf
9.5033 0 TD
[(\(e.g.,)-633.2(blood)]TJ
-21.422 -1.2203 TD
[(glucose)-448.9(metabolism,)-449.8(hormone)-446.8(synthesis\);)]TJ
/F7 1 Tf
18.9877 0 TD
[(molecular)-450.8(and)-445.8(cel-)]TJ
-18.9877 -1.2203 TD
[(lular)-254.8(events)]TJ
/F6 1 Tf
4.9508 0 TD
[(\(e.g.,)-253.8(chemotaxis,)-253.1(phosphorylation)-256(reactions\);)-260.9(and)]TJ
/F7 1 Tf
-4.9508 -1.2266 TD
[(genetic/epigenetic)-438.3(events)]TJ
/F6 1 Tf
10.4897 0 TD
[(\(e.g.,)-430.9(transcription/translation,)-443.3(gene)]TJ
-10.4897 -1.2203 TD
[(silencing\).)-379.8(Elements)-382.1(of)-376.3(the)-370.5(psychologic)-380.2(domain)-376.5(can)-375.2(be)-377.4(sub-)]TJ
T*
[(divided)-250.7(in)-247.2(two)-245.1(broad)-244.4(categories)-252.1(of)-243.5(processes:)]TJ
/F7 1 Tf
19.8919 0 TD
(affective)Tj
/F6 1 Tf
3.25 0 TD
[(,)-249.5(related)]TJ
-23.1419 -1.2266 TD
[(to)-407.9(the)-414.7(emotional)-405.5(processes)-412.5(\(e.g.,)-411.9(affect,)-407.7(emotions\);)-413.4(and)]TJ
/F7 1 Tf
25.0008 0 TD
(cog-)Tj
-25.0008 -1.2203 TD
(nitive)Tj
/F6 1 Tf
2.3015 0 TD
[(,)-382.3(related)-373.7(to)-382.6(the)-376.8(intellectual)-385.1(processes)-380.9(\(e.g.,)-380.3(beliefs,)-376.4(atti-)]TJ
-2.3015 -1.2203 TD
[(tudes\).)-565.8(Social)-563.5(factors)-560.9(consist)-568.5(of)]TJ
/F7 1 Tf
15.1244 0 TD
[(socio-economic)-567.3(status)]TJ
/F6 1 Tf
9.4528 0 TD
(\(e.g.,)Tj
-24.5772 -1.2203 TD
[(income,)-363.4(work)-363.6(and)-360(employment,)-367.9(education)-361(level\),)]TJ
/F7 1 Tf
22.3388 0 TD
[(social)-368.4(sup-)]TJ
-22.3388 -1.2266 TD
[(port)-581.7(and)-578.6(positive)-579.3(relationships)]TJ
/F6 1 Tf
13.6259 0 TD
[(\(e.g.,)-576.3(presence)-587.4(of)-578.6(signicant)]TJ
-13.6259 -1.2203 TD
[(other,)-421.1(family\),)-417.1(and)]TJ
/F7 1 Tf
8.8521 0 TD
[(culture)-422.3(and)-414.2(lifestyle)]TJ
/F6 1 Tf
8.675 0 TD
[(\(e.g.,)-418.2(diet,)-414.5(transport,)]TJ
-17.5271 -1.2203 TD
[(cultural)-610.4(practices\).)]TJ
6.7246 0 0 5.9768 135.2126 72.2267 Tm
(37)Tj
8.9663 0 0 8.9663 147.4015 68.2583 Tm
[(Behavioral)-604.6(factors)-611.5(include)]TJ
/F7 1 Tf
12.6774 0 TD
(health-risk)Tj
/F6 1 Tf
-22.4527 -1.2267 TD
[(\(e.g.,)-424.5(smoking,)-425(alcohol)-419.5(consumption,)-431.1(other)-424.5(addictions\))-424.9(and)]TJ
/F7 1 Tf
28.0042 44.1023 TD
(health-promoting)Tj
/F6 1 Tf
7.2397 0 TD
[(\(e.g.,)-329.7(exercise,)-332.1(relaxation\))]TJ
/F7 1 Tf
11.4508 0 TD
(behaviors)Tj
/F6 1 Tf
3.7621 0 TD
(.)Tj
6.7246 0 0 5.9768 514.3747 456.6613 Tm
(31,65)Tj
8.9663 0 0 8.9663 532.4597 452.6928 Tm
(And)Tj
-24.7163 -1.2203 TD
[(nally,)-311.2(spiritual)-318.8(factors)-314.3(include)-311.2(sense)-315.6(of)]TJ
/F7 1 Tf
17.9381 0 TD
[(purpose)-314.6(and)-313(meaning)]TJ
/F6 1 Tf
-17.9381 -1.2203 TD
[(in)-240.9(life,)-250.6(and)-239.9(a)-246.1(sense)-246.1(of)]TJ
/F7 1 Tf
9.301 0 TD
(connectedness)Tj
/F6 1 Tf
5.8993 0 TD
[(with)-243(the)-250.3(self,)-242.1(others,)-251.7(and)-239.8(a)]TJ
-15.2003 -1.2266 TD
[(larger)-331.2(reality.)]TJ
6.7246 0 0 5.9768 364.1385 423.8361 Tm
[(16,66)-9.4(,67)]TJ
8.9663 0 0 8.9663 320.8251 408.8692 Tm
[(In)-555.6(this)-558.8(transdisciplinary)-557.3(framework,)-560.7(interrelated)-558.8(health)]TJ
-1.1128 -1.2203 TD
[(domains)-245(interact)-241.2(holistically)-250.1(as)-241.1(a)-239.8(whole)-245.2(system.)-241.8(Each)-245.5(domain)]TJ
0 -1.2266 TD
[(is)-346.3(associated)-345.7(with)-344.1(every)-347.1(other)-348.7(element,)-349(either)-349.3(directly)-343.6(or)-344.9(in-)]TJ
0 -1.2203 TD
[(directly,)-333.9(within)-338.4(global)-334.3(health)-332.7(\(Fig.)-338.2(1\).)]TJ
1.1128 -1.2203 TD
[(The)-720.8(major)-720(conceptual)-731.7(difference)-725(between)-724.1(the)-724.6(Global)]TJ
-1.1128 -1.2266 TD
[(Health)-455.7(Framework)-454.2(and)-454.8(the)-459(biomedical)-453.3(and/or)-455(biopsycho-)]TJ
0 -1.2203 TD
[(social)-345.1(models)]TJ
6.7246 0 0 5.9768 364.5353 347.0739 Tm
[(55,68)-9.4(,69)]TJ
8.9663 0 0 8.9663 391.2377 343.1054 Tm
[(is)-352.6(that)-345.3(this)-350.1(framework)-355.4(does)-348.4(not)-348.1(assume)]TJ
-8.9659 -1.2203 TD
[(hierarchical)-307.1(or)-300.6(linear)-301.4(relationships)-309.2(among)-298.5(its)-308.8(factors.)-304.6(Rather,)]TJ
0 -1.2266 TD
[(it)-377.1(considers)-388.3(these)-384.3(factors)-383.9(as)-380.2(expressions)-384.4(or)-382.9(outcomes)-384.8(of)-382.6(the)]TJ
0 -1.2203 TD
[(global)-353.3(health)-358(state.)-358.7(Each)-359.3(domain)-357.5(and)-360(its)-353.1(factors)-358.6(are)-360.5(concur-)]TJ
T*
[(rent)-516.6(but)-518.4(conceptually)-524.6(distinct)-520.8(expressions)-523.5(of)-515.4(the)-522.2(complex)]TJ
T*
[(dynamics)-378.7(of)-382.6(the)-383.1(health)-383.2(state.)-377.6(For)-380.9(instance,)-386.8(multiple)-384.3(expres-)]TJ
0 -1.2266 TD
[(sions)-252.6(of)-256.2(illness)-256.8(and)-258.8(wellness)-254.8(such)-258.3(as)-253.7(organ)-257.4(function,)-257.9(systemic)]TJ
0 -1.2203 TD
[(processes)-279.7(of)-275.1(allostasis,)-279(and)-277.8(quality)-276.5(of)-281.4(life)-279.3(are)]TJ
/F7 1 Tf
19.7528 0 TD
[(related)-281.4(outcomes)]TJ
/F6 1 Tf
6.6643 0 TD
(.)Tj
-26.4171 -1.2203 TD
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