In this presentation, we will take a look at the cost flow through the general ledger for a job cost system. If we can understand the general ledger and be able to see what is happening as the costs go through the general ledger, we really get a good idea of what a job cost system is doing and a good idea of general ledgers t-accounts and how the double entry accounting system works. First, a word from our sponsor. Well, actually these are just items that we picked from the YouTube shopping affiliate program, but that's actually good for you because these aren't things that were just given to us from some large corporation which we don't even use in exchange for us selling them to you. These are things that we actually researched, purchased and used ourselves. Acer 27-inch monitor. I've been using an Acer monitor as my primary monitor for a few years now. This is the first Acer monitor that I have used after having used a series of different brands of monitors in the past. The Acer monitor has been performing well and I'm trusting the Acer brand more and more as I use the monitor. I have a 27-inch monitor which I think is ideal for what I do which is of course the screen recording and the editing. If you would like a commercial free experience, consider subscribing to our website at accountinginstruction.com or accountinginstruction.thinkific.com where we have many different courses. You can purchase one at a time or have a subscription model given you access to all the courses. Courses which are well organized have other resources like excel files and PDF files to download and no commercials. We're now going to go through this in a step-by-step process. Not looking at the journal entry but just looking at the GL and try to think about okay if we see the GL, the posted transactions, the posted journal entries, what is it that actually happened to make these transactions and see the flows through the GL account and our goal is to be able to look at really the last slide which has all of our transactions in the GL account and be able to see how they're all related to each other as the GL account is basically put together. So we're going to construct the GL account as we go and then look at that last slide and if you can look at that last slide and say okay I see how all this stuff is basically tying together without really looking at the at the journal entries then you're getting a good idea of the flows that are happening through a job cost system. So for example this first one we see that we have the raw materials here and we see the work in process. These are the two things that are happening from this GL account at this time and we can see that the raw materials is going from zero I'm sorry the work in process is going to go from zero up by 2230 to 2230 and the raw materials inventory is going down was at 150,000 going down by 2232, 147, 770. So what happened here is that of course we took raw materials from we can imagine the warehouse and we're putting it into the work in process account. So we can imagine a requisition form happening here in order for us to say hey warehouse we need uh we need material to be taken out and put into the factory where we're going to make stuff if it's guitars again we're going to take stuff out of the wood out of the uh out of the warehouse and start to work on it in the work in process as we do so we put this into work in process and remember every time we do that we're also supporting this number by job we have to apply it to jobs. So then the next thing that we're going to have happen is say this is our next transaction the next new thing is this item and this item. So factory overhead is going up and the raw materials is going down from 147, 770 down by 552, 147, 220. So what happened here is raw materials going down again but it didn't go to the work in process this time it instead went to factory overhead. Why? Because we didn't know which job to put it to this might be small stuff it might be glue on the guitar might be small components on the guitar where the the factory just went into the to the uh to the warehouse and said hey I just need glue I don't I don't know which job we're going to work on we're going to put it in the middle of the factory and use it for like all the jobs well then then we're going to have to just put it in the factory overhead because we don't know which job we'll assign it out later so this is indirect materials here. So then the next thing that happens is work in process here and wages payable okay so wages payable and work in process wages payables a liability account it went from zero up in the credit direction to 4200 the other side going to work in process so this one's a little bit more confusing for most people because you can think of it it's kind of like we process payroll what happened here and instead of crediting cash we haven't paid it yet so we credited wages payable and instead of debiting wages expense as you would think we debited work in process now that's confusing for a couple different reasons because obviously we're not dealing with withholdings or payroll taxes and that stuff and one and two because most people you know think of a journal entry that should be the debit should be going to wages expense and that's the thing we got to kind of unlearn this lot of these things that we think of as just expenses because of what they are are really expenses because of the period that they are being incurred in in other words these wages expenses are not being incurred in this time period to generate revenue but to generate an asset inventory so instead of debiting wages expense we're putting it into this work in process as we do so the work in process is going up from 2002 30 from the direct materials up by the 4200 for the wages to 6430 and we're also going to have to post that to the job it's direct therefore we know exactly which jobs were worked on by this 4200 and we'll be posting to the job sheets as well the job sheets then if we add them all up should add up to the 6430 next thing that happens wages again we're crediting it but this time not debiting work in process but factory overhead same thing we're kind of like thinking that like we're processing payroll instead of crediting cash we're crediting wages payable because we haven't paid it yet liability account bringing the liability up from 4200 by 1200 to 5400 the debit not going to wages expense not going to work in process as it did before but going to factory overhead because it is going to a job I mean it is going to inventory but we don't know which job so it's not expense because it's not helping us generate revenue now it's part of inventory but it's not part of work in process because I don't know which jobs to apply it to instead it's going to go into the bucket of factory overhead it's going to be indirect labor stuff like on you know the supervisor salary the maintenance and the warehouse anything really wages related that we couldn't apply to a job next thing that happens is we're going to say that we credited accumulated depreciation and debited factory overhead why would that happen well accumulated depreciation is related to equipment we know that journal entry always has a credit to accumulated depreciation it being a counter asset account it's going in a credit direction 153 000 credit up in a credit direction by 2500 to 155 500 the debit then is not going to depreciation expense as we would normally expect but is going into factory overhead why because it's depreciation on factory equipment and it's we're not using it's not helping us to generate revenue and we didn't put it so it's got to go into inventory we didn't put it into work in process because we don't know which job to put it to and therefore we had to put it into this bucket again it's working the factory overhead next thing that happened is that factory overhead increased and we credited cash now note that this journal entry doesn't tell us a lot of detail we don't know exactly what we paid the cash for because the factory overhead doesn't really define that what we do know however is that whatever we paid for it was probably something on the factory because cash is decreasing and it's going into factory overhead so it should have been part of the inventory so things like utilities on the factory insurance on the factory anything that's on the factory that we couldn't apply to a particular job we're just going to dump into this factory overhead bucket next thing that happens is factory overhead goes down and work in process goes up meaning work in process was at 6430 it's going up by 6722 13150 factory overhead was at 7100 it's going down by 6722 380 now these are both kind of asset accounts they're both kind of inventory accounts this inventory account is going down we're putting it into work in process why well the factory overhead we really wanted it in work in process the whole time but we couldn't do so what was stopping us from applying these directly out to work in process we didn't know which job to apply them to now we must have figured that out we figured out hmm we figured out how to apply them to a job and we just used an estimate so we used some type of estimate to say I know which job to apply this amount to so I can support this amount on job cost sheets and therefore apply it to the work in process account so now the work in process account is here it includes direct materials direct labor and overhead and all of these numbers can be broken out and supported by job cost sheets next thing that happens is factory overhead is going to zero and had 380 in it we credited it by that exact amount making it go to zero cost to get sold went from zero up by 380 200 380 why would that happen well the factory overhead you know really never gets to zero unless we force it that to do so because it's only an estimate remember that these items represent indirect labor and direct material anything else on the factory that we couldn't apply to an actual job and these are actual costs and then we applied it out to the jobs using an estimate which means that they're never going to be exact those two things are never going to be exact either it will be under or over applied this act happened to be under applied because we applied less here then of the actual costs and therefore we had to close this out and the other side went to cost of goods sold this just being kind of like what we had to do doesn't have anything to do with actual cost of goods sold it's just an estimate it being small and therefore not affecting our our decision-making so not material that's why we can do it even though we don't exactly know exactly what happened because it's just an estimate that we're trying to clear out this estimate so that next period we can start at zero next thing that happens we see that the working process is going down from 13,150 down by 8,736 to 4,414 finished goods is going from zero up by 8,736 to 8,736 these are two basically inventory accounts there they're two asset accounts one is going down one is going up what is happening here well this is working process meaning the the jobs are still in process these are finished process jobs that means whatever some jobs must have been completed we took them out of the you know in process account and put them into finished goods account and so these two numbers then are going to be supported by job cost sheets we counted up those job cost sheets for which jobs have been completed and then transferred them from work in process to finished goods so this number then can be supported by job cost sheets what's still left in work in process should be able to be supported by job cost sheets next thing that happens is we debit accounts receivable bringing it up from 180,000 by 8,593 to 188,593 we see that the revenues the other side of that these two are the same number it's going from zero up by a credit to 8,000 by a credit of 8,593 to 8,593 and then we see cost of goods sold is going from 380 up by 6,610 to 6,990 and finished goods finally is going from 8,736 down by 6,610 to 2,126 so there's a lot going on here there's two journal entries happening and why would we combine those in one slide because that's the normal sales journal entry so we're recording the sale of our inventory the sales here is going up and the related account to that is is accounts receivable we've made a sale and accounts receivable goes up these two although they're usually the thing we focus on in practice are confusing here a little bit because they're not where our focus on is here our focus on through this entire process has been on the inventory which means finished goods inventory has now been completed and shipped and is going down from 8,736 down by 6,610 to 2,126 and the other side of that is not sales but cost of goods sold the expense account the expense of us you know our inventory which is the same as a merchandising company where this is a same transaction that you would see for a merchandising company that's just selling inventory except they wouldn't have finished goods inventory they would just have inventory so it's going to go from 380 up by that 610 6,610 to 6,990 the other side sales going up and accounts receivable going up is the other side of just the sales journal entry but it has nothing to do with really the numbers we've been tracking here if you want to tie this number into all the other numbers or how we got it from the job cost system you can't unless we use the job cost sheets to derive the sales number which may happen but it's not necessarily the case the sales number is not tied necessarily to the job cost sheet unless that's how we create the sales number so now if you want to take a look at the final sheet here if you can kind of go through this and and see how all these are related if you go through this and basically take and tie out the numbers that we have from just just the end result here you'll have a good idea of what is going on so for example if you can go through here and say okay here's here's the working process account here's the raw materials account and maybe even tie these out here's a one and a one on that one next thing that happened so that's working process that we tied out directly next thing that happened is a two raw materials went down here and that went to factory overhead and that's happened because this is indirect labor or indirect materials that went to factory overhead and so you can kind of tie tie those things out three what happened is this account here wages payable is going to work in process because we applied that out to work in process and then for what happened this wages payable is going to factory overhead for because that is going to be indirect labor and so if you if you just keep on going through that process and you can see the flow through here and see it how it all ties together within the GL accounts then that's a good practice to do because it gives you good information again just of the flow of a job cost system and it's also gives you just a good working with like these are basically T accounts GL accounts and just getting a good idea of debits and credits and how how debits and credits are flowing through the T accounts


There are a few huge players in North America when it comes to amusement park chains which focus on high-thrill and family entertainment markets. These chains operate numerous amusement parks located across the continent. There is a chain in particular, however, that puts more focus onto far less properties, resulting mostly in more themed experiences and attraction resorts. These properties include three theme parks that offer a good selection of thrilling roller coasters, flat rides, family and kids attractions, and live entertainment, among other things. This chain is known as Herschand Family Entertainment, and I will be looking at each of these three parks and doing my best to predict which roller coaster will get the X first at each of these parks. Before I get into my selection for each of these three parks, I do have a caveat to discuss before doing that, just as I did in the last video of this series with the SeaWorld Entertainment parks. Two of the Herschand parks have been around for a very long time, but even still, I don't believe a coaster removal is necessarily imminent for the very near future at any of these parks. Only over the past decade has Herschand really begun to put more of a focus on high-profile thrill coasters resulting in rapid expansion for their two main parks. As a result, a large majority of these rides are safe, and I had to make very difficult decisions for each one of these parks and deciding which I think will go next based on my perceived popularity, maintenance issues, and other factors that go into determining whether a ride stays or leaves. I certainly do not know these parks inside and out, and these predictions aren't meant to be taken too seriously, just a way to discuss what I think may happen in the future. Let's get into my selections. The first park on the list is Dollywood in Pigeon Forge, Tennessee. For Dollywood, I did have a couple options in mind, and I did consider Mystery Mine, which is one of their earlier thrill coasters they added from 2007. It's the first coaster of its kind that came to the United States, and it does seem to get some mixed reviews, but it is a very popular ride, and ultimately I decided on Blazing Fury. Now, I love Blazing Fury. I actually think it's a really cool, unique ride. It's a mix of a dark ride and roller coaster. This was actually built by Park Maintenance Staff way back in the 70s, and like I said, it opened in 1978, and because of that, you know, it's an older ride. It's over 40 years old. I'm sure it's getting harder to maintain, and it doesn't really seem to be that popular. When I went to Dollywood in December of 2019, it was very busy, and a lot of the time, this didn't have that long of a line. It is kind of tucked away in the park, and it's pretty easy for this to get overlooked, and I think maybe in the coming years, if they remove this, this could maybe be replaced by a modern dark ride and or coaster. I know Dollywood has sent out surveys before asking about a potential new indoor roller coaster, and I've also heard some rumors about a dark ride coming to Dollywood in the future for Phase 2 of Wildwood Grove. So maybe they're looking to add a more modern type of dark ride to the collection in anticipation of getting rid of this. As it currently stands, it does seem like Blazing Fury is popular to go to during times of bad weather, such as when it gets really rainy out, because it is indoors, and this is basically the only indoor ride at Dollywood. So I could definitely see this getting removed in the future due to its age, and it's likely getting harder to maintain and probably needs a lot more work done to it than the other rides. So ultimately Blazing Fury I think will go next at Dollywood. For Silver Dollar City in Branson, Missouri, I selected Fire in the Hole, which opened at Silver Dollar City in 1972. This is pretty much the same thing as Blazing Fury. This opened before Blazing Fury, so Blazing Fury was probably based off of this ride, but they're both very similar, they're both technically roller coasters that function as dark rides, and opening in 1972, that makes Fire in the Hole 48 years old this year. So it's a very old ride, so I'm sure it is getting harder to maintain. I'm not exactly sure how popular it is, but I imagine that it's not one of the most popular rides in the park. Correct me if I'm wrong on that, but that's just how I perceive it. But I'm sure it's also costly and time-consuming to upkeep this ride, and this could also potentially be replaced with an updated dark ride I feel like. I'm sure they wouldn't get rid of the building and infrastructure of this ride, but maybe they could use what is there for a more modern type of ride, or even a roller coaster. The last park is Wild Adventures in Valdosta, Georgia. This park is really interesting. This park was acquired by Herschand in 2007, and it's by far the newest park on the list. And this was the hardest selection for me to make by far. I had several options for this park in mind. I considered several of the coasters including Boomerang, Cheetah, Go Bananas, and Twisted Typhoon. Ultimately, I selected Boomerang, which is a Vakoma Boomerang, and the reason I picked this, ultimately, was because it is the oldest coaster in the park, beating the Vakoma SLC Twisted Typhoon by only one year. This park does have mostly family coasters, and it doesn't get significant investment, unlike the other two Herschand parks have in more recent years. In reality, I believe the SLC Twisted Typhoon could be just as likely to go, but I don't know how popular these rides are for guests in the park, and I don't know a whole lot about the park. The thing about Vakoma Boomerangs and SLCs is that they are actually very reliable rides and hold up for a very long time and are easy and cheap to maintain, even though many guests complain about them. I really think though that the major coasters at this park are probably safe for some time, as wild adventures likely won't see any large investments from Herschand for the foreseeable future. Like I said, Herschand bought this park in 2007, they haven't really put a whole lot of money into it. It's mostly smaller family additions and themed areas and things like that. Certainly nothing on the level of Dollywood or Silver Dollar City. What do you think as far as which roller coasters could potentially be on the chopping block next for each of these parks? As previously mentioned, I think most, if not all of these coasters are safe for some time, but I think some of them could pose a challenge to their respective parks where they may have to make a decision to remove them due to maintenance upkeep issues among other things. Let me know your thoughts, subscribe, like this video if you enjoyed it, and like my page CoasterDaddy on Facebook and follow me at CoasterDaddy official on Instagram. Also, don't forget to check out the other videos available from this series and a playlist on my channel if you haven't seen them yet. Thanks for watching, this is CoasterDaddy, bye.


going to drill a hole I think right here right there so that means I need to raise this up up up so then there's a proper size to get in there so this is what the bed frame looks like when it is disassembled alright I seem to have ran into an impasse I forgot that when Hotel Prius and I installed these we did this I think it's called the Craig system where it's screwed into this top two by four here and here so the only other option the only other option I guess is to cut this area out and additionally cut out the area in this bed platform and then have an inlet right here which then goes down to here if anyone is following me or if that makes sense to anyone that's what I'm thinking then I wouldn't have to raise the bed I wouldn't have to take this thing out and raise it up you see how it's kind of low and it only provides like an inch or two inches inch and a half maybe of protection for sliding for this for this mattress so I'm thinking maybe go ahead and do get more two by fours for support back here so it doesn't bow out so much or maybe two by eights because what I what I could do is I could take this two by four slide it over here and then have a two by eight in the middle and provide some extra rigidity actually this is pretty rigid if I slid this one over and then I had one two by eight in the middle I think that's what I'm gonna do I'm gonna cut out this and do as planned tomorrow when that thing arrives at Amazon then I can rent a jigsaw cut this thing out cut this wall out through the bus and they can have yeah it's all the water thing so here is a little switch that I made last night I did like six trips to the hardware store I knew I was gonna I knew it was gonna be a long day and there was gonna be multiple trips so I didn't want to have a broken record video Lowe's greatest hits so I just did I was just working yesterday so anyways that's a plan I'm gonna go and I'm gonna buy one two by eight petasize then I'll drill it in all right I am back from Lowe's look the difference with the flex two by four two by ten all right two by four two by ten see this is nice and secure this is not so I'm gonna rearrange some things here I'm gonna drill this one in permanently over here on the edge so I have some stability towards the edge of the bed and then I'm gonna temporarily put the other two over here so I can work around that tomorrow cuz I think I want to put the inlet like right here just so it has a nice easy shot right to that spot see that you understand so there will be a little bit of flex but you got two basically a two by eight instead of two by four and this is totally solid this is gonna be super solid so it's gonna be a lot better than before cuz I actually noticed when I would sleep on that edge it would kind of sink down a little bit so and if it bothers me I suppose I could install a little piece of board or maybe flip this flip this over since it's been you know on the other side for so long anyways it's gonna be a lot better regardless okay here we go half reinstalled really easy really really easy guys as you can see the saying is super flimsy but once the mattress is on the weight will be distributed and even this is so much better so much better so I knew there's a reason I didn't like to sleep when the edge because it was I would sink especially with two people on there so anyways that's it for today for this particular project because I gotta wait for that thing to arrive overnight shipping from Amazon then I can put the rest of this actually maybe I'll maybe I'll bore this pull out and get it ready and these need to be cut to size as well but I don't exactly know what size so maybe I will wait for tomorrow should be pretty simple of course I do have a few of the things to do as well one being fixing this wood right here so maybe I'll take a crack at that I'm not really sure what to do all right well that concludes today still got work to do tomorrow just kind of getting back in the swing of things after my little surgery so I appreciate all of those people out there who have understood and you know a patient with my uploads was a bit longer recovery time than I expected and as I've said before I really don't want to make boring content it's not my my goal not my ambition in life if you will and yeah so looking forward to hitting the road soon if I can get the shower fully installed or at least fully plumbed tomorrow that would be that would be a major accomplishment that would be great especially since this is the first time installing a shower I feel like the majority of the time that I spent on this build unfortunately has been a learning experience I'm not a carpenter not a handyman not a plumber not a tradesman if you will just a guy with a camera talking to his right hand all day just trying to learn and so I have definitely learned a lot and it's been quite an amazing experience so far I mean the build part of it has been an amazing experience the travel part of it has been an equally amazing experience I met so many amazing people the van life hashtag van life or bus life has been in the probably the most incredible experience meeting other like-minded people other travelers other you know frugal digital nomads other youtubers and stuff like that and it's you know I came to this conclusion of downsizing as a result of an internal frustration of me wanting a certain lifestyle which was unattainable with my current situation current situation was rent apartment you know things that go into an apartment having a job and responsibilities and once I was able to save up money and kind of like just take off and just hope for the best it's been incredible and hopefully this continues hopefully I can hit my target number of like you know 50 to 100,000 subscribers under be amazing 50 would be great but somewhere in there I think from ad revenue which I'm gonna have to turn ads on somewhere with the ad revenue would give me enough money to survive on a shoestring budget and that is the goal right now and then obviously to build upon that but yeah it's been been awesome even the downtime has been great to reflect on my videos I was just sending Dylan Magister some some old videos and I was watching like the really early ones and I was like you totally sucked but I watch my videos now and I'm like these are like watchable and I still have a long ways to go you know I'm still I'm still 11 months old for YouTube and I really want to improve I really believe that I can create captivating and interesting content for you content that is not on TV content that is impossible to make with a production crew or production company this is intimate it's just me and you look there's no one else in here it's just us with me and my thoughts and that is the priceless part of the video that can't be replicated the producer can't tell me to say things and for it to come out natural like it is now I feel like that's why TV is declining there is too many reality shows and they're just complete and utter BS the place I used to work at the bar is now a reality show thank God I'm not there they hire a bunch of actors to pretend to be employees and then after the fact I heard they were hired and just it's crap not them not the not that place not that my old co-workers they're not crap but the whole formula is crap Kardashians crap it's all fake it is all fake trust me I went to school with someone who was on the hills and it was just I mean you can't tell you don't know what's rallying what's not I mean it's just it's fake producers tell you what to say so anyways this is a real deal this is me this is you this is my bus this is my life I have a dwindling bank account I'm hoping to make it to the end of the year hope I then have a monthly income what else I mean this is it what you see what you see is my life right here I have you know trash bag right there choose right there dirty bed sheets right there a bunch of pillows up there bus still with the ignition switch issue right there half completed shower I got a full heart and a empty bank account but I wouldn't change anything for the world and that is the truth that is a real truth that you wouldn't see on a reality TV show


Now, today's webinar is the Early Retiree Divestor Workforce, a quantitative analysis of early retirement among health professionals using CLA-SA data. So let me introduce our speaker for today, Dr. Sarah Yuko. Dr. Sarah Yuko is an assistant professor in the Department of Applied Health Sciences at the University of Prince Edward Island. She's a registered dietician with more than 10 years of clinical experience. Her primary interest is in human resources, and in her program of research, she seeks to better understand what keeps Canadian allied health professionals in their jobs and the impact of allied health professionals' continuity on patient outcomes. So over to you, Dr. Yuko. Thank you very much. All right. So welcome, everybody. Thank you for coming to listen to my webinar talking about my thesis research, which I used the Canadian Longitudinal Study on Aging Data for. And as already mentioned, I was looking at how the early retiree can divest the workforce and quantitatively exploring early retirement and involuntary retirement a bit among health professionals. So the members of my committee for my thesis were Dr. Trish Ray at the Alberta School of Business at the University of Alberta, and Dr. Carol Esther Brooks and Dr. Rita Cummings both at the University of Alberta in the Faculty of Nursing. I did complete my PhD there in the Faculty of Nursing, despite being a registered dietician. I do have no disclosures for non-financial or financial interests in the subject matter of this research and neither do any of my committee members. So just to give you an idea of the structure for this presentation, I'm going to be first talking a bit about the study objectives, the methods and then the results, the so what and the next steps and then any questions you may have. You can ask at the end. I did have four manuscripts that were incorporated into my paper-based thesis. And I have cited them throughout, so several of them have already been published. The first has been published in the Canadian Journal on Aging and that's the development of the conceptual models that I used and tested. The second paper is a descriptive paper and it's in press with health care policy. And the third is an early retirement paper that was published in Human Resources for Health and the fourth on involuntary retirement has yet to be submitted. But basically what the way I'm going to do the presentation is I'm going to sort of talk about all of the objectives for the entire study and then the methods for the entire including all four papers and ongoing like that, just to make it a little less disjointed. So my question when I started my study was sort of why do health professionals specifically registered nurses and allied health professionals retire early? Report from the Global Health Workforce Alliance and World Health Organization had estimated a deficit of 12.9 million skilled health professionals by 2035, which would be a 79% increase to the current deficit at the time the report was written. So it seemed as though prolonged labor force participation among health professionals was becoming increasingly necessary. And nurses specifically are known as really a staple of the health care system and without them other health care professionals really struggle to deliver any health services. And for the first time in 20 years in 2014, the supply of registered nurses in Canada had declined. Allied health professionals, which I define in my study as baccalaureate degree prepared as a minimum health professionals, including speech language pathologists, pharmacists, dieticians, physiotherapists, occupational therapists and clinical social workers, they all provide really key services across the health care continuum and their particular value in the prevention, treatment and management of chronic diseases. Comparatively, both RNs and health professional, allied health professionals require a baccalaureate level of education at a minimum and both groups are female dominated and can be found in diverse health care settings. Their professional services are often provided in shared workspaces and neither are likely to be the most responsible practitioner as this is the typical purview of the physician. The differences between the two groups are most apparent when we consider the content and scheduling of their work with nursing tasks frequently being more physical and more demanding on the body than those of allied health professionals and nurses being more likely to work rotating elongated shifts on evening nights and weekends. So, for definitions for this, all of my study, early retirement was defined as retirement before the age of 65 and retirement was considered involuntarily if the individual who'd retired considered their retirement to have been involuntary as this was how it was measured in the Canadian longitudinal study on aging. And there was no real literature indication of how frequently involuntary retirement occurred among registered nurses and allied health professionals. So going to the objectives, I started by developing and validating conceptual models of early and involuntary retirement among registered nurses and allied health professionals. And then using the CLA data after that, I was able to identify and compare factors that were reported to influence retirement decisions among registered nurses and allied health professionals. Following that, I looked to explore the relative importance of factors that influence early retirement and on time or late retirement, so that being 65, later than 65 years, among publicly employed nurses and allied health professionals. And then I quantitatively tested conceptual models of early and involuntary retirement in that same population. Last, two objectives I obsessed or obsessed the model fit and the association of identified variables with either early or involuntary retirement across occupational groups. So trying to look at differences in the testing between the RNs and the HPs. And last, tried to identify and discuss some implications for RN and HP workforce policy. So I started off with a theory to guide my methods. Many theories and conceptual frameworks have been developed and applied to enhance understanding of retirement and retirement decisions. The life course as a key concept in the life course perspective is defined as the coalescing of age-graded trajectories, which includes family pathways and career paths, which are contingent on changes and conditions and the availability of future options and short-term transitions, such as exits from education and retirement. And I selected the life course perspective because, firstly, employment-related decisions intertwine significantly with many other decisions during the life course. Second, because the perspective is inherently interdisciplinary, so it incorporates concepts and learnings from economics, anthropology, developmental psychology, demography, and sociology. And this was important to me, both being sort of an interdisciplinary scholar, so being a registered dietitian who did a Masters of Health Administration and then ended up in PhD in nursing, but also because I was looking at multiple different professions who would come from, you know, very different theoretical and didactic forms of education. And last, the life course perspective encouraged looking at micro, meso, and macro-level factors, which was important to me. So even though I may not have been able to look at all those factors, with the Canadian Longitudinal Study on Aging Data, it did help me to develop what I hope are comprehensive conceptual models that can be tested later, potentially, and have more accommodation for some of the, particularly the meso-level factors. And that's what this graph, which I developed for my study, is supposed to just demonstrate that over time, an individual has their own career trajectory towards retirement and they may retire on time, as we call it, or late early or late. It may be voluntary or involuntary and it may be a partial or a full retirement and factors at the macro-level and the micro-level and the meso-level, which is right in the middle, where that trajectory is, will all have an impact on what types of decisions they make about their retirement. So I won't talk too much about the Canadian Longitudinal Study on Aging, as many of you are probably very familiar with it, but it was developed to provide an infrastructure for state-of-the-art interdisciplinary population-based research. And for this study, I accessed baseline data for all respondents in both cohorts, which the comprehensive cohort, which included 30,000 people who had complete face-to-face interviews and site visits, and 20,000 in the tracking cohort who completed telephone interviews. And the questions, as you probably know, there was many questions on the survey related to demographics, health status, health behaviors, physical ability, psychological mental health, socioeconomic status and participation in the workforce. And specifically for my purposes, they did ask about occupation and settings of employment. So as far as my steps go, I began with a literature review and I conducted this search in multiple electronic databases. I ended up including 23 studies sort of in developing the conceptual model. There was a real absence of relevant studies related to retirement among allied health professionals in particular. And there was a limited scope and fairly low quality of existing reviews on registered nurse retirement. And then there was multiple meta-analysis and reviews related to sort of retirement in the broader population, which obviously would include health professionals. So I elected to sort of include results from high quality reviews that from the broader population, individual studies and reviews on registered nurse retirement and then any individual studies that existed on allied health professional retirement. So after developing the models, where all the factors identified as contributing to retirement were sort of added into the models and into the appropriate model, whether early or involuntary retirement. And last, I conducted interviews with 14 current and former health professionals between 45 and 85 years old to sort of validate the models to find out if they appear to be, you know, valid in line with their experience. And I'll talk a bit more about that on the next slide. So the goal, these were the demographics of people who participated in my qualitative interviews. So as you can see, I tried to get a range from across the Canadian longitudinal study on aging age range from 45 to 85. And I tried to have one registered nurse represented or represented in each category. And then the allied health professionals divided across the categories fairly equally. And 50 percent of them were already retired and the other were not, which means that they were able to give me sort of there. They were in that age range, but still able to give me their perceptions of what would impact on their decision making. I was able to get different provinces or representation from different provinces and from many of the allied health professionals, which actually made me quite satisfied to, especially some people like radiation therapists, where there aren't as many of them. It was nice and speech language pathologists to get representation in my interviews. So ideally, I was trying to achieve sort of a face validity of my conceptual models, and I tried to recruit them based on the principles of maximum variation sampling. So prior to the interview, I sent them the conceptual models, so both the early and involuntary retirement conceptual models, which we'll see later. And I conducted the interviews that are over telephone or Skype and one took place in person. And they were asked explicitly if the model appeared clear, logical and relevant to the retirement of registered nurses and allied health professionals. Additionally, I asked them if they had any changes they would suggest to improve the model. I analyzed the registered nurse and allied health professional responses separately to sort of see if there was any comparison across the professional groups in terms of differences. And then I applied those results to refine the models. And if I thought that factors factors were added or adjusted in the model, if more than two people who had participated in the qualitative interviews identified it as an issue. So this was a big step for me, the data cleaning, as you might have guessed from the way of described who I included. I didn't use all of the participants in the CLA. I used only those in the occupations of interest. So originally, my understanding had been that the CLA was going to code occupation and setting of employment. So I was kind of informed that that was decided they decided not to do that. So I ended up reviewing free text entries for both occupation and setting of employment for all 50,000 respondents and pulling out only those who were publicly employed, registered nurses and allied health professionals. So this was complicated by the fact that a lot of nurses reported themselves as simply a nurse. And this could have meant registered nurse, licensed practical nurse or health care aid. So for those who didn't specifically identify themselves as registered nurses, I filtered out those who had less than a baccalaureate level degree. So as a result, I'm sure that there may have been some diploma paired registered nurses who had identified themselves only as a nurse and I might have missed them even though they were registered. It's also possible that some licensed practical nurses or health care aides had undergraduate degrees in other fields and weren't actually registered nurses. As far as setting goes, this was also free text. And so I was looking mainly at publicly employed, where that was my intention. So I removed participants who reported self-employment, retail employment or government employment from the sample, as my objective was to sort of look at people to try to give information of relevance for health policy makers and administrators in the public health care system, inclusive of hospitals, regional public health centers, primary care centers and provincially run long term care facilities. So in some cases, that setting was really unclear. So if it was simply health care, I included them in the sample. So it is definitely possible that some respondents were self-employed or employed outside the public health care system. So the type of model testing I used was logistic regression. What this did mean is that everyone who was included in my model testing had to be retired already. So because the binary was for the logistic regression, the outcome was either early retirement or not early retirement or involuntary or nonvoluntary, but the premises that you've retired already. So this meant that anyone who wasn't already retired but who met my criteria for a profession couldn't be included in my regression models. So I did do some exploratory data analysis looking for outliers, distribution and variance. And this was definitely an appeal of the CLSA data is that there was very minimal missing data, especially probably the one with the most was income, but even then it was very low. One issue was just that the voluntariness of retirement. So whether or not retirement was voluntary was only asked of one of the cohorts and this significantly limited my sample size for testing the model of involuntary retirement. So I did conduct correlations, colonnuity and I looked at variance inflation factor before conducting non-stepwise unconditional multivariate logistic regression. For the early retirement model, I had enough enough people to run a separate model for the registered nurses and allied health professionals. And that allowed me to compare them. But for involuntary retirement, I wasn't able to have to do a blended sample and use occupation as a variable instead of separating by profession, which again was because only one cohort answered the question about the voluntariness of their retirement. So this descriptive in my descriptive paper, I basically showed because I was able to use the full sample for this paper of people who hadn't yet retired and people who had retired in each of the professions. I was able to look at age of retirement, the mean and the standard deviation for and then the plan to retirement age and the mean and standard deviation for that for registered nurses, pharmacists, social workers, dieticians, occupational therapists, physiotherapists, SLPs and other allied health professionals, which included audiologists, radiation therapists and child life specialists. So the age of retirement did range from about 55.8 among SLPs to 60.5 among other allied health professionals with a close sort of second oldest being pharmacists. And the planned retirement age for those people who hadn't yet retired range from 61.6 among nurses to 62.8 among pharmacists. And what I think is most important to me to take away from this is that all of these are pretty well below the age of 65. So even the planned retirement ages were all below the age of 65 and the average age of retirement for nurses in particular is 58.1 and was statistically significantly different than allied health professionals average age of retirement as a group. OK, so in this table, which is also in the descriptive paper, which is in press, I was able to compare factors contributing to retirement. So not all people, so basically people who hadn't yet retired weren't necessarily asked which factors they thought might contribute to their retirement in all the all the cohorts. But I was able to see sort of which factors of the factors contributing to retirement were more significant for early retirees versus on time or late and which were more significant for RNs versus HPs. So just as I don't know if it's a reminder, but the question people are asked were just sort of like, did you financial possibility? Was this a contributor to your decision to retire? Yes or no. So it was sort of a binary and people could choose more than one of these factors contributing to their retirement. So the only significant difference there was between early retiring RNs and allied health professionals was that RNs were less likely to report a desire to pursue hobbies as contributing to their retirement decision. Whether it was early or on time or late, which I found really interesting and I still haven't really found a reason to say why that may be. And then as far as differences between early and on time or late retirees, regardless of profession, early retirees were more likely to indicate that financial possibility, requirement for caregiving and organizational restructuring had contributed to their retirement decision. Whereas on time or late retirees were more likely to indicate that a desire to stop working contributed to their decision to retire. So I know this is a really busy slide, but this is basically the conceptual model for early retirement that I came up with after, you know, the literature review and and had validated or did face the legity with participants. So none of the people interviewed. I didn't end up having or two or more people recommend a change to this particular model in terms of what impacts on early retirement. Both registered nurses and Alley Health professionals felt that the model was clear, logical and relevant. So obviously, I mean, it may not be obvious, but I wasn't able to test all these variables. Not all of them are in the CLSA and some of them are in the CLSA, but were not included for both cohorts. So there's different reasons why I might not be able to include them in my testable model. So and the another reason was limited sample size. So I ended up selecting variables for inclusion in my tested model based on the highest correlations with early retirement and those that were factors speaking specifically to retirement decision making. So those questions of was, you know, financial possibility of factoring your decision to retire, just because those were most most related to my question and also most temporarily focused because a lot of the questions asked are true to the current times of the time when they were originally asked by the CLSA sort of like what is your income or those types of questions. Whereas was this a factor in your decision to retire puts it at the time and place of their retirement decision. OK, so what you see here is my results of my logistic regression. So you can see the RN model and the Alley Health professional model on the right side and the RN model on the left. And basically for RN, there was several significant odds ratios with financial possibilities, a factor contributing to retirement. Basically, there was a 2.49 greater odds of having retired early. If somebody indicated that was one of the factors. Organizational restructuring was associated with a 3.94 greater odds of having retired early and 7.60 greater odds of having retired early was related to caregiving responsibilities. And then on the other side for, you know, a decreased odds of retiring early being tired of work was associated with an odds ratio of 0.49. So basically people who identified as being tired of work were half as likely to have retired before the age of 65. Organizational restructuring was also predictive of early retirement among Alley Health professionals and they had a slightly higher odds ratio than nurses with 5.59. And that was basically the only factor that was significantly predictive of early retirement in both groups. So this is the model of involuntary retirement. Involuntary retirement is much less studied. And so it's not surprising. It wasn't surprising that there was far fewer articles that specifically explored this and the candidates of people who reviewed it for me thought that it was a clear, logical and relevant model. We did end up modifying it or I didn't modify it because more than one person indicated that they thought caregiving responsibilities may be necessary or should be included in the model as contributing to involuntary retirement in this group. So as I said, the sample size was a great issue here. And if you're familiar with logistic regression, you'll know that cases is how you determine the number of, you know, the power of your model or how much power you need. So because in involuntary retirement. So the issue being not only that one cohort didn't answer this question, but also that involuntary retirement is actually fairly rare in this population. That meant I had very few cases. So I was only able to test a very limited number of variables in my model. So I tested only self-rated general health, chronic diseases, which is basically a continuous number of chronic diseases. Caregiving as a factor for retirement and occupation were included in the model. So here's the model results. This is the paper. The manuscript is still in preparation. If anyone has any tips of where a journal might be interested in this type of study, I'd be very interested in hearing. So as you can see, only 8 percent of variants in involuntary retirement was explained by the model. So this may be partially obviously that I didn't get to test all the different variables that I had indicated, but it may also be that a lot is not understood about involuntary retirement as of yet. The only thing that was significantly predictive in this population of involuntary retirement was self-reported health. So in this case, it's sort of counterintuitive, but a one-digit increase in self-reported health is actually associated with a poor sense of health. So basically someone with a very poor health rating, which was self-reported, would have had or did have 6.3 greater odds of involuntary retirement than someone with a very good health rating. Allied health professionals, as compared to registered nurses, had a far lower odds of involuntary retirement with an odds ratio of 0.24. But this should be interpreted with caution just because there was such a small number of allied health professional respondents that reported in voluntary retirement the majority of the people in this sample were registered nurses. So as far as the results go, in word form, I guess, essentially registered nurses and allied health professionals were largely in agreement regarding the clarity, logic, and relevance of the conceptual models that I had developed. The average age of our in retirement of 58.1 years is significantly lower than that of allied health professionals from a statistical perspective. Financial possibility and desire to stop working are among the most frequently reported factors contributing to early and on-time or late retirement among registered nurses and allied health professionals. 85% and 77% of allied health professionals do retire early. The model of early retirement has tested explained a variance of 25%, or a maximum of 25% of variance. And I believe this is largely because a lot of the meso-level variables were not included and many of the macro as well. The only real sort of macro one was looking at province of residence, which could give an indication of how provincial policies affect retirement decision making. RNs and HPs whose retirement decision had been influenced by organizational restructuring were more likely to have retired early. Registered nurses with caregiving responsibilities were more likely to retire early and only 8% of variation in involuntary retirement was explained by the tested model. And it's somewhat surprising even that things like chronic disease were not predictive of involuntary retirement. Some of the key limitations to the study are related to this, my study related to the timing of the CLSA survey in terms of, so some questions that were asked that I would have included in my early retirement model, like things related to marital status, household income and dependent kids living at home are reflective of the individual's current status and they may not reflect the status that they had at the time of the retirement. So they may have been married at retirement and not married now or vice versa. So that was one factor. And then even questions about, you know, did this contribute to your decision to retire may be subject to recall bias because there are some people who may have retired in the sample as many as 20 years before that question was being asked to them. So their memory may not be completely accurate. So in conclusion, registered nurses and allied health professionals do consider many factors when they're contemplating early retirement. There's much that remains to be known about publicly employed, are in an allied health professional pathways to retirement, particularly involuntary. And the conceptual models have only been partially tested. Further quantitative testing is definitely needed. Some of the administrative and policy implications, strategies to reduce rates of early retirement among registered nurses and allied health professionals might include reducing the frequency of restructuring in healthcare or at a minimum sort of improving the implementation and the management of these restructuring efforts, a potentially legislated expansion of pay lead policies to people providing informal care and subsidization of caregiving support for would-be caregivers who wish to remain in the workforce. As far as involuntary retirement goes, work-based interventions, there are some that have been proven to improve self-rated health and self-rated health was the only factor of protective and voluntary retirement. So maybe some of these interventions could improve self-rated health which reduces the risk of involuntary retirement in this population. And I do want to add just to make it, because I haven't explicitly stated this to make it clear, is that I don't think necessarily that the goal would be to even have everybody work until 65 or to increase the average to 65, but just based on the volume of professionals, particularly registered nurses. If we were able even to increase the retirement age by six months on average, the mean retirement age, this could have a significant impact on work, you know, supply and demand in the country of Canada and help us to maybe stave off some shortages or predicted shortages in these populations or these professional populations. So as far as next steps go, I am hoping to deepen my understanding of publicly employed pathways to early and involuntary retirement. I am hoping to get some funding to get a larger sample of allied health professionals because I would like to make comparisons across allied health professions. I believe that there could be very significant differences in the way, for instance, that a pharmacist approaches retirement than an occupational therapist. And this is knowing that it's one reason why I think there may not have been as many significant results in relation to allied health professionals in that model where RNs had a few, and that might be just because there's some of that difference within the group across professions. Additionally, I'm interested in the question of involuntary retirement as a concept because there are, and there's been some papers talking about this too, and involuntary retirement is sometimes measured differently in different studies where certain reasons are attributed as being considered involuntary, such as having to retire for poor health. And I feel that some people in the study, you know, it may be if I didn't hand in my resignation letter, then for some people that would mean they didn't consider it involuntary or if they, yeah, essentially if they did sorry, hand in the resignation letter.  And lastly, which I just found out today and I'm very excited about it, I am going to have the opportunity to do comparative analysis using the Irish longitudinal database on aging to be able to see how this compares with them. I'm sure small sample size is going to be an issue there as well, especially with allied health professionals, but I'm really looking forward to that and seeing how there's a difference across countries. And that's it for now, so I look forward to hearing your questions. Thank you so much, Dr. Yuko, for your excellent presentation. I'd now like to open it up for questions. Just a reminder for the participants that muting will remain on, but you can enter your questions into the chat box in the bottom right corner of the WebEx window. So there is a first question, and you can also see it in the chat box. The question is, what are your thoughts on the implications of R&S caregivers in a both paid and unpaid setting, on the job and then retiring to be caregivers for loved ones? This transition is very interesting that one would retire from their professional caregiving job to an unpaid one. What are your thoughts about that? I mean, it's a big question. I think that it's because I didn't do qualitative interviews around sort of the experiences of people who've retired and how they go from their job to maybe a job afterwards in terms of taking care of loved ones. I did certainly, I can't really speak to it broadly, but I definitely did look at the literature to see sort of what the patterns are, and certainly it's a very gendered thing, and we are a very female-dominated professions, allied health professionals and registered nurses. And in general, women are more likely to give up work or to reduce their hours of work to take care of loved ones, and actually, at least in general, are more likely, as the evidence indicates, to work more or work longer in order to pay for caregivers. So it's sort of an interesting, I think, partly tied up with the roles that women are expected to play, especially women in caring professions. Okay, great. I guess I had another question that came to my mind, is that the sample size that you used would cover all the different provinces in Canada, with the healthcare system being provincially determined. Did you see or was your sample size large enough to look at differences between people working in different provinces on their factors, for example, influencing early retirement? So the sample size, unfortunately, wasn't large enough to look at differences in factors, but in early sort of descriptive analysis, it was definitely clear that rates and also the age of retirement were significantly different across provinces with, I believe, Newfoundland had the lowest age of retirement in many of the professions, and I think the province of Saskatchewan, I feel like, might have had the highest age of retirement. So certainly there were differences cross-provincially in terms of age of retirement. Yeah, and I'm sure that also with provincial elections or governments turning over in different times and perhaps implementing new changes to this system, it will make it very challenging to look at it with a small sample size. The other question that somebody had was to, you looked mostly at public employees. Have you had a chance to kind of think about how it would be different from private employees or health professionals that work in private settings such as private, long-term care homes, for example, and what differences you would expect to see? Yeah, so the evidence that I looked at it anyway indicates that people working privately do work longer, and that's typically more connected to sort of private practice. So pharmacists in particular, one of the reasons I suspect that they were the highest in terms of average age of retirement and expected age of retirement is because they probably had some privately employed pharmacists in there and they do tend to work longer because they are often owners of a business and there's not always a pension. I think one of the biggest things is definitely pension. So if you are self-employed, you don't necessarily have a pension and so that decision might be different depending on how much money you've saved. The other reason I think it might be different in self-employment is it's a lot easier to make adjustments to your work hours and the type of work that you do when you're the one deciding on your own employment. So if you want to do this type of work or you don't, and I think that that's one of the flexibilities, one thing that makes working later in life more tolerable, I guess, so that would be my suspicion. As far as people working in private sector, long-term care facilities, those sometimes would be unionized. So I'm not sure what the difference would be in those particular situations. I think to me it has more to do with sort of unionization versus non-unionization. Okay, great. You also mentioned that you are looking at the Irish or Tilda, the Irish Longitudinal Study on Aging. And there's lots of other cohorts available. Is there any reason why you chose to look at Tilda, the Irish Longitudinal Study on Aging? Because the Health and Retirement Study, I'm sure has lots of information as well in the U.S. about retiring and health professionals. Yes, the main reason is because there's a confederation of Ireland and Canada University Foundation, I believe it's called, and they had awards basically that were available to do studies that looked at particularly connections and I guess similarities between the Maritimes and Ireland. And so I applied for that just because I work at a university in the Maritimes. So it was more convenient. But I am certainly interested in Ireland in particular and hope maybe eventually to be able to do more comparative analysis with bigger samples and in other countries. Yeah, okay. Okay, thank you, Dr. Yuko. For any of the participants that are online, please feel free to enter questions in the chat box. And I will continue to close the session, but if any questions pop up, I will interrupt that and take that question. So Dr. Yuko, thank you again for such an excellent presentation. It was really good to see for myself as the CELSA managing director how well your presentation was put together and how you've used the data of the CELSA. So we really appreciate that and of course we appreciate your participation in the CELSA webinar series. I'd like to remind everyone that CELSA data access request applications are ongoing. The next deadline for application is February 12th, 2020. And please visit our CELSA website under data access to review available data and further information and details about how you can apply, specifically for a graduate student, there are fee waivers available. I also like to remind everyone to complete their survey located under the polling option. If you don't see beside the chat button on your screen, please click the drop down arrow and then we'll define it. Okay, so our next seminar will take place on Wednesday, February 19th, at noon. Dr. Alexandra May, a scientist working with the CELSA at McMaster University will present sarcopenia in the CELSA, the impact of diagnostic criteria on the agreement between definitions and your association of sarcopenia with falls. And registration for that is open right now. Finally, graduate students and postdoctoral fellows with an interest in longitudinal studies at aging are encouraged to save the date for SPA 2020. Now, this is not a real SPA, but this is the summer program in aging that's funded by CIHR. This innovative five-day training program will take place next June at the Hockley Valley Resort in southwestern Ontario. And applications will open in February on CHR's research net. So if you're interested in that, please keep that in mind. And remember, the CELSA promotes this webinar series using the hashtag CELSA Webinar and we also invite you to follow us on Twitter and the handlers at CELSA underscore ELCV. So there are no further questions. So again, Dr. Yuko, thank you so much very much for your presentation and to all the participants, thank you for attending today's CELSA Webinar. Thank you.


As Japan westernized, their stroke rate plummeted. Stroke was the leading cause of death in Japan, but the mortality rate sharply decreased as they moved away from their traditional diets and started eating more like those in the West. So maybe there was a protective effect of all the extra meat and dairy they started to eat. After all, their animal fat and animal protein intake were going up, and at the same time, their stroke rates were going down. Protection from stroke by eating animal foods? Surely not, commented a noted Loma Linda cardiology professor. Many vegetarians, like myself, have almost come to expect the data to indicate that they have an advantage, whatever the disease that's being considered. Thus, it is disquieting to find evidence in a quite different direction for at least one subtype of stroke. Can dietary saturated fat like that found it meat and dairy beneficial in the prevention of stroke risk? There appeared to be a protective association, but only in East Asian populations. High dietary saturated fat was found associated with a lower risk of stroke in Japanese, but not in non-Japanese. So what was it about the traditional Japanese diet where the westernization of their diets made things better when it came to stroke risk? At the same time, their meat and dairy was going up there, salt intake was going down. The traditional Japanese diet was packed with salt. In fact, they had some of the highest salt intakes in the world, like a dozen spoonfuls of salt a day. Before the widespread availability of refrigeration, they all sorts of salted, pickled, fermented foods from soy sauce to salted fish. And in the areas that had twice the salt intake, they had twice the stroke mortality. But when the salt intake dropped, so did the stroke death rates, because when the salt came down, their blood pressures came down too. And high blood pressure is perhaps the single most important modifiable risk factor for stroke. So there's no big mystery why the westernization of the Japanese diet led to a drop in stroke risk. When they abandoned their more traditional diets, their obesity rates went up. Their diabetes and coronary artery disease went up. But as they gave up the insanely high salt intake, their insanely high stroke rates correspondingly fell.  Their stomach rates came down beautifully as they westernized their diets away from salt-preserved foods. But of course, as they started eating more animal foods like dairy, their rates of fatal prostate cancer, for example, shot through the roof. Compared to Japan, not only does the US have seven times more deaths from prostate cancer, but five times more deadly breast cancer, three times more colon cancer, and lymphoma mortality, and six to 12 times the death rate from heart disease. Yes, Japanese stroke and stomach cancer rates were higher, but they were also eating up to six spoonfuls of salt a day. That would seem to be the most likely explanation rather than some protective role of animal fat, as eventually acknowledged by the official Japanese guidelines for the prevention of cardiovascular disease.  Even though the researchers clearly concluded that of course we all have to cut down on animal fat and trans fat for the heart disease benefit regardless, but looking at another major Harvard cohort, they found no such protective association for any kind of stroke and put all the studies together and zero protection across the board. Observational studies have found that higher LDO cholesterol seems to be associated with lower risk of hemorrhagic stroke, raising the possibility that cholesterol may be a double-edged sword. Decreasing the risk of ischemic stroke, but increasing the risk of hemorrhagic stroke. But low cholesterol levels in the aged may just be a surrogate for nutrient deficiencies or a sign of debilitating diseases, or maybe they're on a combo of cholesterol-lowering drugs and blood thinners, and that's why we tend to see more brain bleeds in those with low cholesterol. You don't know until you put it to the test. Put together about two dozen randomized controlled trials and the lower your cholesterol, the better when it comes to overall stroke risk. With no significant increases in the risk of hemorrhagic stroke risk, with lower achieved LDL cholesterol levels, the genetic data appears mixed, with some suggesting a lifetime of elevated LDL would give you a higher hemorrhagic stroke risk, and other data suggesting more of a double-edged sword effect. But any possible excess of bleeding stroke with lower cholesterol is greatly outweighed by the protective effect against the much more common clotting stroke, not to mention heart disease, perhaps on the order of 18 fewer clotting strokes for every one extra bleeding stroke with cholesterol-lowering. How about this as a candidate to explain the increased stroke risk among vegetarians? This is the type of stroke that appeared higher in vegetarians, but the cholesterol levels in vegans were even lower, and if anything, they had a trend towards a higher clotting stroke risk. So that doesn't really make sense. If there's some kind of protective factor in animal foods, it's to be hoped that a diet can be found that still protects against killer number one, heart disease, without increasing the risk of killer number five, stroke. But first we have to figure out what that factor is, a hunt that will continue next.


Okay, before going out to questions, I think we've got clearly a bit of a dispute here about the dispute resolution mechanism. So maybe just tease that issue out a little between David and Tom before we throw it open to the floor. So maybe David, you'd like to sort of start with responding perhaps to that, if you're familiar with that particular Romania-Swedan issue, or more generally some cases that have been brought up and that are quite controversial. Well, thank you, Dan, and if we should open to the floor, would I just like to make a couple of comments on what Tom said, because I think they're important. Firstly, on ISDS, Germany invented ISDS. The Germans invented the Bilateral Investment Treaty. They have some 1,200 bilateral investment treaties. They're the country's most heavily biggest user of that. Every single one of those agreements contains Investor to State Dispute Settlement Clause. Frankly, none of this was very controversial, and yes, there are some cases. There's the one you mentioned. I'm not familiar with the details, but there's the Wattenthal case against Germany on the Energie Verwendung, but which is taken under the Energy Charter, not under Bilateral Investment Treaty, but where German companies are also suing the German government because of investments they made in nuclear installations, which now will not be able to see the light of day. So there are occasional cases, but two-thirds of all ISDS disputes are won by governments. So there's no inherent bias in the system against governments. And the fact is that we are proposing very substantial modifications, in particular in terms of defining what is the perimeter of what cases can be taken. So under the new text proposed by the European Commission, for example, the Philip Morris case against Australia would not be admissible. And I believe that what the Americans are negotiating in the Pacific Deal is also a redefinition of the perimeter of ISDS to make it absolutely clear that government's right to regulate for the purposes of general public policy cannot be the subject of the Investor to State Dispute Settlement. It is exclusively dealt with the unfair discriminatory treatment of foreign investors. On the question of public services, this is an absolute non-problem. We are absolutely clear. We have said this for, I've been through this, with every trade negotiation we've ever had. All our trade deals contain clauses which say they are without prejudice to the right of governments to choose what they nationalize or what is provided through public provision versus private provision. The Americans are on the same line, and by the way, Mike Froman and Cecilia Malstrom issued a joint declaration before the summer clarifying this to deal with the speculation in the UK that somehow TTIP could challenge the existence of the National Health Service as a former trade negotiator. I can't even imagine how you would draw up such a trade agreement, but okay. So there were absolutely on record on both sides of saying that this will not, this trade deal cannot affect the decision of governments as to public versus private provision of services. On environment and labor, we are committed to a sustainable development chapter which will deal with environmental standards, will deal with labor standards, particular reference to the ILO. This is the practice both of ourselves and of the Americans, and I imagine we will continue it in our, in this deal. Finally, on the economic benefits of TTIP, there I agree with you, Tom. I'm not trying to oversell this. I'm not saying this is the magic bullet, the silver bullet. This is the solution to all our problems. No. I'm just saying it will add to our net economic wealth. It will add to job creation. Point to me, a trade deal that we have concluded in the last 20 years that did not do that. We have, all our trade deals have had net positive effects. With Korea, we've increased our exports to Korea by 35%. That's all I'm saying. I'm not saying this will be the solution to Ireland's economic difficulties. I'm just saying it will create new economic opportunities. It will create economic wealth. It will create new jobs. And it will be a net positive for both the Americans and ourselves. And finally, with the AFL-CIO, the American Trade Union, yes, I've had lengthy discussions with them. They're not opposed to TTIP. They have far fewer problems with TTIP than they do with the Pacific deal because they accept that we are a high wage, high labor standards, high environmental standards economy in Europe so they don't feel threatened. The big issue for the American trade unions as for the European trade unions, as for some members of the European Parliament, is this investor-state dispute settlement issue. But frankly, the suggestions I've seen coming from the AFL-CIO almost look like a carbon copy of what the Commission has proposed as a way of revamping and modernizing this mechanism to address some of the concerns of trade unions and civil society. Thank you. Just before giving Tom the opportunity to respond to that, could you just clarify that controversial case of Philip Morris in Australia? Did you say that that couldn't happen under TTIP? Because the reason it happened in Australia is being dealt with under TTIP? Yes. I mean, there is, under the existing ISDS provision, which is the Bilateral Investment Treaty, which the Philip Morris are using, the Australian government has mounted a very strong defense that it's a case which should not be retained. We're waiting to see what the arbitrators will say. In the meantime, faced with that case, we have already put into the Canada Agreement a redefinition of the scope of ISDS to make absolutely sure that there is no question of a company being able to take a case against a government for what is a matter of horizontal public policy and which is not a discrimination against foreign investors. And the Americans are doing exactly the same thing in the Pacific deal. So that loophole, if you like, which may or may not be accepted by the arbitrators in the case of Australia, has already been closed down in one of our agreements. And as I understand it, the Americans are working in the same direction in TPP because you will remember that Australia will be a party to TPP, and I think it was one of their insistences that that loophole would also be closed off in any new trade deal. Thank you. Anybody who wants to ask a question or make a point, please just indicate your interest at Tom. Just briefly on the principle of ISDS, it is that there would be an arbitration mechanism outside and over and above the national legal system, and that really raises a question about what is wrong with the national legal systems. Now, reference has been made to the principle of discrimination, for example, against European investors. But if we go down that route, we have to be very clear that where would these arbitration bodies be, where would they be accountable? Who would actually compose these structures? And what balance would there be between corporate rights, between citizen rights, workers rights? The burden of proof, it seems to me, is on those who are promoting ISDS as an essential component of a TTIP agreement. And that still remains an area of huge uncertainty. I mean, just to give one brief example, I mean, supposing a right, a comprehensive right in the full sense to collective bargaining was implemented in Ireland, which seems to be unique in regards to this, or the progress has been made legally in recent months. But if it became a comprehensive right and it was not open to constitutional challenge here, what if it was open to challenge under some provision of ISDS? This is not an unreal possibility. And it's ironic that if Germany was the country that more or less made ISDS, that in fact the Wattenfahl case came back to haunt and that when Germany decided not to proceed with nuclear energy provision there, that they were taken to task by Swedish company Wattenfahl. So I think there are still major issues and concerns here, and it strikes me that reform of ISDS is not the answer. It's to take ISDS away completely. Look, when Argentina nationalized Repsol, the Spanish petroleum company, there was no way that Repsol could go to court in Argentina to claim compensation for the seizure of their assets because it was legal under Argentinian law. They had passed a law enabling the government to nationalize the assets. What was the purpose of ISDS? The purpose of ISDS is not to force the Argentinians not to nationalize. It was to monetize the compensation which was due to a company who basically had had their assets stolen. That's because that's what it is, it's theft. And that is the issue. The example you cite of collective bargaining could never enter into the remit of ISDS because it is not a discrimination against a foreign investor. I'm very sorry, Tom, but I'm clear on this. This is only in situations where a foreign company has been manifestly discriminated against in a national jurisdiction where recourse to that national jurisdiction could not possibly give any satisfaction. And the outcome of the process is simply a monetization of the damage done. It is not to force the government to change the regulations or to go back on what they've decided. It simply says, has there been theft of assets or theft of market rights which otherwise would have been accrued to the company? So it's a process of putting a monetary value on a potential seizure of assets belonging to a foreign investor. And that is why it has always been considered an indispensable part of bilateral investment treaties because when you invest in foreign countries, you run certain risks, particularly those with unstable governments or unstable legal situations. Between ourselves and the US, I imagine it will rarely be used. But the issue arises, which to me is still extremely important, that if we don't have it in an agreement between ourselves and the United States, do we then have it with ourselves in China, with ourselves in Vietnam, with ourselves in Argentina, with ourselves in India? Where do we draw the line between what is a legal system that we feel we don't need ISDS for? And where do we say that a system does require ISDS? Isn't it much simpler to have an intelligent, revamped, modernized system of ISDS between the US and the EU, which can be the model which we would both then use in our dealings with third countries? OK, thank you. Let's open it to the floor.