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Anderson, Unorthodox Health Care Cost Reductions

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Novel Big Hitter interventions that will have dramatic cost savings due to improved health. Chronic diseases of aging and how to prevent them with unorthodox, effective interventions.

Novel Big Hitter interventions that will have dramatic cost savings due to improved health. Chronic diseases of aging and how to prevent them with unorthodox, effective interventions.

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  • * * Food corporations, politics and a barrage of competing health products and food advertising touting everything under the sun have basically overwhelmed and confused people. Milk’s good for you, no it’s chocolate, eat tomatoes and so on. * Saying very slow may be optimistic. Food politics, with huge sums of money at stake, is so powerful that it may never happen without significant reforms of the schizophrenic FDA which is charged with promoting commercial agriculture and with safeguarding the public health. * Incorporating current research into public health action is a 20-40 year process. By the ’50s it was certain that cigarettes were a leading cause of cancer and heart disease. It took until the late 80s for most work places to ban smoking on the job. We’re still in process of shutting smoking down but still allow advertising. * King County, as a small entity “below the radar” of national issues has the potential capability of greatly reducing the time to implement and eliminating the confusion with simple, clear guidelines and classes to offset the health tragedies employees and their families are experiencing.
  • * *I wanted to say EVERY study, but that’s possibly an over reach. I have yet to find an epidemiological study that considers all of the relevant variables as disclosed by modern research. Analysis errors are less common, but still there; usually the result of looking for what the researcher wants to find. Interpretations are sometimes based more on what the funding institution wants to find than the data. I’ve found studies where the conclusions support, say, sugar consumption but the data didn’t. At least they didn’t falsify the data. It’s very important to keep a clear mind on this point. When you find that hypertension, obesity, heart attacks and diabetes often coexist, it is comletely improper to say obesity caused… the other three. In fact, they all have a common root cause, which is none of the above and I have yet to find a nutritionist’s study that properly addresses that root cause. A randomized, double blind human clinical trial is the gold standard and can provide strong proof. In nutrition these, by and large, have not been done yet. There are difficulties such as expense, long times for chronic diseases to show up, and ethical issues if you may be deliberately harming humans. So, we’re left with cross-disciplinary study of laboratory research in medicine, basic research in biochemistry, biology and physiology and the study of isolated groups of people with common diet and health outcomes.
  • * * * *To be honest, that’s a SWAG, silly wild ass guess. Certain groups of isolated traditional peoples with excellent nutrition show NONE of the diseases of civilization we are so subject to. NO heart disease, diabetes, obesity, strokes or dementias. They are typically buoyantly happy, sing a lot and never have locks on their doors, if they even have doors. Their lives are typically shorter than ours due to acute illnesses, accidents, and other sudden deaths. If they survive these into old age, they are still active and capable to the end. A few live into their 90s.
  • This diagram illustrates the hepatic (liver) metabolism of fructose, a simple sugar. Multiply it by 100,000 or more to understand the metabolism of food. Add in other body processes and we may never understand it all. Here’s the take-home point. Biochemistry is incredibly complex. We mess with it at peril of our health. While we’re here, I’d like to make a further point. Fructose, through this pathway, increases blood pressure. This pathway results in inflammation, and this is only one cause of inflammation by fructose. There are several other mechanisms. This one increases liver insulin resistance. Lipoprotein lipase induces muscle insulin resistance. Increased insulin resistance leads to the hyperinsulinemic diseases of civilization: Type 2 DBM, Add some leptin resistance and you have: Obesity and more. Related diseases are: CAD, early menarche, malocclusion, narrowed pelvis, myopia, cutaneous papillomas, breast, colon and prostate cancer, male vertex balding and polycystic ovary syndrome. I think this is still a short list. VLDL relates to increased triglycerides and is thought to be the initiator of atherosclerosis Dyslipidemia: low HDL, high LDL, VLDL and TG Liquid droplets refers to the fat globules that initiate fatty liver disease. With time, stress hormones, high insulin and inflammation this turns to cirrhosis and possible death. Ethanol and fructose both cause fatty liver disease. This diagram was first shown in 2008! The take home is the astonishing complexity of biological systems. Simplistic solutions are unlikely to be enough.
  • Our bodies are primarily made of proteins and some minerals. Proteins are continually being digested, constructed and repaired, even in the adult. Most of this involves very precise “zipping and snipping” operations under the control of enzymes and template molecules like DNA. This simplified “stick and ball” model of a very small segment of DNA illustrates the fundamental complexity and beauty of the template of life. The even more drastically simplified model shows how enzymes open a traveling oval “window” to access the genetic code on the inside of the helix. When things go well, the resulting separate strands are identical. When there are deficiencies in the number of any type of molecule or atom required, or a toxin interferes, or an enzyme is defective or partially blocked, errors occur. These errors are sometimes repaired and sometimes persist to accumulate during aging.
  • Our bodies are primarily made of proteins and some minerals. Protein are continually being digested, constructed and repaired, throughout life. Most of this involves very precise “zipping and snipping” operations under the control of enzymes and template molecules like DNA. This simplified “stick and ball” model of a very small segment of DNA illustrates the fundamental complexity and beauty of the template of life. The even more drastically simplified model shows how enzymes open an oval “window” to access the genetic code on the inside of the helix. When things go well, the resulting separate strands are identical. When there are deficiencies in the number of any type of molecule or atom required, or a toxin interferes, or an enzyme is partially blocked, errors occur. These errors are sometimes repaired and sometimes persist to accumulate during aging. Take home message: Deficiency of required reactants, molecules with even one atom in the wrong location (trans fats vs cis-fats), functionally crippled enzymes and many other factors cause errors that are long term toxic.
  • In the United States and most Western countries, diet-related chronic diseases represent the single largest cause of morbidity and mortality. These diseases are epidemic in contemporary Westernized populations and typically afflict 50–65% of the adult population, yet they are rare or nonexistent in hunter-gatherers and other less Westernized people. Although both scientists and lay people alike may frequently identify a single dietary element as the cause of chronic disease (eg, saturated fat causes heart disease and salt causes high blood pressure), evidence gleaned over the past 3 decades now indicates that virtually all so-called diseases of civilization have multifactorial dietary elements that underlie their etiology, along with other environmental agents and genetic susceptibility.
  • Transcript

    • 1. By Effective Prevention, the lowest cost approach Joe Anderson, Fall 2011
    • 2. About Joe Anderson:
      • I have graduate school level studies in Biophysics, Biochemistry and Physiology plus Systems Engineering.
      • My views are not the result of conventional education in Nutrition, Public Health or Medicine
      • I’ve extensively studied Nutrition-Health and Glycochemistry for the last 9 years, over 5,000 hours invested.
      • Reviewed over 2,000 scientific articles.
      • Have been an R&D Engineer most of my career.
      • Have no financial interests in any nutrition, food or medical activities or companies.
      • This is a pro bono presentation to further the Greater Good.
    • 3. Taboos and Sacred Cows
      • There is a huge body of nutritional/health orthodoxy based on outdated ’50s-’70s knowledge.
      • Much of this orthodoxy is not only outdated, but damaging to public health.
      • Correction of this situation is very slow because of food politics.
      • It takes 20-40 years for research to become incorporated into public knowledge.
      • Employee Health Plans have a way to help short circuit this health tragedy.
    • 4. Open Minds, Please
      • MOST nutrition/public health advice is based on epidemiological research.
      • Nearly every epidemiological study has errors in design, analysis and/or interpretation.
      • Confusion and conflicts result. Are eggs good for you?
      • Epidemiology can only show correlation (linkage) NOT causation or mechanism.
      • Laboratory and clinical trials, using a control group and controlled parameters, can demonstrate causation and mechanisms. It’s still difficult .
      • This presentation will report unorthodox information based on non-epidemiological, cross-disciplinary , research.
    • 5. Cross-Disciplinary?
      • Scientific reductionism
      • Medicine
        • Cardiology
        • Oncology
        • Diabetology
        • more
      • Nutrition
      • Paleoanthropology
      • Biochemistry
      • Physiology
      • Botany
      • Physiology
      • more
      Integrative Concepts Simple, well-nuanced, science-based nutritional rules and guidelines for optimal health
    • 6. King County Employee Health Insurance Plan
      • King County, WA, Plan emphasizes personal responsibility, interventions and financial rewards.
      • Substantial savings result. IT WORKS
      • An ideal platform for improved interventions.
      • Improved interventions can further increase savings, possibly a lot!
      • KC is attracting attention and may become a popular model, increasing its importance.
    • 7. Some Basics:
      • Biochemistry is extraordinarily complex.
      • This diagram shows how fructose, a simple sugar is metabolized in the liver.
      • First reported in 2008!
      Lustig, R, Fructose: Metabolic, Hedonic, and Societal Parallels with Ethanol , doi: 10.1016/j, jada.2010.06.008
    • 8. Basics:
      • Biochemistry is like “zippers” separating & mating or precise “snipping” operations by enzymes at exact locations in molecules.
      • Enzymes open a moving oval window to the middle of the helix, then close it when the replication is complete.
      DNA (simplified model) DNA Replication (simplified model)
    • 9. Basics:
      • The “zipping” and “snipping” by enzymes depends on:
      • Fully functional enzymes
        • Not glycated (more coming)
        • Enzyme coding errors are common genetic errors
      • Adequate supply of the right molecules for new protein.
        • Adequate molecules
        • Right atoms in the molecules being added.
        • Right shape to fit
      • Proper folding and function of proteins depends on everything.
      • Adequate nutrient supply, no deficiencies.
      • Metabolically unusual molecules, with even one atom out of place, perhaps changed by heat, chemistry or “foreign,” don’t “zip,” “snip” or fold well, so are often long-term toxic .
    • 10. Basics, Sugars:
      • Many sugar types in food. (mannose, sucrose, lactose, fructose, levulose, maltose, glucose, more)
      • All carbohydrates digest to sugars.
      • Sugars are “fuel” and, like any fuel, are dangerous due to their inherent energy content.
      • After digestion only 3 simple sugars are absorbed into the bloodstream. (glucose, galactose and fructose)
      • Fructose is unique in molecular structure (a 5 atom ring instead of a 6 atom ring) , chemical activity and glycation potential (~10X higher than glucose).
    • 11. Basics, Sugars:
      • Continued:
      • Sugars are like “kindling.”
      • Fats and ketone bodies, our other fuel, are like efficient, long-burning fuel “logs.”
      • Fats and ketone bodies are more efficient and create less “smoke” (oxidizing molecules and other byproducts of metabolism) plus are non-glycating .
      • Sugars are consumed before fats and ketone bodies; an evolutionary adaptation to reduce their damage to the body.
      • Red blood cells are the only cells in the body that require a sugar, glucose.
      • This puts a lower limit on glucose concentration ~60 mg/dl.
    • 12. Basics, Glycations
      • Glycations result from a sugar bonding without an enzyme to proteins and/or fats, thereby forming “foreign” molecules.
      • Follow-on effects of glycations:
        • Formation of toxic molecules (formaldehyde & more)
        • Formation of oxidizing and carbonyl molecules, (hydrogen peroxide & more)
        • Activation of Receptors for AGEs (RAGES) (inflammatory & autoimmune disorders)
      • Glycations are a primary cause of dysfunction and aging.
    • 13. Basics, Glycations
      • Glycations cause:
        • Oxidative and carbonyl stress from intermediate reactions (whole body damage)
        • Cross linking of proteins increases stiffness and decreases strength. (wrinkling, aneurysms, hypertension, cirrhosis, lens rigidity, kidney disease)
        • Reduced/blocked enzyme action (digestive, replication and hormonal errors/insufficiency)
        • Browning of fats and proteins that is similar to the brown components of tobacco smoke both chemically and damage-wise. (heart disease, cancer)
    • 14. Basics, Glycations
      • Continued:
        • Auto-immune disorders (neuropathic diseases such as loss of sight, hearing, feeling, Lupus, Parkinson’s and more)
        • Inflammatory disorders (rheumatoid arthritis, asthma, allergies)
        • DNA mutations and cleavage (fructose only) (Birth defects, cancers)
        • Mineral sequestration leading to calcium, copper, chromium and other deficiencies. (osteoporosis, depression, ADD)
        • Glycations are little understood by public, high damage causing, good intervention targets
    • 15. Basics: Models of Disease
      • Modern medicine is highly effective for acute illnesses and trauma such as:
      • Modern medicine is ineffective for chronic illnesses such as:
      • Tuberculosis
      • Typhoid
      • polio
      Atheroscleosis & CHD Diabetes Dementias Diphtheria Whooping Cough Anthrax
      • Yellow Fever
      • Skeletal Injuries
      • more
      • Losses of sight, hearing
      • Cancers
      • Obesity
      • Cataracts
      • Strokes
      • more
      • For these, modern medicine provides few answers or cures. WHY?
    • 16. Basics, Models of Disease
      • Modern medicine concentrates on the “magic” pills and procedures to cure single-cause, acute illnesses.
      • Chronic diseases are multi-modal and follow other models:
        • Telomere shortening
        • Advanced Glycation Endproduct (AGE) accumulation
        • Time dependent mutation accumulation
        • Long term toxic damage
        • Long term nutritional deficiencies
        • Inherited genetic errors (digestion, enzymes mostly)
        • Oxidative and carbonyl stress (whole body damage)
        • More
      • High Complexity, but some simple solutions are possible for high value interventions.
    • 17. Basics, Nutrition:
      • Biochemistry, hormones, enzymes, genetics and more are extraordinarily complex and evolved over millions/billions of years.
      • Life and humans evolved in the natural world, not in the recently created civilized world.
      • In the civilized diet we now know there are good and bad of each macronutrient: fats, carbohydrates and proteins.
      • Simplistic nutritional guidelines based on macronutrient ratios are completely inadequate guides to nutrition needs.
      • Much more finely tuned guides are needed.
    • 18. US Gov’t Dietary Guidelines (DGs)
      • Rough draft, published in 1977, advised a low fat, high carbohydrate diet based on heart disease mortality only.
      • DGs are premised on the Seven Countries Study , Ancel Keys primary author.
      • Keys was a long-time low-fat diet proponent (1957 publication) and excellent debater.
      • There was significant controversy over Keys’ theory at the time, with others claiming that sugars were the root cause of most chronic illnesses.
    • 19. US Gov’t Dietary Guidelines (DGs)
      • The Seven Countries Study is deeply flawed. In fact, the primary conclusion, that dietary fat causes heart disease, is probably wrong.
      • No significant study confirms it yet.
      • Flaws in this study include:
        • Neglect of relevant variables - Poor design, excessive simplification, inability to separate variables
        • Data from only 7 of 22 countries was used - Cherry picking
        • Incomplete statistical analysis - Investigator bias .
    • 20. US Gov’t Dietary Guidelines
      • The last issue of the DGs, in 2010, reemphasized the same old things.
      • Diets, on average, have moved to the DGs.
      • Age-related chronic diseases and health costs have soared since 1980.
      • Increased disability and illness with more expensive, but non-curative, pills and procedures have resulted.
      • Health costs soared since issue of the DGs.
      • DGs fail to warn against long term toxins and nutritional deficiencies AND give outdated, harmful advice.
    • 21. US Gov’t Dietary Guidelines
      • DGs are simplistic and do not provide needed detailed guidance.
      • Continuing the DGs as-is seems to be increasing chronic diseases.
      • All of us are unwitting subjects in a long-term experiment without confirmed research.
      • It would probably have been better to do nothing.
      • Lack of a control group has allowed standards and perceptions to drift away from our genetic heritage of good health, even into old age .
    • 22. Isolated Traditional Peoples, Our Only “Control Groups”
      • Our ancient ancestors ate fresh, whole, naturally organic, minimally processed foods.
      • Traditional diets provided superior mental, moral and physical health
      • “ Modern” Kitavans:
      60 Years Old 95 Years Old
    • 23. Our genetic heritage is robust health
      • Kitavan’s diet by calories:
      • 69% carbohydrates
        • Mostly starches, very low fructose
      • 21% fats
        • Mostly from coconuts (highly saturated)
        • Seafood provides 4 g fats/day (omega 3s)
      • 10% protein
      • Exercise only slightly above US
      • NO heart disease, obesity, strokes, diabetes or other chronic diseases.
      70% smokers!
    • 24. Genetics/Diet Mismatch
      • Quotes :
      • In the United States and most Western countries, diet-related chronic diseases represent the single largest cause of morbidity and mortality. These diseases are epidemic in contemporary Westernized populations and typically afflict 50–65% of the adult population, yet they are rare or nonexistent in hunter-gatherers and other less Westernized people.
      • … Industrial era foods (dairy products, cereals, refined cereals, refined sugars, refined vegetable oils, fatty meats, salt, …
      • … the ultimate factor underlying diseases of civilization is the collision of our ancient genome with… the nutritional qualities of recently introduced foods.
      • Loren Cordain, et al, Origins and evolution of the Western diet: health implications for the 21st century , American Journal of Clinical Nutrition, Vol. 81, No. 2, 341-354, February 2005
    • 25. Genetics-Diet Mismatch
      • Humans can be robustly healthy on full meat diets (Eskimos) to plant-rich omnivory (Kitavans).
      • No traditional peoples studied are exclusively vegetarian, though Kitavans are mostly so.
      • NO traditional diet utilizes significant amounts of processed foods, including flour, refined sugars, grains or vegetable oils.
      • Arguably our modern diet has changed drastically in the last 200 years which is 0.01% of a 2 million plus year genetic adaptation to a hunter-gatherer diet.
      • Chronic disease rates with good traditional diets are 10X to 1000x lower.
    • 26. Why Are We So Sick?
      • Commercialization of HFCS circa 1980-2000; total fructose intake increased roughly 20% and obesity nearly doubled .
      FIGURE 1. Availability of total fructose in relation to obesity prevalence (x) in the United States. http://www.ajcn.org/content/80/4/1090.long
    • 27. Why Are We So Sick?
      • Increased fructose intake.
      • The average diet very nearly reached the Dietary Guidelines over the same period, increasing carb intake and lowering fat intake
      • Processed foods, dietary AGEs, additives and other long term toxin intakes also increased.
      • Endemic deficiencies were not addressed.
      • All of the above probably contributed to chronic disease increases.
      • It can’t be genetics; traditional peoples adopting our diet get sick, too, within months.
      • Increased fructose intake is thought to be the most important contributor.
    • 28. Toxins we are poorly adapted for
      • Tobacco
      • Alcohol
      • Fructose
      • Browned Foods (dAGEs and MRPs)
      • The last two are the big hitters for cost savings/health improvement.
      Well known, somewhat adequate interventions Becoming known, inadequate interventions Unknown, inadequate interventions
    • 29. Browned Foods
      • Over the last 30-40 years, the dietary Advanced Glycation Endproduct (dAGE) load has increased significantly.
      • Why? Increased use of:
        • Barbecue grills, fried foods
        • Sugars in foods (dAGE formation)
        • Gourmet cooking (seared/blackened/etc)
        • Additions to processed foods
          • Strong, tasty flavors
          • Semi-addictive (“bet you can’t eat just one”)
    • 30. Fructose Promotes:
      • Heart Disease
      • High Blood Pressure
      • Obesity
      • Non Alcoholic Fatty Liver Disease
      • Insulin Resistance
        • Type 2 Diabetes
        • Early menarche (~17 years to 11 or 12)
        • Narrowed dental palate (orthodontia)
        • Narrowed pelvis (increased Caesarian births)
        • Myopia
        • More
      • Cancers
      • Dementias, including Alzheimer’s
      • More
      Lustig, R, Fructose: Metabolic, Hedonic, and Societal Parallels with Ethanol , doi: 10.1016/j, jada.2010.06.008 Cordain, L, Hyperinsulinemic diseases of civilization: more than just Syndrome X ; PMID: 14527633
    • 31. Fructose?
      • HOW can a single substance cause such a variety of diseases?????
      • Claiming fructose causes so many diseases may seem nonsensical at first because we are so used to the standard, modern-medicine, single-activator, infectious model of disease.
      • Chronic diseases are multi-modal, long-term nutritional deficiency/toxicity issues.
      • ALSO, these disease are caused by many different mechanisms which are buried in the research papers of many disciplines.
    • 32. Fructose?
      • Fructose is found in:
        • Table sugar, sucrose, 50%
        • High fructose corn syrup (HFCS), 42% & 55%
        • Fruits, root vegetables (least damaging form)
        • Processed foods and beverages
      • Average daily fructose consumption: ~90 grams = 25 teaspoonfuls! The damage is in the dose!
      • Beverages, processed and snack foods are loaded.
      • Fructose is a very active glycation-former, 10x glucose
    • 33. Fructose?
      • Continued:
      • Fructose is a plant sugar we are poorly adapted to eat in quantity, 24/7/365.
      • Glucose, a universal sugar and Lactose, a mammalian sugar, do not cause problems nearly as severely.
      • Fructose is addictive for many, with action similar to opioids, making it difficult to quit.
      Thus, fructose is a high-value, opportune target for interventions.
    • 34. Quick effects for most quitting fructose:
      • Blood pressure down to normal within weeks to a few months (stroke, kidney and heart disease risk)
      • Dyslipidemia corrected to normal within weeks (heart and liver disease risk)
      • Fasting blood glucose down to normal within months (T2 Diabetes risk)
      • Overweight reduced significantly within weeks to years (osteoarthritis, more)
    • 35. Fructose costs us the most
      • Almost exclusively liver metabolism.
      • Fructose metabolites are virtually identical to alcohol and similarly promote many age-related chronic diseases.
      • Small Dense LDL is a direct result of hepatic fructose metabolism. (atherosclerosis)
      • All sugars cause glycations, but Fructose’s glycation potential is ~10x higher than glucose.
      • Glycations are similar to tobacco smoke chemically and damage-wise.
      • Fructose’s effects in the body mimic BOTH alcohol and tobacco smoke PLUS it has other, unique, damaging mechanisms .
    • 36. Fructose costs us the most
      • Starches, which digest exclusively to glucose, are much less damaging than sucrose and HFCS which digest to glucose + fructose.
      • No other single molecule approaches fructose’s damage potential.
      • This gives interventions based on reducing fructose consumption a lot of leverage
    • 37. Common Deficiencies:
      • Long chain omega 3s (DHA, EPA from fish oil)
        • Omega 6s are significantly over supplied by vegetable oils, contributing to omega 3 deficiency since both compete for 1 enzyme
      • Other fats are synergistic with omega 3s, necessary.
      • Vitamin D
      • Copper, chromium and other minerals depleted from soils of factory farms.
      • Unknowns – little research done for 60 years.
    • 38. Omega 3 Deficiency
      • Increases in rates of:
      • ADD and other attention/learning disorders
      • Autism spectrum disorders
      • Depression
      • Bipolar disorder
      • Schizophrenia
      • Migraines & seizure disorders
      • Autoimmune (Lupus, asthma, arthritis, more)
      • Strokes
      • Cancer
      • More
      Learn more: http://www.naturalnews.com/016353_omega-3_fatty_acids_mental_health.html#ixzz1ZalSR3Fk
    • 39. Omega 3 Deficiency
      • Omega 3 supplementation in recent studies has shown:
      • Risk of all-cause mortality reduced 47-87% by long chain omega 3s.
      • Improved IQ and learning ability.
      • Depression reduced/cured.
      • Improved vision
      • More
      • Omega 3 is a heavy hitter for interventions
      Learn more: http://www.naturalnews.com/016353_omega-3_fatty_acids_mental_health.html#ixzz1ZalSR3Fk
    • 40. Vitamin D3
      • Is known to affect:
      • Heart disease
      • Stroke
      • Osteoporosis (rickets if severe)
      • Depression
      • Seasonal Affective Disorder
      • Type 1 Diabetes
      • More
      • Reduces risk 50-80% for:
      • Cancer
      • Schizophrenia
      • Vit D3 is a heavy hitter, synergistic with omega 3s.
      Learn more: http://www.naturalnews.com/003069.html http://www.naturalnews.com/027580_vitamin_D_heart_disease_prevention.html
    • 41. Cost Effective Interventions:
      • Examples:
      • Cooking-nutrition-lifestyle classes covering cost & time-effective techniques and recipes for low fructose, low AGEs, high omega 3 and low inflammation meals.
      • Education on supplements: Vitamin D3, omega 3s, more
      • Support for fructose quitting and withdrawal phases with needs possibly identified from classes.
      • More
    • 42. Summary
      • Highly important, long-term deficiencies and toxics are neglected by orthodox nutritionists/public-health policies and MDs
      • Chronic diseases are complex, but treatable with simple, long-term nutrition/lifestyle interventions to correct root causes .
      • The King County Employee Health/Insurance program is an ideal model.
      • Updating diet recommends to current modern research will greatly improve outcomes for Employees
    • 43. The End, For Now.
      • Thank you for listening!
      • Questions?
      • Follow ups?