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ChristianaCare Appoints Jennifer Moberg, DNP, Vice President of Emergency Services
Jennifer Moberg, DNP, MPA, RN, CPPS, NEA-BC, has been appointed vice president of Emergency Services at ChristianaCare. In this role, she will oversee the delivery of safe, high-quality, patient-centered care across ChristianaCare’s emergency departments and support prehospital services and trauma programs. Jennifer Moberg, DNP, has been appointed vice president of Emergency Services at ChristianaCare. Moberg has a strong track record of improving care quality, safety and caregiver engagement in complex health care settings. She has helped build more diverse teams, reduce staff turnover and lead major emergency department renovation projects. She has also worked to make patient care more efficient and improve safety for caregivers by strengthening security practices. Prior to joining ChristianaCare, Moberg served as director of Emergency Services at HealthPartners in Bloomington, Minnesota. She also worked as a senior advisor assessing and standardizing security protocols across hospitals and clinics. Earlier in her career, she spent more than 20 years at Abbott Northwestern, where she served as a critical care nurse and later as a patient care manager. Moberg earned a Doctor of Nursing Practice in executive leadership from Baylor University. She holds a Master of Public Affairs in nonprofit leadership from the University of Minnesota and a Bachelor of Science in nursing from Bethel University. She reports to Chief Nurse Executive Danielle Weber, DNP, MSM, RN-BC, NEA-BC.
In the News: School Choice and Vouchers
A Trump administration proposal to use the federal tax code to offer vouchers that students could use to attend private secular or religious schools has reignited public debate over school choice. David Figlio, a professor of economics and education at the University of Rochester whose research on vouchers has been widely cited, is available to offer insight on the matter. A recent study he co-authored on a school choice program in Ohio showed that low-income children in the program were likely to realize significant and positive academic benefits. Figlio warned in an interview with National Public Radio, though, that the results need to be taken “with a grain of salt.” “This program was a highly targeted program that bears little resemblance to the statewide, universal vouchers that are being rolled out today,” he said. Figlio’s research spans a wide range of education and health policy issues, from school accountability and standards to welfare policy and the intersection between education and health. Contact Figlio by clicking on his profile.
Best Places for Families in the U.S.
Dr. Martine Hackett, associate professor and chair of Hofstra’s Department of Population Health was interviewed by WalletHub about the best places in the United States to raise a family and factors to consider when deciding where to plant roots. According to the report, the five top places in the country for families are: Fremont, CA; Overland Park, KS; Plano, TX; Irvine, CA; and South Burlington, VT.
Georgia Southern University’s Office of Student Wellness and Health Promotion, Jiann-Ping Hsu College of Public Health (JPHCOPH) Center for Addiction Recovery and Health Services have partnered to provide overdose prevention education to the campus community. The University will distribute naloxone, which is used to rapidly and temporarily reverse the effects of an opioid overdose, allowing time for first responders to arrive and initiate further intervention, to the campus community at no cost. Savannah nonprofit No More O.D.s donated a large quantity of naloxone to Georgia Southern for this purpose. “The health and safety of our campus and the many visitors it welcomes are of high priority,” said Shay Little, Ph.D., vice president for Student Affairs. “By increasing access to naloxone we are equipping our community with another life-saving tool.” Georgia Southern Public Health Administrator Sean Bear, DPH, agrees. “Naloxone is a life-saving medication,” he noted. “It is safe, fast-acting and easy to use.” Although many in the Georgia Southern community do not consume alcohol or other recreational substances, opioid overdoses can occur under a number of circumstances. Misuse of prescription opioids provided by a health care provider or the use of illegal opioids can result in negative health consequences, including overdoses. Some common prescription opioids include codeine, morphine, hydrocodone and oxycodone, among others. Counterfeit pills designed to look like prescription opioids often contain a synthetic opioid known as fentanyl, with many of these pills containing enough fentanyl in just one dose to cause an opioid overdose. “The primary aim of distributing naloxone and providing education on overdose prevention, recognition and response is to save lives,” said Robert Bohler, Ph.D., JPHCOPH assistant professor. Just as AED/CPR first aid boxes are placed strategically across campus, naloxone kits and utilization instructions will be placed in high-traffic, high-risk areas. Distribution locations include the Campus Food Pantries (all campuses), Center for Addiction and Recovery (Statesboro Campus), Health Centers (Statesboro and Armstrong campuses), Counseling Centers (Statesboro and Armstrong campuses), and Student Wellness and Health Promotion (Statesboro and Armstrong campuses). “All naloxone packages come with instructions, however, additional educational information, such as a video link on how to administer naloxone, where to find additional information and more will be available at each of these distribution locations,” said Gemma Skuraton, DPH, director of Student Wellness and Health Promotion. Universities play a vital role in promoting harm-reduction strategies. As such, Georgia Southern is committed to ensuring the availability, accessibility and education surrounding naloxone on each of its campuses. Educational initiatives will focus on overdose prevention, recognizing signs and symptoms of overdose, overdose response planning, naloxone administration, legal protections (Georgia’s 911 Medical Amnesty Law and Georgia Southern’s Amnesty Protocol), bystander intervention, and treatment and recovery service availability on campus and in the community. You can sign-up for an open workshop to learn more on the Student Wellness and Health Promotion webpage: Interested in learning more? If you want to connect with any of the experts from this story and want to book time to talk or interview, then let us help - simply contact Georgia Southern's Director of Communications Jennifer Wise at jwise@georgiasouthern.edu to arrange an interview today.
ChristianaCare has once again been recognized by the American Association of Critical-Care Nurses (AACN) for its exceptional complex care. The AACN has awarded the Beacon Award for Excellence to three intensive care units at Christiana Hospital in Newark, Delaware: the Medical Intensive Care Unit (MICU), the Surgical Critical Care Complex (SCCC), and the Transitional Surgical Unit (TSU) Beacon Awards honor critical-care nursing units that demonstrate exceptional patient care, improved patient health outcomes, a supportive work environment and opportunities for collaboration. The Beacon Award is widely considered to be the most prestigious award in critical-care nursing. “The Beacon Award shines a light on individual nursing units for their commitment to providing critically ill patients with exceptional care and evidence-based practices,” said Danielle Weber, DNP, MSM, RN-BC, NEA-BC, chief nurse executive at ChristianaCare. “These awards reflect nursing excellence and commitment to exceptional health outcomes, an outstanding work environment and superior patient experience.” AACN President Jennifer Adamski, DNP, APRN, ACNP-BC, CCRN, FCCM, applauds the commitment of the caregivers at ChristianaCare for working together to meet and exceed the high standards set forth by the Beacon Award for Excellence. These dedicated healthcare professionals join other members of our exceptional community of nurses, who set the standard for optimal patient care. “The Beacon Award for Excellence recognizes caregivers in outstanding units whose consistent and systematic approach to evidence-based care optimizes patient outcomes. Units that receive this national recognition serve as role models to others on their journey to excellent patient and family care,” Adamski said. Consecutive successes Each of these units has received multiple Beacon Awards. • The MICU has been continuously recognized as a Beacon unit since 2009. It is the sixth time that the MICU—Delaware’s first Beacon Award-winning unit—has received the national award, with four silver and two gold recognitions. The unit holds the most Beacon Awards in Delaware. • The SCCC received a silver-level award for the fourth time. • The TSU received a gold-level award for the first time, after receiving two silver-level awards. “For us to be designated for such a consecutive amount of time is a testament to the ongoing, intensive work that we do and the focus on excellence that we have,” said Carol Ritter, MSN, RN, CCRN, CNML, nurse manager for the MICU. “It’s an affirmation of the care that the nurses provide and the excellence that they bring every day, using advanced protocols and the latest technology and research.” Beacon-designated units are renowned for their healthy work environments and high morale, which results in strong relationships among the nurses and outstanding patient care. “Our nurses are committed to providing exceptional care and patient outcomes,” said Amanda Latina, MSN, MBA, RN, TCRN, nurse manager of the TSU and SCCC. “They embody what it means to be a critical-care nurse.” Of the seven Beacon Award-winning patient care units currently in Delaware, all are at Christiana Hospital in Newark. These include the Neuro Critical Care Unit (silver), the Cardiovascular Stepdown Unit 4E (silver), the Cardiovascular Critical Care Complex (three-time gold winner), the Transitional Medical Unit and the 3C Intermediate Medical Unit (both silver).
ChristianaCare Charts New Course With Nurse Robotics Research Fellowship
ChristianaCare, the first hospital system in the region to deploy collaborative robots, has once again broken new ground, this time with a nationally unique initiative that puts bedside nurses at the helm of robotics research and innovation. At a graduation ceremony April 30, ChristianaCare celebrated the first four clinical nurses completing the Nursing Research Fellowship in Robotics and Innovation — the first program of its kind in the nation. The fellowship was part of a larger three-year, $1.5 million grant from the American Nurses Foundation’s Reimagining Nursing Initiative. The grant supports ChristianaCare’s broader study on how collaborative robots impact nursing practice. Over eight months, nurses from different units and specialties participated in immersive research training and lectures designed to expand their knowledge, curiosity and professional growth. Their work culminated in national conference presentations and preparations for journal submissions. The inaugural Nursing Research Fellows in Robotics and Innovation are: Briana Abernathy, BSN, RN, CEN – case management, Christiana Hospital emergency department Elizabeth Mitchell, BSN, RN-BC – Christiana Hospital surgical stepdown unit Hannah Rackie, BSN, RN, C-EFM – Union Hospital maternity unit Morgan Tallo, BSN, RN, CCRN – Christiana Hospital cardiovascular critical care unit A ‘real seat at the table’ “When you create programs that empower nurses to lead, innovate and tackle meaningful challenges, you see real impact — not just in new skills and knowledge, but in job satisfaction, well-being and retention,” said Susan Smith Birkhoff, Ph.D., RN, program director of Technology Research & Education at ChristianaCare. “This fellowship is built on the belief that when nurses are given the space to learn and lead, they bring fresh ideas and collaborative solutions back to their clinical practice areas.” Created and led by Smith Birkhoff, the fellowship is a standout in the U.S. health care landscape: It gives bedside nurses the chance to step away from their daily routines and gain advanced research experience, an opportunity rarely available at the clinical level. While the fellowship directly trained four nurses, its reach extended well beyond thazt. Fellows shared what they were learning along the way, sparking wider interest in research across the health system. The research program was highlighted as a new knowledge and innovation exemplar in the latest evaluation by the American Nurses Credentialing Center, which in March awarded ChristianaCare its fourth Magnet designation — the gold standard for nursing excellence. Adriane Griffen, DrPH, MPH, MCHES, vice president of programs at the American Nurses Foundation, praised ChristianaCare’s responsiveness in shaping the program around nurses’ needs and building a model for future innovation. “What makes this fellowship stand out is its focus on giving bedside nurses a real seat at the table,” Griffen said. “When nurses are trusted to lead and have the right support, they develop solutions that are practical, sustainable and transformative. This fellowship shows how nurse-led innovation can grow from a local pilot into a model for improving care across the country.” Through the fellowship, nurses gained a deeper understanding of applying research methodology to advance robotics science at the intersection of nursing and hospital operations, which is groundbreaking and novel. “This is such an exciting and important moment for our profession,” said Danielle Weber, DNP, RN, NEA-BC, chief nurse executive at ChristianaCare. “Innovation is about improving care, easing the burdens on our teams and finding smarter ways to meet the complex needs of our patients. Tools like collaborative robots don’t replace the human touch, they help protect and elevate it.” Mitchell said she was initially intimidated when she saw the fellowship application because it had been years since she last engaged in formal research. Learning everything from literature reviews to abstract writing pushed her outside her comfort zone and gave her practical tools to take new ideas forward. The experience inspired her to return to school this fall to pursue a graduate degree. A ‘ripple effect’ “This fellowship reignited my enthusiasm for learning and gave me the skills and confidence to keep growing,” Mitchell said. “It’s been amazing to collaborate with other fellows and mentors, and I’m excited to apply what I’ve learned to improve patient care and strengthen our teams.” In addition to Smith Birkhoff, Kate Shady, Ph.D., RN, OCN, RN IV, served as a mentor to the fellows, bringing expertise from her hematology/oncology background. Kati Patel, MPH, provided key administrative coordination and support throughout the program. ChristianaCare continues its broader research into robotics integration, with findings from the multi-year collaborative robot study expected to be shared later this year. Shady said the fellowship is already influencing ChristianaCare’s nursing culture by expanding interest in research and evidence-based practice well beyond the initial group. The program’s ripple effect is helping build lasting infrastructure for nurse-led innovation across departments. “One of the most rewarding parts of this fellowship has been seeing these nurses step into new confidence and capability,” Shady said. “They began unsure about research, but by the end, they were reading studies, writing abstracts and mentoring peers — laying the groundwork for bigger change in how we advance nursing practice.” Learn more about nursing at ChristianaCare.
Vishesh Agarwal, M.D., Appointed Chief of Addiction Medicine Services
Vishesh Agarwal, M.D., has been appointed chief of Addiction Medicine Services at ChristianaCare. In this role, Agarwal will lead and expand ChristianaCare’s comprehensive addiction treatment services, guiding care for people with substance use disorders across inpatient, outpatient, emergency and consultation settings. He will oversee addiction programs across all campuses, help create consistent care guidelines and support teams of experts working together to provide safe, effective and compassionate care for patients. A key priority for Agarwal will be to explore strategic growth opportunities to broaden ChristianaCare’s reach and strengthen its impact on individuals and families affected by substance use disorders. His leadership will be instrumental in ensuring that ChristianaCare continues to set the standard for innovation and excellence. Agarwal will continue in his role as vice chair of the Department of Psychiatry at ChristianaCare, maintaining his leadership of clinical and operational initiatives in the Behavioral Health Service Line. He will continue to lead efforts to improve provider well-being, develop care pathways and foster clinical growth. He also oversees the Behavioral Health Unit, Emergency Department crisis services and psychiatric consultations for hospitalized patients. Agarwal is board certified in general adult psychiatry, addiction psychiatry and obesity medicine. He has published research on substance use and behavioral addictions in peer-reviewed journals and has presented at national conferences. His 2021 study linking gambling disorder, major depression and suicide risk was published in Addictive Behaviors and gained national attention. Agarwal holds an Executive MBA from Quantic School of Business and Technology and completed an addiction psychiatry fellowship at the Zucker Hillside Hospital. He completed his psychiatry residency and served as administrative chief resident at Einstein Medical Center. He earned his medical degree from Gauhati Medical College. Agarwal teaches and mentors psychiatry residents and medical students as a clinical assistant professor at Sidney Kimmel Medical College at Thomas Jefferson University. He also co-chairs system committees and serves on the board of the Mental Health Association in Delaware. He reports to Mustafa Mufti, M.D., chair of the Department of Psychiatry.
Why Simultaneous Voting Makes for Good Decisions
How can organizations make robust decisions when time is short, and the stakes are high? It’s a conundrum not unfamiliar to the U.S. Food and Drug Administration. Back in 2021, the FDA found itself under tremendous pressure to decide on the approval of the experimental drug aducanumab, designed to slow the progress of Alzheimer’s disease—a debilitating and incurable condition that ranks among the top 10 causes of death in the United States. Welcomed by the market as a game-changer on its release, aducanumab quickly ran into serious problems. A lack of data on clinical efficacy along with a slew of dangerous side effects meant physicians in their droves were unwilling to prescribe it. Within months of its approval, three FDA advisors resigned in protest, one calling aducanumab, “the worst approval decision that the FDA has made that I can remember.” By the start of 2024, the drug had been pulled by its manufacturers. Of course, with the benefit of hindsight and data from the public’s use of aducanumab, it is easy for us to tell that FDA made the wrong decision then. But is there a better process that would have given FDA the foresight to make the right decision, under limited information? The FDA routinely has to evaluate novel drugs and treatments; medical and pharmaceutical products that can impact the wellbeing of millions of Americans. With stakes this high, the FDA is known to tread carefully: assembling different advisory, review, and funding committees providing diverse knowledge and expertise to assess the evidence and decide whether to approve a new drug, or not. As a federal agency, the FDA is also required to maintain scrupulous records that cover its decisions, and how those decisions are made. The Impact of Voting Mechanisms on Decision Quality Some of this data has been analyzed by Goizueta’s Tian Heong Chan, associate professor of information systems and operation management. Together with Panos Markou of the University of Virginia’s Darden School of Business, Chan scrutinized 17 years’ worth of information, including detailed transcripts from more than 500 FDA advisory committee meetings, to understand the mechanisms and protocols used in FDA decision-making: whether committee members vote to approve products sequentially, with everyone in the room having a say one after another; or if voting happens simultaneously via the push of a button, say, or a show of hands. Chan and Markou also looked at the impact of sequential versus simultaneous voting to see if there were differences in the quality of the decisions each mechanism produced. Their findings are singular. It turns out that when stakeholders vote simultaneously, they make better decisions. Drugs or products approved this way are far less likely to be issued post-market boxed warnings (warnings issued by FDA that call attention to potentially serious health risks associated with the product, that must be displayed on the prescription box itself), and more than two times less likely to be recalled. The FDA changed its voting protocols in 2007, when they switched from sequentially voting around the room, one person after another, to simultaneous voting procedures. And the results are stunning. Tian Heong Chan, Associate Professor of Information Systems & Operation Management “Decisions made by simultaneous voting are more than twice as effective,” says Chan. “After 2007, you see that just 3.4% of all drugs and products approved this way end up being discontinued or recalled. This compares with an 8.6% failure rate for drugs approved by the FDA using more sequential processes—the round robin where individuals had been voting one by one around the room.” Imagine you are told beforehand that you are going to vote on something important by simply raising your hand or pressing a button. In this scenario, you are probably going to want to expend more time and effort in debating all the issues and informing yourself before you decide. Tian Heong Chan “On the other hand, if you know the vote will go around the room, and you will have a chance to hear how others’ speak and explain their decisions, you’re going to be less motivated to exchange and defend your point of view beforehand,” says Chan. In other words, simultaneous decision-making is two times less likely to generate a wrong decision as the sequential approach. Why is this? Chan and Markou believe that these voting mechanisms impact the quality of discussion and debate that undergird decision-making; that the quality of decisions is significantly impacted by how those decisions are made. Quality Discussion Leads to Quality Decisions Parsing the FDA transcripts for content, language, and tonality in both settings, Chan and Markou find evidence to support this. Simultaneous voting or decision-making drives discussions that are characterized by language that is more positive, more authentic, and more even in terms of expressions of authority and hierarchy, says Chan. What’s more, these deliberations and exchanges are deeper and more far-ranging in quality. We find marked differences in the tone of speech and the topics discussed when stakeholders know they will be voting simultaneously. There is less hierarchy in these exchanges, and individuals exhibit greater confidence in sharing their points of view more freely. Tian Heong Chan “We also see more questions being asked, and a broader range of topics and ideas discussed,” says Chan. In this context, decision-makers are also less likely to reach unanimous agreement. Instead, debate is more vigorous and differences of opinion remain more robust. Conversely, sequential voting around the room is typically preceded by shorter discussion in which stakeholders share fewer opinions and ask fewer questions. And this demonstrably impacts the quality of the decisions made, says Chan. Sharing a different perspective to a group requires effort and courage. With sequential voting or decision-making, there seems to be less interest in surfacing diverse perspectives or hidden aspects to complex problems. Tian Heong Chan “So it’s not that individuals are being influenced by what other people say when it comes to voting on the issue—which would be tempting to infer—rather, it’s that sequential voting mechanisms seem to take a bit more effort out of the process.” When decision-makers are told that they will have a chance to vote and to explain their vote, one after another, their incentives to make a prior effort to interrogate each other vigorously, and to work that little bit harder to surface any shortcomings in their own understanding or point of view, or in the data, are relatively weaker, say Chan and Markou. The Takeaway for Organizations Making High-Stakes Decisions Decision-making in different contexts has long been the subject of scholarly scrutiny. Chan and Markou’s research sheds new light on the important role that different mechanisms have in shaping the outcomes of decision-making—and the quality of the decisions that are jointly taken. And this should be on the radar of organizations and institutions charged with making choices that impact swathes of the community, they say. “The FDA has a solid tradition of inviting diversity into its decision-making. But the data shows that harnessing the benefits of diversity is contingent on using the right mechanisms to surface the different expertise you need to be able to see all the dimensions of the issue, and make better informed decisions about it,” says Chan. A good place to start? By a concurrent show of hands. Tian Heong Chan is an associate professor of information systems and operation management. he is available to speak about this topic - click on his con now to arrange an interview today.
Have you ever dreamed of being an Olympic athlete? Perhaps you have wondered what it would feel like to stand on that podium in front of the world as your national anthem plays. For most Olympic athletes, the journey begins very early in life. But imagine what it would be like if you started training for this event in your 60s? Read on if you want an edge to discover how to win the Retirement Games and still pass the drug test (let’s face it, peeing is not an issue for many at that age)! Here is your chance to get on the podium at the most crucial game of your life. On Your Marks, Get Set, Ready, Go! Retirement was more like a coffee break five decades ago—brief, predictable, and over before your muffin cooled. In 1975, the average Canadian could expect to live about 73.53 years. Fast forward to 2025; we're clocking in at nearly 83.26 years. Even juicier? The lastest research shows half of today's 20-year-olds in Canada are expected to live past 90. That’s why we need to think of retirement these days, not as a sprint; instead, it’s an ultramarathon with hills, potholes, and the occasional pulled hamstring. Most of us never expected to be training for it in our sixties, but here we are—so pull up your compression socks and move. The starter's pistol is about to fire, whether you're ready or not! Surprise! You're Retired While you may dream of selecting your retirement date like a fine wine, many face the reality of a boxed kind instead. Approximately 6 in 10 Americans retire earlier than they planned. Research from the Transamerica Center for Retirement Studies shows that many individuals experience unexpected early retirement due to personal health issues, employer discretion, or family-related circumstances. https://www.cbsnews.com/news/retirement-age-in-america-62-claiming-social-security-early/ Sometimes, it's a health scare, a loved one’s illness, or a harsh employer downsizing. Nobody whispers the term "ageism," but when companies replace senior employees with younger, more affordable talent (or AI bots), it’s not subtle—it’s math.As Morgan Housel reminds us in his bestseller, The Psychology of Money, "The most important part of every plan is planning for your plan, not going according to plan." Expect the unexpected. Train as if retirement could sneak up on you—because it just might. Get Fit, Stay Sharp: Health is the First Leg of the Race Physical and mental health are the fuel for your retirement. The rest doesn’t matter without them; we’re not just talking about lifting weights. (Though, yes, lift some weights.) Regular physical activity provides numerous benefits for older adults, including a reduced risk of dementia and enhanced cognitive function. Exercise can help maintain brain health, reduce mental decline, and even reverse some age-related brain shrinkage. Additionally, physical activity can improve mood, reduce anxiety, and enhance balance and coordination, leading to a better quality of life. • Strength training enhances bone density, metabolism, and mental health. (Source: Mayo Clinic) • Flexibility and balance? Try yoga or tai chi. Harvard Health says they reduce pain and stiffness. • Mental fitness? Cue up Wordle, Canuckle (the Canadian cousin), or Sudoku. • Dancing? It's beneficial for your brain and your swagger • Listening to music or playing an instrument can reduce stress and boost memory. Gold Medal Tip: Motivation is overrated; action is everything. Don’t be a couch potato. A new study conducted at the University of Pittsburgh School of Medicine shows that older adults who spend more time sedentary — such as sitting or lying down — may be at a higher risk for lower cognition and in areas linked to the development of Alzheimer’s disease, no matter how much they exercise! So make sure you show up, move, and the motivation will catch up. Wealth Training: Stop Hoping, Start Budgeting Here's a shocker: Retirement doesn't mean your expenses magically disappear. According to Steve Willems' podcast “10 Retirement Myths You May Not Want to Believe,” most retirees don’t spend less. Aside from the mortgage, spending remains surprisingly consistent, especially during the Go-Go years (ages 55-75)”. We like what we like: groceries, entertainment, travel, and stylish or comfortable clothes are still on our shopping lists. That’s why many of us in retirement will need to pay more attention to spending and budgeting. Check Obligation Spending Retirement is the perfect time to reevaluate expenses from obligation rather than genuine need or joy. Here's a thoughtful way to frame that idea: Retirement is the season of freedom, so why are you still paying for things that feel like a burden? Now that you’re no longer earning a regular paycheck, every dollar matters more than ever. This means it’s time to take a closer look at obligatory expenses. These might include: • Helping adult children financially (even when it stretches your budget) • Donating to every fundraiser or cause just because someone asked • Hosting large family gatherings that leave you exhausted and over budget • Maintaining memberships, subscriptions, or traditions that no longer bring you joy. (We talk a lot more about this in a previous post What’s your Retirement Plan B While generosity is admirable, it shouldn’t jeopardize your financial security or peace of mind. Retirement should focus on investing in what truly matters to you now, rather than keeping up appearances or adhering to outdated expectations. Here’s a gentle mantra to adopt: “I’ve earned the right to say no with love and confidence.” Freeing yourself from obligation spending doesn’t mean becoming stingy; it means becoming intentional. Give where your heart feels full, not where your guilt feels heavy. After all, you didn’t work all those years to keep writing checks out of habit. Balance Beam- Budget What’s your plan when overtime isn’t an option and the budget doesn’t balance? Start with a good old-fashioned reality check: • Write down ALL expenses. • Tally up your income. • Look for a surplus (yay, trip!) or a shortfall (boo, time to pivot). Look at Canadian Government Pensions • Here's the math. Old Age Security (OAS): Max is about $713/month or $8,556/year. And don’t forget the dreaded government clawback (formally known as the Old Age Security Pension Recovery Tax which starts at ~$90,997. • Canada Pension Plan (CPP): The average monthly payment is $758, while the maximum is $1,364 per month or $16,368 per year. So with these two programs combined, provided you meet requirements, as a senior, you're looking at somewhere between $17,000–$25,000/year before tax. If your lifestyle needs a bit more jazz hands, here’s how to bridge the gap: DIY Income Builders: • Slash debt. Every dollar you don't spend is one you keep. • Downsize and bank the equity. • Buy or build an ADU and rent it. I have written more about ADU's here. • HELOC or Reverse mortgage (borrow strategically). • Withdraw from investments (4% rule). • Monetize your skills: consulting, tutoring, or writing that novel you started in 1993. Gold Medal Tip: Track your joy per dollar. If you’re going to spend, make it worth it. Rewire, Don’t Retire: Finding Purpose The biggest myth of retirement? That doing nothing feels good forever. (Spoiler alert: it doesn’t.) Passion is your GPS. It guides you towards what fills your heart. Whether you write poetry, walk dogs, or paint birds wearing tiny hats, your joy matters. And legacy? That’s just purpose with staying power. There’s science to support the benefits of this lesson. A study in JAMA Psychiatry found that people with a sense of purpose had a lower risk of mortality and disability Purpose-Driven Paths: • Volunteer: Look for a cause that fires you up. • Get a part-time job: Perhaps you can fill in at a local bookstore, garden center or be a barista? • Hobbies: Take up painting, pottery, or poetry. • Go Back to School: Many Universities such as The University of Toronto offer free, non-credit courses through programs as part of their community outreach. Seniors (over 60) enrolled at York University may have all or part of their academic fees waived at the domestic fee rate for York University degree credit courses as part of their mature student program. • Spend real time with people you love, maybe your grandkids or elderly parents. • Reconnect with old friends – not just on Facebook, but in person • Get out of your backyard and see the world Gold Medal Tip: You're never too young (or too old) to chase what lights you up. Start a business, get that degree you always wanted, and write that book. Go. For. It. Support: No One Trains Alone Retirement can be lonely. As we age, friends pass, routines fade, and isolation creeps in. That’s why your squad matters more than ever. Find Your Pod: • Family & Friends: Set expectations. Ask for help. Host Sunday dinners. Stay connected. • Fitness & Social Clubs: Join a walking group or participate in a gym class, followed by regular post-sweat coffee. • Faith Communities: Spirituality and structure in one. Sing in the choir. Serve at events. • Third Places: As sociologist Ray Oldenburg says, these are neutral hangouts like libraries, community centers, or your local café. They’re tied to lower loneliness and better mental health. Think of Cheers: “Where everyone knows your name!” Gold Medal Tip: Your local pickleball court or knitting circle might just be your new training ground. Attitude Training: Stop Acting Your Age Here’s a radical thought: Maybe we feel old because we act old. Want to stay young? Stay curious, try new things. Try line dancing, pickleball, bird watching, improv, or learning to code. Yes, code. What was the worst advice our mothers gave us? “Act your age.” Nonsense! Whoever said, “You’re only as old as you feel” was on to something – but let’s take it up a notch: How about you’re only as old as your playlist! The Power of a Youthful Attitude in Retirement A successful retirement isn’t just about savings accounts and spreadsheets — it’s about mindset. A positive, youthful attitude is one of the most powerful (and overlooked) assets you can carry into retirement. Even if you don’t feel youthful or optimistic, “fake it ‘til you make it” is more than just a catchy phrase—it’s a strategy. The goal isn't to accurately describe your aches, fears, or fatigue but to set yourself up for success! Science backs it up: a positive outlook boosts health, sharpens cognition, and increases longevity. From a practical perspective, optimism makes it easier to try new things, adapt to change, and enjoy the present—all essential in retirement. So, if the voice in your head says, “I’m too old for that,” try responding with, “This is my time.” You begin to build because what you tell yourself matters, as does what you believe. Retirement is your reward. Approach it like the vibrant, capable, unstoppable human you are because attitude, not age, sets the tone. Gold Medal Tip: You’re only as old as the last thing you tried for the first time. Try something ridiculous, I double dare you! Final Stretch The Retirement Games are here, and let me be crystal clear: this isn’t amateur hour. This is your Olympic moment, with medals awarded for stamina, strategy, and a solid sense of humour. Whether you're rounding the first turn at 45 or doing your victory lap at 75, now is the time to train. You’ve built strength, stretched your budget, flexed your purpose muscle, assembled your dream team, and rebooted your mindset. Now it’s time to lace up, lean in, and live life to the fullest. This isn’t about perfection; it’s about preparation. You won’t achieve a podium finish through wishful thinking; you’ll attain it through action, adaptation, and a great deal of repetition. So, put on your metaphorical tracksuit (or actual tracksuit if it's laundry day) and begin training with determination. The gold medal retirement isn’t just possible—it’s within reach. Cue the confetti cannon. You’re not just aging—you’re advancing. And champions, as we know, don’t retire… they rewire, recharge, and rewrite the playbook. On Your Marks, Get Set, THRIVE! Don’t Retire … Re-Wire! Sue
Professor Gina Rippon signs a copy of The Lost Girls of Autism for talk attendee Dr Georgie Agar Professor Gina Rippon’s new book, The Lost Girls of Autism, investigates why autism was thought to be a male condition for so long She gave a public talk at Aston University on 6 May 2025 exploring the central themes of the book Women and girls with autism have long been overlooked as they are better at masking and camouflaging so ‘fail’ standard tests. Autism in women and girls has been overlooked for decades, and Gina Rippon, professor emeritus of cognitive neuroimaging at Aston University Institute of Health and Neurodevelopment (IHN), has given a talk about her new book on the topic at Aston University. The book, The Lost Girls of Autism, was released on 3 April 2025, coinciding with Autism Acceptance Month, with the subtitle ‘How Science Failed Autistic Women and the New Research that’s Changing the Story’. Autism is characterised by a number of now well-known traits, including social awkwardness, extreme obsessions, and unusual movements and coping mechanisms known as ‘stimming’. It was (allegedly) first described in the 1940s separately by Austrian psychiatrists Leo Kanner and Hans Asperger. Originally identified as a rare developmental condition, since the 1980s, there has been an 800% increase in diagnoses, leading to concerns about an ‘autism epidemic’. There is a strong and enduring belief that it is a condition much more prevalent in males. Professor Rippon described her research as “looking at how brains get to be different and what that means for the owners of those brains”. This includes looking at the functions of different areas of the brain using scanners. During research into a number of brain conditions and diseases with obvious differences between the sexes, including how the disease progresses, such as Alzheimer’s in women, or prevalence in one particular sex, such as Parkinson’s in men, Professor Rippon also became interested in autism, also assumed to be largely a condition in males. However, during a research review, she found that many autism studies made no reference to sex differences. Amalgamated data from autism studies found that 80% of participants were male, and 25% of testing centres only tested males with autism. By only looking at males, Professor Rippon explained, the notion that autism is a male disorder became self-fulfilling. This does not just refer to scientific research. Even now, boys are ten times more likely to be referred for assessment for autism and twice as likely to be diagnosed than girls, even when they have exactly the same traits. 80% of autistic females have received multiple wrong diagnoses, including borderline personality disorder, social anxiety or obsessive-compulsive disorder (OCD). But why? The reason is the unchallenged belief that ‘autism is a “boy” thing’ causing a male spotlight problem in all aspects of the autism story. It could also be that females with autism express the condition differently. Professor Rippon said: “This took me back to [my previous book] The Gendered Brain when I was looking at the very clear view of what males should be like and what females should be like. If you look at the autistic population you have this clear idea that males are like this, but females, er, not so much? Females have poor social skills, but not as poor, or obsessive interests, but not as obsessive, so the trouble with females, is that they are not autistic enough.” The gold standard tests for autism are the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview (ADI) tests. Professor Rippon believes these are heavily biased towards how the condition manifests itself in males, such as social awkwardness or extreme obsessions. For example, parents may well be asked if their son has an unusual interest in weather patterns or train timetables, but they are not asked if their daughter has an unusual interest in Barbie dolls, because dolls are seen as socially acceptable. Research has shown that females with autism are more likely to ‘camouflage’ their symptoms, watching how ‘normal people’ behave, even practising social interactions, so they appear more normal. They are also more likely to ‘mask’ symptoms behind a persona, such as the ‘class clown’ or ‘star athlete’, in an effort to fit in. Autistic females describe this behaviour as a ‘survival strategy’ to avoid being spotted as different. It is also the case that girls are more likely to have sensory processing problems, such as aversion to strong smells, which can be enough to affect their day-to-day lives. This has only recently been added to the diagnostic criteria for autism. If the camouflaging or masking collapses, rates of other conditions such as disordered eating or anorexia, self-harm and gender dysphoria are disproportionately high, and it is these which will become identified as the underlying difficulty, rather than autism itself. Professor Rippon said: “The next stage should be asking why this group of individuals persists in hiding their autism, especially when autism has been defined as a lack of interest in social connection. There’s what I call the ‘born to be mild’ effect, where little girls are trained to socialise more, to behave, not to make a fuss, if you feel uncomfortable, don’t tell anyone else about it. There’s a lovely comment from one late-diagnosed female who rues the fact that she was so well behaved and wishes that she had just burned more cars so that someone would have spotted her carefully camouflaged distress!” The final slide in the presentation covered what Professor Rippon called “an ironic footnote”. While Leo Kanner and Hans Asperger are described as the fathers of autism, writing in the 1940s, it was in fact a Soviet female psychiatrist, Grunya Sukhareva, writing in the 1920s, who first described autism, even clearly examining the differences in the condition between boys and girls. Why her research was ignored for so long is unclear, but the male spotlight problem may well have been avoided. For more information about The Lost Girls of Autism, visit https://www.panmacmillan.com/authors/gina-rippon/the-lost-girls-of-autism/9781035011629.
