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Study: Many pregnant women uncertain of marijuana risks even as use increases
Many pregnant women are unsure if it’s safe to use marijuana or products containing cannabidiol, an active compound in marijuana, even as they increasingly turn to them to combat morning sickness, anxiety or insomnia, a recent University of Florida Health study shows. The American College of Obstetricians and Gynecologists advises against the use of marijuana and cannabidiol, or CBD, during pregnancy. Marijuana use has been associated in some studies with adverse fetal neurodevelopmental outcomes. Evidence of cannabidiol safety is sparse in human studies, but researchers remain concerned that it might nonetheless pose a danger. CBD is not intoxicating. The UF Health researchers said their study shows a need for the medical community to better educate women about the potential hazards to the fetus from using marijuana, also called cannabis. One worry is that some people believe the spreading legalization of marijuana or CBD around the nation equates to the government giving its stamp of approval that the products are safe, researchers said. Medical marijuana is legal in Florida, although its recreational use is not. “If a medication is legal, we assume that maybe it’s safe, although other things like tobacco and alcohol are also legal and we know that those can be harmful to pregnancies,” said Kay Roussos-Ross, M.D., the study’s senior author and a professor in the UF College of Medicine’s Department of Obstetrics and Gynecology. “We see a good deal of data out there that shows that there is increased risk of psychiatric and behavioral issues related to marijuana use in pregnancy, but we need more,” she added. “We need more so that we can be correct in our assessments and our educational efforts to women of reproductive age who are using marijuana.” It’s difficult to quantify the rise of marijuana and CBD use during pregnancy, with most estimates showing an increase predating COVID-19. A 2021 federal survey reported 7.2% of pregnant women used marijuana. The UF Health study noted that emerging evidence from obstetrics care shows more pregnant women are trying the products, perhaps because of increased legalization. The study, published in Medical Cannabis and Cannabinoids, surveyed 261 women and used focus groups to explore participants’ perceptions of the products. The women were either pregnant, breastfeeding or caring for a child 5 years old or younger, and reported use of marijuana or CBD products, such as vapes, smoking, tincture oils or ointments. “There seems to be a disconnect,” said Amie Goodin, Ph.D., an assistant professor in the UF College of Pharmacy’s Department of Pharmaceutical Outcomes and Policy and the study’s lead author. “About one in six pregnant women are telling us, ‘Yes, I have used marijuana or a CBD product while I’m pregnant.’ But half are saying, ‘I don’t know what the risks are.’” About 40% of the pregnant women surveyed said they were unsure how risky it was to use marijuana once or twice a week during pregnancy, compared with 34.5% of women who were not pregnant when surveyed for the study but who had children. Asked the same question about CBD, more than 52% of pregnant women were unsure of the risk, compared with 41.8% for mothers who weren’t pregnant when surveyed. About 36% of pregnant women reported using marijuana, compared with 65% of mothers not currently pregnant, perhaps reflecting at least some increased caution among those in the former group. CBD use was 19.9% for pregnant women and 38.2% for women who were not pregnant. “Some women did mention that the legalization of marijuana has made marijuana more socially acceptable,” said study co-author Deepthi Varma, Ph.D., an assistant professor in the College of Public Health and Health Professions’ Department of Epidemiology. The researchers said they were especially concerned that women were even less sure of the safety of CBD use because it is widely available and often seen as harmless. “You might notice that it’s even something that you can buy at a gas station or a grocery store,” Goodin said. “CBD in a purified form has actually got an FDA approval to treat certain types of pediatric epilepsy on its own … but pharmaceutical-grade CBD is not quite the same thing as you would expect to get if you were purchasing CBD oil at a smoke shop or a gas station.”
Retirement Maxxing: How Small Decisions Help You Build a Better Future
The basic idea is to pick a corner of your life and optimize it ruthlessly. Sleep maxxing. Health maxxing. Productivity maxxing. In its more extreme corners, people are attempting to optimize their actual physical features. Go ahead and Google "looksmaxxing" if you are curious and have a strong constitution. One influencer named Clavicular — a 20-year-old from Hoboken who claims to have taken a literal hammer to his face to coax a chiselled jawline — has become the reigning king of this particular rabbit hole. Medical experts would prefer you not try that at home. The Globe and Mail published a comprehensive explainer on the whole phenomenon. The Republican National Committee put out a press release praising Donald Trump for "jobsmaxxing" the economy. The Department of Defence posted a soldier with the caption "lethality maxxing." It has become, as one writer put it, the suffix that just will not quit. Retirement Maxxing: because chin waxing, I mean maxxing, was already taken. And yet, buried beneath all the absurdity, the underlying impulse is not entirely ridiculous. Humans want to optimize things. We always have. The real question is whether we are optimizing the right things. Then, as these things sometimes happen, three articles landed in my inbox in the same week and refused to leave my mind. Maxxing. The psychology of future selves. A golfer named Max Greyserman, who sits just one-tenth of a stroke from the top of his sport. I am not a woman who ignores signs. The connection was obvious once I saw it: retirement might be the most important time to apply this kind of thinking. Not the obsessive version involving ice baths and fourteen supplements before breakfast. The practical version. Thoughtful maxxing that quietly stacks the odds in your favour over decades. Retirement isn't just one decision; it's hundreds made over the years, each guiding your future self toward either financial dignity or a Shaggy tribute tour you never signed up for. The “Shaggy Problem”: How Your Retirement Decisions Today Determine Your Financial Security Tomorrow You remember Shaggy. The reggae artist. Enormous hit. "It Wasn't Me." When it comes to retirement, it absolutely was you. Every decision you make today is writing a letter to your future self. Some of those letters are generous and thoughtful. Others arrive decades later, like a bill you forgot to pay, from a creditor with excellent memory and zero sympathy. The seventy-five-year-old version of you hopes the fifty-five-year-old paid attention. The eighty-five-year-old version would very much like functioning knees, a dignified income, and the ability to say "I planned for this" rather than "I did not think it would go this fast." It went that fast. That's why the most useful habit you can develop right now is what I call the future-self test. Before making a major financial or lifestyle decision, pause and ask: how will this look from the other end? Will I still think this tattoo is a good idea when I’m ninety? Will I regret staying in a house that is too large and too expensive for another decade? Will my future self thank me for delaying CPP, or curse me for taking it early because waiting felt uncomfortable? Or as the Beatles asked rather memorably: “when I'm sixty-four, will you still need me, will you still feed me?” The song is charming. The financial planning version is considerably less so if you have not thought it through. The future-self test is not complicated. It is just the habit of writing better letters. What Sports Analytics Can Teach Us About Smarter Retirement Decisions Speaking of decisions that come back to haunt you, let's discuss probabilities. A recent New York Times article about golfer Max Greyserman stopped me mid-scroll (Lindgren, 2026). Not because of the golf — though the golf is fascinating — but because of what it revealed about the gap between what the data says and what people actually do when the stakes are high. Greyserman's scoring average is less than one-tenth of a stroke per round away from the elite level. One-tenth of a stroke. Not a full swing, a putting mistake, or a collapse on the eighteenth. The difference between obscurity and greatness in pro golf is about the time it takes to find your reading glasses. Which, as we've established, were on your head the entire time. Hockey analytics have demonstrated that teams trailing late in a game should often pull the goalie much earlier than the traditional last-ninety-seconds rule. Research indicates that pulling the goalie around the eight-minute mark can significantly boost the chances of scoring, as the extra attacker alters the odds. However, most coaches still wait until the final minute or two. Why? Because if you pull the goalie at eight minutes and lose badly, it can look like you lost your mind. The math checks out, but the optics are terrifying. Soccer offers a similarly uncomfortable example. A widely cited study analysing thousands of penalty kicks found that about one-third of kicks are aimed straight down the middle of the net, yet goalkeepers stay in the centre only around six percent of the time (Chiappori, Levitt, & Groseclose, 2002). Shooting directly down the middle often provides good odds because the keeper has already committed to diving one way or the other. But if the goalkeeper stays put and makes the save, the kicker seems to have tried to outsmart the odds and failed. The math checks out. The optics, however, are still terrifying. Retirement is filled with these moments. And most people make their decisions based on the optics. Common Retirement Decisions Canadians Get Wrong — And What the Data Actually Says: Working a couple of extra years often delivers significantly better retirement outcomes, yet people retire early because they feel emotionally ready. Delaying CPP can greatly increase guaranteed lifetime income, yet many choose to claim early because waiting seems risky. Downsizing can free up cash and lessen financial stress, yet people stay in large homes because selling feels like giving up. Using home equity wisely can boost retirement income, yet many retirees dismiss this option because of a stigma rooted in outdated beliefs rather than current data. In each case, the emotionally comfortable choice is not the one with the best long-term odds. Fear of loss, fear of regret, fear of looking foolish — those emotions sprint ahead of rational thinking every single time. That is why the future-self test matters. Math is universal, but money is deeply personal, and the goal is to let one inform the other before it is too late. The Psychology of Retirement Saving: Why We Treat Our Future Self Like a Stranger The second New York Times article examined the psychology of how we connect with our future selves (The New York Times, 2026). The findings are humbling. Psychologists have discovered that people often see their future self almost like a stranger, which explains why saving for retirement can seem somewhat punishing. It feels less like helping yourself and more like sending a cheque to someone who shares your cheekbones but whose problems seem distant and abstract. Research led by Hal Hershfield found that when people feel more connected to their future selves, they save more and make consistently better long-term financial decisions (Hershfield, 2011). Retirement planning is not just about spreadsheets and withdrawal rates. It is about being genuinely generous towards the person you are becoming. It is a love letter, written in small decisions, over a very long time. So, write a good one. Your future self is counting on you. How to Optimize Your Retirement: A Practical Framework for Canadians If retirement maxxing were a lifestyle trend — and I am formally proposing that it should be — it wouldn’t involve bone-smashing or extreme jawline enhancement. It would look more like this. Health Maxxing: Why Strength and Mobility Are Financial Assets Move your body. Lift weights now and then. Walk up hills. Muscle strength is one of the most underrated assets for retirement that nobody discusses at dinner parties. Research from the National Institute on Aging confirms that strength training improves mobility, balance, and healthy longevity (National Institute on Aging, 2023). These are the very factors that influence whether your later years feel like a gift or a burden. People hesitate over the cost of a gym membership while ignoring the significant long-term benefit of staying upright, independent, and capable. Skipping exercise to save a few dollars is like stepping over a hundred-dollar bill to find a quarter. As Aunt Equity likes to say: be careful not to get out over your skis. (Yes, that was an exercise metaphor. You’re welcome.) Income Maxxing: How to Build Reliable Cash Flow That Lasts Build reliable income streams so you can sleep at night without one eye on the market. Pensions, annuities, dividends, home equity, and carefully structured withdrawals — these all play a role in a well-crafted retirement income plan. The goal isn’t to maximize a single number – it’s to reduce the worry behind all of them. If your retirement plan currently makes you watch financial news at midnight while eating crackers over the sink, something has gone wrong and we should talk. Purpose Maxxing:Why It Matters for Your Health and Longevity Retirement is not a forty-year holiday. Humans need purpose, connection, and something worth getting out of bed for — especially on days when nobody expects you anywhere and the morning is entirely, terrifyingly yours. NIH research consistently shows that social engagement and a sense of purpose are linked to better health and longer life (National Institute on Aging, 2023). Purpose is what makes a retirement that feels like freedom different from one that feels like a long Sunday afternoon with nowhere to go. Somewhere along the way, society decided that aging meant quietly fading into the background. Retirement is when you finally have permission to dye your hair a vibrant colour, volunteer somewhere meaningful, start a project that genuinely excites you, or do all three at once and totally surprise your grandchildren. Purpose is not optional. It is the foundation. Decision Maxxing: How to Overcome Emotional Bias Use data when the stakes are high. Emotions are useful for choosing dessert but much less reliable for planning a thirty-year income. Don't swat away analytics like a fly at a family picnic just because they suggest something uncomfortable. Run projections. Stress-test your plan. Understand probabilities. Pull the goalie early if the math indicates so, even if it looks odd at the moment. Because appearing odd now and being wrong later are not the same thing. Not even close. The Ending That Brings It All Together: Small Decisions That Compound Over Time Here’s what three articles about “maxxing” our future selves, and golf, taught me about retirement. Clavicular is out there taking a hammer to his face in pursuit of optimization. Max Greyserman is grinding for one-tenth of a stroke. Hal Hershfield is reminding us that we treat our future selves like strangers when we should treat them like people we love. And somewhere between all three of them is the retirement insight that really matters: the best decisions compound quietly. Tiny improvements in health, income strategy, purpose, and decision-making build up into dramatically different outcomes over decades. Not because of one dramatic move, but because of many small, sensible ones made with the future in mind. Your future self isn't a stranger waiting to judge you. They are the person you are intentionally becoming, shaped by every decision you make today. Perform the future-self test before making risky decisions like pulling the goalie, shooting down the middle, or getting a tattoo that might lead to an awkward chat with your colonoscopy technician (this is for you, JK). Consider whether your fifty-five-year-old self is being kind to your seventy-five-year-old self. Look at what the data says, not just what feels right. Retirement maxxing isn't about perfection. It's about making small, sensible decisions consistently and thoughtfully over time. Think of it as compound interest for your future self. Einstein allegedly called compounding the most powerful force in the universe. He was talking about money, but he might as well have been talking about the small, steady choices that create a retirement worth living. Your future self will be deeply grateful—having functional knees, a dignified income, and a tattoo they still absolutely love. And when you turn sixty-four, and someone asks how you got there so gracefully, you won't need to channel your inner Shaggy. You just smile and say: It was me! Sue Don’t Retire…ReWire! P.S. Aunt Equity approves. Ready to start retirement maxxing? Here are two things you can do today. Run the future-self test on one financial decision you have been avoiding. Just one. Write down what your seventy-five-year-old self would think of the choice you are leaning toward. You might be surprised what comes up. Move your body and find your people. Join a pickleball club, a walking group, a trivia night, or a bridge league. Laugh often. Sweat occasionally. Your future self needs both, and your colonoscopy technician will be thrilled. Want more insights like this? Subscribe to my free newsletter here, where I share practical strategies, real-world stories, and straight talk about navigating retirement with confidence—not confusion. Plus, all subscribers get exclusive early access to advance chapters from my upcoming book. For Canadians 55+: Get actionable advice on making your home equity work for you, understanding your options, and living retirement on your terms. For Mortgage Brokers and Financial Professionals: Learn how to become the trusted advisor your 55+ clients desperately need (and will refer to everyone they know). This isn't just another revenue stream—it's your opportunity to build lasting relationships in Canada's fastest-growing demographic.
Manitobans are still eager to travel, but how and where they’re going is changing, and so are the risks they may not see coming. New survey findings released as part of CAA Manitoba’s Travel Wise Week show a clear shift toward staying closer to home. Sixty per cent of Manitobans prefer travelling within Canada, while just 20 per cent are planning a trip to the United States. Global uncertainty, rising costs, and changing perceptions about international destinations are influencing those decisions. “We’re seeing more Manitobans choosing Canada because it feels familiar and safe,” said Susan Postma, Regional Manager, CAA Manitoba. “But that sense of comfort can lead people to underestimate the financial risks that can still come with travelling, even within our own borders.” Staying in Canada and Leaving Coverage Behind While Canadians feel confident travelling within their own country, many assume “home turf” means low risk. This misconception leaves millions exposed to unexpected costs when trips don’t go as planned. The survey found that 64 per cent of Canadians did not have travel insurance for their most recent trip within Canada. Provincial health coverage often provides only limited protection when travelling outside your home province, and in some cases, does not cover services such as air ambulances, extended hospital stays, or trip interruption costs. Recent media stories have highlighted Canadians facing unexpected medical bills, emergency transportation costs, or sudden trip changes, all during trips that never left the country. “People are often surprised to learn how quickly expenses can add up if something goes wrong,” says Postma. “A simple injury on a hiking trail or a family emergency back home can turn a short trip into a major financial stress.” With recent geopolitical incidents in Cuba, Mexico and the Middle East, CAA’s Travel Wise Campaign is focused on helping Canadians understand risk, avoid misinformation, and make decisions grounded in facts rather than fear or speculation. Here are some tips: Understand what an “avoid non-essential travel” advisory really means: Travel advisories reflect real-time safety risks, and an “avoid non-essential travel” signal indicates rapidly changing conditions that may change quickly, and support may be limited. Know that advisories can affect your insurance and your exit options: Travelling against government advice can limit your travel insurance, including medical care or emergency evacuation. Coverage must be in place before conditions deteriorate. Flexibility is essential; review cancellation and change policies now: Travellers should proactively confirm cancellation deadlines, refund eligibility, rebooking options for all reservations and understand the limits of credit card protections, employee benefits, and pension coverage benefits. Stay connected to Canada while abroad: Canadians should monitor official updates from Global Affairs Canada and register with the Registration of Canadians Abroad service before departure or while on location if something arises. Rely on reputable sources and be cautious of misinformation online: Canadians should rely on official government sources, established travel organizations, and verified news outlets for travel guidance. Additionally, the CAA Air Passenger Help Guide helps you understand your rights when faced with common flight disruptions, such as delayed or cancelled flights or lost bags. The guide can be found at CAA.ca/AirPassengerHelpGuide. For more information on travel insurance and how to stay protected, visit www.caamanitoba.com/travelwise The online survey was conducted by DIG Insights from September 29 – October 8, 2025, with 2,0210 Canadian travellers aged 25 to 64 who have travelled outside their province of residence in the past three years and plan to travel again in the next five years, out of which 137 travellers were from Manitoba or Saskatchewan. Based on the sample size of n=2,021 and with a confidence level of 95%, the margin of error for this research is +/- 2%.)
Canadians remain passionate about exploring new destinations, but changing global dynamics are reshaping how and where they travel. According to CAA’s Travel Wise survey, more than half of Canadians (51 per cent) now say geopolitical and economic factors, such as instability abroad, a perception of the U.S. as being less welcoming, and rising travel costs, are influencing where Canadians choose to travel. Shifting Destinations and Attitudes Travel patterns are evolving. The survey conducted in 2025 shows that only 22 per cent of Canadians planned to visit the U.S., an 11 per cent drop from 2024. Instead, many are opting to stay within Canada (40 per cent) or explore international destinations. The perception of the U.S. as less welcoming, coupled with rising travel costs and global instability, is prompting Canadians to reconsider their travel plans. "Canadians are adventurous by nature, but today’s travellers are having to make thoughtful decisions," says Kaitlynn Furse, Director of Corporate Communications. "We’re seeing a clear trend toward exploring closer to home and seeking out new international experiences, all while keeping an eye on safety and value." Travel Insurance: A Critical, Yet Overlooked, Safeguard While Canadians feel confident travelling within their own country, many assume “home turf” means low risk. This misconception leaves millions exposed to unexpected costs when trips don’t go as planned. The survey found that 64 per cent did not have travel insurance on their most recent trip when travelling within Canada. “Recent stories have highlighted Canadians facing unexpected medical bills, trip interruptions, and emergency expenses while travelling within Canada, often because they didn’t realize their regular provincial health coverage or credit card benefits had limits,” says Furse. “If something were to happen, provincial healthcare only partially covers you outside of your home, and sometimes, not at all, covering only basic emergency medical services when travelling in another province.” Among those who travelled uninsured, 44 per cent believed coverage wasn’t needed, and 29 per cent thought their provincial government’s health plan would suffice. However, provincial healthcare only partially covers emergency medical services in other provinces, and sometimes not at all. “One of the biggest misconceptions we see is the idea that travelling within Canada comes with less risk,” says Furse. “Unexpected medical costs, trip interruptions and emergencies can happen anywhere, and many travellers are surprised to learn they’re not fully covered.” With recent geopolitical incidents in Cuba, Mexico and the Middle East, Travel Wise is focused on helping Canadians understand risk, avoid misinformation, and make decisions grounded in facts rather than fear or speculation. Here are some tips: Understand what an “avoid non-essential travel” advisory really means: Travel advisories reflect real-time safety risks, and an “avoid non-essential travel” signal indicates rapidly changing conditions that may change quickly, and support may be limited. Know that advisories can affect your insurance and your exit options: Travelling against government advice can limit your travel insurance, including medical care or emergency evacuation. Coverage must be in place before conditions deteriorate. Flexibility is essential; review cancellation and change policies now: Travellers should proactively confirm cancellation deadlines, refund eligibility, rebooking options for all reservations and understand the limits of credit card protections, employee benefits, and pension coverage benefits. Stay connected to Canada while abroad: Canadians should monitor official updates from Global Affairs Canada and register with the Registration of Canadians Abroad service before departure or while on location if something arises. Rely on reputable sources and be cautious of misinformation online: Canadians should rely on official government sources, established travel organizations, and verified news outlets for travel guidance. For many travellers, cancelled or delayed flights remain a top concern. CAA’s Air Passenger Help Guide offers a straightforward resource for travellers facing disruptions. The online survey was conducted by DIG Insights from September 29 – October 8, 2025, with 2,0210 Canadian travellers aged 25 to 64 who have travelled outside their province of residence in the past three years and plan to travel again in the next five years. Based on the sample size of n=2,021 and with a confidence level of 95%, the margin of error for this research is +/- 2%.)
The AI In Action Symposium, hosted by the LSU E. J. Ourso College of Business, brings together expert voices at the heart of the AI revolution to explore how they have successfully navigated this evolving landscape. The 2026 symposium focuses on the practical implications of AI in business, including hiring AI-ready talent, ensuring responsible and ethical use, and exploring the challenges of implementing AI across both large enterprises and small startups. Speakers Attendees will hear from Louisiana leaders and national AI experts, including… Secretary Bruce Greenstein of the Louisiana Department of Health April Wiley, Senior Vice President at Community Coffee Robert Veit and Julian Tandler from Scale Team Six, a San Francisco-based business accelerator Dr. Tonya Jagneaux, who leads medical analytics at the Franciscan Missionaries of Our Lady Health System (FMOLHS) Hunter Thevis, president and co-founder of Lafayette-based S1 Technology …and many more! Details March 20, 2026, 8:00 a.m. – 1:00 p.m. Registration deadline is March 15. Held on the LSU A&M Campus, in the LSU Student Union Register at lsu.edu/business/ai-symposium Discount available for LSU System employees
MedPage Today: Ozzy Osbourne shined a light on Parkinson’s stigma
Ozzy Osbourne was best known for two things: his shape-shifting resilience as a pioneer of heavy metal music and, most recently, his remarkable authenticity during his public journey with Parkinson's disease. Osbourne, who passed away on July 22, possessed a unique ability to connect directly with people who were suffering. He was an honest and transparent voice for what it was like to live with a neurodegenerative disease. He was willing to go where others would not, and he took on the stigma of a Parkinson's diagnosis. Stigma remains one of the most underrecognized yet pervasive challenges in Parkinson's disease. Far too often, individuals are made to feel ashamed of their visible symptoms like tremors, facial masking, or soft speech. This reality can lead to social withdrawal, depression, and even delayed medical care. Research has shown that perceived stigma is not only linked to reduced quality of life, but it also correlates with worse outcomes. That's why, when someone like Osbourne rises up and speaks out, it matters. It sends a powerful message that Parkinson's does not define a person, and that no one should suffer in silence. Many people with Parkinson's disease choose to conceal their diagnosis from those closest to them. A recent study published in Scientific Reports found that nearly 23% of participants kept their condition hidden, even from family members. Broader surveys have suggested that more than half of individuals with Parkinson's disease may conceal symptoms, mask tremors, or avoid public situations due to stigma and fear of judgment. People who hide their diagnosis frequently report lower social support, reduced engagement in physical activity, and significantly worse emotional well-being. These findings underscore how pervasive and harmful disclosure avoidance can be.
Surgery past 65? Brain health screening can aid recovery
Before surgery, your doctor will order evaluations to identify any health problems that may need to be addressed before the procedure. This typically includes medical histories, laboratory tests and checking blood pressure, heart rate and temperature. There’s one vital sign that is often not on the list, but is crucial for older adults: screening for mental and cognitive health. “There is an overwhelming amount of evidence that presurgical brain health predicts complications after surgery,” said Catherine Price, Ph.D., a professor in the University of Florida College of Public Health and Health Professions Department of Clinical and Health Psychology and the UF College of Medicine Department of Anesthesiology. “For example, individuals with weaknesses in memory and attention and people with neurodegenerative diseases, such as Parkinson’s, have higher rates of confusion and memory complications that affect their recovery from surgery.” Research by Price and others has shown that a patient’s cognitive, memory and mental health status before surgery is an excellent indicator of whether they will experience cognitive problems such as delirium, a common complications in older adults after surgery. Delirium, characterized by confusion, disorientation and impaired awareness, can lead to longer recovery times, increased dementia risk, higher mortality rates and health care costs. Price founded and directs the University of Florida Perioperative Cognitive Anesthesia Network, or PeCAN, a first-of-its-kind, multidisciplinary program that seeks to identify older adults who may be at risk of developing cognitive problems after surgery so that clinicians can intervene. In recent findings published in the journal Anesthesia and Analgesia, Price and her colleagues report on two years of PeCAN patient data. Of the thousands of patients over age 65 who received presurgical screening, 23% were found to have issues with their cognitive performance, yet only 2% of the patients screened had a previous note in their medical charts indicating they had a cognitive impairment. “It’s so important to know when an individual has cognitive complications because that changes their care path,” Price said. “From medication to monitoring, the patient’s care is more complex for the perioperative team and family.” For PeCAN patients identified as being at risk for postsurgery cognitive problems, Price and her team will share tailored recommendations with the patient’s care team before, during and after surgery. These may include more monitoring during anesthesia and medication adjustments, such as using medications for nausea and pain management less likely to contribute to delirium. The PeCAN team also might offer the surgical care team specific communication strategies. For example, health care providers should repeat information several times for patients who have trouble remembering new material and ask them to write it down. Recently published research by Price and colleagues found PeCAN patients reported the focus on brain health improved confidence in their surgical team and care plan. Health care systems are only starting to incorporate preoperative brain health teams like PeCAN. Until they are offered more frequently, Price offers a few steps anyone can take to help protect brain health, including a focus on reducing inflammation in the body prior to surgery. To help achieve this: Optimize nutrition. Reduce your intake of added sugars and refined carbohydrates, like white bread. Get good sleep. Improve sleep hygiene so you are well-rested. “Sleep is essential for the brain for a number of reasons,” Price said. Reduce alcohol intake to limit inflammation and dehydration. Pay attention to your medications. Follow your care team’s instructions. Enlist a family member or caregiver to help you keep tabs on what you’re taking, how much and how often. Practice techniques to limit anxiety, such as visualization and deep breathing. The box breathing method is an easy one to remember: Breathe in slowly for four seconds. Hold your breath for four seconds. Slowly exhale for four seconds. Wait four seconds before inhaling again.
Delaware is taking a major step to strengthen its health care workforce. ChristianaCare, Bayhealth and the Philadelphia College of Osteopathic Medicine (PCOM) have announced the Delaware Collaborative Clinical Campus, a first‑in‑the‑region initiative that will expand medical student training opportunities, increase residency placements and build a more sustainable pipeline of physicians committed to caring for Delawareans. This collaboration positions Delaware to attract, train and retain the clinicians our communities depend on — ensuring a stronger, more resilient health care workforce. Brian Levine, M.D., chief academic officer and designated institutional official for ChristianaCare is available for interviews to discuss: What the new clinical campus means for Delaware’s health care future How this collaboration strengthens the physician pipeline The impact on training, recruitment and long‑term retention of physicians in the state
Brian Levine, M.D., Named Chief Academic Officer and Intellectual Property Administrator
ChristianaCare announced Feb. 12 the promotion of Brian Levine, M.D., to chief academic officer, along with his appointment as intellectual property administrator. He will also continue in his role as designated institutional official. As chief academic officer and leader of ChristianaCare’s Department of Academic Affairs, Levine oversees 38 residency and fellowship programs encompassing 315 residents and fellows, along with the education and training of students across the continuum of medical education. He leads the continued growth and strengthening of ChristianaCare’s undergraduate and graduate medical education infrastructure, ensuring that ChristianaCare continues to prepare physicians to care for our community well into the future. In addition, Levine oversees physician assistant education and allied health educational programming, supporting workforce development and long-term community health needs. As the largest academic medical center between Philadelphia and Baltimore, ChristianaCare has been a hub of academic excellence for over a century. ChristianaCare is one of the largest community-based teaching hospital systems in the United States. ChristianaCare also serves as the Delaware Branch Campus for Sidney Kimmel Medical College and the Philadelphia College of Osteopathic Medicine. This unique program allows medical students to complete their third and fourth years of clinical rotations exclusively at ChristianaCare, providing a clear pathway to launch their medical careers in Delaware. Each year, 55 students participate in the Branch Campus program, with many continuing into ChristianaCare’s highly sought-after residency programs and remaining in Delaware to serve local communities. ChristianaCare is a destination of choice for medical students and residents because of its strong patient-centered culture, reputation for excellence, and diversity of clinical experiences that include urban and suburban campuses with a wide range of pathologies. In his newly expanded role as intellectual property administrator, Levine manages and enforces ChristianaCare’s intellectual property policy, ensuring fair and consistent application in alignment with applicable laws and regulations. He also leads the multidisciplinary committee responsible for guiding organizational decisions related to intellectual property valuation, commercialization strategies and revenue distribution. Levine brings deep experience in academic medicine, health system education and scholarly publishing to these responsibilities. An emergency physician, he led the development of widely used clinical reference guides published by the Emergency Medicine Residents’ Association. These pocket-sized tools — covering topics such as antibiotic stewardship, orthopedic injury management, and EKG interpretation — are used by thousands of emergency medicine residents worldwide. Levine has held leadership roles at ChristianaCare for nearly two decades. Since 2018, he has served as associate chief academic officer and designated institutional official. Previously, he was program director of the Emergency Medicine Residency program from 2012 to 2018 and associate program director from 2006 to 2012. Levine is a clinical professor of Emergency Medicine at Sidney Kimmel Medical College at Thomas Jefferson University and previously served as associate medical director for the LifeNet aeromedical transport program. He earned his medical degree from the University of Vermont Larner College of Medicine and completed his emergency medicine residency at ChristianaCare.
Most patients taking popular weight loss and diabetes medications such as Ozempic and Wegovy can safely continue them before gynecologic surgery, according to a new journal article from ChristianaCare published in Obstetrics & Gynecology. The review found that serious anesthesia risks linked to these drugs are uncommon for most patients and can usually be managed through individualized planning rather than stopping the medication. The paper is the first to take a focused look at glucagon-like peptide-1 receptor agonists, commonly called GLP-1 drugs, in gynecologic surgery. These medications were first approved to treat diabetes and are now widely used to support weight loss and metabolic health, which refers to how the body processes sugar and energy. “Our study shows that the evidence does not support routinely stopping these medications before surgery and that the actual risk is low for most patients,” said Michelle Pacis, M.D., MPH, senior author of the study and a minimally invasive gynecologic surgeon at ChristianaCare. Why these medications raised concerns GLP-1 drugs work in part by slowing how quickly the stomach empties. This helps patients feel full longer, but it also raises concerns for surgery. Doctors worry that food remaining in the stomach could increase the risk of aspiration, when stomach contents enter the lungs during anesthesia. Because of this, early recommendations often advised stopping GLP-1 medications before surgery. The ChristianaCare review found that this approach was largely based on caution rather than strong evidence. The authors reviewed data from multiple studies, including large patient groups, that examined outcomes in people taking GLP-1 drugs during procedures. While some studies showed higher amounts of stomach contents, aspiration events were rare and occurred at rates similar to patients who were not taking the medications. New guidance reflects a change in thinking Recent national guidance from several medical societies now recommends a more tailored approach. Most patients can continue GLP-1 medications before surgery. For patients with higher risk factors, such as significant stomach symptoms or known delayed digestion, simple precautions can reduce risk. These precautions may include a clear liquid diet for 24 hours before surgery or closer monitoring during anesthesia. A clear liquid diet includes fluids like water, broth and clear juices. “This shift recognizes both the benefits of these medications and the importance of patient-specific decision making,” Pacis said. Why this matters for gynecologic surgery Many gynecologic surgeries require patients to be positioned in ways that can affect breathing and circulation. At the same time, many patients needing these procedures also have obesity or diabetes, which can increase surgical risk. GLP-1 medications can improve blood sugar control and support weight loss, helping patients enter surgery in better overall health and enhance recovery. Stopping these drugs without a clear reason may work against those benefits. Practical steps to support patient safety The study outlines several strategies care teams can use when patients remain on GLP-1 medications. These include thoughtful anesthesia planning, careful monitoring of heart and lung function, and, in select cases, the use of ultrasound to check stomach contents before surgery. “The goal is not to ignore risk, but to manage it wisely,” Pacis said. “For many patients, continuing these medications supports safer surgery and better recovery.” The authors note that more research is needed, particularly studies focused specifically on gynecologic surgery. Still, the findings offer clarity for patients and clinicians navigating a rapidly changing area of care. “This review helps bring evidence and balance to an issue that has caused a lot of confusion,” Pacis said. “It supports keeping patients on therapies that benefit their health whenever it is safe to do so.”