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The Retirement Games

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

Why generative AI 'hallucinates' and makes up stuff

Generative artificial intelligence tools, like OpenAI’s GPT-4, are sometimes full of bunk. Yes, they excel at tasks involving human language, like translating, writing essays, and acting as a personalized writing tutor. They even ace standardized tests. And they’re rapidly improving. But they also “hallucinate,” which is the term scientists use to describe when AI tools produce information that sounds plausible but is incorrect. Worse, they do so with such confidence that their errors are sometimes difficult to spot. Christopher Kanan, an associate professor of computer science with an appointment at the Goergen Institute for Data Science and Artificial Intelligence at the University of Rochester, explains that the reasoning and planning capabilities of AI tools are still limited compared with those of humans, who excel at continual learning. “They don’t continually learn from experience,” Kanan says of AI tools. “Their knowledge is effectively frozen after training, meaning they lack awareness of recent developments or ongoing changes in the world.” Current generative AI systems also lack what’s known as metacognition. “That means they typically don’t know what they don’t know, and they rarely ask clarifying questions when faced with uncertainty or ambiguous prompts,” Kanan says. “This absence of self-awareness limits their effectiveness in real-world interactions.” Kanan is an expert in artificial intelligence, continual learning, and brain-inspired algorithms who welcomes inquiries from journalists and knowledge seekers. He recently shared his thoughts on AI with WAMC Northeast Public Radio and with the University of Rochester News Center. Reach out to Kanan by clicking on his profile.

Sample Discusses Court Hearing on Alien Enemies Act

Maurice A. Deane School of Law at Hofstra University Professor James Sample recently joined MSNBC and CNN to discuss the federal court hearing on the use of the Alien Enemies Act. Professor Sample was in-studio with MSNBC’s Alex Witt, former federal prosecutor Kristy Greenberg, and former Acting Director of U.S. Immigration and Customs Enforcement John Sandweg to discuss the ongoing legal battle. He later joined CNN’s Lynda Kinkade to discuss the temporary block against President Donald Trump’s use of the Alien Enemies Act.

Expert: Meta ditches fact checking, a major loss for the American people

Meta moving away from fact-checking towards a "community notes" model is the equivalent of crowd-sourcing truth, says the University of Delaware's Dannagal Young. This shift in policy is a victory for intuition, common sense and lived experience over data, expertise and evidence. It also stands as another example of media institutions acting preemptively to avoid political and economic fallout under the incoming administration. Young, director of UD's Center for Political Communication and professor of communication, can talk about epistemology (how people understand the world) and how it relates to populism and populist leaders like incoming President Donald Trump. Young can also discuss the following: • The contents of Meta CEO Mark Zuckerberg's announcement video, in which he explains that recent elections mark a "cultural tipping point" in the direction of "free speech." "He's acknowledging that this policy change isn't a principled stance Meta is now taking, as much as a response to what he thinks the public is calling for (a dubious conclusion to draw from a narrow electoral victory)," Young said. • Zuckerberg's new stance, and how it will allow him to curry favor with the incoming administration because it allows Meta to avoid having to moderate Trump-friendly content. • Why content moderation and fact checking are expensive, and how moving away from that model is a "WIN-WIN-WIN for Meta: politically, culturally, and economically. And a LOSE LOSE LOSE for the American people: socially, culturally, and democratically," Young said.

Are you a Senior, Seasoned Citizen or "Seenager"?

Summary: The article humorously explores the different identities associated with aging: Seniors, Seasoned Citizens, and "Seenagers." Seniors embrace relaxation and nostalgia, Seasoned Citizens exude wisdom with style, and Seenagers live rebelliously youthful lives. Each group showcases the joy of aging uniquely, proving that growing older can be fabulous and fun. The aging mindset and associated vocabulary Aging: the thing we can't avoid, no matter how many anti-wrinkle creams or kale smoothies we try. But hold on! Getting older doesn’t have to be all about orthopedic shoes and early bedtimes. Sometimes, we can be intentional about how we age.  Bring to life the old saying, "You are only as old as you feel," or in this case, "only as old as we think. " Aging comes with its own vocabulary these days—like a senior high school class, except your class ring is arthritis-friendly. Your mindset will determine how you behave, and your behaviour will determine what label you fall under. Let’s dive into three hot buzzwords (labels) making waves in the grey hair community: Senior, Seasoned Citizen, and the fabulous Seenager. Buckle up your seatbelt (or your compression socks) because we’re about to break down what makes each term hilariously unique. Spoiler alert: the ability to laugh at yourself will help keep you young! The Senior: Official Member of the Blue-Haired Special Club Ah, Senior. It's the classic, the OG (Old Gangster) of aging terms. This one paints a picture of someone “past their prime” (which could mean they just don’t remember how Netflix works). Seniors have earned the right to relax, avoid emails, tell stories that start with "Back in my day…." and yell at the character on the TV to "speak up!" s But let’s not sugarcoat it—being called a senior can sometimes feel like being handed a ticket to the Rest-and-Retirement Express with a Has-Been Hangover. And if you’ve ever wondered why seniors are so good at discussing the weather, it's because everyone assumes their Wi-Fi password is “sunshine.” Historically, seniors are seen as a little out of touch, like trying to send a text from a rotary phone. But here’s the twist: while the term “senior” may suggest slowing down, many secretly download TikTok tutorials and know more about memes than they let on. The Seasoned Citizen: Aged Like Fine Wine, Not Expired Milk If Senior sounds too much like a countdown clock, I'd like to introduce you to Seasoned Citizen. Doesn’t that have a nice ring to it? Seasoned citizens aren’t just “old”—they’re marinated in life, baby! They’re wiser than your smartphone autocorrect and have more knowledge than an entire season of Jeopardy. "I'll take Guru for $1,000, Alex!" Seasoned citizens have been there, done that, and have the wrinkles to prove it—but in the coolest way possible. They’re like that hip grandparent who can teach you life lessons and how to win at poker. They’re the Yoda’s of society, doling out advice with just the right amount of sass. But don’t get it twisted. While they might be experts in wisdom, seasoned citizens know they’ve already done their share of life’s heavy lifting. They’re likelier to give great advice from the sidelines than participating in the next CrossFit challenge. And why shouldn’t they? With all that life seasoning, they’ve earned their spot as society’s wise sanseis. The Seenager: 70 Going on 17, and Loving Every Minute of It Then there’s the Seenager—aka the fun aunt of aging. This term combines “senior” and “teenager,” and that’s exactly how it sounds: older folks acting like rebellious teens with more fabulous cars and better credit scores. Seenagers know how to throw a wrinkle cream party, hit a Zumba class in the same evening (and still be home by 9 pm). Forget bingo; Seenagers are out here gaming on their consoles, posting selfies on social media, and flexing their fashion sense like it’s senior prom all over again. The Golden Bachelor, anyone? And don’t be surprised if they’re showing you how to work your smartphone because they’ve already FaceTimed the grandkids from halfway around the world. Seenagers are here to remind us that age is just a number that occasionally needs reading glasses. They defy the stereotype that aging means slowing down; instead, they speed up, engage in spontaneous activities, and sometimes wear questionable amounts of leather. They’re aging rebels, shaking their fists at society’s rules like, “No, I will have dessert for dinner, thank you very much!” What Kind of Fabulous Oldie Are You? So, there you have it: whether you're a Senior, a Seasoned Citizen, or a Seenager, each term brings its flavour of fabulous to the aging process. Seniors take life slow and steady; Seasoned Citizens throw wisdom around like confetti, and Seenagers party like it’s 1959 all over again (but with fewer sideburns and more disposable income). No matter which camp you fall into, one thing’s sure: getting older is a journey full of choices. You can nap through it, sprinkle sage advice everywhere, or rock that Seenager spirit with a fresh pair of Prada sneakers. The choice, dear friend, is yours—don’t forget your reading glasses! Don't Retire---Re-Wire! Sue

Head trauma and long-term impacts

Last week, NFL great Brett Favre revealed publicly that he has Parkinson's disease. It was an announcement that has also put the devastating affliction back in the media spotlight, and has experts and the public wondering if there's a link between high-impact sports like football and Parkinson's. It's why researchers like Christopher Watts from TCU are getting contacted by national media looking for answers. Head trauma alone is not the sole risk factor for Parkinson’s. Experts say the disease has also been linked to environmental factors, like exposure to certain pesticides or chemicals, and genetic mutations. “If all the ingredients in the recipe come together, you may develop Parkinson’s disease,” said Christopher Watts, Texas Christian University's Dean of the Harris College of Nursing & Health Sciences, who researches the disease. “The reason why we know is because not every boxer develops Parkinson's disease… it has to be other things that are acting along with that exposure to head trauma.” The median age for a Parkinson’s diagnosis is about 65, Watts said. At 54, Favre is on the younger end of that spectrum. Parkinsonism – an umbrella term for brain conditions that cause slow movement, rigidity and tremors – has been well studied in boxers, Watts said. One of history’s most legendary boxers, Muhammad Ali, was diagnosed with the disease. However, the research among football players isn't as robust. A 2023 study published in JAMA found participants with a history of playing organized football had higher odds of Parkinsonism or Parkinson's disease compared with those involved in other organized sports. But other studies have reported mixed findings, Watts said. He said researchers must determine if there is a link. “Football is such a big part of American society,” he said. “We need to know the answers to this.” September 25 - USA Today With the NFL season in full swing - this will be a subject that will be receiving ongoing coverage throughout the season. And if you're a journalist looking to know - then let us help with your stories, questions and coverage. Chris Watts is the Marilyn & Morgan Davies Dean of Harris College of Nursing & Health Sciences at Texas Christian University and is an expert in the areas of neurological disorders. Chris is available to speak with media about this important topic - simply click on his icon now to arrange an interview today.

Election 2024: Providing insight during a pivotal campaign season

Voter behavior and emotion, civil discourse, the spread of misinformation, the role of gender and race in politics and conspiracy theories are among the many topics University of Delaware experts can comment on during this final stretch of the 2024 campaign. David Redlawsk Professor of Political Science and International Relations Expertise: Political psychologist who studies voter behavior and emotion, focuses on how voters process political information to make their decisions. He has written several books on politics, worked behind the scenes on campaigns and ran for local office. Dannagal Young Professor of Communication Director of the Center for Political Communication Expertise: The spread of misinformation in politics and the intersection of entertainment and information, with an emphasis on political satire, political media effects, public opinion and the psychology of political humor. Kassra Oskooii Professor of Political Science and International Relations Expertise: Focuses on the interplay between the contextual and psychological determinants of political opinions and behaviors of high and low status group members. Erin Cassese Professor of Political Science and International Relations Expertise: Explores the behavior of women as voters and candidates for political office, and studies political psychology, gender stereotypes, public opinion, elections and the intersection of religion and politics. Yasser Payne Professor of Sociology and Africana Studies Expertise: Research program also focuses on Black racial identity; street identity; economic and educational opportunity or the impact of structural violence. Tim Shaffer SNF Ithaca Director Stavros Niarchos Foundation (SNF) Chair of Civil Discourse Expertise: Civil discourse in politics; can talk about partisanship, polarization and their impact on media outlets. advancement of democratic practices by focusing on the role of civic professionals in institutional settings. Alice Ba Professor and acting chair, Political Science and International Relations. Expertise: Her work on the international relations of East and Southeast Asia examines the structures, processes, and systemic effects of regionalism and cooperative regime building, as well as relations between smaller and major powers. Joanne Miller Professor of American Politics, Research Methods and Political Psychology Expertise: Studies political psychology, with an emphasis on political propaganda, misinformation and conspiracy theories. Muqtedar Khan Professor of Comparative Politics, International Relations and Political Theory Expertise: Issues surrounding U.S. foreign policy in the Muslim World as well as national security and counter-terrorism. To speak with any of these experts, simply visit their profle and click on the "contact" button, which will send a message directly to them (while also copying UD's media relations team).

Expert Insight: Training Innovative AI to Provide Expert Guidance on Prescription Medications

A new wave of medications meant to treat Type II diabetes is grabbing headlines around the world for their ability to help people lose a significant amount of weight. They are called GLP-1 receptor agonists. By mimicking a glucagon-like peptide (GLP) naturally released by the body during digestion, they not only lower blood sugar but also slow digestion and increase the sense of fullness after eating. The two big names in GLP-1 agonists are Ozempic and Wegovy, and both are a form of semaglutide. Another medication, tirzepatide, is sold as Mounjaro and Zepbound. It is also a glucose-dependent insulinotropic polypeptide (GIP) agonist as well as GLP-1. Physicians have been prescribing semaglutide and tirzepatide with increasing frequency. However, both medications come with a host of side effects, including nausea and stomach pain, and are not suitable for every patient. Many clinics and physicians do not have immediate access to expert second opinions, as do the physicians at Emory Healthcare. Creating a Digital Twin That lack of an expert is one of the reasons Karl Kuhnert, professor in the practice of organization and management at Emory University’s Goizueta Business School, is using artificial intelligence to capture the expertise of physicians like Caroline Collins MD through the Tacit Object Modeler™, or TOM. By using TOM, developed by Merlynn Intelligence Technologies, Kuhnert and Collins can create her “decision-making digital twin.” This allows Collins to reveal her expertise as a primary care physician with Emory Healthcare and an Assistant Professor at Emory School of Medicine, where she has been leading the field in integrating lifestyle medicine into clinical practices and education. Traditional AI, like ChatGPT, uses massive amount of data points to predict outcomes using what’s known as explicit knowledge. But it isn’t necessarily learning as it goes. According to Kuhnert, TOM has been designed to learn how an expert, like Collins, decides whether or not to prescribe a drug like semaglutide to a patient. Wisdom or tacit knowledge is intuitive and rooted in experience and context. It is hard to communicate, and usually resides only in the expert’s mind. TOM’s ability to “peek into the expert’s mind makes it a compelling technology for accessing wisdom.” “Objective or explicit knowledge is known and can be shared with others,” says Kuhnert. "For example, ChatGPT uses explicit knowledge in its answers. It’s not creating something new. It may be new to you as you read it, but somebody, somewhere, before you, has created it. It’s understood as coming from some source." Karl Kuhnert “Tacit knowledge is subjective wisdom. Experts offer this, and we use their tacit know-how, their implicit knowledge, to make their decisions. If it were objective, everyone could do it. This is why we hire experts: They see things and know things others don’t; they see around corners.” Mimicking the Mind of a Medical Expert Teaching TOM to see around the corners requires Collins to work with the AI over the course of a few days. “Essentially what I do is I sit down with, in this case, a physician, and ask them, ‘What are thinking about when you make this decision?'” says Kuhnert. “The layperson might think that there are hundreds of variables in making a medical decision like this. With the expert’s tacit knowledge and experience, it is usually between seven and twelve variables. They decide based on these critical variables,” he says. "These experts have so much experience, they can cut away a lot of the noise around a decision and get right to the point and ask, ‘What am I looking at?’" Karl Kuhnert As TOM learns, it presents Collins with more and different scenarios for prescribing semaglutide. As she makes decisions, it remembers the variables present during her decision-making process. “Obviously, some variables are going to be more important than other variables. Certain combinations are going to be challenging,” says Collins. “Sometimes there are going to be some variables where I think, yes, this patient needs a GLP-1. Then there may be some variables where I think, no, this person really doesn’t need that. And which ones are going to win out? That’s really where TOM is valuable. It can say, okay, when in these difficult circumstances where there are conflicting variables, which one will ultimately be most important in making that decision?” The Process: Trusting AI After working with TOM for several hours, Collins will have reacted to enough scenarios for TOM to learn to make her decision. The Twin will need to demonstrate that it can replicate her decision-making with acceptable accuracy—high 90s to 100 percent. Once there, Collins’ Twin is ready to use. “I think it’s important to have concordance between what I would say in a situation and then what my digital twin would say in a situation because that’s our ultimate goal is to have an AI algorithm that can duplicate what my recommendation would be given these circumstances for a patient,” Collins says. “So, someone, whether that be an insurance company, or a patient themselves or another provider, would be able to consult TOM, and in essence, me, and say, in this scenario, would you prescribe a GLP-1 or not given this specific patient’s situation?” The patient’s current health and family history are critical when deciding whether or not to prescribe semaglutide. For example, according to Novo Nordisk, the makers of Ozempic, the drug should not be prescribed to patients with a history of problems with the pancreas or kidneys or with a family history of thyroid cancer. Those are just the start of a list of reasons why a patient may or may not be a good candidate for the medication. Kuhnert says, “What we’re learning is that there are so many primary care physicians right now that if you come in with a BMI over 25 and are prediabetic, you’re going to get (a prescription). But there’s much more data around this to suggest that there are people who are health marginalized, and they can’t do this. They should not have this (medication). It’s got to be distributed to people who can tolerate it and are safe.” Accessing the Digital Twin on TOM Collins’s digital twin could be available via something as easy to access as an iPhone app. “Part of my job is to provide the latest information to primary care physicians. Now, I can do this in a way that is very powerful for primary care physicians to go on their phones and put it in. It’s pretty remarkable, according to Colllins.” It is also transparent and importantly sourced information. Any physician using a digital twin created with TOM will know exactly whose expertise they are accessing, so anyone asking for a second opinion from Colllins will know they are using an expert physician from Emory University. In addition to patient safety, there are a number of ways TOM can be useful to the healthcare industry when prescribing medications like semaglutide. This includes interfacing with insurance companies and the prior approval process, often lengthy and handled by non-physician staff. “Why is a non-expert at an insurance company determining whether a patient needs a medication or not? Would it be better to have an expert?” says Collins. “I’m an expert in internal medicine and lifestyle medicine. So, I help people not only lose weight, but also help people change their behaviors to optimize their health. My take on GLP-1 medications is not that everyone needs them, it’s that they need to be utilized in a meaningful way, so patients will get benefit, given risks and benefits for these medications.” The Power of a Second Opinion Getting second, and sometimes third, opinions is a common practice among physicians and patients both. When a patient presents symptoms to their primary care physician, that physician may have studied the possible disease in school but isn’t necessarily an expert. In a community like Emory Healthcare, the experts are readily available, like Collins. She often serves as a second opinion for her colleagues and others around the country. “What we’re providing folks is more of a second opinion. Because we want this actually to work alongside someone, you can look at this opinion that this expert gave, and now, based on sourced information, you can choose. This person may be one of the best in the country, if not the world, in making this decision. But we’re not replacing people here. We’re not dislocating people with this technology. We need people. We need today’s and tomorrow’s experts as well,” according to Kuhnert. But also, you now have the ability to take an Emory physician’s diagnosing capabilities to physicians in rural areas and make use of this information, this knowledge, this decision, and how they make this decision. We have people here that could really help these small hospitals across the country. Caroline Collin MD Rural Americans have significant health disparities when compared to those living in urban centers. They are more likely to die from heart disease, cancer, injury, chronic respiratory disease, and stroke. Rural areas are finding primary care physicians in short supply, and patients in rural areas are 64 percent less likely to have access to medical specialists for needed referrals. Smaller communities might not have immediate access to experts like a rheumatologist, for example. In addition, patients in more rural areas might not have the means of transportation to get to a specialist, nor have the financial means to pay for specialized visits for a diagnosis. Collins posits that internal medicine generalists might suspect a diagnosis but want to confirm before prescribing a course of treatment. “If I have a patient for whom I am trying to answer a specific question, ‘Does this patient have lupus?’, for instance. I’m not going to be able to diagnose this person with lupus. I can suspect it, but I’m going to ask a rheumatologist. Let’s say I’m in a community where unfortunately, we don’t have a rheumatologist. The patient can’t see a rheumatologist. That’s a real scenario that’s happening in the United States right now. But now I can ask the digital twin acting as a rheumatologist, given these variables, ‘Does this patient have lupus?’ And the digital twin could give me a second opinion.” Sometimes, those experts are incredibly busy and might not have the physical availability for a full consult. In this case, someone could use TOM to create the digital twin of that expert. This allows them to give advice and second opinions to a wider range of fellow physicians. As Kuhnert says, TOM is not designed or intended to be a substitute for a physician. It should only work alongside one. Collins agreed, saying, “This doesn’t take the place of a provider in actual clinical decision-making. That’s where I think someone could use it inappropriately and could get patients into trouble. You still have to have a person there with clinical decision-making capacity to take on additional variables that TOM can’t yet do. And so that’s why it’s a second opinion.” “We’re not there yet in AI says Collins. We have to be really careful about having AI make actual medical decisions for people without someone there to say, ‘Wait a minute, does this make sense?’” AI Implications in the Classroom and Beyond Because organizations use TOM to create digital twins of their experts, the public cannot use the twins to shop for willing doctors. “We don’t want gaming the system,” says Collins. “We don’t want doctor shopping. What we want is a person there who can utilize AI in a meaningful way – not in a dangerous way. I think we’ll eventually get there where we can have AI making clinical decisions. But I don’t think I’d feel comfortable with that yet.” The implications of using decision-making digital twins in healthcare reach far beyond a second opinion for prescription drugs. Kuhnert sees it as an integral part of the future of medical school classrooms at Emory. In the past, teaching case studies have come from books, journals, and papers. Now, they could come alive in the classroom with AI simulation programs like TOM. "I think this would be great for teaching residents. Imagine that we could create a simulation and put this in a classroom, have (the students) do the simulation, and then have the physician come in and talk about how she makes her decisions." Karl Kuhnert “And then these residents could take this decision, and now it’s theirs. They can keep it with them. It would be awesome to have a library of critical health decisions made in Emory hospitals,” Kuhnert says. Collins agreed. “We do a lot of case teaching in the medical school. I teach both residents and medical students at Emory School of Medicine. This would be a really great tool to say, okay, given these set of circumstances, what decision would you make for this patient? Then, you could see what the expert’s decision would have been. That could be a great way to see if you are actually in lockstep with the decision-making process that you’re supposed to be learning.” Kuhnert sees decision-making twins moving beyond the healthcare system and into other arenas like the courtroom, public safety, and financial industries and has been working with other experts to digitize their knowledge in those fields. "The way to think about this is: say there is a subjective decision that gets made that has significant ramifications for that company and maybe for the community. What would it mean if I could digitize experts and make it available to other people who need an expert or an expert’s decision-making?" Karl Kuhnert “You think about how many people aren’t available. Maybe you have a physician who’s not available. You have executives who are not available. Often expertise resides in the minds of just a few people in an organization,” says Kuhnert. “Pursuing the use of technologies like TOM takes the concept of the digital human expert from simple task automation to subjective human decision-making support and will expand the idea of a digital expert into something beyond our current capabilities,” Kuhnert says. “I wanted to show that we could digitize very subjective decisions in such areas as ethical and clinical decision-making. In the near future, we will all learn from the wisdom codified in decision-making digital twins. Why not learn from the best? There is a lot of good work to do.” Karl Kuhnert is a Professor in the Practice of Organization & Management and Associate Professor of Psychiatry, School of Medicine and Senior Faculty Fellow of the Emory Ethics Center. If you're looking to connect with Karl to know more - simply click on his icon now to arrange a time to talk today.

MEDIA RELEASE: CAA Awards the Dedication and Compassion of a School Zone Safety Ambassador

CAA South Central Ontario (CAA SCO) is proud to recognize Sonia Preston, a teacher at Brookmill Boulevard Junior Public School in Scarborough, as an outstanding road safety ambassador and an integral part of the CAA School Safety Program (CAA SSP) – a program that teaches children life-long leadership skills on how to interact in a busy world with the confidence to be able to act in emergency situations. Preston is the winner of the CAA School Safety Patrol Supervisor of the Year and was nominated by Brookmill Boulevard Junior Public School Principal Helena Syptak.  For 21 years, Preston has been part of the CAA School Safety Patrol program, acting as a Patrol Supervisor and trusted member of the community. Going above and beyond her duties, she consistently maintains a visible presence during peak traffic hours, providing guidance and support to Patrollers as they fulfil their duties by conducting regular training sessions to equip Patrollers with the skills to handle various traffic scenarios with poise and precision. “Ms. Preston's volunteerism, commitment, dependability, and leadership are the cornerstones of our Safety Patrol program's success,” says Syptak. “Her efforts above and beyond the expected Patrol Supervisor role have made a lasting impact on our school community, enriching the lives of countless students and inspiring them to become responsible leaders and compassionate citizens.”  The CAA School Safety Patrol program was developed in 1929 to protect, educate, and empower elementary school children on safe road-crossing practices. With more than 90 years of proven experience in teaching road safety and children’s safety in school zones, the program gives Patrollers an acute awareness of road safety and gives them the tools to help them stay safe as they travel to and from school.   Preston's commitment to promoting pedestrian safety goes beyond the school grounds. She has actively engaged with local authorities and community stakeholders, such as the School Advisory Council, to address traffic concerns in the surrounding area, advocating for improved infrastructure and implementing strategies to mitigate potential hazards.  “Ms. Preston leads by example, demonstrating integrity, compassion, and resilience in everything she does,” says Syptak “Her ability to inspire and motivate others has a profound impact on patrollers, instilling in them a sense of purpose and pride in their roles. Under her guidance, patrollers not only fulfil their duties with excellence but also emerge as confident leaders and responsible citizens.”  We thank Sonia Preston for being a local hero in her community and advocating for road safety in her everyday life. Since its start, the CAA School Safety Patrol program has helped keep students safe in school zones. Every year, approximately 800 schools in Ontario participate in the CAA SSP program, which CAA SCO delivers with local partners. For more information on the program, visit www.caaschoolsafetypatrol.com

Changes to Philadelphia's Tax Structure Could Represent "Pivotal" Economic Shift

On March 14, Philadelphia mayor Cherelle Parker delivered her first budget proposal in a 75-minute address to City Council. Throughout her speech, the new mayor touched on subjects ranging from corridor cleaning and housing programs to police spending and anti-violence grants. However, one set of items was absent from her $6.29 billion plan and presentation. In a break from recent administrations, Mayor Parker abstained from calling for cuts to the city's wage or business taxes. She also refrained from speaking on adjustments to Philadelphia's tax structure, which depends more heavily than other municipalities on wage taxes and has a relatively light property tax burden. Theodore Arapis, PhD, chair of Villanova University’s Department of Public Administration and an expert on fiscal policy in local governance, believes that changes to how Philadelphia levies and handles taxes, particularly on the real estate front, should be discussed further. "[Having property taxes play a larger role] represents a pivotal shift towards creating a more resilient and efficient revenue system," said Dr. Arapis, after reviewing the mayor's plan. "The current reliance on wage taxes is subject to considerable volatility, undermining fiscal stability. In contrast, property taxes offer a more inelastic and predictable revenue stream, suggesting a strategic move towards them would be beneficial for the city." Dr. Arapis also maintains that, with Harrisburg's go-ahead, Philadelphia's real estate taxes could be structured in a way that effectively facilitates business growth, while ensuring that homeowners are not unduly burdened. "Differentiating tax rates between commercial and residential properties could strike a delicate balance—spurring economic development while maintaining equitable tax distribution," he stated. "This segmentation could stimulate business activity by creating favorable conditions for commercial enterprises, which is essential for Philadelphia's economic vitality." Additionally, Dr. Arapis contends that tweaks to the city's tax abatement policy, which is currently in the process of a gradual phaseout, could further provide for inclusive and sustainable growth. "Tax abatements have been utilized as a policy tool to stimulate property revitalization and neighborhood renewal. However, these measures often carry unintended consequences that disproportionately impact existing residents," he shared. "Specifically, such incentives can precipitate a rise in property values and, consequently, a hike in the tax burdens of non-abated properties. This dynamic can exacerbate gentrification, leading to the displacement of longstanding community members. "To address the complexities of tax abatement policies in fostering affordable [and accessible] housing, a nuanced strategy is vital. A more equitable distribution of housing affordability could be achieved by, say, mandating that at least 50% of units in new developments meet affordability criteria... [and diversifying] the approach to income targeting, perhaps through a tiered system that caters to various income levels [and indexes] these categories to local inflation and wage growth." Despite the content of her first budget proposal and address, Mayor Parker likely shares some similar perspectives on tax reform and structural adjustments. Prior to entering office, during her years as a City Council member and days on the campaign trail, the acting executive worked to lower Philadelphia's wage tax, acknowledged the untapped potential of property taxes and expressed her desire for a differentiation of property tax rates. Before pursuing these measures further, as The Philadelphia Inquirer reports, Mayor Parker is probably (1) holding off until the newly announced Tax Reform Commission shares its findings, (2) ensuring that there are no immediate, major disruptions to the city's flow of revenue, as she launches her "safer, cleaner, greener" agenda, and (3) waiting for state lawmakers to make greater progress on raising the minimum wage and restructuring the Commonwealth's tax legislation, namely the uniformity clause. The mayor did, however, make one notable tax-related recommendation in her budget plan: She proposed an increase to the school district's share of real estate tax revenue from 55% to 56%, which could boost funding for the district by $119 million over five years. "The redistribution of real estate taxes between the school district and the city is commendable as an initial measure," observed Dr. Arapis. "However, without a comprehensive reform of the real estate tax system, encompassing regular property reassessments and adjustments to mill rates, this change is likely to yield only ephemeral benefits."