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Turning 21? Here’s How to Manage Your Money Like a Real Adult

Turning 21 is a pretty big milestone.

Aside from the ability to legally drink alcohol and all the responsibility that comes with that, your 21st birthday serves as the final stepping stone into adulthood and all the responsibilities that come with that.

I mean, sure, for some people, 21 is liberating — the beginning of the rest of their lives.

But for others, 21 simply means financial independence.

And while it’s all rosé-colored glasses for the first few months, you quickly realize just how much a good bottle of your favorite Cab Sav costs and that things like, oh, y’know, cooling and heating your living space to temperatures that don’t make you want to tear your skin off or burrow into the earth, respectively, means dropping the big bucks.

Yeah, there’s a reason that internet joke about dads and thermostats makes the rounds, and I’m betting you can finally relate.

Add in student loan payments that are about to kick in, heading into your first adult job and your parents letting you know you’re on your own for car insurance, and it’s enough to make your head spin more than it did the night you went out to celebrate your first night as a legal consumer of alcohol.


If you’re freshly 21 — or getting close to it — we’ve got some tips and tricks for making, saving and managing your money so you don’t end up blowing this whole adulthood thing on your first try.

Financial Tips and Tricks Every 21-Year-Old Should Know

Whether you’re worried about budgets, bills or booze money, here are some things a 21-year-old should know about managing money.

1. Make a Little Wiggle Room in Your Bar Budget

hand holding glass of beer on table
Carmen Mandato/The Penny Hoarder

Look, I understand. You’re finally legal. You’re ready to hit the very bars that have been turning you away for years. (Just remember to drink like a responsible adult!)

But if you’re not careful, it’s easy to blow your entire beer budget in one weekend — after which you’ll be stuck drinking $ 3 wine at home by yourself while your coworkers hit up happy hour.

Luckily, there’s a way to earn cash back on alcohol.

Yeah, seriously.

Ibotta is an easy-to-use cash-back app that’s partnered with more than 50 retailers offering deals on many of your favorite brands.

The app features both liquor store deals and cash back on drinks from any restaurant or bar.

We’ve seen deals like $ 5 back on 750-milliliter or 1-liter bottles of Absolut vodka, $ 3 back on any pitcher or bucket of Budweiser or Bud Light and $ 3 back on any mixed drink or cocktail featuring 1800 Tequila.

Those are some pretty sweet deals.

2. Know Your Credit Score

credit score on chalkboard
Carmen Mandato/The Penny Hoarder

If you’re just starting out in the adult world, you’ll quickly learn your credit score is the key that opens nearly every door. (Sometimes frustrating, but true.)

Want to rent an apartment? They’re going to check your credit.

Ready to buy a car? Credit check.

Need to refinance your student loan? They’ll be checking. That. Credit.

The first step to having a good (or great!) credit score is knowing what you’re dealing with.

Your credit report will give you this information.

You can get your credit score and “credit report card” for free from Credit Sesame. The website breaks down exactly what’s on your credit report in layman’s terms, how it affects your score and how you might address it.

Jerry Morgan was able to increase his credit score 120 points after signing up with Credit Sesame, thanks to the platform’s suggestions and resources.

He’s also learned a lot about what elements go into a credit score and how to keep his score as high and healthy as possible.

If there’s one thing you learned at college, it’s to never pass up free stuff, right?

3. Cut Your Debt Interest Rates

Credit card being cut with scissors
Elenathewise/Getty Images

Like so many other young people these days, if you grew up in a home where debt wasn’t discussed, you probably weren’t aware of just how easily you could get sucked into the quicksand pit of credit card debt.

And you probably didn’t understand the impact it would have on your young life, either.

If you’re sitting on an account showing a few too many zeros (and not the positive kind), but find yourself unable to dig yourself out because of sky-high interest rates, it might be time to look into refinancing or consolidating your credit card debt.

A good resource is consumer financial technology platform Even Financial, which can help match you with the right refinancing loan to meet your needs.

Even searches the top online lenders to match you with a personalized loan offer in less than 60 seconds. Its platform can help you borrow up to $ 100,000 (no collateral needed) with fixed rates starting at 4.99% and terms from 24 to 84 months.

All it takes is three easy steps to know what kind of loan you qualify for.

4. Wow Your Friends by Becoming a Real Estate Investor

house for sale in st. petersburg
Tina Russell/The Penny Hoarder

Listen, it’s not every day a 21-year-old can say they invest in real estate.

But this one isn’t just for the street cred — it’s also a smart way to dip your toes into the world of real estate investing without handing over thousands (or even hundreds of thousands) of dollars.

Twenty-one-year-old Katie Smith, who recently graduated from Georgetown University in Washington, D.C., had some money sitting in a regular, low-interest savings account.

She knew her money could be making more money and liked the idea of investing in real estate, she didn’t really have “buy a house” kind of money.

Then she heard about Fundrise.

You can start investing in real estate with a minimum investment of just $ 500, and Fundrise does all the heavy lifting for you.

Through the Fundrise Starter Portfolio, your money will be split into two portfolios that support private real estate around the United States.

This isn’t an obscure investment, though. You can see exactly which properties are included in your portfolios.

“I can go into my Fundrise account and see what I actually own,” Smith says. “I own a piece of an apartment complex in Ann Arbor, Michigan. Property on the West Coast. Bits and pi

5. Set Your 401(k) — and Yourself — up for Success

Kelsey Buxton walks through the downtown area of St Petersburg
Carmen Mandato/The Penny Hoarder

If you’re just getting started with a real adult job (or will be soon), you’ve probably been hearing a lot of talk about 401(k)s.

If you have a 401(k), you’re on the right track.

Now, though, you need to make sure it’s doing the absolute most to get you ready for retirement.

We know: Understanding, managing and optimizing your 401(k) account takes up more time and brain-power than most of us are willing to commit.

When Kelsey Buxton opened her 401(k) account in November 2016, she had big plans to get the most out of it with some smart investing.

“But that’s a full-time job,” she says. “That’s what a financial adviser is for.”

Luckily, she found a robo-adviser for that. Blooom, an SEC-registered investment advisory firm, will optimize and monitor your 401(k) for you.

It gives you an initial 401(k) checkup for free, and you’ll get to know your account a little more intimately. Find out whether you’re paying too many hidden fees, have the appropriate amount invested in stocks versus bonds, that kind of fun stuff.

After that, the tool is $ 10 a month to use to continue to monitor your retirement account. Let Blooom know your target retirement age, and it can help you get there by investing more and less aggressively.

6. Save for a Rainy Day

Rainy Day Outdoor silhouette
Xesai/Getty Images

Remember all that adult responsibility we were talking about earlier? Yeah, that comes with a lot of surprise expenses.

From emergency vet visits or medical bills to pricy repairs when your car starts making that thudding noise one random morning, unplanned expenses crop up everywhere.

The adult thing to do? Save up an emergency fund to fall back on.

If you’ve tried (and failed) in the past to beef up your savings account, you’re probably wondering how this time will be any different.

Not to worry: Chime has your back.

Chime is an online-only bank account that offers some unique features other banks haven’t caught on to yet.

Along with not charging overdraft fees, monthly maintenance fees, foreign transaction fees or minimum balance fees, Chime gives you access to thousands of fee-free MoneyPass ATMs around the country and even has a “Pay Friends” feature, so you don’t have to mess with cash, math or other apps to split the bar tab.

But that’s not even the best part.

Chime also has this awesome feature called “the round-up tool,” which will round up your transactions to the nearest dollar and dump the change into savings.

Recently, Samuel Demeny switched from Wells Fargo to Chime to get away from those unnecessary fees and restrictive daily spending limits.

After opening his account, Demeny decided to try out Chime’s automatic savings tools. Within nine months, he managed to save up $ 800 — money that will help him with last-minute moving expenses when he and his boyfriend make the move from Texas to the Pacific Northwest.

7. Start Investing Like an Adult

Derek Mateo handles cash in Orlando Florida
Carmen Mandato/The Penny Hoarder

As you venture further into adulthood, you’ll hear more and more people at more and more social functions talking about things like investing.

If you want to get ahead of the financial game (the small-talk-at-adult-dinner-parties potential is an added perk), try investing with Stash.

Stash lets you start investing with as little as $ 5 and for just a $ 1 monthly fee for balances under $ 5,000.

The app curates investments from professional fund managers and investors and lets you choose where to put your money — but it leaves the complicated investment terms out of it.

You just choose from a set of simple portfolios reflecting your beliefs, interests and goals.

Plus, right now, The Penny Hoarder is teaming up with Stash to fund your first investment — so you’ll get a $ 5 bonus to get started!

8. Stay on Top of Your Student Loans

Graduating class
LawrenceSawyer/Getty Images

If you recently graduated or will soon be graduating from college, you probably have student loans looming ominously on the horizon.

The best thing you could possibly do for yourself? Learn everything you can about paying them off, and make a plan to stay on top of them when repayment time hits you like a ton of bricks.

First, you’ll need to know your loans inside and out.

Then, set your student loan repayment journey up for success: Know what you owe, understand what “deferment” means, figure out how to lower your interest rate and learn how to make a little extra money so you can pay down your loans quicker.

And when you hit that point that we all hit — that “will this be the rest of my life?!” point — here’s a little inspiration that just might get you through it.

9. Let This Financial Assistant Negotiate Your Bills Down

man sitting at a desk by a window at home, paying bills.
kali9/Getty Images

Somebody’s gotta keep the Wi-Fi on.

I mean, how else would you Tweet your very valid opinions on the latest episode of “Drag Race” or post that fire selfie on Instagram? (You’ve got your priorities; no shame in that game.)

While you’ve probably heard you can call your cable company to negotiate your cable and internet prices down, if you’ve actually tried it, you know how long you can sit on hold.

That’s why it’s time to call in a robot. The personal finance bot Trim will negotiate your cable or internet bills down for you.

It works with Comcast, Time Warner, Charter and other major providers.

You can sign up simply with Facebook or your email address. Then, upload a PDF of your most recent bill, and Trim’s magic gets to work. If at first it doesn’t succeed, it’ll keep negotiating until it can save you some money.

Trim takes 25% of the savings tab, and you get the rest.

A robot that will work to save you money? That’s some of that “living in 3018” business.

10. Learn How to Budget

Margo Macys is the trusty mascot of a home office in Tampa Florida
Carmen Mandato/The Penny Hoarder

A 21-year-old needs a budget — no ifs, ands or buts about it.

If you’re making money, paying bills and still hoping to have a little spending money to live that (sort of) carefree lifestyle of the young and untethered (you’ve got big plans to travel, right?!), you need to be allocating every dollar to, well, something.

Yeah, now that you’re 21, it’s time to create a budget for yourself.

It’s not as easy as just spitting out some guesstimates of what you spend (or want to be able to spend) on the daily, but it also doesn’t have to be a totally intimidating process. We’ve got some tips that will help you create a budget that works for you — meaning you’ll still be able to funnel some money into your travel fund.

The most basic budgeting rule is the 50/20/30 rule. It’s not a science, but it’s a great starting point that will help you understand how much of your paycheck you should allocate to different areas of your life.

Once you’ve got the basics down, follow these seven steps to creating a budget that fits into your life — not one you have to fit your life into.

eces of apartment complexes in Texas and Denver, a construction loan, a mixed-use property.”

11. See Whether You’re Paying Too Much for Car Insurance

General View of the city of Chicago
Carmen Mandato/The Penny Hoarder

For most people, car insurance rates will begin to drop dramatically once you hit 25. But even at 21, you might be overpaying for car insurance and not even know it.

While there’s no way to completely avoid paying for car insurance if you own a car, one way you could save money is by shopping around and comparing rates at least once a year.

If you’re a smart shopper, you already compare prices, right? So just like you compare the prices of flights, shoes and laptops before purchasing, why not compare car insurance?

The Zebra, an online car insurance search engine that offers “insurance in black and white,” compares your options from 204 providers in just a few minutes.

Artie Januario was paying $ 95 a month for car insurance, and because one of his best friends was his insurance agent, Januario didn’t question it. (Question everything, guys.)

After a cross-country move from Boston to Austin, Texas, he decided to try out The Zebra’s services. Within half an hour of starting his search, Januario had new insurance, and his monthly payment was just $ 65 — a pretty big deal, because car insurance rates in Texas are generally higher than those in Massachusetts, where he’d been living before.

A Real Adult With Real Adult Finances

Yeah, that’s you — the real adult.

And whether your plans involve grad school, a life of travel and adventure, or getting a jumpstart on your career goals, you’ll need to keep a close eye on your finances to ensure they’re going to get you where you want to go.

In the meantime, though, feel free to pop a few bottles to celebrate the last birthday people will actually get excited about.  

Grace Schweizer is a junior writer at The Penny Hoarder.

This was originally published on The Penny Hoarder, which helps millions of readers worldwide earn and save money by sharing unique job opportunities, personal stories, freebies and more. The Inc. 5000 ranked The Penny Hoarder as the fastest-growing private media company in the U.S. in 2017.

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Even brief maternal deprivation early in life alters adult brain function and cognition: Rat study

When a baby is taken from its mother for even a brief period early in life, this traumatic event significantly alters the future, adult function of the brain, according to a new animal model study. These changes in the brain are similar to disturbances in brain structure and function that are found in people at risk for neuropsychiatric disorders, such as schizophrenia.
Child Development News — ScienceDaily


Planning for a Low Maintenance Adult Lifestyle

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Low Maintenance Adult Lifestyle

One of the options that we offer at both The Vintages at Four Mile Creek and The Oaks at Six Mile Creek is a townhouse plan with a variety of low maintenance adult lifestyle features. These townhouse plans appeal to homeowners in our adult-living communities because all of the exterior maintenance and yard work including lawn care, planting beds, lawn irrigation and winter snow removal are taken care of. You have the freedom to come and go as you please without wasting valuable time and energy on upkeep! Exterior home finishes are also specifically designed for low or no maintenance. Exterior walls are clad in stone, brick Hardie Plank or stucco, while the roofs are finished with maintenance-free 50 year fibreglass shingles.

Of course, when choosing a home in an adult-living community, there are other things to consider as well. One major consideration for many homeowners is pre-planning for future needs. Ensuring that the home you choose will be able to accommodate future changes to your health and mobility will allow you to enjoy the home for many more years without the need for expensive renovations.

When planning both the detached and townhome options for our adult-living communities, we take this into consideration. In order to make these homes truly adult-friendly, doorways to master bedrooms and ensuite baths are extra wide for easy access. Soaker tubs are designed with ledges for easy support to get in and out of the bath. Optional walk in baths are also available. Solid railings are standard on all stairs to basements and lever handles are standard on all interior doors. All home plans offer single level living on level lots for easy access. Home security systems and emergency call devices are also available for homeowners who want to add an extra layer of security and safety. All of these little details work together to create a luxury home that allows homeowners age in place gracefully without expensive changes or renovations. – Robert Mills, Blythwood Homes

The post Planning for a Low Maintenance Adult Lifestyle appeared first on Home Trends Magazine.

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Proximity to books and adult support enhance children’s learning opportunities

An innovative book distribution program that provides free children’s books in low-income neighborhoods, combined with supportive adults who encourage reading, can boost children’s literacy and learning opportunities, finds a new study.
K-12 Education News — ScienceDaily


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“It: Chapter 2” will be even more scary than last year’s horror blockbuster, director Andy Muschietti promised Tuesday. “Bring your adult diapers,” he told the audience at Caesar’s Palace in a video clip on the second day of the CinemaCon convention of the nation’s theater owners during the Warner Bros. presentation. Though the studio showed […]



Early life experiences influence DNA in the adult brain

In the perennial question of nature versus nurture, a new study suggests an intriguing connection between the two. Scientists report that the type of mothering a female mouse provides her pups actually changes their DNA. The work lends support to studies about how childhood environments affect brain development in humans and could provide insights into neuropsychiatric disorders such as depression and schizophrenia.
Child Development News — ScienceDaily


Many adolescent and young adult cancer survivors have more social connections than peers

Survivors of adolescent and young adult cancer often have stronger social networks than their non-cancer peers, according to researchers, who hope to translate that support into better lives for the nation’s growing population of cancer survivors.
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Children’s clothes that are so cool we wish they came in adult size

Seriously, that printed silk shirt!

Mandatory Credit: Photo by Tim Rooke/REX/Shutterstock (8970142dd)
Prince William, Prince George, Catherine Duchess of Cambridge and Princess Charlotte visit Airbus Headquarters in Hamburg
Prince William and Catherine Duchess of Cambridge visit to Germany – 21 Jul 2017

Call it the Harper Beckham or the Blue Ivy Carter effect, but children’s clothes have never been so cool.

Kidswear has its own brand of adorable trends for this season. Just as gorgeous as the ready-to-wear collections, the little ones’ are embracing florals, leopard print and blush pinks as much as we are. In fact, some of it is so great we wish they’d make it in adult size too.

Prepare for the fact that your little girl may out-do you in the style stakes this season with their mini-me party dresses, sparkling flats, floral blouses and puffa jackets.

As for the boy’s collections, logo t-shirts, check shirts and cool jeans are the top looks for little dudes. And when it comes to shoes, boys can be just like dad with cool trainers for running around in. We don’t know who’s more excited about shopping these stylish wares, us or them.

From designer to high street, we’ve rounded up the best boys and girls clothes for you to smarten up their back to school wardrobes with. From mini-me party dresses to see them through important events such as their best friend’s birthday party, to bold, printed satchels to be the envy of their friends at school.

We’ve included the must-have designer items favoured by Kim Kardashian’s children, like Bonpoint’s print dresses, and don’t get us started on Burberry jackets and glitter Converse…

We’ve got some seriously cute babygrows for newborns, too. From bowtie trompe l’oeil styles to funny logos, these are some very Instagrammable ensembles.

But if you don’t have the caviar budget, the high-street is bursting at the seams with achingly cool clothes. H&M, GAP, Zara, Monsoon and Boden all have amazing ranges.

From the cutest newborn baby clothes to the kids clothes we wish they made for adults too, we’ve compiled the top kidswear available to buy right now. Scroll down to shop our edit…

The post Children’s clothes that are so cool we wish they came in adult size appeared first on Marie Claire.

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Why Adult Swim’s ‘Rick and Morty’ Is Millennials’ Favorite TV Show

Pickle Rick. Get Schwifty. Wubba lubba dub dub. Those phrases may not strike a chord with you. But, for TV viewers of a certain age (adults between the ages of 18 and 34, for instance), they should be instantly recognizable from the Cartoon Network/Adult Swim animated series, Rick and Morty: millennials’ favorite TV comedy.

Currently in its third season since debuting in 2013, the show is part intergalactic adventure, part family comedy, led by a brilliant but caustic (and alcoholic) scientist, Rick, and his relatively average teen grandson, Morty. Stacked deep with pop culture references and absurdist nihilism, Rick and Morty doesn’t seem like a safe bet for broad appeal on it surface.

But, overall viewership for the current season is up 81% over the previous season, and the series is the number one comedy on TV so far this year in the coveted demographics of adults 18-24 and adults 18-34, based on Nielsen ratings that track live viewership plus streaming and on-demand viewing over an initial week-long period. By that measurement, Rick and Morty is outpacing award-winning broadcast TV shows like CBS’ The Big Bang Theory and ABC’s Modern Family with younger viewers this year.

Christina Miller, the president of the Time Warner-owned Cartoon Network and Adult Swim, told Fortune that Rick and Morty goes beyond just appealing to millennials, though. Based on recent ratings, more than 2.5 million people overall are likely to tune in for the current season’s finale, which premieres this Sunday night at 11:30 pm ET. Those are especially impressive results for an animated show that’s definitely aimed at adults (most episodes feature adult language and animated violence), much less one that airs so late on Sunday nights. Those numbers also suggest that people of all ages are watching the show, and Miller thinks the audience will only grow more.

“I do think more people will come to it,” Miller said. “But, more importantly, they’re staying with it, and that’s been the difference-maker.”

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Indeed, Rick and Morty‘s early fans exercised no small amount of patience over the nearly two-year period that lapsed between the end of the show’s second season and the current season’s official return over the summer. In the world of “Peak TV” and countless entertainment options, two years is a long time to stay excited and engaged with a TV show.

And, yet, instead of hurting the show, though, Rick and Morty returned from its long absence with a stronger viewership than ever. First, the show briefly returned to TV in an April Fools Day stunt, when Adult Swim surprised fans by streaming the first episode of Season 3 online in a constant loop for four hours on April 1. The streams pulled in 3 million unique visitors, while a similar livestream hosted on Facebook got 8.7 million video views. (The show’s social media following is also very strong and active, with more than 2.8 million followers on Facebook, plus more than 1 million on Twitter and 1.6 million on Instagram.)

When the series finally returned to cable, on July 30, 2.86 million people tuned in for the Sunday night premiere, according to Nielsen, making it the night’s second most-watched cable program, behind HBO’s ratings monster Game of Thrones (9.2 million). The most-watched episode before this year was Season 2’s second offering, “Mortynight Run,” with 2.19 million total viewers.

Last week, the show’s penultimate episode of the season pulled in just under 2.5 million total viewers (1.9 million of whom were between the ages of 18 and 49). The episode was the most-watched cable show on that Sunday night, beating out a new installment of AMC’s Fear the Walking Dead, and making Rick and Morty cable’s most-watched non-sporting event of the week for viewers between 18 and 49.

Another indicator that Rick and Morty‘s footprint ascended to a whole new level with the current season is the fact that a reference to a long-discontinued McDonald’s condiment (Szechuan McNugget sauce) in the season’s first episode resulted in a fan-driven online campaign to resurrect the sauce (McDonald’s even responded by sending some of the sauce to the show’s creators). “To me that’s just an example of Rick and Morty driving pop culture more than anything else,” Miller said.

One reason for the uptick in viewers could be that the show needed time to grow its audience, with the earliest, most die-hard fans building hype via word of mouth. It also helped that co-creators Dan Harmon (Community) and Justin Roiland spent that time engaging with fans on social media–interactions that sometimes found the two writers and voice actors having to assuage anxious fans’ concerns that the new season was delayed because of personal difference between the two men and that Rick and Morty might never return.

But, Miller and her team at Adult Swim also used the show’s time off the air as an opportunity to get a lot of mileage out of the types of ancillary content and fan events that typically accompany the marketing-heavy period that comes before a popular show returns to the air. During that time, fans of the show could keep up with the Rick and Morty comic book series that first launched in April 2015, while a roving pop-up “fan experience” featuring a vehicle shaped like the character Rick (aka the “Rickmobile Tour“) attracted huge crowds in 40 U.S. cities over the summer, with fans lining up to buy merchandise from the show.

Meanwhile, in April of this year, Adult Swim’s gaming arm launched a virtual reality video game for HTC Vive and Oculus Rift, called Rick and Morty: Virtual Rick-ality, which became the most-downloaded game for the day it debuted on online game store Steam. And, over the summer, the network released an online multiplayer video game, called Pocket Mortys, where users compete to collect various incarnations of the Morty character from the show.

Looking ahead to the next layoff between seasons (the network already ordered a fourth season, and creators Harmon and Roiland have hinted it could have more than the show’s usual 10 episodes), Miller said Rick and Morty fans will have no shortage of comic books and Pocket Mortys (the game has 13.1 million downloads to date) to pass the time.

Miller said that the extra content kept fans energized about the show and helped bridge the gap between seasons. “In order to be a so-called modern hit, you always have to be on,” she said, referring to the show’s multi-platform approach that allows fans to find no shortage of content related to the show even when it’s off the air. “The way people experience entertainment and content has changed a lot,” she added. “People expect for it to be dynamic, and when you can do it, and do it well, I think you can build a success like this.”


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Young adult substance abuse down significantly among PROSPER program participants

Children who participated in the PROSPER (PROmoting School-community-university Partnerships to Enhance Resilience) program over seven years ago showed lower rates of substance abuse after high school graduation, according to a new study.
Teen Health News — ScienceDaily


Youthful plasticity restored to brains of adult mice

Like the rest of the body, the brain loses flexibility with age, impacting the ability to learn, remember, and adapt. Now, scientists report they can rejuvenate the plasticity of the mouse brain, specifically in the visual cortex. The study shows that manipulating a single gene triggers the shift, revealing it as a target for new treatments to recover the brain’s youthful potential.
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Kaiser Permanente Emergency Department Intervention for Adult Head Trauma Reduces CT Use

PASADENA, Calif. — Implementing a decision support tool for the use of computed tomography for adult head injuries resulted in reduced CT use and allowed for better identification of injuries, according to a new Kaiser Permanente study published today in the Annals of Emergency Medicine.

This study examined the use of the Canadian CT Head Rule (known as CCHR) in U.S. emergency departments. CCHR was developed to help physicians determine which minor head injury patients needed head CT imaging. According to the study’s authors, this tool has the potential to be replicated in other health systems.

photo of Adam L. Sharp, MD, MS

Adam L. Sharp, MD, MS

“Our aim with this study was twofold: to decrease unnecessary CT scans that may harm patients and increase costs, while ensuring patients receive the highest quality, recommended care,” said lead author and emergency department physician Adam L. Sharp, MD, MS, Kaiser Permanente Southern California Department of Research & Evaluation. “This effort also demonstrates the feasibility and positive impact the implementation of a clinical decision rule has on CT use in community emergency departments.”

The intervention included clinical leadership endorsement of CCHR; physician education through an e-learning module; and a clinical decision support tool embedded into the electronic health record, which prompted emergency department physicians to avoid CT imaging based on the CCHR recommendations.

The study included 43,053 adult trauma patients from January 2014 to December 2015 in 13 Kaiser Permanente community emergency departments in Southern California. Patients had a mean age of 59, were 53.6 percent female and racially diverse. Overall, 14,018 (31.1 percent) of all adult trauma patients received a head CT. Researchers noted a 5.3 percent reduction in CT use and an increase in CT-identified injuries. Nearly all (12 of 13) of the emergency departments reduced head CT following the implementation of the intervention.

This analysis reflects real-world examination of a simple intervention that many emergency departments should be able to replicate. It also adds to previous Kaiser Permanente research published earlier this year by Dr. Sharp, which found approximately 33 percent of CT scans performed for head injury could be avoided.

Additional study authors include: Brian Z. Huang, MPH, Tania Tang, PhD, MPH, Ernest Shen, PhD, and senior author Michael K. Gould, MD, MS, all with the Kaiser Permanente Department of Research & Evaluation; Michael H. Kanter, MD, regional medical director of Quality and Clinical Analysis at Kaiser Permanente in Southern California; and Edward R. Melnick, MD, MHS, and Arjun K. Venkatesh, MD, MPH, from the Department of Emergency Medicine, Yale University.

This study was supported by Kaiser Permanente Southern California’s Care Improvement Research Team internal funds, which support operational research to improve patient care.

About the Kaiser Permanente Southern California Department of Research & Evaluation
The Department of Research & Evaluation conducts high-quality, innovative research into disease etiology, prevention, treatment and care delivery. Investigators conduct epidemiologic research, health services research, biostatistics research, and behavioral research as well as clinical trials. Major areas of study include chronic disease, infectious disease, cancer, drug safety and effectiveness, and maternal and child health. Headquartered in Pasadena, California, the department focuses on translating research to practice quickly to benefit the health and lives of Kaiser Permanente Southern California members and the general public. Visit

About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 11.8 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to:

The post Kaiser Permanente Emergency Department Intervention for Adult Head Trauma Reduces CT Use appeared first on Kaiser Permanente Share.

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Bobbi Kristina Brown’s Ex Nick Gordon Arrested for Domestic Violence and Kidnapping an Adult

Nick GordonBobbi Kristina Brown’s ex boyfriend Nick Gordon was arrested earlier today on two charges–one for domestic violence battery and the other for kidnapping/false imprisonment of an adult in…

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Jerry O’Connell on Why He Thinks His Twin Daughters Are Jedi: ‘It’s Funny When They Pick Up on Adult Mind Games’


Rebecca Romijn and Jerry O’Connell might have been Jedi Masters this whole time without even realizing it.

The hilarious actor sat down with PEOPLE to talk about parenting his 8-year-old twin daughters Dolly Rebecca Rose and Charlie Tamara Tulip, sharing that they might just be channeling the Force.

“I love it when they pick up on adult things that I’m trying to do that I don’t explain to them,” says O’Connell, 43. “For example, if I’m washing dishes and I accidentally break something, one of my daughters will go, ‘You gonna tell Mom about that?! You gonna tell Mom?!’ ”

“And they know I’m never gonna tell their mother. just let my wife find out,” he continues. “It’s funny when they pick up on adult mind games. My kids are Jedis.”

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O’Connell says he and his wife are strict about certain things, like looking people in the eye when speaking to them and saying “Please” and “Thank you.” But Romijn, 44, is a stickler for one rule that the Finding Dory voice actor is a little more laid-back about — maybe even to a fault.

“My wife is super strict about bedtimes. It’s like a prison in that house. Lights out, 8, boom, warden’s set it. I mean, that’s it. Alcatraz. Bang,” he jokes. “I’m like, ‘Girls, we’ll go to bed when you wanna go to bed. I’m gonna watch TV all night. If you wanna sit here and watch TV with me, let’s have at it.’ ”

But Dolly and Charlie’s dad is into a show that might be a little above their age range — maybe that’s O’Connell’s strategy, though.

” ‘You guys wanna learn about history and watch Game of Thrones with me? Let’s go. This is what the world used to be like, dragons and stuff,’ ” he continues. “There used to be a wall, . Life used to be crazy. You should be thankful you live in today’s world.’ ”

RELATED VIDEO: Jerry O’Connell Shares How He Prepares His Twins For Life — And Gets Surprised With His Barbie Doppelgänger!


Even though his girls aren’t taking in too much real history by watching Game of Thrones with their dad, they are learning the importance of a dollar with their chores routine.

“My wife keeps a list, and they get a dollar for washing dishes or they get 50 cents for making their bed,” O’Connell explains.

“And they keep a list. They are hardcore, they’re like accountants, it’s like H&R Block,” he says of his girls. “They’re like , ‘Dad, you owe me $ 47.95!’ ”

“The big one is dog poop in the backyard. I think that’s the big-money one,” the Love Locks star continues. “We’re getting into $ 2 to $ 3 fees there.”

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The funny dad is super proud of his girls and just wants the best for them, but he can’t help keeping the laughs going when he thinks about his biggest hope for them.

“My greatest wish for my children? At times, they’d just zip it,” he says. “I’m kidding. (Mouthing: I’m not).”

“I hope they don’t talk about this interview in therapy someday,” he laughs, adding seriously, “I guess that they do well, you know? I mean, do well in school, have a good life. I hope they have fun.”

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How To Call Off Your Wedding Like An Adult

Saying “yes” to a marriage proposal takes major guts. It arguably takes equal guts to call off your wedding and notify family, friends and guests of the change in plans. 

To guide readers in this sticky situation, we turned to Amber Harrison, Wedding Papers Divas’ resident etiquette expert, and Diane Gottsman, author of Modern Manners for a Better Life, for their best advice for canceling a wedding like an adult. 

1. Keep calm and don’t panic. 

Believe it or not, your situation isn’t that unique. Harrison says most wedding planners will tell you that it isn’t unusual to have at least a few cancellations each year.  With that knowledge, take a deep breath and ready yourself for the job of notifying loved ones and guests. 

“While it can feel overwhelming to think of cancelling a wedding, especially once guests have been invited, it is absolutely possible and may be a better option than going through with a marriage you are not feeling confident about,” Harrison said. 

2. Do it sooner than later. 

Don’t put off the inevitable. As soon as you know your relationship is donezo ― or that the wedding is not going to happen on schedule ― reach out to your guests to notify them. 

“When a couple cancels their wedding, there is no time to delay,” Gottsman said. “If it’s definite, start letting the guest know as soon as possible, especially if the wedding was a destination wedding and travel and lodging plans need to be changed.”

3. Designate a proxy to make the calls. 

OK, so you’re not exactly looking forward to letting everyone ― your judgmental sophomore year roommate included ― know what happened. That’s fine. Gottsman reassured us that it’s totally kosher to designate a caller or two to get the word out. 

“It’s seldom the couple that makes the call, actually,” she said. “Ask a trusted friend or family member to go through the guest list and contact each guest, in person when possible. For a large ceremony, it may take several people. Just make sure the let them know how much or little they should divulge.”

4. If the invitations have already been sent, you may want to followup with a formal announcement.

If the invites have already been delivered, Harrison recommends sending a more official announcement by mail. 

“The wording can be quite simple and mirror your invitation,” she said. “Something like ‘Mr. and Mrs. Wiliam Layton announce that the marriage of their daughter, Jessy Layton, to Taylor Morgan will not take place.’” 

5. There’s no need to divulge too much to your guests. Just give them the info they need. 

Save the drama for phone calls with your mama. Share exactly what guests need to know, and nothing more. 

“This is the time to inform guests about the change of plans, not get into a 30-minute conversation about what happened,” Gottsman said. “If asked, let the guests know they will be informed as to how the wedding and shower gifts will be returned in the future. That’s something they need to know.”

6. Don’t forget to notify the vendors!

You need to get word out to your guests ASAP, but don’t forget to let your vendors know in the process, Gottsman said. 

“It’s equally important to inform all the people who are counting on providing services,” she said. “Start with the officiant, the hotel, caterer, DJ and gift registries. Take careful notes of penalties and refund protocol!”

7. Oh, and if you think there’s half a chance the wedding will happen, let your guests know.

Modern relationships are complicated. If you and your S.O. just need some time before tying the knot or intend to reschedule, just let your guests know that, Harrison said. 

“If you are still planning to get married to the same person sometime in the future, make sure you communicate that the wedding has been postponed, rather than cancelled,” she said. 

Calling off a wedding: That wasn’t so hard, was it? 

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