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Families have the potential to foster a healthy home environment aimed at reducing the risk of overweight and obesity. Establishing habits associated with reduced risk of obesity and overweight early in childhood can have lasting effects into adulthood. Nurse practitioners can encourage families to participate in healthy habits by addressing areas of growth for obesity prevention within the home. A review of the most recent literature, approximately over the past decade, was used to provide a consolidated source of reference for healthy home habits for the nurse practitioner. The search included terms such as “obesity,” “overweight,” “healthy habits,” “physical activity,” “obesogenic behaviors,” “family meals,” “screen time,” “depression,” “sugary beverages,” and “portion sizes.” The information was synthesized into three content areas nutrition and consumption, patterns of activity, and stress within the home. Establishing healthy habits early in life can protect against the development of overweight and ofor healthy home habits for the nurse practitioner. The search included terms such as “obesity,” “overweight,” “healthy habits,” “physical activity,” “obesogenic behaviors,” “family meals,” “screen time,” “depression,” “sugary beverages,” and “portion sizes.” The information was synthesized into three content areas nutrition and consumption, patterns of activity, and stress within the home. Establishing healthy habits early in life can protect against the development of overweight and obesity. Nurse practitioners can serve a vital role in the prevention of pediatric, adolescent, and adult obesity. Equipped with the unique role of assisting those from a diverse patient base, nurse practitioners can inform patients how to improve healthy habits to decrease the likelihood of obesity or overweight. Encouraging behavior change related to the healthy habits associated with the prevention of overweight and obesity can have a long-term impact on the health of an entire family.

Many patients present to an initial pediatric orthopedic clinic visit without bringing previously obtained x-rays (XRs), leading to repeat imaging, unnecessary radiation exposure, and increased health care costs. Importing images to the picture archiving and communication system and the use of cloud-based medical image-sharing software systems result in the reduction of reimaging rates and health care costs.

Unnecessary duplicative XR imaging was recognized in our pediatric orthopedic clinic as an area for quality improvement. Our purpose was to determine the magnitude of the problem and the feasibility of decreasing total visit charges through electronic retrieval of previous XRs.

Data collection occurred from May 22, 2019, through June 22, 2019, in the orthopedic trauma clinics at the main campus of a quaternary care pediatric hospital in the northeast United States and its three satellite locations.

The number of patients who did not bring XRs to their initial orthopedic visit and the type of XR ordered were recorded by clinicians. A retrospective chart audit was also completed for comparison.

Of 699 new patient visits, 77 (11%) did not bring previous XRs. This resulted in total reimaging charges of $33,326, representing 30%-50% of total visit charges. Retrospective chart audit identified 60% more new patients than the clinicians.

Electronic retrieval of XRs in pediatric orthopedic clinics can decrease duplicative charges, radiation exposure, and health care waste. It can also contribute to successful care of patients via virtual visits in times of restricted access such as a pandemic.

Electronic retrieval of XRs in pediatric orthopedic clinics can decrease duplicative charges, radiation exposure, and health care waste. It can also contribute to successful care of patients via virtual visits in times of restricted access such as a pandemic.The opioid crisis continues to exact a heavy toll on the United States, and overdose deaths have only increased during the current global pandemic. One effective intervention to reduce overdose deaths is to distribute the opioid antagonist naloxone directly to persons actively using opioids (ie, “take-home naloxone”), especially at touchpoints with the potential for significant impact such as emergency departments and jails. A number of hospital emergency departments have recently sought to implement individual take-home naloxone programs; however, programmatic success has been inconsistent due primarily to the inability to secure reliable funding for a naloxone supply. In this commentary, we establish the argument for a publicly funded naloxone supply to support take-home naloxone distribution in emergency department settings. We posit that the complex billing and reimbursement system for medication dispensing is impossibly burdensome during emergency care for an acute opioid overdose, and that the mounting death toll from this public health crisis demands a strong commitment to harm reduction. ALK inhibitor A publicly financed naloxone supply would demonstrate this commitment and make a measurable impact in saving lives. Ultimately, provision of naloxone should be coupled with other comprehensive treatment services and medications for opioid use disorder to meaningfully reduce harms associated with opioid use.

Child and adolescent psychiatric (CAP) inpatient admissions have increased since 2009 and the clinical profile of these patients has become more complex. Unrecognized dual diagnosis, that is, comorbid substance use or substance use disorder (SUD) may contribute to this problem, but the prevalence of dual diagnosis in this population is inadequately understood. The goal of this scoping review was to summarize the range and content of research on this topic.

MEDLINE, EMBASE, and PsychINFO databases were systematically searched for studies published from 2008 to 2019 containing information on rates of comorbid substance use or SUD in CAP inpatients.

A total of 23,326 abstracts were located. After removing duplicates, screening abstracts and full-text papers, and extracting data with full-text reviews, fourteen studies meeting our criteria remained. Rates of substance use or SUD ranged from 0.9% to 54.8%, differing on the basis of (1) type of outcome; (2) type of data source; and (3) whether samples had a specific diagnostic focus or not.