JAMA network open
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Randomized Controlled Trial Multicenter Study
Effect of Implementing Discharge Readiness Assessment in Adult Medical-Surgical Units on 30-Day Return to Hospital: The READI Randomized Clinical Trial.
The downward trend in readmissions has recently slowed. New enhancements to hospital readmission reduction efforts are needed. Structured assessment of patient readiness for discharge has been recommended as an addition to discharge preparation standards of care to assist with tailoring of risk-mitigating actions. ⋯ Implemented in a broad range of hospitals and patients, the READI interventions were not effective in reducing return to hospital. However, adding a structured discharge readiness assessment that incorporates the patient's own perspective to usual discharge care practices holds promise for mitigating high rates of return to the hospital following discharge.
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The association of the Great East Japan Earthquake and the subsequent Fukushima Daiichi Nuclear Power Plant disaster of March 11 and 12, 2011, in Fukushima, Japan, with birth rates has not been examined appropriately in the existing literature. ⋯ The Great East Japan Earthquake and the Fukushima Daiichi Nuclear Power Plant disaster were followed by significant reductions in birth rates for 2 years. There was insufficient evidence to indicate that the trend in the 3 to 7 years after the disaster differed from the predisaster trends. The recovery from the reductions in the birth rate may be indicative of the rebuilding efforts. The continuing long-term decrease in birth rates observed before the Great East Japan Earthquake and the Fukushima Daiichi Nuclear Power Plant disaster suggests that continuing measures to support birth planning should be considered at the administrative level.
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Multicenter Study
Injuries Associated With Standing Electric Scooter Use.
Since September 2017, standing electric scooters have proliferated rapidly as an inexpensive, easy mode of transportation. Although there are regulations for safe riding established by both electric scooter companies and local governments, public common use practices and the incidence and types of injuries associated with these standing electric scooters are unknown. ⋯ Injuries associated with standing electric scooter use are a new phenomenon and vary in severity. In this study, helmet use was low and a significant subset of injuries occurred in patients younger than 18 years, the minimum age permitted by private scooter company regulations. These findings may inform public policy regarding standing electric scooter use.
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Randomized Controlled Trial
Comparative Clinical Effectiveness of Nonsurgical Treatment Methods in Patients With Lumbar Spinal Stenosis: A Randomized Clinical Trial.
Lumbar spinal stenosis (LSS) is the most common reason for spine surgery in older US adults. There is an evidence gap about nonsurgical LSS treatment options. ⋯ A combination of manual therapy/individualized exercise provides greater short-term improvement in symptoms and physical function and walking capacity than medical care or group exercises, although all 3 interventions were associated with improvements in long-term walking capacity.
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Randomized Controlled Trial Multicenter Study
Evaluation of the Integrated Intervention for Dual Problems and Early Action Among Latino Immigrants With Co-occurring Mental Health and Substance Misuse Symptoms: A Randomized Clinical Trial.
Immigrants are at an increased risk for co-occurring mental health and substance misuse symptoms; however, effective treatments are lacking. ⋯ The IIDEA treatment did not change drug misuse but did improve secondary mental health and substance misuse outcomes for a heterogeneous population with moderate to severe symptoms; this finding provides a path for treating Latino immigrants with co-occurring mental health and substance misuse symptoms.