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Timely access and continuum of care in older adults with Alzheimer's Disease and Related Dementia (ADRD) is critical. This is a retrospective study on Medicare fee-for-service beneficiaries with ADRD diagnosis discharged to home with home health care following an episode of acute hospitalization. Our sample included 262,525 patients. White patients in rural areas have significantly higher odds of delay (odds ratio [OR], 1.03; 95% CI, 1.01–1.06). Black patients in urban areas (OR, 1.15; 95% CI, 1.12–1.19) and Hispanic patients in urban areas also were more likely to have a delay (OR, 1.07; 95% CI, 1.03–1.11). Black and Hispanic patients residing in urban areas had a higher likelihood of delay in home healthcare initiation following hospitalization compared to Whites residing in urban areas. [ABSTRACT FROM AUTHOR]

Background: Anxiety is a prevalent issue among adolescents and can adversely affect their academic performance and everyday functioning. Aims & Objectives: To estimate the prevalence of anxiety among adolescents in urban and rural areas and to study the socio-demographic correlates of anxiety among adolescents in urban and rural areas. Methods: A comprehensive survey was conducted in the field practice area of Department of Community Medicine of a Medical College in western district of Uttar Pradesh. The survey was aimed at young people between the ages of 10 and 19 who lived in the practice area of the medical college. Result: The burden of anxiety was observed to be 19.6 % (n=92). Female gender, urban residence, early adolescent age-group (10-13 yr), nuclear family, day-time somnolence and family history of mental illness were factors having statistical significance. Poor education level of parents was also statistically significant. Physical activity and substance abuse did not have significant contribution in burden of anxiety. Conclusion: Anxiety in adolescents is a significant issue influenced by various factors. Early intervention and support are crucial. [ABSTRACT FROM AUTHOR]

Introduction: Adolescence is a stressful period due to physical, psychological, sexual changes, and presence of disorder such as depression is a matter of concern. Objectives: To study the prevalence of depression among adolescents in urban and rural areas and its socio-demographic correlates. Materials and methods: The PSU consisted all villages (n=29) and mohallas (n=23) in field-practice area. The required number of villages and mohallas, i.e., 10 each, were chosen using the basic random procedure, wherein each village and Mohalla has been assigned a unique serial number. Results: Overall, depression was observed in 110 participants (27.5%) with similar distribution in urban and rural areas. Low maternal and paternal education was a significant risk factor. Adolescents from the upper middle socioeconomic class (42.9%) and those from the lower middle socioeconomic class (33.3%) experienced the most depression. Burden was more among adolescents with low physical activity. Conclusion: This community based study of 400 adolescents residing in the urban and rural areas of Moradabad observed significant burden of depression in adolescent with poor maternal education, living in nuclear families, leading poor lifestyle and affected by any chronic illness at the time of the interview. Positive family history of mental illness was also an important risk factor. [ABSTRACT FROM AUTHOR]

Backgroud: Coronavirus Disease 2019 (COVID-19) has spread globally affecting all strata of people including the orthopaedic surgeons of India. We have witnessed a drastic fall in the number of patients. The aim of study was to assess the extent to which the Indian orthopaedic practice has been affected by the pandemic. Methods: We conducted an online survey amongst currently practicing Indian orthopaedic surgeons. Those currently not in practice or under training or having left clinical practice before the onset of pandemic were excluded. A total of 533 orthopaedic surgeons took part in the study amongst which, complete responses were obtained from 407 individuals. Statistical analysis was done to see the association between demographic profile of study participants and various variables of orthopaedic practice. Results: There was drastic fall in all the parameters of orthopaedic practice. Over half of the practicing surgeons witnessed fall in out-patients over 90%. Most had stopped elective surgeries (64%) and even emergency ones (21%) altogether. More than 50% of doctors had their earnings reduced by > 75%. We found a statistically highly significant association of reduction in earnings with the sector, type of set-up and duration of practice. (p-value < 0.001). Conclusion: This study suggests that orthopaedic surgeons across all sectors in different kinds of set-ups have been affected in their out-patient and operative numbers. With regards to earnings, those working in private and running their own (individual) hospitals & clinics have been most severely affected while those in government sector and medical colleges have been affected the least. [ABSTRACT FROM AUTHOR]

Background Little is known about variation in use of rehabilitation services provided in acute care hospitals for people who have had a stroke. Objective The objective was to examine patient and hospital sources of variation in acute care rehabilitation services provided for stroke. Design This was a retrospective, cohort design. Methods The sample consisted of Medicare fee-for-service beneficiaries with ischemic stroke admitted to acute care hospitals in 2010. Medicare claims data were linked to the Provider of Services file to gather information on hospital characteristics and the American Community Survey for sociodemographic data. Chi-square tests compared patient and hospital characteristics stratified by any rehabilitation use. We used multilevel, multivariable random effect models to identify patient and hospital characteristics associated with the likelihood of receiving any rehabilitation and with the amount of therapy received in minutes. Results Among 104,295 patients, 85.2% received rehabilitation (61.5% both physical therapy and occupational therapy; 22.0% physical therapy only; and 1.7% occupational therapy only). Patients received 123 therapy minutes on average (median [SD] = 90.0 [99.2] minutes) during an average length of stay of 4.8 [3.5] days. In multivariable analyses, male sex, dual enrollment in Medicare and Medicaid, prior hospitalization, ICU stay, and feeding tube were associated with lower odds of receiving any rehabilitation services. These same variables were generally associated with fewer minutes of therapy. Patients treated by tissue plasminogen activator, in limited-teaching and nonteaching hospitals, and in hospitals with inpatient rehabilitation units, were more likely to receive more therapy minutes. Limitation The findings are limited to patients with ischemic stroke. Conclusion Only 61% of patients with ischemic stroke received both physical therapy and occupational therapy services in the acute setting. We identified considerable variation in the use of rehabilitation services in the acute care setting following a stroke. [ABSTRACT FROM AUTHOR]