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Objectives To examine the association between routine physical activity and risk of 3-year mortality in Mexican Americans aged 75 and older. Design Longitudinal study involving a population-based survey. Setting Hispanic Established Population for the Epidemiologic Study of the Elderly ( H- EPESE) survey conducted in the southwestern United States ( TX, CO, AZ, NM, CA). Participants Mexican- American men and women aged 75 and older ( N = 948) participating in the H- EPESE. Measurements Responses to the Physical Activity Scale for the Elderly ( PASE) were assessed in 2005-06. Mortality was determined according to report of relatives at 3-year follow-up and from the National Death Index. Covariates included sociodemographic characteristics, financial strain, smoking status, body mass index, activities of daily living, depressive symptoms, cognitive function, and comorbid conditions. Results The mean age of the sample was 82.2 ± 4.5. Cox proportional hazard regression estimated that the hazard ratios of death for persons in the low, moderate, and high quartiles of physical activity ( PASE scale) ranged from 0.36 (95% confidence interval ( CI) = 0.21-0.62) to 0.50 (95% CI = 0.31-0.82) compared to persons in the sedentary quartile after adjusting for covariates. Conclusion Routine physical activity involving household and leisure activities was associated with lower 3-year risk of mortality in a sample of older Mexican Americans living in the community. [ABSTRACT FROM AUTHOR]

Background: St. Vincent's Student Run Free Clinic (St. Vincent's Clinic) provides primary care and specialty services to uninsured and underinsured individuals of Galveston, Texas, and surrounding areas. Patient care at this clinic is provided by medical and allied health professional students. St. Vincent's Clinic offers a psychiatry specialty clinic twice a month which helps fill the gap between clinical- and public health-related mental health services provided by the state-funded outpatient mental health services. This study aims to describe the demographics, clinical, and treatment modality of patients receiving mental health services at St. Vincent's Clinic. Methods: Retrospective secondary analysis of electronic medical records (EMR) for all patients seen at the psychiatry clinic from September 2013 through August 2014. EMR was reviewed for patient demographic information, psychiatric diagnoses, medications, comorbidities, and follow up time-period. Results: In one year, St. Vincent's Clinic saw a total of 708 patients, 117 (16%) of whom received treatment at the psychiatry clinic. Depression (55.4%) and anxiety disorders (42.2%) were the two most common diagnoses of psychiatric patients. Selective serotonin reuptake inhibitors, fluoxetine, and citalopram were the most commonly prescribed medications. Almost 33.3% of psychiatry patients utilized counseling services while 38.5% of psychiatry patients had only one psychiatry visit at St. Vincent's Clinic. Conclusion: St. Vincent's Clinic provides free mental health services to uninsured psychiatric patients, primarily in the form of medication management. Student volunteers are able to use their training skills to deliver mental health services in Galveston and surrounding counties for patients not covered by existing public health services. The high prevalence of comorbid conditions and poor follow-up among psychiatric patients have greater implications on student-run free clinics with limited resources. More institutional support is needed to deliver integrated care and proper follow-up of patients with a psychiatric diagnosis. [ABSTRACT FROM AUTHOR]

Background: Little is known about older patient's mobility soon after discharge home from an acute hospitalization. We examined daily postdischarge mobility levels as marker of overall health and response to in-hospital treatment in older medicine patients., Methods: One hundred and eleven ambulatory men and women aged 65 years and older hospitalized with an acute medical illness and discharged to home were studied. Patients received an ankle-worn accelerometer during hospitalization and wore it continually for up to 1 week after discharge. Total number of steps taken per day was assessed. The primary outcome was all-cause 30-day readmission., Results: Thirteen (11.7%) participants were readmitted within 30 days of discharge. There was a significant association between mean daily steps taken postdischarge and 30-day readmission (odds ratio = 0.85, 95% confidence interval = 0.72-0.99, and p = .04; odds ratio and confidence intervals were calculated for 500-step intervals). Though not statistically significant in the fully adjusted model (odds ratio = 0.83, 95% confidence interval = 0.71-1.02, and p = .08), mean daily steps was the strongest predictor among known readmission risk factors. The least active participants postdischarge were significantly more likely to be older (p = .02), be not married (p = .02), use a cane or walker prior to admission (p < .01), have longer lengths of hospital stay (p = .02), and be readmitted (p = .05)., Conclusions: Mobility level soon after discharge home shows promise as a simple physical biomarker of overall health and risk of 30-day readmission in older patients.