Introduction: Sleep is one of the main occupations defined in the occupational therapy (OT) Practice Framework-4. Methods: A survey link was sent to registered OT practitioners in Florida (N = 14,978) in September 2019 through E-mail addresses obtained from the Florida Department of Health website. A convenience sample of 213 OT practitioners responded; the majority were female (87%), with 56% reporting over 10 years of experience treating patients with neurological disorders. The person-environment-occupation-performance (PEOP) OT process provided the guiding framework for the proposed model. Spearman's rho correlation coefficients determined the correlations between the variables of interest. Regression coefficients attained through hierarchical ordinal logistic regression estimated the log odds between the variables. Results: Therapists who wrote more sleep-oriented goals were predicted to use a greater variety of sleep-related assessments (odds ratio [OR] = 1.256; 95% confidence interval [CI] = 1.171–1.347). Furthermore, a greater repertoire of sleep interventions was predicted when more types of sleep assessments were utilized (OR = 2.134 (95% CI = 1.750–2.602); more clients expressed sleep-related concerns to the OT practitioners (OR = 1.207; 95% CI = 1.044–1.395); and when the OT practitioners worked in a greater number of clinical settings (OR = 1.308; 95% CI = 1.113–1.539). Conclusion: The findings confirmed that the PEOP model might guide the OT service process when addressing sleep-related problems in neurorehabilitation. However, variations between settings and environmental facilitators/barriers may also play a role in sleep-related interventions.

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Introduction: The Internet has become an essential part of our daily life, especially the lives of adolescents and youth. With the growth of Internet users, there is also a growing concern about whether the use of the Internet is excessive and if so, whether it amounts to addiction or not. The present study aimed to find the Internet addiction and anxiety effects among undergraduate students. Methods: It was a cross-sectional study conducted among undergraduate students of Bhilai Institute of Technology, Durg and Yugantar Institute of Technology and Management, Rajnandgoan, Chhattisgarh selected using purposive sampling. The total enumeration method was obtained to select students. A total of 854 students were selected for the study. Students were assessed with sociodemographic datasheet, The Internet addiction test, and Hamilton Anxiety Rating Scale. Results: About 4.3% of the undergraduate students reported severe Internet addiction, 7.7% had moderate-to-severe level of anxiety. Internet addiction was found to have significant positive correlation with overall anxiety, psychic anxiety, and somatic anxiety symptoms. In regression analysis, anxiety contributes significantly to the prediction of Internet addiction among undergraduate students. Conclusion: Students are suffering from stress, anxiety, and depression may have a tendency to use the Internet excessively to relieve low mood, insomnia, fearfulness, feelings of guilt, and hopelessness.

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Introduction: The coronavirus disease 2019 (COVID-19) pandemic has notably changed the working and community environment for health-care workers (HCWs) leading to burnout and feeling of being stigmatized by the community due to their work. This study aims at assessing the prevalence of burnout, perceived social stigma, and their demographic and work-related predictors. Methods: A cross-sectional study using Oldenburg Burnout Inventory and perceived stigma scale was carried out among 348 HCWs in COVID-19 designated hospital at Ahmedabad about 6 months after the onset of the outbreak in September 2020. The prevalence of burnout was assessed in two dimensions: disengagement and exhaustion. Severity of each was measured on low, moderate, and high levels. Results: Total 348 HCWs participated in study with a mean age of 28.05 ± 6.75 years. Two hundred and sixty-five (76.15%) HCWs experienced burnout and 200 (57.47%) high levels of perceived stigma. The level of burnout was measured on three severities. Factors which predict high burnout are female gender, lower education, unmarried status, living in a nuclear family, and high perceived stigma. Work characteristics such as duty hours, days of working, monthly income, and work experience does not predict burnout. Intern doctors had high burnout (87.25%, χ² = 28.067, P < 0.001) while nurses had high perceived stigma (70.97%, χ² = 14.307, P < 0.05). Perceived stigma is positively correlated with burnout (r = 0.26, P < 0.001) with its both components, disengagement (r = 0.19, P < 0.001) and exhaustion (r = 0.30, P < 0.001). Conclusion: Burnout and stigmatization are prevalent among HCWs. Psychological interventions needed to reduce their burden and improve quality care during pandemic.

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Introduction: Social distancing is a public health tool that seeks to reduce opportunities for an infectious agent to spread among individuals. The current study aimed at investigating the social-distancing compliance among pedestrians in Ahvaz city, South-west Iran during the COVID-19 pandemic. Methods: This cross-sectional study was conducted in Ahvaz, South-west Iran, from 2 to August 11, 2020. The data collection was performed based on observation of passers-by in the streets. Chi-square, Fisher's exact test, Chi-square for trend, and logistic regression were used for the data analysis. Results: The overall compliance rate of social distancing was 16.3%. There was a statistically significant difference between age groups and social distancing (P < 0.001), but this relationship was not seen in gender (P = 0.12). The compliance rate of social distancing was significantly higher during morning hours than evening hours (P < 0.001). A significant inverse association was founded between the number of observed group members and the compliance rate of social distancing so that the odds of social distancing compliance among two members groups were 59% higher than the group of 6 and more members (odds ratio = 1.59; 95% confidence interval, 1.47–1.72; P = 0.003). Conclusion: We found that the overall compliance rate of social distancing among the participants was very low and inefficient. This can make disease control difficult and leads the city to a critical situation in terms of coronavirus outbreaks. The findings can help health policymakers and health workers to plan and conduct preventive interventions.

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Introduction: The psychological impacts of the coronavirus disease 2019 (COVID-19) on health-care workers (HWs) are undeniable, especially that knowledge on the disease is limited, and the credibility of some existing sources of information is questionable. We aimed to assess the level of anxiety and trust in information resources among Iranians' HWs. Methods: A web-based cross-sectional survey was conducted on 1199 HWs between March and April 2020 in Iran. Data on demographic variables, sources of information about the COVID-19, and the trust level to them were collected using online self-administered questionnaires. The anxiety severity level was assessed using the Zung self-rating anxiety scale. Data were analyzed using simple and multiple linear regression models. Results: The mean age of participants was 32.5 ± 8.79, and 65.7% (n = 763) were male. 30.4% (95% confidence interval (CI) (CI: 27.8%–33.1%) of HWs had mild to moderate, and 21.3% (95% CI: 18.9%–23.7%) had severe and extremely severe levels of anxiety. TV (83.7%) and social media networks (58.2%) were the most frequent information sources. The lowest trust level and highest anxiety levels, and in contrast, the highest trust level and lowest anxiety levels were observed among social media users and TV viewers, respectively. The results of the multiple linear analysis showed that less work experience (P = 0.003), master's degree or above (P = 0.006), being divorced or widowed (P < 0.001), higher levels of exposure to COVID-19 patients (P < 0.05), having a history of mental illness (P < 0.001), and having underlying medical conditions (P < 0.001) were associated with higher anxiety levels. Conclusion: The study results revealed that the anxiety level among the HWs is relatively significant, and the trust level in social media networks was the lowest. Further psychological assessments and more investigations regarding the reasons for the reduction of trust and the development of the appropriate approaches to improve it are required.

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Introduction: There is a lack of research in investigating functional disability (FD) among middle-aged populations. The aim of the study was to estimate the prevalence and correlates of FD among middle-aged persons in India. Methods: The national cross-sectional sample consisted of 34,098 persons (45–59 years) from the Longitudinal Aging Study in India Wave 1 in 2017–2018. FD was assessed with difficulties of six items in activities in daily living (ADL) and seven items in instrumental activities in daily living (IADL). Results: The prevalence of 0 ADL/IADL was 70.7%, 1 ADL/IADL 10.4%, and 2 or more ADL/IADL 18.9%. The overall prevalence of ADL difficulty was 9.9% and IADL difficulty 26.5%. In the adjusted logistic regression analysis, older age (55–59 years) (adjusted relative risk ratio: 1.45, 95% confidence interval [CI] 1.23–1.70), having no education (adjusted odds ratio [AOR]: 1.79, 95% CI: 1.54–2.07), poor or fair self-rated health status (AOR: 2.06, 95% CI: 1.81–2.34), 2 or more chronic conditions (AOR: 1.67, 95% CI: 1.39–2.01), insomnia symptoms (AOR: 1.86, 95% CI: 1.57–2.20), major depressive disorder (AOR: 1.66, 95% CI: 1.39–1.99), physical pain (AOR: 1.42, 95% CI: 1.22–1.65), poor distant vision (AOR: 1.37, 95% CI: 1.17–1.62), hearing or ear problem (AOR: 1.39, 95% CI: 1.10–1.74), falls (AOR: 1.34, 95% CI: 1.15–1.55), and poor word recall (AOR: 1.60, 95% CI: 1.30–1.97) were positively associated with 2 or more ADL/IADL. In addition, male sex (AOR: 0.37, 95% CI: 0.31–0.45), and urban residence (AOR: 0.70, 95% CI: 0.58-0.84) were negatively associated with 2 or more ADL/IADL. Conclusion: Almost two in five middle-aged adults in India had 2 or more ADL/IADL and several associated factors were identified.

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Introduction: Readmission after discharge is recognized as one of the major indicators of the quality of care provided in hospitals. Recurrent hospitalization is common among patients in psychiatric wards and is caused by a myriad of factors. The present study aimed to identify the causes of readmission and associated risk factors in patients with a history of recurrent hospitalization in 22 Bahman Psychiatric Hospital in Qazvin, Iran. Methods: This retrospective cross-sectional study was performed by the census method in Psychiatric Hospital in Qazvin, Iran, on all the patients who were admitted at least three times from 2015 to 2019. The following data were extracted from patient profiles using certain checklists: age, gender, educational level, residential location, occupation, marital status, clinical diagnosis, number of hospitalizations, duration of disease, intervals between admissions, substance abuse, regular outpatient visits, and regular use of medications. Data were analyzed in SPSS software (version 22). A P < 0.05 was considered statistically significant. Results: The current study was conducted on 182 patients with a history of readmission who were selected by the census method. The majority of subjects (n = 131) were male, and their mean age score was reported as 39.96 ± 10.41 years. Furthermore, the most frequent clinical diagnosis based on which the patients were admitted included bipolar I disorder (manic phase) (29.7%) and schizophrenia (22.2%), respectively. The number of hospitalizations was significantly correlated with education level (0.013), marital status (0.012), residential location (0.049), intervals between admissions (0.009), follow-up pattern (<0.001), and treatment pattern (<0.001). Conclusion: As evidenced by the results of the present study, clinical diagnosis, education level, marital status, residential location, intervals between admissions, treatment patterns, and follow-up patterns of patients were effective in the frequency of recurrent hospitalization in patients with mental disorders.

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