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The aim of this study was to determine factors associated with participation of community-dwelling older Australians (≥65 years) in the Exercise Right for Active Ageing program, consisting of 12 low- to moderate-intensity group exercise classes, delivered weekly, in person or online, by accredited exercise scientists and physiologists across Australia. Out of 6,949 participants recruited, 6,626 (95%) attended one or more classes and were included in the primary analysis, and 49% of participants attended all 12 classes. Factors associated with higher class attendance included participation in yoga/flexibility/mobility classes, attendance at a free trial class (adjusted incidence rate ratio [95% confidence interval]: 1.05 [1.03, 1.08]), and attending online classes (1.19 [1.11, 1.26]). Factors associated with lower class attendance included state of residence, living in inner regional areas (0.95 [0.93, 0.98]), and having two or more comorbidities (0.97 [0.95, 0.99]). High class attendance suggests that the Exercise Right for Active Ageing program was well received by older Australians, particularly in states less impacted by COVID-19 lockdowns. [ABSTRACT FROM AUTHOR]

Introduction: The study has investigated the lived experience of flautists, focusing on their experiences and perceptions of performance-related physical discomfort, injury and related mental health challenges that they might have encountered in practice and performance. The aims of the research have been to provide flautists with an opportunity to reflect on any physical or psychological performance issues in their own words, and to understand the subjective meaning of these experiences. Methods: A basic qualitative approach was used for gathering data. All the fieldwork was undertaken during or immediately after the Covid-19 pandemic. Consequently, the participating flautists were deliberately selected using professional networks on the basis of their answers to a pre-interview initial questionnaire related to the characteristics of their personal backgrounds and their experiences, as well as being able to participate remotely. There have been two data collection phases. Phase 1 was a specially designed pre-interview questionnaire drawing on themes from appropriate literature. Phase 2 built on the pre-interview questionnaire responses and was designed as semi-structured interviews, undertaken on Zoom, and included a 'River of Flute-playing Experience' activity during the interview. The 'River of Experience' method is an autobiographical research tool in which participants were asked to annotate key biographical experiences and challenges at various points along their drawing of a meandering river. The combined data analyses drew on thematic analysis. Results: The eight participants reported a personal history of performance-related health and wellbeing challenges that they had faced at some point in their lives. The findings reveal that flautists encounter health-related challenges associated with their practice and performances, and the data suggest that they each require an understanding of likely performance-related health challenges and supportive resources to assist them in managing these challenges. Discussion: The participants' diverse experiences highlight the importance of managing health and the value of supportive social connections. They cope with health challenges by integrating passion, resilience, and adaptability into their lives, finding ways to grow and continue to thrive in their flute-playing journey. The study underscores the need for comprehensive health education and support resources for flautists, emphasising the significance of resilience and adaptability in fostering health, wellbeing, and success. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic significantly affected the physical health of older adults around the world, causing day‐to‐day disruptions in routines and changes to usual patterns of mobility. Despite the passing of 2 years since vaccinations, older adults continue to experience detriments, including social isolation and reduced mobility. This study aims to understand how views of the COVID‐19 pandemic are associated with life‐space mobility—moving about the community. We hypothesize that endorsing stronger perspectives about the persistence of COVID‐19 is correlated with reduced life‐space mobility. Methods: Survey data were collected via online questionnaire in October and November of 2022. Linear regression models were used to examine the relationship between five perspectives on the COVID‐19 pandemic (e.g., agreeing that "I wish people would take COVID‐19 more seriously") and life‐space mobility, measured using a modified version of the life space assessment, in older adults (n = 510). Analyses were adjusted for demographic factors and mental and physical health indicators, including depressive symptoms and number of chronic conditions. Results: In fully adjusted models, the study found that endorsing a stronger lingering impact of the COVID‐19 pandemic across any of the five perspectives was associated with significantly lower life‐space mobility. Conclusions: The results of this study show that endorsing a stronger lingering impact of the COVID‐19 pandemic is associated with reduced life‐space mobility, which underscores the importance of designing public health strategies that carefully balance the safety concerns of older adults with opportunities for physical activity and social interaction. [ABSTRACT FROM AUTHOR]

Background: Severe COVID-19 can lead to a decline in pulmonary and physical functions simultaneously. Patients experiencing significant ambulatory dysfunction often face restrictions in participating in gait training, resulting in insufficient benefits from cardiopulmonary rehabilitation. This underscores the need for tailored rehabilitation approaches that address their specific conditions. Method: This study presents a case examining the impact of combining pulmonary rehabilitation with robot-assisted gait training (RAGT) on pulmonary and physical functions in a patient with severe COVID-19 pneumonia. A 56-year-old male patient with severe COVID-19 pneumonia exhibited impaired pulmonary function, reduced lower extremity strength, compromised balance, and significant limitations in functional ambulation. He underwent an inpatient pulmonary rehabilitation program combined with RAGT for 5 weeks, participating in 30 min RAGT sessions a total of 22 times. The patient showed improvements in his pulmonary function, lower extremity strength, balance, exercise capacity, and functional mobility, along with a reduction in symptoms such as dyspnea and fatigue. Conclusions: The combination of RAGT with pulmonary rehabilitation is a treatment method that can be applied without complications and has the potential to improve pulmonary and physical functions in patients with ambulatory dysfunction due to COVID-19. [ABSTRACT FROM AUTHOR]

• Long-lasting deficits in function and cognition persisted for a year post-COVID-19. • Better recovery was associated with higher premorbid mobility, male sex, shorter hospital stays, fewer comorbidities, and higher force expiratory volume in the first second (FEV1 % pred). • Early targeted interventions are crucial for restoring prior functioning. Limited data exist on post-severe COVID-19 functional trajectory, particularly considering premorbid status. We characterized 1-year functional recovery post-hospitalization for COVID-19, highlighting predictors of long-term recovery. We enrolled adult patients with lab-confirmed SARS-CoV-2 infection and hospitalized for COVID-19 sequelae, from five major Ontario, Canada hospitals in a prospective cohort study. Assessments included telephone interviews on admission followed by telephone and in-person assessments at 3-, 6-, 9-, and 12-months post-discharge. The Activity-Measure for Post-Acute Care (AM-PAC) Mobility and Cognition scales were administered at baseline and every 3 months for 1 year. Secondary outcomes included symptoms, spirometry, physical performance, dyspnea, fatigue, distress, anxiety and depression, and quality of life. A total of 254 patients (57.1% male) with a mean age of 60.0 (±13.1) years and an average hospital stay of 14.3 (±19.7) days agreed to participate. At 12 months, 55.3% demonstrated clinically important deficits in mobility and 38.8% had cognitive deficits compared to premorbid levels. Fatigue was reported in 44.2%, followed by difficulty walking long distances in 35.8% and dyspnea in 33.0%. Almost 40% of patients had an FEV1(% Pred) < 80% at 12 months, 60.3% had impairments in physical performance, and 44.5% had problems with anxiety or depression. Predictors of better mobility at 12 months included higher premorbid mobility status, male sex, shorter hospital stay, fewer comorbidities, and higher FEV1 (% pred) at the 3-month follow-up. Our study provides compelling evidence of the long-term impact of COVID-19 on functional and cognitive status 1-year post-infection. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, older adults were considered one of the most vulnerable groups as they faced obstacles when traveling for daily activities. This study examined the impact of the pandemic on travel behaviors among older adults, aiming to shed light on the challenges they faced and potential strategies for support. Methods: We conducted semi-structured, individual interviews with older adults. The data were analyzed using thematic analysis. In addition, their trip frequencies and usage of different transportation modes were descriptively analyzed. Results: While the participants reduced overall trip frequency during the pandemic, they were more observant when discussing essential needs. Study participants emphasized their reliance on family members for rides to essential destinations. Non-drivers faced added stressors and fears, particularly regarding safety measures and hygiene protocols on public transportation. Several individuals embraced ride-hailing services as a viable transportation solution, indicating benefits such as reduced exposure to crowded public transit and increased convenience. Conclusions: Macro-level efforts should include supplementary technological and transportation assistance services, along with increased awareness of safety protocols within public transit. These initiatives are expected to enhance the accessibility of existing mobility systems for older adults. [ABSTRACT FROM AUTHOR]

Several genetic markers have shown associations with muscle performance and physical abilities, but the response to exercise therapy is still unknown. The aim of this study was to test the response of patients with long COVID through an aerobic physical therapy strategy by the Nordic walking program and how several genetic polymorphisms involved in muscle performance influence physical capabilities. Using a nonrandomized controlled pilot study, 29 patients who previously suffered from COVID-19 (long COVID = 13, COVID-19 = 16) performed a Nordic walking exercise therapy program for 12 sessions. The influence of the ACE (rs4646994), ACTN3 (rs1815739), AMPD1 (rs17602729), CKM (rs8111989), and MLCK (rs2849757 and rs2700352) polymorphisms, genotyped by using single nucleotide primer extension (SNPE) in lactic acid concentration was established with a three-way ANOVA (group × genotype × sessions). For ACE polymorphism, the main effect was lactic acid (p = 0.019). In ACTN3 polymorphism, there were no main effects of lactic acid, group, or genotype. However, the posthoc analysis revealed that, in comparison with nonlong COVID, long COVID increased lactic acid concentrations in Nordic walking sessions in CT and TT genotypes (all p < 0.05). For AMPD1 polymorphism, there were main effects of lactic acid, group, or genotype and lactic acid × genotype or lactic acid × group × genotype interactions (all p < 0.05). The posthoc analysis revealed that, in comparison with nonlong COVID, long COVID increased lactic acid concentrations in Nordic walking sessions in CC and CT genotypes (all p < 0.05). Physical therapy strategy through Nordic walking enhanced physical capabilities during aerobic exercise in post-COVID19 patients with different genotypes in ACTN3 c.1729C>T and AMPD1 c.34C>T polymorphisms. These findings suggest that individuals who reported long COVID who presumably exercised less beforehand appeared to be less able to exercise, based on lactate levels, and the effect of aerobic physical exercise enhanced physical capabilities conditioned by several genetic markers in long COVID patients. [ABSTRACT FROM AUTHOR]

While the impact of the COVID-19 pandemic has affected both developing and developed countries, students from disadvantaged groups have suffered significantly. During the pandemic, these students not only struggled to access online education but also faced various forms of exclusion. In the post-COVID-19 pandemic era, this systematic literature review employs the concept of social justice framework to investigate the implications of the COVID-19 pandemic on higher education worldwide, focusing on the opportunities and challenges of digital transformation in ensuring inclusive and equitable access to quality higher education. The findings suggest that while digital transformation in higher education has provided substantive benefits, its adoption has also ushered in challenges for learning. The review emphasizes that higher education institutions (HEIs), alongside their governments, bear the responsibility of mitigating the challenges inherent in the context of digital learning, thereby advocating for the implementation of comprehensive strategies that adhere to best practices and embrace inclusivity. By operationalizing these strategies, HEIs will be ensuring equitable opportunities and success for all students, while also preventing analogous challenges that may arise in instances of future crises limiting physical mobility. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has led to approximately 3.5 million cases in Romania, causing systemic inflammation and over 200 symptoms affecting various body systems. This complexity has challenged rehabilitation systems, necessitating personalized plans tailored to each patient's illness stage and impairment level. The ISPRM-developed ClinFIT COVID-19 instrument, aligned with the ICF categories, assists in assessing patients during acute, post-acute, and long-term phases. Objective: This study aimed to evaluate and assess functional impairments in post-COVID-19 patients in Romania, with a secondary goal of generating rehabilitation directions. Methods: Data were collected from patients at two Bucharest medical centers, including those with persistent symptoms post-acute phase. Participants were assessed using the adapted ClinFIT COVID-19 instrument, and descriptive statistics were applied. Conclusions: Findings revealed diverse functional impairments in physical, psychological, and social domains among post-COVID-19 patients, with severe impairments more common in those with long-term COVID-19. Complete impairment in complex movement and paid work was noted, affecting one-third of salaried employees and forcing some to retire. In the acute phase, the most frequent functional impairments were sleep, attention, pain sensation, and exercise tolerance functions. In contrast, the most severely affected functions were exercise tolerance and mobility joint functions. Age did not positively correlate with any of the analyzed functions. In the post-acute phase, sleep, energy, and drive functions remained the most frequently affected functions, while the most severely affected was, by far, the moving around function. In the post-acute period, respiratory and respiratory muscle functions strongly correlated with all tasks related to physical activity. In the long COVID-19 phase, remunerative employment was the most severely affected function, while attention functions remained the most frequently affected, similar to the acute phase. The ClinFIT COVID-19 instrument effectively captured these impairments, underscoring the need for comprehensive rehabilitation strategies. [ABSTRACT FROM AUTHOR]

To assess if a high-level mobility programme (HLMP) can promote sustained participation in physical activity by adolescents with cerebral palsy. Eight adolescents with cerebral palsy, Gross Motor Function Classification System levels I-II, 11–16 years, participated in 24 community-based group HLMP sessions across 12 weeks. Participants set attendance, involvement, and physical performance goals, completed activity diaries over 58 weeks and undertook physical capacity tests. Measures of activity frequency and diversity (attendance) and involvement level were collected weekly across baseline (4–6 weeks), intervention (12 weeks), and nine months follow-up (including Covid lockdown). Median attendance was 23 of 24 HLMP sessions. Attendance goal/s attainment was highest during COVID lockdown. Involvement goals were consistently attained throughout all phases. Physical performance goal/s attainment was highest during intervention phase but reduced during nine months follow-up. Frequency of participation in physical activities varied greatly across study phases (range 0–33 episodes/week) with stable variety of activities and generally high 'involvement.' During the intervention, seven participants improved physical capacity and six maintained, or increased, the gains six months later. Most participants improved physical capacity post-intervention but only some had sustained attendance and involvement in physical activity, highlighting the complexity of physical activity participation. Health professionals' promotion of sustained participation in physical activity needs to consider individual preferences for frequency, diversity and duration. Supporting and measuring involvement in physical activity should be prioritised as a key outcome of an intervention. Physical activity interventions should be followed up for longer than six months to determine sustained changes in participation outcomes Measuring physical capacity and performance gains alone is insufficient to determine sustained, meaningful participation. [ABSTRACT FROM AUTHOR]

Background/Objective: This study was conducted during the 2019–2020 academic year to evaluate the impact of participation in school sports on students' Body Mass Index (BMI) and Assessing Levels of Physical Activity (ALPHA) test scores. Interrupted by the COVID-19 pandemic, which led to a suspension of in-person education, the study resumed in September 2021, refocusing on the effects of pandemic-induced inactivity on the physical fitness levels of the same cohort. Methods: The study included twenty-nine male high school students (age: 17,24 ± 0,73 years), divided into thirteen athletes (participating in sports such as football, basketball, and track) and sixteen non-athletic counterparts. They underwent reassessment using the ALPHA test battery, evaluating cardiorespiratory, musculoskeletal, and motor skills fitness. Data were analyzed using independent and paired samples t-tests and a two-way repeated measures ANOVA to assess changes over time and between groups. Discriminant function analysis evaluated the ALPHA test's ability to classify students based on their athletic status pre- and post-pandemic. Results: Initially, athlete students exhibited significantly better BMI, 20 m shuttle run, and 4 × 10 m speed run scores compared to their non-athlete peers. After the pandemic, only the 20 m shuttle run scores remained significantly higher for athletes, with diminished distinctions in other fitness areas. The classification accuracy of the ALPHA test battery decreased from 89.7 to 75.9% post-pandemic. Conclusion: The enforced sedentary lifestyle due to the COVID-19 pandemic adversely affected all students, particularly diminishing health-related fitness parameters such as body composition, cardiorespiratory and musculoskeletal strength, and motor skills. Students previously engaged in regular physical activity, notably school athletes, experienced significant fitness declines. This highlights the urgent need for targeted interventions to encourage active lifestyles among youth in the post-pandemic phase, aiming to avert long-term adverse health outcomes. [ABSTRACT FROM AUTHOR]

To understand and discuss the perceptions about fear of falling (FOF) in older adults without a history of falls. A qualitative study with a convenience sample consisting of 51 older adults. Data collection was out through semi-structured interviews during the Covid-19 pandemic. Data were analyzed using thematic analysis. Three themes were grouped: FOF and its repercussions; Reactions to FOF in the daily life of the pandemic; and No fear, but aware of aging. The older adults reported a fear of dependence, difficulties and cautious behaviors in activities of daily living and mobility in the community. Understanding FOF can contribute for your approach and building multidisciplinary and intersectoral strategies aimed at maintaining independence and strengthening the identity of older adults without a history of falls in the community. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 outbreak might have had several effects on older adults; however, much of the previous research only included self-report, cross-sectional, and online-survey data in the early stage of the pandemic. We conducted a face-to-face survey before and after the COVID-19 pandemic and investigated the influence of the pandemic on several functions to distinguish between changes due to aging and changes due to the pandemic using a linear mixed model. Methods: A total of 8 longitudinal surveys were conducted from 2016 to 2022. Physical function was assessed by weight, body mass index, body fat percentage, skeletal muscle mass index, calf circumference, grip strength, knee extension strength, the 5-times chair stand test, the timed up & go test and 5-m walking test. Functional capacity was measured using the Tokyo Metropolitan Institute of Gerontology index of competence, cognitive function was measured using the Trail Making Test - A, and mental health was measured using the Geriatric Depression Scale. Results: Of a total of 73 participants, 51 (69.9%) were female. The mean age at first participation was 71.82 years (SD = 4.64). The results of the linear mixed model showed that lower-limb muscle strength and body fat percentage and cognitive function changed significantly before and after the pandemic, while grip strength, functional capacity, and mental health did not. Conclusions: The changes in these functions between before and after the pandemic might be attributed to the diminished opportunities for the independent older individuals to go out and engage in activities. Although functional capacity did not change, lower-limb muscle strength is important for functional independence. This decline might influence the functional capacity of these individuals in the future. [ABSTRACT FROM AUTHOR]

Graduate students balance several responsibilities which, in addition to pandemic-related pressures, might pose challenges to their mental wellbeing and resilience. The purpose of this study was to: (1) examine the self-reported resilience and health-related quality of life (HRQOL) of Ontario graduate students 18 months into the COVID-19 pandemic; and (2) determine whether a relationship existed between graduate students' resilience and HRQOL, in general, and based on gender and degree program. Participants completed an online survey containing demographics, the Connor-Davidson Resilience Scale-10, and the RAND 36-Item Health Survey 1.0. Data analyses involved computing measures of central tendency and dispersion for demographic characteristics and scales. Linear regression was employed. A total of 376 students participated. Participants reported low resilience (M = 26.04, SD = 6.31) and, with respect to HRQOL, high physical functioning (M = 91.63, SD = 14.28) and low role limitations due to emotional problems (M = 37.61, SD = 40.52). Participants who identified as non-binary scored lowest on each scale compared to their cisgender counterparts. Resilience was positively associated with HRQOL. It is concerning that graduate students' resilience was low, as low resilience has been associated with a high prevalence of depression, anxiety, and perceived stress. Further, it is surprising that participants reported high physical functioning when engagement in physical activity – a component of physical functioning – has been associated with increased resilience among university students. Study findings may aid researchers and student affairs personnel in understanding graduate students' levels of resilience and HRQOL during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Physiotherapy interventions effectively improved fatigue and physical functioning in non-COVID patients with myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS). There is a research gap on the effectiveness of physiotherapy interventions versus drug management on ME/CFS in post-COVID-19 conditions (PCC). Methods: We planned a three-arm prospective randomized control trial on 135 PCC cases with ME/CFS who are diagnosed between 20 November 2023 and 20 May 2024 from a population-based cohort. The study aims to determine the effectiveness of physiotherapy interventions as adapted physical activity and therapeutic exercise (APTE) provided in institution-based care versus telemedicine compared with drug management (DM). Participants will be assigned to three groups with the concealed location process and block randomization with an enrollment ratio of 1:1:1. The post-treatment evaluation will be employed after 2 months of interventions, and follow-up will be taken after 6 months post-intervention. The Chalder fatigue scale will measure the primary outcome of fatigue. SF-36 and the disability-adjusted life years (DALYs) will measure the secondary outcome of physical functioning and episodic disability. Discussion: This study will address the research gap to determine the appropriate approach of physiotherapy or drug management for ME/CFS in PCC cases. The future direction of the study will contribute to developing evidence-based practice in post-COVID-19 condition rehabilitation. Trial registration: The trial is registered prospectively from a primary Clinical Trial Registry side of WHO CTRI/2024/01/061987. Registered on 29 January 2024. [ABSTRACT FROM AUTHOR]

Background: The Square Stepping Exercise (SSE) is an exercise training program that integrates physical exercise and cognitive elements and can be conducted in a group setting. The potential of SSE in delaying cognitive decline in older adults is promising. However, the coronavirus pandemic has made it more difficult for older adults worldwide to exercise together in person. To address this issue, this study conducted a wholistic evaluation of the effects of a center-based hybrid SSE trial on cognitive, physical, psychological, and group functioning in sedentary older adults. Methods: A total of 93 older adults (19 men, 74 women) participated in the study. Fifty-eight participants (9 men, 49 women) completed center-based hybrid SSE sessions over 12 weeks under coronavirus pandemic circumstances, whereas other 35 participants in the control group maintained their current level of daily activities. Cognitive functions focused on executive functions assessed by the Stroop Color-Word Test (inhibition) and the Trail Marking Test (TMT) (set-shifting). Psychological and group functioning were assessed by the Subjective Vitality Scale and the Physical Activity Group Environment Questionnaire. Physical function was evaluated by measuring gait speeds. A repeated ANOVA was conducted on the measured variables separately for the intervention and control groups to focus on the change of participant's performance over data collection points. Results: Outcomes of the Stroop Color-Word Test and the TMT revealed that the hybrid SSE was highly effective in improving executive function. Stroop performance (correct trials) was significantly improved in the incongruent condition, as well as both TMT-A and -B over the intervention period in the intervention group. The hybrid SSE was also beneficial to improve physical (gait speed at usual pace and at the maximum pace) as well as psychological functioning (subjective vitality). Furthermore, SSE participants reported increased engagement with the SSE task, social communication, and increased bonding and closeness with their group members through the hybrid SSE. Conclusions: In this study, hybrid SSE was found to be effective in enhancing cognitive, physical, psychological, and group functioning in sedentary older adults. The findings of this study are crucial to provide older adults with a safer and efficient option to exercise. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, concerns were raised that face covering use may elicit risk compensation; a false sense of security resulting in reduced adherence to other protective behaviours such as physical distancing. This systematic review aimed to investigate the effect of face covering use on adherence to other COVID-19 related protective behaviours. Medline, Embase, PsychInfo, EmCare, medRxiv preprints, Research Square and WHO COVID-19 Research Database were searched for all primary research studies published from 1st January 2020 to 17th May 2022 that investigated the effect of face covering use on adherence to other protective behaviours in public settings during the COVID-19 pandemic. Papers were selected and screened in accordance with the PRISMA framework. Backwards and forwards citation searches of included papers were also conducted on 16th September 2022, with eligible papers published between 1st January 2020 and that date being included. A quality appraisal including risk of bias was assessed using the Academy of Nutrition and Dietetics' Quality Criteria Checklist. This review is registered on PROSPERO, number CRD42022331961. 47 papers were included, with quality ranging from low to high. These papers investigated the effects of face covering use and face covering policies on adherence to six categories of behaviour: physical distancing; mobility; face-touching; hand hygiene; close contacts; and generalised protective behaviour. Results reveal no consistent evidence for or against risk compensation, with findings varying according to behaviour and across study types, and therefore confident conclusions cannot be made. Any policy decisions related to face coverings must consider the inconsistencies and caveats in this evidence base. [ABSTRACT FROM AUTHOR]

At the beginning of the coronavirus disease 2019 (COVID-19) pandemic, there was scarce data about clinical/functional conditions during hospitalization or after hospital discharge. Little was known about COVID-19 repercussions and how to do early mobilization in intensive care unit (ICU). Identify the time to the initiation of out-of-bed mobilization and the levels of mobility (sitting over the edge of the bed, sitting in a chair, standing, and ambulating) reached by critically ill patients with COVID-19 during hospitalization and the factors that could impact early mobilization. This was a retrospective observational study of patients with COVID-19 in the ICU. There were 157 surviving COVID-19 patients included in the study (median age: 61 years; median ICU length of stay: 12 days). The median time to initiate out-of-bed mobilization in the ICU was 6 days; between patients who received mechanical ventilation (MV) compared with those who did not, this time was 8 vs. 2.5 days (p <.001). Most patients who used MV were mobilized after extubation (79.6%). During ICU stays, 88.0% of all patients were mobilized out of bed, and 41.0% were able to ambulate either with assistance or independently. The time to initiate out-of-bed mobilization is associated with sedation time and MV time. Despite the pandemic scenario, patients were quickly mobilized out of bed, and most of the patients achieved higher mobility levels in the ICU and at hospital discharge. Sedation time and MV time were associated with delays in initiating mobilization. [ABSTRACT FROM AUTHOR]

Mobile health (mHealth) technology has increased dramatically in the wake of the pandemic. Less research has focused on people with mobility impairing (PMI) disabilities. This study determined the prevalence of mHealth use among PMI adults during the COVID-19 escalation and examines demographic, health and COVID-19 concerns correlates. PMI adults (N = 304) completed an online survey investigating mHealth use and COVID-19 concerns related to food access in June of 2020. Smartphone and mHealth use were measured with an adapted version of the survey used in the Pew Internet & American Life project. Descriptive and multivariable analyses were conducted to determine associations of demographics, health status, and COVID-19 concerns with mHealth use. About two-thirds (N = 201) of the sample were mHealth users (owned a smartphone and engaged in health-promoting behaviors with the smartphone; e.g., sought online information, tracked health behaviors, used patient portals). Having hypertension was associated with higher mHealth use, and having higher COVID-19 concerns about food access was associated with higher mHealth use. Those who used mHealth were also more engaged with smartphone apps for communication, services, and entertainment. Only the association between educational attainment and mHealth use remained significant after adjusting for other covariates in multivariable logistic regression models. PMIs continue to need support in the use of mHealth technology to help maximize access to potentially important tools for rehabilitation and health management. There is a need to continue to investigate mHealth and its applications for people with disabilities. Many people with mobility impairing disabilities may be missing opportunities for mHealth rehabilitation and healthcare. COVID-19 has widened existing gaps in access and use of mHealth technology among people with mobility impairing disabilities. Focused education is needed to help people with disabilities exploit the full range of services of their smartphones to increase access to care, social connectivity, and other important goods and services to enhance rehabilitation and health management. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic brought about numerous changes. Access to health services was limited, and restrictions were imposed to prevent the spread of the disease. These restrictions included wearing protective masks, staying indoors, keeping distance from others in public places, quarantines, and home isolation in confirmed SARS-CoV-2 cases. Consequently physical activity of children was limited due to their increased time at home, which could result in reduced physical performance and abnormal development. Aim: This study aimed to assess the access to physiotherapy and the use of telemedicine regarding children after subtalar arthroereisis surgery during the COVID-19 pandemic. Material and methods: Seventy-nine parents/guardians of children who underwent subtalar arthroereisis surgery at Chorzow Municipal Hospital Complex between May 2019 and May 2021 participated in the study. A self-administered questionnaire designed for the study was used as the research method. Results: The results showed that some respondents perceived the wait times at the National Health Service and the cost of private services as problems during the COVID-19 pandemic. However, increased problems associated with general access or course of treatment were not confirmed. Sixty-seven percent of respondents confirmed decreased physical activity in children due to the COVID-19 pandemic. One-third of parents noticed weight gain and muscle weakness in their children, while for 56% of respondents, the weight gain was not noticeable. In addition, more than 70% of the children had no complaints of pain. The results also showed that only 36.8% of respondents used telemedicine during the pandemic. Conclusions: The constraints imposed by the COVID-19 pandemic caused a decline in children's physical activity; one-third of parents reported weight gain in their children. In addition, waiting times for physiotherapy reimbursed by the National Health Fund were long, and the cost of private physiotherapy was higher; it could not be confirmed whether more patients subsequently used telemedicine. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had a profound impact on various aspects of our lives, affecting personal, occupational, economic, and social spheres. Much has been learned since the early 2020s, which will be very useful when the next pandemic emerges. In general, mobility and virus spread are strongly related. However, most studies analyze the impact of COVID-19 on mobility, but not much research has focused on analyzing the impact of mobility on virus transmission, especially from the point of view of monitoring virus incidence, which is extremely important for making sound decisions to control any epidemiological threat to public health. As a result of a thorough analysis of COVID-19 and mobility data, this work introduces a novel measure, the Infection Ratio (IR), which is not sensitive to underestimation of positive cases and is very effective in monitoring the pandemic's upward or downward evolution when it appears to be more stable, thus anticipating possible risk situations. For a bounded spatial context, we can infer that there is a significant threshold in the restriction of mobility that determines a change of trend in the number of infections that, if maintained for a minimum period, would notably increase the chances of keeping the spread of disease under control. Results show that IR is a reliable indicator of the intensity of infection, and an effective measure for early monitoring and decision making in smart cities. [ABSTRACT FROM AUTHOR]

Ben Pettitt‐Wade, Artistic Director at Hijinx Theatre, spoke to Grant Powell MBCS about how a move toward tech during Covid has led to an innovative and immersive dimension of theatre. [ABSTRACT FROM AUTHOR]

Introduction: The mortality rate in patients on maintenance hemodialysis (HD) is high and is associated with low functional capacity (FC). We analyzed the association of FC and COVID‐19 lethality among HD patients. Methods: A cohort study that included evaluations of FC in patients on HD was underway, and the association between FC and lethality was included as an ad‐hoc outcome. Results: One hundred and twelve patients were submitted to a physical, 31 patients contracted symptomatic COVID‐19, 20 recovered and 11 died (lethality rate of 35.5%). There was a difference between survivors and non‐survivors on six‐minutes‐walking‐test (6MWT) 386.1 ± 112.8 versus 296.9 ± 103.3 meters (p = 0.04), 30 s sit‐to‐stand test (30CST) score 11.7 ± 3.1 versus 7.7 ± 4.1 (p = 0.006), and timed up and go test (TUG) 9.4 versus 13.6 s (p = 0.009). There was also an association between percentages of predicted 6MWT, 30CST, and TUG with COVID‐19 lethality. Conclusion: Patients on maintenance HD with poorer physical performance presented the worst prognosis from COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Lingering breathing difficulties are common after COVID‐19. However, the underlying causes remains unclear, with spirometry often being normal. We hypothesized that small airway dysfunction (SAD) can partly explain these symptoms. We examined 48 individuals (32 women, 4 hospitalized in the acute phase) who experienced dyspnea and/or cough in the acute phase and/or aftermath of COVID‐19, and 22 non‐COVID‐19 controls. Time since acute infection was, median (range), 65 (10–131) weeks. We assessed SAD using multiple breath washout (MBW) and impulse oscillometry (IOS) and included spirometry and diffusing‐capacity test (DLCO). One‐minute‐sit‐to‐stand test estimated physical function, and breathing difficulties were defined as answering "yes" to the question "do you experience lingering breathing difficulties?" Spirometry, DLCO, and IOS were normal in almost all cases (spirometry: 90%, DLCO: 98%, IOS: 88%), while MBW identified ventilation inhomogeneity in 50%. Breathing difficulties (n = 21) was associated with increased MBW‐derived Sacin. However, physical function did not correlate with SAD. Among individuals with breathing difficulties, 25% had reduced physical function, 25% had SAD, 35% had both, and 15% had normal lung function and physical function. Despite spirometry and DLCO being normal in almost all post‐COVID‐19 individuals, SAD was present in a high proportion and was associated with lingering breathing difficulties. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic demonstrated the importance of social distancing practices to stem the spread of the virus. However, compliance with public health guidelines was mixed. Understanding what factors are associated with differences in compliance can improve public health messaging since messages could be targeted and tailored to different population segments. We utilize Twitter data on social mobility during COVID-19 to reveal which populations practiced social distancing and what factors correlated with this practice. We analyze correlations between demographic and political affiliation with reductions in physical mobility measured by public geolocation tweets. We find significant differences in mobility reduction between these groups in the United States. We observe that males, Asian and Latinx individuals, older individuals, Democrats, and people from higher population density states exhibited larger reductions in movement. Furthermore, our study also unveils meaningful insights into the interactions between different groups. We hope these findings will provide evidence to support public health policy-making. [ABSTRACT FROM AUTHOR]

Background and objective: Treatments of lymphoma can lead to reduced physical functioning, cancer-related fatigue, depression, anxiety, and insomnia. These side effects can negatively impact the cancer survivor's quality of life. Mounting evidence indicates that physical activities are highly therapeutic in mitigating the short- and long-term side effects of cancer treatments. Yet, lymphoma survivors' participation in physical activities remains suboptimal, which has been further exacerbated by the deleterious effects of isolation during the COVID-19 pandemic. The Lymfit intervention aims to offer motivational support, expert guidance, and a personalized exercise prescription to optimize physical activities among lymphoma survivors. This proof-of-concept study explores implementation feasibility (retention, technical and safety), and the preliminary effects of Lymfit on various health outcomes. Method: This was a single-armed trial with a pre-and post-test design. Twenty lymphoma survivors were recruited to participate in the 12-week Lymfit intervention. Wearable activity trackers (Fitbit) were given to participants as a motivational tool and for data collection purposes. Participants received a personalized exercise prescription designed by a kinesiologist. Physiologic metrics were collected by the Fitbit monitors and were stored in the Lymfit database. Self-reported questionnaires measuring health outcomes were collected at baseline and post-intervention. Results: The retention rate of this trial was 70%. Minimal technical issues and no adverse effects were reported. Lymfit led to significant improvements in sleep disturbances and the ability to participate in social activities and decreased fear of cancer recurrence. It also increased daily steps and decreased sedentary time in participants who did not meet the recommended physical activity guidelines. Significance: With access to resources and fitness centers being limited during the pandemic, the Lymfit intervention filled an immediate need to provide physical activity guidance to lymphoma survivors. Findings provide preliminary support that implementing the Lymfit intervention is feasible and demonstrated promising results. [ABSTRACT FROM AUTHOR]

Understanding what factors are linked to public health behavior in a global pandemic is critical to mobilizing an effective public health response. Although public policy and health messages are often framed through the lens of individual benefit, many of the behavioral strategies needed to combat a pandemic require individual sacrifices to benefit the collective welfare. Therefore, we examined the relationship between individuals' morality and their support for public health measures. In a large-scale study with samples from 68 countries worldwide (Study 1; N = 46,576), we found robust evidence that moral identity, morality-as-cooperation, and moral circles are each positively related to people's willingness to engage in public health behaviors and policy support. Together, these moral dispositions accounted for 9.8%, 10.2%, and 6.2% of support for limiting contact, improving hygiene, and supporting policy change, respectively. These morality variables (Study 2) and Schwartz's values dimensions (Study 3) were also associated with behavioral responses across 42 countries in the form of reduced physical mobility during the pandemic. These results suggest that morality may help mobilize citizens to support public health policy. [ABSTRACT FROM AUTHOR]

Nutritional supplements have been extensively used as health interventions for the elderly. However, with the spread of COVID-19, no consensus exists on whether nutritional interventions could improve muscle mass and physical activity in community-dwelling older adults. To conduct a systematic review and meta-analysis to explore the effects of different nutritional interventions on muscle mass and physical performance in the elderly, we searched PubMed, Web of Science, Elsevier, and Cochrane databases from their founding dates to December 2023. The meta-analysis was performed using RevMan5.3 software. Only randomized controlled trials (RCTs) were considered, and the overall mean difference (MD) or standardized mean difference (SMD) with 95% confidence interval (CI) was calculated. There were 33 studies comprising 3579 elderly persons meeting the inclusion criteria. Comprehensive analysis suggested that the intervention effect of fat-free mass (FFM), appendix skeletal muscle mass (ASMM), handgrip strength (HGS), gait speed, and short physical performance battery (SPPB) score was higher in the nutritional supplement group than in the control group. The results of subgroup analysis demonstrated that protein supplementation (SMD = 0.82, p < 0.0001) had an optimal effect on ASMM (SMD = 0.89, p < 0.0001) and FFM (MD = 2.09, p < 0.0001) in the elderly. Vitamin D supplementation (SMD = 0.52, p < 0.0001) had a marginal effect on ASMM, and energy supplementation (SMD = 0.39, p = 0.0005) had the lowest effect. Moreover, nutritional interventions had the most significant impact on HGS (MD = 1.06, p < 0.0001) and TUG (MD = 0.14, p < 0.0001) in individuals aged 65–75 years old, with positive effects on FFM (MD = 1.62, p < 0.0001) and HGS (MD = 0.82, p < 0.0001) when compared to healthy elderly individuals, and had greater effect on ASMM (SMD = 0.69, p < 0.0001) than on the elderly with sarcopenia. Nutritional supplements can enhance muscle mass and physical performance in the elderly, while protein is recommended for muscle function. The golden period for implementing nutritional interventions to improve muscle function is before the age of 75 years. However, the impact of nutritional interventions varies with age and population. Given the limited evidence on nutritional interventions, more detailed and high-quality studies are highly warranted in the future. [ABSTRACT FROM AUTHOR]

Objective: This study investigates the impact of community-based exercises with action observation therapy (AOT) on the physical and cognitive performance of older adults experiencing social isolation during the COVID-19 pandemic. Methods: One hundred participants aged 65–80 years were randomly divided into two groups: the AOT group, which engaged in balance, strengthening, and mobility exercises guided by 15-minute action observation videos before a 45-minute exercise session, and the control group, which performed the same exercises without action observation. Both groups underwent three sessions per week for eight weeks (24 sessions in total). The assessment tools used in this study included the following: For evaluating mobility and fall risk in older adults, the Timed Up-and-Go (TUG) Test was employed. To assess functional strength of lower extremities, balance, and fall risk, the Five Times Sit-to-Stand (5XSST) Test was administered. Balance and gait were measured using the Tinetti Balance and Gait Assessment (TBGA), utilizing the Tinetti Scale. Individuals' confidence in performing daily activities without falling or losing balance was assessed using the Activities-Specific Balance Confidence Scale (ABC). Furthermore, cognitive functions across multiple domains, including attention-concentration, executive function, memory, language, visual construction skills, abstract thinking, calculation, and orientation, were evaluated using the Montreal Cognitive Assessment (MoCA) Tests. Results: Results revealed significant improvements in both groups. Group I, which received Action Observation Therapy (AOT) in addition to exercise, demonstrated superior outcomes in the 5XSit-to-Stand test (Δ = -1.92, p < 0.0001, Cohen's d = 0.77), Tinetti Balance and Gait Scale (Balance: Δ = 2.77, p < 0.0001, Cohen's d = 0.91), and Timed Up and Go test (Δ = -1.98, p < 0.0005, Cohen's d = 0.83). On the other hand, Group II, which received exercise only, exhibited substantial gains in the Tinetti Balance and Gait Scale (Walking: Δ = 0.52, p < 0.01, Cohen's d = 0.27) and Activity-Specific Balance Confidence Scale (Δ = 5.77, p < 0.0001, Cohen's d = 0.26). Conclusion: These findings underscore the effectiveness of AOT-enhanced community-based exercises in enhancing both physical and cognitive performance among older adults facing social isolation during the pandemic, with Group I (AOT + exercise) showing particularly promising results. Trial registration: This study was registered with ClinicalTrials.gov Identifier: NCT04759690, ClinicalTrials Protocol ID: p3957ghb. [ABSTRACT FROM AUTHOR]

Objectives: The coronavirus disease‐2019 pandemic has contributed to widespread social and economic stressors, along with substantial health problems, including loss of life. To date, however, relatively few studies have examined the prevalence and correlates of declines in mental and physical functioning in U.S. military veterans, an older and potentially vulnerable segment of the U.S. adult population. Methods: Data were analyzed from the 2019–2020 National Health and Resilience in Veterans Study, a nationally representative, longitudinal study of 3078 veterans. Veterans were surveyed prior to the pandemic (pre‐pandemic) and 1 year later during the height of the pandemic (peri‐pandemic). Multivariable analyses were conducted to identify risk and protective variables associated with pre‐to‐peri pandemic declines in self‐reported physical and mental functioning. Results: The prevalence of veterans who experienced functional decline (≥0.5 standard deviation reductions) pre‐to‐peri‐pandemic was 18.1% (N = 541) for physical functioning and 18.3% (N = 547) for mental functioning. Older age, greater adverse childhood experiences (ACEs), and pandemic‐related posttraumatic stress symptoms were the strongest correlates of physical functional decline, while greater ACEs, loneliness, pandemic‐related posttraumatic and social restriction stress symptoms, and lower protective psychosocial characteristics were the strongest correlates of mental functional decline. Conclusions: Although the majority of U.S. Veterans showed functional maintenance or improvement 1 year into the pandemic, nearly one‐in‐five experienced a decline in physical or mental functioning. Results could help inform identification of veterans who may be at risk for functional decline during large‐magnitude stressors, such as national or global pandemics. Key points: In this nationally representative sample of 3078 veterans, 18.1% experienced a significant decline in physical functioning and 18.3% experienced a significant decline in mental functioning during the first year of the coronavirus disease‐2019 (COVID‐19) pandemic.Older age, greater adverse childhood experiences (ACEs), and pandemic‐related posttraumatic stress symptoms were the strongest correlates of physical functional decline.Greater ACEs, loneliness, pandemic‐related posttraumatic and social restriction stress symptoms, along with lower protective psychosocial characteristics, were the strongest correlates of mental functional decline.Nearly 1‐in‐5 veterans experienced significant functional decline during the COVID‐19 pandemic, which could lead to increases in disability and overall healthcare burden. [ABSTRACT FROM AUTHOR]

Echolocation is used by people with low vision or blindness to support their navigation. Internationally, Orientation and Mobility (O&M) Specialists have learned echolocation skills and how to teach them to clients, through formal workshops with a subject matter expert. However, COVID-19 has limited access to these in-person professional development opportunities. This study investigated whether an O&M professional could learn echolocation skills in a self-paced programme with only the support of a lay assistant. We developed the EchoRead Programme to equip an individual O&M Specialist to learn basic echolocation skills in 4 hours. This auto-ethnographical perspective describes how the draft programme was trialled by one trainee O&M Specialist in her home and local neighbourhood. She developed sufficient skills to complete most of the seated, standing, and walking tasks in the programme, but needed more support developing tongue-clicking and recognising driveways when shorelining fences. She found it was important to use learning environments that were graduated in physical and audio complexity. The EchoRead Programme was then trialled and revised by an experienced O&M Specialist, beginning at home, then exploring a range of venues available within a 5 km radius – the roaming range allowed during COVID lockdown. The resulting EchoRead Programme can equip O&M professionals to be self-directed in learning early echolocation skills, using online and locally available resources. This programme could be especially useful for vision professionals and their clients, who have limited access to in-person learning opportunities with colleagues or peers because of geographical isolation, low resources, or a global pandemic. [ABSTRACT FROM AUTHOR]

This research explored the instructional practices and strategies used by orientation and mobility (O&M) specialists in March and April 2020 during the COVID-19 pandemic. The Access and Engagement survey from the American Foundation for the Blind included open-ended responses from 318 O&M specialists. The authors used thematic analysis to examine the main themes regarding instructional practices consistent throughout the responses. This article focused on the themes of collaboration between families and professionals and the creative instructional strategies used for adaptive O&M lessons. Parents took on a more active role and professionals found creative ways to make instruction useful in most cases. There were fundamental changes to the content and structure of O&M lessons when they were moved from in-person to online instruction. Creative and collaborative practices were used to adapt for the absence of the travel environment. Virtual instruction in O&M will continue to be used in certain circumstances when in-person services are not possible, but we need to better explore how to ensure it is safe and effective. [ABSTRACT FROM AUTHOR]

After lockdowns and school closings associated with COVID-19 began throughout the United States and Canada in March 2020, this research was completed to explore how the pandemic affected access to orientation and mobility (O&M) services. Using qualititave responses from a mixed methodology study, this article reports the findings from 318 individuals, including both O&M specialists and dually certified teachers of students with visual impairments (TVIs) and O&M specialists. Four major themes emerged through data analysis, including (1) prioritization of O&M goals for students with visual impairments, (2) personal factors affecting access to O&M training, (3) access to O&M services through virtual learning, and (4) creative approaches to O&M instruction during the pandemic. Within these themes, professionals, students, and families alike were asked to assume roles that went beyond traditional expectations. Questions and concerns that professionals in the field need to consider when looking at the future of O&M services were raised as part of this research, including a number of ideas for future studies. [ABSTRACT FROM AUTHOR]

Pandemics, such as the emergence of COVID-19, have their roots in the intricate interplay across animals, humans and the environment. The transition from epidemics to full-blown pandemics can be visualized as the proliferation and spread of transmissions across a web of interlinked networks. These networks encompass not only human-human interactions but also encompass animals, inanimate objects, and elements within the environment. Human civilization has seen an unprecedented increase in the mobilities of humans, animals and artefacts, and formation of innumerable interconnections across them as well as with the environment. Furthermore, there is widespread expansions of these networks, and a global reach. These are in a state of constant flux due to increasing mobilities of their individual nodes as well as their corresponding networks. The interactions occur across predefined pathways (eg. along transport routes) or more randomly (eg. floating atmospheric pollutants). The concept of "Dynamic Physical Hyperconnectivity" is proposed to capture the situation when there is synchronization or approximation of these high-mobility networks, creating the environment for very close physical connectivities of nodes across adjacent networks. If multiple networks coincide, the connectivities can occur across the globe. This hypothesis could explain the swift worldwide spread of COVID-19 virus during the pandemic, and is supported by preliminary data. If this is proven with modelling, it implies that mitigation of pandemics such as COVID-19 requires a multifaceted approach that curtails the velocity of agent mobility, minimizes interaction frequencies, reduces node mobility scope, and disentangles interwoven networks. [ABSTRACT FROM AUTHOR]

Effective international project team development and management is a crucial aspect of project management that directly influences the performance and satisfaction of team members. As reductions in travel and physical mobility are prioritized for sustainability efforts, especially after the COVID-19 pandemic, it is of paramount importance to identify and share effective innovative remote, online project management practices. The purpose of this study is to address the scarcity of related research and investigate the impact of Microsoft (MS) Teams usability on team management effectiveness as mediated by intergroup relation. The population of this study includes university personnel that have participated in the Erasmus+ project Benefit, with a sample size of 52 respondents. The data was analyzed using SmartPLS 4.0. The findings revealed that the usability of MS Teams had a direct, positive, and substantial influence on intergroup interactions and team performance. Further intergroup relations have a direct and significant impact on team effectiveness. The findings of the mediation study indicated that the association between MS Teams usability and team effectiveness is partially mediated by intergroup interactions. [ABSTRACT FROM AUTHOR]

This review aimed to (1) analyze whether the home advantage was diminished; (2) investigate the impact of the crowds' support on the match outcome and team performance; (3) explore the bias of the referee without crowds. Based on the PRISMA 2020 (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, this systematic review searched of literature was conducted in December 2022. The keywords related to soccer, COVID-19 and home advantage were used. The search returned 135 articles. After screening the records against set criteria, 28 articles were analyzed. Results showed that the absence of crowds would reduce the home advantage of teams, but the findings varied by country. Most leagues have evidence that without the support of the spectators, their technical, tactical and physical performances would be worse. The referee seems likely to be fairer when the spectators are absent. Therefore, crowd supports is an important factor affecting home advantage, the clubs can at least try to strengthen the home advantage and increase the winning possibility by encouraging spectators to enter the stadium or reducing the ticket price. [ABSTRACT FROM AUTHOR]

Introduction: During the COVID-19 pandemic, prioritizing certain surgical patients became inevitable due to limited surgical capacity. This study aims to identify which factors patients value in priority setting, and to evaluate their perspective on a decision model for surgical prioritization. Methods: We enacted a qualitative exploratory study and conducted semi-structured interviews with N = 15 patients. Vignettes were used as guidance. The interviews were transcribed and iteratively analyzed using thematic analysis. Results: We unraveled three themes: 1) general attitude towards surgical prioritization: patients showed understanding for the difficult decisions to be made, but demanded greater transparency and objectivity; 2) patient-related factors that some participants considered should, or should not, influence the prioritization: age, physical functioning, cognitive functioning, behavior, waiting time, impact on survival and quality of life, emotional consequences, and resource usage; and 3) patients' perspective on a decision model: usage of such a model for prioritization decisions is favorable if the model is simple, uses trustworthy data, and its output is supervised by physicians. The model could also be used as a communication tool to explain prioritization dilemmas to patients. Conclusion: Support for the various factors and use of a decision model varied among patients. Therefore, it seems unrealistic to immediately incorporate these factors in decision models. Instead, this study calls for more research to identify feasible avenues and seek consensus. [ABSTRACT FROM AUTHOR]

This case study on COVID-19 warning designs in a Swedish context illustrates how a unified affordance approach may contribute to an understanding of the meaning-making in reminders, instructions, cues and prompts that communicate the message "keep your distance." The analysis combines semiotic and ecological affordance categories, taking both Gibson's original theorizing on affordances and more recent affordance-informed research efforts into consideration. In so doing, the study aims to bridge a knowledge gap in the study of visual instructions and warning designs as well as in a more comprehensive way delineate the multimodal design strategies associated with COVID-19 warning designs. The analysis shows that Swedish COVID-19 warning designs of the keep-your-distance-kind belong to a non-standardized and emerging genre that is marked by great variation and ad-hoc design solutions, several of which combine physical blocking functions with verbally based messages. The analysis also highlights the tension between verbal and visual recourses, on one hand, and the signage placement and choice of materials, on the other hand. It is concluded that communication resources do not always appear to convey the same basic message, but in incongruent ways weaken what might be considered the intended main message. [ABSTRACT FROM AUTHOR]

Introduction: Post-COVID-19 syndrome (PCS) is a multisystemic disorder marked by impaired physical performance as one lead symptom. Since it has been suggested that endurance training as part of medical rehabilitation may be effective in improving physical performance capacity in PCS, this study aimed to compare different modes of aerobic endurance training. Methods: A total of 110 PCS patients (49.3 ± 11.8 years; 38% women; time after infection = 260.2 ± 127.5 days) underwent detailed clinical screening including symptom-limited cardiopulmonary exercise testing at admission and after 4–6 weeks of inpatient medical rehabilitation. Questionnaires were used to assess disease perception. Patients performed controlled isocaloric cycle ergometer training (3–5 sessions/week; 18 min) as either continuous training (CT) at 50% of maximal workload or as interval training (IT; load = 60%, relief = 30%). Outcomes of PCS patients were compared to coronary artery disease patients (CAD; n = 96) to evaluate overall training effectiveness. Results: Training participation was comparable between the groups, with no indication of training-specific exercise-induced fatigue. Overall, PCS patients improved significantly by a mean of 6.8 ± 12.1% for W at VT1; 3.1 ± 10.0% for VO2 at VT1; 5.5 ± 14.7% for O2 pulse at VT1; 7.5 ± 15.0% for W at VO2peak; 2.7 ± 11.0% for VO2peak and 4.6 ± 12.4% for O2 pulse at VO2peak (all p < 0.05) with no significant differences between groups (p > 0.05). Both groups showed reduced levels of fatigue, anxiety, and depression as well as improved quality of life and wellbeing (all p < 0.05). Compared to guideline-based cardiac rehabilitation, PCS patients showed a similar improvement in workload and oxygen uptake compared to CAD patients. Conclusion: PCS patients benefit from aerobic endurance training performed as moderate continuous or interval training as part of a medical rehabilitation program in terms of improved physical exercise capacity and disease perception. The results for PCS patients are comparable to the guideline-based rehabilitation of CAD patients. [ABSTRACT FROM AUTHOR]

Background: A post-COVID condition can reduce activity and quality of life, resulting in a significant socioeconomic and health burden. Understanding its impact on patients' health is important for the development of personalized rehabilitation interventions. An independent association between obesity and post-COVID condition was found because of complications and comorbidities. Methods: Sixteen patients with obesity and post-COVID symptoms (i.e., dyspnea, pain, poor sleep quality, muscle fatigue), admitted to the Istituto Auxologico Italiano, Piancavallo (VB), Italy, were recruited for a four-week rehabilitation program including conventional exercise therapy, nutritional intervention, psychological support and whole-body cryostimulation (WBC). Results: All participants attended all sessions of the program. Anthropometric data showed statistically significant changes in weight, waist circumference and body mass index. Biochemical analyses showed significant reductions in lipid and inflammatory profiles. There was a significant improvement in physical performance, reduction in pain and improvement in psychological well-being. Conclusion: A multidisciplinary rehabilitation protocol including WBC, designed for patients with obesity and a post-COVID condition, is safe and feasible. The overall improvements demonstrate that multidisciplinary rehabilitation was effective on post COVID patients and suggest that the use of WBC is safe and could play a role as a booster in rehabilitation programs. [ABSTRACT FROM AUTHOR]

Against the backdrop of growing prevalence of digital platforms in higher education, strong considerations are being made for the potential of virtual student mobility in the aftermath of the pandemic. While extant literature on digital education platforms has shed light on the relationships between platform interfaces and wider political economies, less is known about students' experiences of virtually mediated mobility and immobility. This article draws upon research that examines how students and universities are responding to the COVID-19 pandemic and its subsequent impact on border control and international travel. First, it discusses how the socio-technical platform of Zoom extends and stabilises students' imagined, communicative, and aspirational mobilities in a context of stalled physical mobility. Second, it underlines the crevices and moorings of digital platforms in the mediation of students' experiences of mobility and immobility. Third, it examines how students refashion their (im)mobile subjectivities in and through digital spaces vis-à-vis a negotiation of co-presences in a renewed context of virtual interaction. In doing so, we argue the role of corporeal mobility, social interaction, and inhabiting tangible places remain a core aspect of student mobility experiences and aspirations. [ABSTRACT FROM AUTHOR]

Aim. Early neurological rehabilitation is essential to regain functional efficiency and achieve an optimal level of independence, especially during the COVID-19 pandemic. The objective of the work was to assess the functional performance of patients of working age after hemorrhagic or ischemic brain stroke admitted to the neurological rehabilitation unit and to assess additional factors aff ecting the eff ectiveness of neurological rehabilitation. Material and methods. The study group included 89 patients admitted to the neurological rehabilitation unit. The eligibility criterion for the treatment group was the age of 25-55 years (professionally active people) and the suff ered hemorrhagic or ischemic brain stroke. The functional performance assessment was performed using the Barthel Index and the NHPT (Nine Hole Peg Test) test. Socio-demographic data were obtained from the analysis of medical records. The survey was conducted on the fi rst and last day of stay. Results. There was a signifi cant impact of age on the type of stroke, with people with an ischemic stroke being indeed statistically older than those with hemorrhagic stroke (50± 5 years), compared to those with hemorrhagic stroke (46± 8 years). It has been established that the time spent in a unit is dependent on the age of the patient, the older the patient the longer the hospitalization lasts. The tests assessing the functionality of the hands have showed statistically signifi cant improvements in the study group. It has been demonstrated that the improvement of functional performance depended on gender. People with diabetes performed statistically worse (Me=28 vs. Me=21). Conclusions. 1. Older people after stroke need more time to rehabilitate. 2. There is a need for more rehabilitation in people with diabetes. 3. Longer rehabilitation for men is advisable regardless of the type of stroke. [ABSTRACT FROM AUTHOR]

The article in the journal "Intensive Care Medicine" discusses the long-term outcomes of critically ill patients with hematological malignancies, particularly during the coronavirus disease 2019 (COVID-19) pandemic. The study followed a cohort of patients in Canadian intensive care units from 2018 to mid-2020, revealing low 1-year survival rates and challenges in physical and mental well-being for survivors. The impact of the pandemic on mortality rates and functional outcomes among these patients was highlighted, suggesting a need for further research to understand and improve outcomes for this vulnerable population. [Extracted from the article]

Introduction: Fatigue is a common symptom in post-COVID-19 patients. Individuals with fatigue often perform less well compared to healthy peers or without fatigue. It is not yet clear to what extent fatigue is related to the inability to reach maximum exhaustion during physical exercise. Methods: A symptom-based questionnaire based on the Carruthers guidelines (2003) was used for reporting the presence of fatigue and further symptoms related to COVID-19 from 85 participants (60.0% male, 33.5 ± 11.9 years). Cardiopulmonary exercise testing (CPET) and lactate measurement at the end of the test were conducted. Objective and subjective exhaustion criteria according to Wasserman of physically active individuals with fatigue (FS) were compared to those without fatigue (NFS). Results: Differences between FS and NFS were found in Peak V̇O2/BM (p < 0.001) and Max Power/BM (p < 0.001). FS were more likely to suffer from further persistent symptoms (p < 0.05). The exhaustion criterion Max. lactate was reached significantly more often by NFS individuals. Conclusion: Although the aerobic performance (Max Power/BM) and the metabolic rate (Peak V̇O2/BM and Max. lactate) of FS were lower compared to NFS, they were equally able to reach objective exhaustion criteria. The decreased number of FS who reached the lactate criteria and the decreased V̇O2 peak indicates a change in metabolism. Other persistent post-COVID-19 symptoms besides fatigue may also impair performance, trainability and the ability to reach objective exhaustion. Trial registration Trial registration: DRKS00023717; date of registration: 15.06.2021 (retrospectively registered). [ABSTRACT FROM AUTHOR]

For patients with chronic liver disease (CLD), telemedicine is emerging as a useful tool to prevent liver decompensation or hospitalization, allowing access to and the decentralization of care, even for patients with limited resources. However, research and attendant evidence are still lacking; thus, this review aims to systematically explore the topic of telemonitoring for CLD to describe the currently used tools and clinical outcomes. The review was conducted by using key terms on PubMed/EMBASE and searching for observational studies or clinical trials (according to PRISMA recommendations) that were published between 6 April 2013 and 6 April 2023 to keep the technological framework limited to the last 10 years. The studies were described and grouped according to the aim of telemonitoring, the underlying disease, and the tools adopted to achieve remote monitoring. A total of 32 articles met the inclusion criteria. Of these, 11 articles report the successful use of a telehealth program to support and improve access to care in the management of HCV-related cirrhosis, eight articles examine the efficacy of telemedicine for remote monitoring interventions to prevent or decrease the risk of decompensation in high-risk patients, and five articles examine improvements in the physical performance and quality of life of cirrhotic patients through telehealth rehabilitation programs. Four studies were completed during the recent COVID-19 pandemic. Telehealth has the potential to provide and expand treatment access and reduce barriers to care for the most disadvantaged patients and might be able to reduce the need for hospital readmission for CLD, though most practice to test feasibility is still in the pilot stage. [ABSTRACT FROM AUTHOR]

Background: This systematic review and meta-analysis examines how pulmonary rehabilitation impacts in patients suffering from subacute and long COVID-19 infections, gauging enhancements in of dyspnea, physical function, quality of life, psychological state (anxiety and depression), and fatigue. Methods: Three electronic databases (PubMed, Web of Science, Cochrane Library) were systematically searched for full-text articles published from inception to January 2023. Randomized, quasi-experimental, and observational studies were included, with adults diagnosed with subacute or long COVID-19 who received pulmonary rehabilitation as intervention. Outcomes related to dyspnea, physical function, quality of life, fatigue, and psychological status were included. Risk of bias was assessed with Cochrane Risk of Bias Tool for Randomized Controlled Trials and Risk of bias in non-randomized studies of intervention. The review was registered before starting in PROSPERO (CRD: 42022373075). Results: Thirty-four studies were included, involving 1970 patients with subacute and long COVID-19. The meta-analysis demonstrated moderate to large effects on dyspnea, physical function, quality of life, and depressive symptoms compared to usual care intervention. No significant differences were found in fatigue compared to usual care, nor in anxiety levels after pulmonary rehabilitation intervention. Conclusions: Pulmonary rehabilitation has the potential to improve health outcomes in patients with subacute and long COVID-19. However, due to the high risk of bias of included studies, conclusions should be taken with caution. [ABSTRACT FROM AUTHOR]

Objective: Immunocompromised patients with chronic inflammatory disease (CID) may have experienced additional psychosocial burden during the COVID‐19 pandemic due to their immunocompromised status. This study was undertaken to determine if vaccination would result in improved patient‐reported outcomes longitudinally among individuals with CID undergoing SARS–CoV‐2 vaccination regardless of baseline anxiety. Methods: Data are from a cohort of individuals with CID from 2 sites who underwent SARS–CoV‐2 vaccination. Participants completed 3 study visits before and after 2 messenger RNA vaccine doses in the initial vaccination series when clinical data were collected. Patient‐reported outcomes were measured using the Patient‐Reported Outcomes Measurement Information System 29‐item Health Profile and expressed as T scores, with 2 groups stratified by high and low baseline anxiety. Mixed‐effects models were used to examine longitudinal changes, adjusting for age, sex, and study site. Results: A total of 72% of the cohort was female with a mean ± SD age of 48.1 ± 15.5 years. Overall, sleep disturbance improved following both doses of SARS–CoV‐2 vaccinations, and anxiety decreased after the second dose. Physical function scores worsened but did not meet the minimally important difference threshold. When stratifying by baseline anxiety, improvement in anxiety, fatigue, and social participation were greater in the high anxiety group. Physical function worsened slightly in both groups, and sleep disturbance improved significantly in the high anxiety group. Conclusion: Sleep disturbance decreased in a significant and meaningful way in patients with CID upon vaccination. In patients with higher baseline anxiety, social participation increased, and anxiety, fatigue, and sleep disturbance decreased. Overall, results suggest that SARS–CoV‐2 vaccination may improve mental health and well‐being, particularly among those with greater anxiety. [ABSTRACT FROM AUTHOR]

Introduction: Maharashtra, India, remained a hotspot during the COVID-19 pandemic. After the initial complete lockdown, the state slowly relaxed restrictions. We aim to estimate the lockdown's impact on COVID-19 cases and associated healthcare costs. Methods: Using daily case data for 84 days (9 March–31 May 2020), we modeled the epidemic's trajectory and predicted new cases for different phases of lockdown. We fitted log-linear models to estimate the growth rate, basic (R0), daily reproduction number (Re), and case doubling time. Based on pre-restriction and Phase 1 R0, we predicted new cases for the rest of the restriction phases, and we compared them with the actual number of cases during each phase. Furthermore, using the published and gray literature, we estimated the costs and savings of implementing these restrictions for the projected period, and we performed a sensitivity analysis. Results: The estimated median R0 during the different phases was 1.14 (95% CI: 0.85, 1.45) for pre-lockdown, 1.67 (95% CI: 1.50, 1.82) for phase 1 (strict mobility restrictions), 1.24 (95% CI: 1.12, 1.35) for phase 2 (extension of phase 1 with no restrictions on agricultural and essential services), 1.12 (95% CI: 1.01, 1.23) for phase 3 (extension of phase 2 with mobility relaxations in areas with few infections), and 1.05 (95% CI: 0.99, 1.123) for phase 4 (implementation of localized lockdowns in high-case-load areas with fewer restrictions on other areas), respectively. The corresponding doubling time rate for cases (in days) was 17.78 (95% CI: 5.61, −15.19), 3.87 (95% CI: 3.15, 5.00), 10.37 (95% CI: 7.10, 19.30), 20.31 (95% CI: 10.70, 212.50), and 45.56 (95% CI: 20.50, –204.52). For the projected period, the cases could have reached 631,819 without the lockdown, as the actual reported number of cases was 64,975. From a healthcare perspective, the estimated total value of averted cases was INR 194.73 billion (USD 2.60 billion), resulting in net cost savings of 84.05%. The Incremental Cost-Effectiveness Ratio (ICER) per Quality Adjusted Life Year (QALY) for implementing the lockdown, rather than observing the natural course of the pandemic, was INR 33,812.15 (USD 450.83). Conclusion: Maharashtra's early public health response delayed the pandemic and averted new cases and deaths during the first wave of the pandemic. However, we recommend that such restrictions be carefully used while considering the local socio-economic realities in countries like India. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic restrictions may have significant implications for patients with multiple sclerosis (MS). The objective of this study is to explore the impact of the pandemic on physical activity levels and health outcomes among MS patients, as well as to examine potential associations between these factors. In this cross-sectional study, 197 patients with confirmed MS diagnosis were included. Physical activity and health status were assessed using international physical activity questionnaire-long form (IPAQ-LF) and short form 36 health survey questionnaire (SF-36) during the period of restrictions. The relationship between clinical characteristics, physical activity levels and health status parameters were examined. A total of 45 participants (22.8%) scored low, 73 (37.1%) scored moderate, and 79 (49.1%) achieved a high level of physical activity during the COVID-19 pandemic. We observed no significant association between total physical activity and any domains of SF-36 health status, except for pain. However, correlations were found between IPAQ and SF- 36 domains. Specifically, walking showed positive correlations with physical functioning, physical limitation, general health, and physical component summary score. Vigorous activity demonstrated a negative correlation with social functioning, while moderate activity displayed a positive correlation with energy levels. Despite the challenges of home isolation and quarantine, most of our participants managed to achieve a moderate to high level of physical activity, while their overall health status was found to be moderate. Additionally, significant correlations were identified between the domains of health status and different types of physical activity, particularly walking. Further studies are warranted to optimize the care and support provided to patients with MS. [ABSTRACT FROM AUTHOR]