Exploring Factors Associated with Physical Activity in the Elderly: A Cross-Sectional Study during the COVID-19 Pandemic.

The COVID-19 pandemic negatively influenced individuals' physical activity levels (PALs) and particularly the PAL of the elderly. However, few studies have examined the correlates of PALs in this population during the pandemic. This study aimed to evaluate the residence-specific correlates of PALs in elderly people from Croatia and Bosnia and Herzegovina during the COVID-19 pandemic. The participants were 211 persons older than 65 years (101 females), of whom 111 were community-dwelling residents, and 110 were nursing home residents (71.11 ± 3.11 and 72.22 ± 4.01 years of age, respectively; t-test = 0.91, p < 0.05). The variables included health status, residential status sociodemographic factors, anthropometrics (body mass, height, and body mass index), and PAL. PAL was evaluated using a translated version of the Physical Activity Scale for the Elderly (PASE), and was validated in this study. PASE showed good test-retest reliability (51% of the common variance) and validity (57% of the common variance, with the step count measured using pedometers). Apart from participants' health status and age, PAL was positively correlated with (i) community-dwelling residence (OR = 1.93, 95% CI: 1.60-2.23), and (ii) a lower BMI (OR = 0.85, 95% CI = 0.71-0.98). The pre-pandemic physical activity was positively correlated with the PAL of the nursing home residents (OR = 1.2, 95% CI: 1.02-1.45). A higher education level was positively correlated with the PAL of community-dwelling residents (OR = 1.31, 95% CI: 1.04-1.66). This study evidenced the residence-specific correlates of PALs, and enabled the identification of specific groups that are at risk of having low PALs during the pandemic. Future studies examining this problem during a non-pandemic period are warranted.

Tracking changes in atmospheric particulate matter at a semi-urban site in Central France over the past decade.

Nearly 10-year (2013-2022) data on atmospheric particulate matters (PMs) were collected to investigate the air quality in a suburban site of Orléans city (France). The PM10 concentration decreased slightly between 2013 and 2022. PMs concentrations showed a monthly variation with higher concentration in cold periods. PM10 presented a clear bimodal diurnal variation peaking at morning rush hour and midnight, whereas the fine PMs such as PM2.5 and PM1.0 only had significant peaks during nighttime. Further, PM10 had more pronounced week-end effect than other fine PMs. COVID-19 lockdown impact on PMs levels was further investigated, showing that the lockdown during cold season could result in an increase of PMs concentrations because of the enhanced household heating. We concluded that PM10 could originate from biomass burning and fossil fuel related activities, air parcels from the western Europe through Paris were also important source of PM10 in the investigated area. Fine PMs, such as PM2.5 and PM1.0, originated mainly from biomass burning in addition to secondary formation at the local scale. This study provides a long-term PMs measurement database to explore the sources and characterization of PMs in central France, which could support future regulation and formulation of air quality standards.

Nature visits during the COVID-19 pandemic in Norway: Facilitators, motives, and associations with sociodemographic characteristics.

Introduction: The COVID-19 pandemic has been linked to increased mental health issues and reduced well-being. Researchers also reports increased frequency of nature visits during the pandemic, proposing it may mitigate some of these negative consequences. Using the case of Norway, a country with ample access to nature and relatively low levels of pandemic-related restrictions, this study sought to (i) understand how the COVID-19 crisis impacted patterns of nature visits and specific nature-based activities, (ii) examine how these patterns varied among different population groups and levels of restrictions, and (iii) explore the motives and facilitators for increased frequency of nature visits. Methods: The data were retrieved from a national cross-sectional survey conducted in June 2021, which was designed to assess participants (n = 1,005, age > 15 years) habits in relation to nature visits and outdoor recreation since the beginning of the COVID-19 crisis, and associated factors. Results: The results showed that 32 % of participants increased their frequency of nature visits during the crisis, while 11 % experienced a decrease. Multivariate logistic regression revealed significant positive associations between increased frequency of nature visits and longer duration of lockdown restrictions (OR [95% CI] = 2.35 [1.28-4.29] and 4.92 [2.77-8.74] for a few weeks and several months of lockdown, respectively). Increased frequency of nature visits was also more likely among women, younger respondents, and individuals from high-income households. A Cochran's Q test showed that the most common motive for increased frequency of nature visits was "To be physically active" (74%). The most commonly reported facilitators were the possibility of using natural environments as an alternative to gyms and organized sports alongside having more time available (58 and 49%, respectively). Conclusion: These findings suggest that nature visits provided important opportunities for physical activity during the COVID-19 crisis, but also that the mental health benefits of nature visits during such times may be under-communicated. This highlights the importance of access to natural environments to promote physical activity and health, but also suggests that campaigns that specifically communicate the beneficial effects of nature visits during lockdowns or similar stressful situations might help people cope with the situation.

Lockdown life - experiences of partners of individuals with an acquired brain injury during the COVID-19 pandemic: a qualitative study.

OBJECTIVES: The present study sought to investigate the experience of individuals living with their partner with an acquired brain injury (ABI) during the first lock down period of the COVID-19 pandemic. METHOD: Semi-structured interviews were conducted with seven partners of individuals who had sustained a range of ABIs. Interviews were transcribed verbatim and thematic analysis was carried out by two of the researchers exploring the unique narratives. RESULTS: ABI occurs within a relational framework, which means that it has repercussions not only for the individual but also the entire family system. COVID-19 prevented family systems (living separately) from coming together which negatively impacted them; however, it also slowed life down, with many people working from home with flexible arrangements in place which participants found to be beneficial. Three main themes emerged from the interview data: partner focus, slowing down and support networks. The narratives identified the struggles of having to continue their partner's rehabilitation when face to face services could not visit the home, the importance of establishing routine, the positives of a slower paced life (due to COVID-19) that enabled them to build stronger relationships with their partners, and the difficulties of being separated from family and loved ones. CONCLUSION: This research suggests that it is imperative to consider individual experiences and choices. Some families benefited from reduced treatment and a slowed pace of life, whilst others may find this overwhelming and burdensome. The study makes recommendations for supporting couples after an ABI during the ongoing pandemic.

Indirect Virus Transmission via Fomites Can Counteract Lock-Down Effectiveness.

The spread of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has raised major health policy questions. Direct transmission via respiratory droplets seems to be the dominant route of its transmission. However, indirect transmission via shared contact of contaminated objects may also occur. The contribution of each transmission route to epidemic spread might change during lock-down scenarios. Here, we simulate viral spread of an abstract epidemic considering both routes of transmission by use of a stochastic, agent-based SEIR model. We show that efficient contact tracing (CT) at a high level of incidence can stabilize daily cases independently of the transmission route long before effects of herd immunity become relevant. CT efficacy depends on the fraction of cases that do not show symptoms. Combining CT with lock-down scenarios that reduce agent mobility lowers the incidence for exclusive direct transmission scenarios and can even eradicate the epidemic. However, even for small fractions of indirect transmission, such lockdowns can impede CT efficacy and increase case numbers. These counterproductive effects can be reduced by applying measures that favor distancing over reduced mobility. In summary, we show that the efficacy of lock-downs depends on the transmission route. Our results point to the particular importance of hygiene measures during mobility lock-downs.

Lifestyle in Obese Individuals during the COVID-19 Pandemic.

BACKGROUND: Stay-at-home orders in response to the Coronavirus 2 (SARS-CoV-2) pandemic have forced abrupt changes to daily routines. The aim of this study is to describe the behavior of lifestyles of individuals with obesity on the waiting list for bariatric surgery in the Department of Medical and Surgical Sciences of University of Foggia during the COVID-19 pandemic. MATERIALS AND METHODS: From June 2020 to December 2020 an online survey format was administered to all the patients (n = 52) enrolled for bariatric surgery subjects with obesity, to obtain information about the COVID-19 pandemic's impact on patients with obesity starting 9 March 2020 until 18 May 2020. RESULTS: Our data showed that 58% of patients stated that the pandemic negatively affected their mood, 60% of patients confirmed that they changed their dietary behaviors during the stay-at-home period, as they consumed more unhealthy foods or spent less time cooking home cooked meals. In addition, 71% of patients stated that the closure of the gyms worsened their obesity condition and their mental well-being with an increase of a feeling of anxiety. CONCLUSIONS: Results showed that the COVID-19 pandemic has had a significant impact on health behaviors, including quality of life, mental health physical activity, weight maintenance, and consumption of sweets in obese patients.

A Turf-Based Feature Selection Technique for Predicting Factors Affecting Human Health during Pandemic.

Worldwide, COVID-19 is a highly contagious epidemic that has affected various fields. Using Artificial Intelligence (AI) and particular feature selection approaches, this study evaluates the aspects affecting the health of students throughout the COVID-19 lockdown time. The research presented in this paper plays a vital role in indicating the factor affecting the health of students during the lockdown in the COVID-19 pandemic. The research presented in this article investigates COVID-19's impact on student health using feature selections. The Filter feature selection technique is used in the presented work to statistically analyze all the features in the dataset, and for better accuracy. ReliefF (TuRF) filter feature selection is tuned and utilized in such a way that it helps to identify the factors affecting students' health from a benchmark dataset of students studying during COVID-19. Random Forest (RF), Gradient Boosted Decision Trees (GBDT), Support Vector Machine (SVM), and 2- layer Neural Network (NN), helps in identifying the most critical indicators for rapid intervention. Results of the approach presented in the paper identified that the students who maintained their weight and kept themselves busy in health activities in the pandemic, such student's remained healthy through this pandemic and study from home in a positive manner. The results suggest that the 2- layer NN machine-learning algorithm showed better accuracy (90%) to predict the factors affecting on health issues of students during COVID-19 lockdown time.

Ear, Nose, and Throat Foreign Bodies in the Paediatric Population: Did the COVID-19 Lockdown Change Anything?

Background In the pediatric population, the ear, nose, and throat (ENT) foreign body is a common presentation for emergency departments (ED) and ENT units. COVID-19 has led to a significant impact on the health care system and the overall mental well-being of the general population. With the health care system under significant strain, we noted a continued presence of children with foreign bodies, with some requiring removal under a general anesthetic. Aim We aimed to assess if lockdown measures increased or decreased the incidence of children presenting to the hospital with ear, nose, and throat foreign bodies and to evaluate their management by the ED and ENT specialties. Method A retrospective data of children presenting with a foreign body in the ear, nose, and throat from March 2020 to August 2020 was compared with the data for the same period in 2019. Results Our study showed an overall decrease in children presenting with foreign bodies in 2020 compared to 2019 (n=90 and n=106, respectively). However, the number of children needing general anesthetic remained the same, and those presenting with foreign bodies in the upper aerodigestive tract were higher in 2020. Conclusion Children with foreign ear, nose, and throat bodies continued to present to the hospital during the COVID-19 lockdown. Our study shows an overall decrease in the number of children presenting with Ear, Nose, and Throat foreign body during the lockdown, but not statistically significantly different.

Digital competence of higher education learners in the context of COVID-19 triggered online learning.

The spread of COVID-19 caused wide scale disruptions in the educational sector across the globe. Digital education, which involves the use of digital tools, virtual platforms and online learning, is seen as one of the viable alternatives to continue academic activities in such an environment. Higher education institutions have largely switched to this new mode of learning and continue to rely on digital mode in many parts of the world, due to the ongoing pandemic threat. However, learners' competency to effectively engage in online courses and the impact of their socioeconomic background on this competency has not been adequately addressed in the literature. The present study was an attempt to explore these aspects, as they are crucial to the success of digital education. The study was conducted with 833 undergraduate, postgraduate, and doctoral students from an agricultural university to assess their digital competencies and factors that influence effective participation in online courses. The Digital Competence Framework 2.0 of EU Science Hub (DIGCOMP) was adapted and used for this study. Our findings suggest that the learners have a satisfactory level of competence in most of the aspects of digital competence. Majority of the participants were relying on smart phones both as the device for accessing internet as well as for their learning activities. The results of a Tukey's difference in the mean test reveals that learners' digital competence varies significantly by gender, economic profile, and academic level. This finding can be attributed to the difference in their socio-economic background, which confirms digital divide among learners. Our findings have implications for the design of digital higher education strategies and institutional management to ensure effective learner participation, especially for higher education institutions in developing countries.

Maintained acute stroke admission during the first wave COVID-19 pandemic in Sweden, a register-based study.

OBJECTIVES: Clinicians and researchers have addressed concerns about the negative impact of COVID-19 outbreaks on the ability of health care systems to provide timely assessment and acute therapies to patients with stroke. The aim of this study is to describe stroke care during the first wave of the COVID-19 pandemic compared to the same period the year before at an acute care hospital in Sweden. MATERIALS AND METHODS: In this cohort study data were collected from March 1st to August 31st in 2019 and 2020 on all patients diagnosed with stroke and TIA and registered at Danderyd Hospital in the national quality registry (Riksstroke). Data were completed with information from the hospital record. Sweden had no lockdown during 2020. RESULTS: During the study period in year 2019 there were 426 registered stroke patients at Danderyd hospital, compared to 403 registered stroke patients the same period during 2020 (p = 0.483). The number of minor stroke and TIA during the period in 2019 compared to 2020 were 468 versus 453 respectively (minor stroke p = 0.475 versus TIA p = 0.50). CONCLUSIONS: There were no difference in the number of patients diagnosed with stroke and TIA during the first wave of the COVID-19 pandemic.

[The Importance of Structural Parameters for Children and Adolescents with Mental Illnesses]. / Die Bedeutung struktureller Rahmenbedingungen für Kinder- und Jugendliche mit psychischen Erkrankungen: Eine Untersuchung im Rahmen von stationärer Rehabilitation während der Corona-Pandemie.

In March 2018, the first Austrian rehabilitation clinic for children and adolescents with disorders from the field of "Mental Health" opened in Wildbad, Styria. On the part of the Austrian Health Insurance (ÖGK), this term subsumes diagnoses from children and adolescents' psychiatrics, developmental and social pediatrics, and psychosomatics. After the lockdown caused by COVID-19, there was a clear excess of assignments from the children and adolescents' psychiatric spectrum. Therefore, it was decided to specialize, which made treatment planning much easier. This specialization also restricted the age group, so that we primarily treated patients between the ages of 12 and 18 years. Because of the homogenization, we noticed that the patients tended to be able to end their stay more satisfied and more mentally stable. Therefore, we asked ourselves what the cause of this supposedly positive effect was. We developed a questionnaire in order to be able to query and compare the most important points in our experience. At the beginning of the stay, self-motivation, subjectively perceived restrictions due to the illness, and own rehabilitation goals were queried. At the end of the stay, we tried to present a differentiated assessment of symptom improvement and the resulting effects on everyday life.

COVID-19: In the Eyes of a Filipino Child.

Objectives: explore thoughts and feelings of children on COVID-19, find out how they cope, and what they did during lockdown. It was total lockdown in Luzon, Philippines, April 2020 - when survey was conducted; pre-tested open-end questionnaire was administered to children who answered either by paper and pen, or through social media, with parents' cooperation. Participants: 200 boys and girls, 6-12 years old, public and private schools in NCR-Luzon. Results: Participants heard COVID-19, pandemic and lock down from media and family; described as deadly, dangerous, contagious, world-wide, death-causing virus; about 90% expressed sadness, fear, boredom, anger, disappointments and difficult time; employed self-enhanced coping mechanisms, and engaged in hobbies and interests to assuage thoughts and feelings; family appeared as saving grace.Recommendations: develop strategies to assist children during critical events; studies - find out effects of pandemic on participants' health; visit participants after two years to find out reminiscence of pandemic experience.

The impact of the reclusion on patients with blepharospasm during the COVID19 pandemic.

BACKGROUND: Blepharospasm (BS) is a focal dystonia that can be treated successfully with Botulinum toxin (BoNT). During the reclusion due to the Covid 19 pandemic many patients missed the scheduled treatment. OBJECTIVES: Aim of the study is to evaluate Level of Disability (LoD) related to BS during the lockdown period. METHODS: LoD was assessed by an adapted version of Blepharospasm Disability Index (4iBSDI) during reclusion (T1), and three months after the first injection following the lock down phase (T2). 4iBSDI scores were compared between T1 and T2, a correlation between the change of LoD in the two periods (t-delta) and patients' clinical data was analyzed. RESULTS: LoD was not modified between the two periods in most of the patients and it was reduced at T1 in almost one third of the participants. No correlation between t-delta and clinical data was found. CONCLUSIONS: LoD did not increase during the lock down period in most of BS patients although BoNT treatment was suspended. Environmental and psychosocial factors may contribute to determine the LoD due to BS.

Modeling for the Stringency of Lock-Down Policies: Effects of Macroeconomic and Healthcare Variables in Response to the COVID-19 Pandemic.

Background: The spread of COVID-19 has been characterized by unprecedented global lock-downs. Although, the extent of containment policies cannot be explained only through epidemic data. Previous studies already focused on the relationship between the economy and healthcare, focusing on the impact of diseases in countries with a precarious economic situation. However, the pandemic caused by SARS-CoV-2 drew most countries of the world into a precarious economic situation mostly caused by the global and local lock-downs policies. Methods: A discriminant analysis performed via partial least squares procedure was applied to evaluate the impact of economic and healthcare variables on the containment measures adopted by 39 countries. To collect the input variables (macroeconomic, healthcare, and medical services), we relied on official databases of international organizations, such as The World Bank and WHO. Results: The stringency lock-down policies could not only be influenced by the epidemical data, but also by previous features of the selected countries, such as economic and healthcare conditions. Conclusions: Indeed, economic and healthcare variables also contributed to shaping the implemented lock-down policies.

Higher HbA1c was observed in young people with diabetes who fasted during COVID-19 pandemic lockdown of 2020 Ramadan in Bangladesh - A Post Ramadan survey.

OBJECTIVE: Muslim people with T1DM should be actively discouraged from fasting during the COVID-19 pandemic, as diabetes has emerged as a significant risk factor for adverse outcomes of COVID-19 infection. We report the experience of young patients with type 1, type 2 and other types diabetes who fasted during Ramadan 2020 at the time of the COVID-19 pandemic time lockdown. RESEARCH DESIGN AND METHODS: A Post- Ramadan survey was designed for young patients who fasted during Ramadan in 2020 during COVID pandemic time. The study was conducted to compared the basal characteristics and other parameters in children and adolescents (<18 years), with young adults (≥18 years) with diabetes at Paediatric Diabetes Center in BIRDEM in Bangladesh. RESULTS: Among the study participants, a significantly higher number of participants were in older age group who fasted for more than 15 days (p = 0.045). A considerable proportion (30.7%) of patients developed mild hypoglycaemia, and only eight patients (2.6%) developed moderate to severe hypoglycemia. There was significant reduction of post Ramadan basal insulin dose in both groups (p = 0.001). Although increased bolus insulin dose requirements were observed in older age group, but decreased requirement was observed in younger age group during Ramadan (p = 0.001). Post Ramadan median HbA1C in both groups was increased with marked increase in older age group compared to younger age group though it did not reach the statistical significance. (p = 0.239) CONCLUSIONS: COVID-19 pandemic had minor impact on fasting during Ramadan in our cohort, they could fast safely with less complications during Ramadan. Our data supports Ramadan focused diabetes education with ample self-care, young people with diabetes can fast safely during Ramadan.

Sexual Addiction, Hypersexual Behavior and Relative Psychological Dynamics during the Period of Social Distancing and Stay-at-Home Policies Due to COVID-19.

During the COVID-19 pandemic, increased stress factors affected people's motivations to engage in potentially addictive behaviors. Sexuality, understood as one of the psychological aspects to be investigated to explore the level of psychological well-being of a person, has suffered considerable repercussions due to the pandemic. A growing body of evidence suggests an unprecedented increase in Internet use and online pornography consumption during the pandemic. Since March 2020, during the lockdown period, Pornhub has seen a worldwide increase in pornography use of 11.6% compared to the previous average days. This research was conducted with the aim of exploring the possible increasing use of pornographic material during the lockdown period, in order to assess whether dysfunctional behaviors, such as compulsive behaviors, and thoughts of sex-related obsessives can lead to hypersexual behavior or a more severe Sexual Addiction. The individuals who participated in our research were 18 years of age or older (mean 23.1, s.d. 5.8), and 48% male and 52% females and were recruited online to complete a self-report questionnaire in the period between April 2020 and April 2021. The questionnaires were delivered via main social networks. The tool used for our survey was the SAST (Sexual Addiction Screening Test), a questionnaire including socio-demographic data and data relating to sexual practices, such as sexual orientation and time spent on the Internet for sexual activities. The results revealed significant differences concerning the various factors investigated such as loss of control, addictive symptoms and hide score.

The Impact of COVID-19 Lockdown on Patients with Lymphedema.

Background: The coronavirus disease 2019 (COVID-19) pandemic poses a challenge to management of lymphedema. The aim of this study was to assess general health conditions and evaluate the problems and concerns of lymphedema patients with regard to access to care and provision of management and control follow-ups during the lockdown period between March and June 2020. Methods: A web-based online survey, which included questions about demographic and clinical properties, compliance with restrictions and self-management, complications, needs, and difficulties in accessing health care, as well as the presence of psychological symptoms, was applied. Results: Two hundred three patients (190 female and 13 male) replied. Majority of them (73.4%) were between 30 and 60 years old and had high school/university education (67%). The duration of lymphedema was more than 3 years and sites were commonly extremities with mild to moderate intensity in 70.5% patients. Majority of them adhered to stay home warnings (88.7%). Weight gain was a common problem and self-care methods were generally skipped (81.8%). Seventeen percent of them had wounds and/or cellulitis. Forty percent of patients needed to apply to health centers to renew the pressure garment, but could not reach it. More than 70% of patients had sleep disorders and anxiety/stress. Majority of patients used television and social media to get information related to COVID-19 and the exposure time was commonly 2 to 6 hours. Conclusions: The COVID-19 lockdown had a great impact on lymphedema patients' health care not only from medical but also from psychosocial aspects. All these implications have to be identified and dealt with properly to avoid concerns and consequences of future pandemic lockdowns. Lymphedema services should be well prepared to be delivered virtually, enable effective care, and share knowledge to meet the needs of patients suffering from lymphedema.

Inside Zambia's 'new normal:' COVID-19 policy responses and implications for peri-urban food security and livelihoods.

This paper explores COVID-19 policy responses and experiences of their impact on food systems and livelihoods, and other factors shaping vulnerability among peri-urban small-scale farmers in Zambia. We draw on household surveys and case studies, multi-level interviews and group discussions to make sense of 'new normal' policy (in)action and its (in) effectiveness in shaping peri-urban production, market linkages and livelihoods during the pandemic. Results show COVID-19 policy responses affected peri-urban production supply and demand for food and inputs. The 'new normal' policy responses aimed at striking a balance between health concerns and economic development as a pathway to recovery have not been followed by systematic peri-urban agriculture support, leading to failure to stimulate production and drive urban market linkages, including supermarkets. Findings bring nuance to fragilities in national food systems and the need for long-term and transformative interventions that can strengthen peri-urban agriculture and livelihoods beyond the pandemic.

Trust in Government Actions During the COVID-19 Crisis.

The worldwide COVID-19 pandemic puts countries and their governments in an unprecedented situation. Strong countermeasures have been implemented in most places, but how much do people trust their governments in handling this crisis? Using data from a worldwide survey, conducted between March 20th and April 22nd, 2020, with more than 100,000 participants, we study people's perceptions of government reactions in 57 countries. We find that media freedom reduces government trust directly as well as indirectly via a more negative assessment of government reactions as either insufficient or too strict. Higher level of education is associated with higher government trust and lower tendency to judge government reactions as too extreme. We also find different predictors of perceived insufficient reactions vs. too-extreme reactions. In particular, number of COVID-19 deaths significantly predicts perceived insufficient reactions but is not related to perceived too-extreme reactions. Further survey evidence suggests that conspiracy theory believers tend to perceive government countermeasures as too strict.

Mathematical modelling of COVID-19: A case study of Italy.

This manuscript describes a mathematical epidemiological model of COVID-19 to investigate the dynamics of this pandemic disease and we have fitted this model to the current COVID-19 cases in Italy. We have obtained the basic reproduction number which plays a crucial role on the stability of disease free equilibrium point. Backward bifurcation with respect to the cure rate of treatment occurs conditionally. It is clear from the sensitivity analysis that the developments of self immunities with proper maintaining of social distancing of the exposed and asymptomatic individuals play key role for controlling the disease. We have validated the model by considering the COVID-19 cases of Italy and the future situations of epidemicity in Italy have been predicted from the model. We have estimated the basic reproduction number for the COVID-19 outbreak in Italy and effective reproduction number has also been studied. Finally, an optimal control model has been formulated and solved to realize the positive impacts of adapting lock down by many countries for maintaining social distancing.