Clinical and physiological risk factors contributing to the restricted mobility in older adults: a longitudinal analysis.

BACKGROUND: Mobility limitations (e.g., using wheelchair) have been closely linked to diminished functional independence and quality of life in older adults. The regulation of mobility is pertaining to multiple neurophysiologic and sociodemographic factors. We here aimed to characterize the relationships of these factors to the risk of restricted mobility in older adults. METHODS: In this longitudinal study, 668 older adults with intact mobility at baseline completed the baseline assessments of clinical characteristics, cognitive function, sleep quality, activities of daily living (ADL), walking performance, beat-to-beat blood pressure, and structural MRI of the brain. Then 506 of them (mean age = 70.7 ± 7.5 years) responded to the follow-up interview on the mobility limitation (as defined by if using wheelchair, cane, or walkers, or being disabled and lying on the bed) after 18 ± 3.5 months. Logistic regression analyses were performed to examine the relationships between the baseline characteristics and the follow-up mobility restriction. RESULTS: At baseline, compared to intact-mobility group (n = 475), restricted-mobility group (n = 31) were older, with lower score of ADL and the Montreal Cognitive Assessment (MoCA), greater score of Pittsburgh Sleep Quality Index (PSQI), poorer cardio- and cerebral vascular function, and slower walking speeds (ps < 0.05). The logistic regression analysis demonstrated that participants who were with history of falls, uncontrolled-hypertension, and/or greater Fazekas scale (odds ratios (ORs):1.3 ~ 13.9, 95% confidence intervals (CIs) = 1.1 ~ 328.2), walked slower, and/or with lower ADL score (ORs: 0.0026 ~ 0.9; 95%CI: 0.0001 ~ 0.99) at baseline, would have significantly greater risk of restricted mobility (p < 0.05; VIFs = 1.2 ~ 1.9). CONCLUSIONS: These findings provide novel profile of potential risk factors, including vascular characteristics, psycho-cognitive and motor performance, for the development of restricted mobility in near future in older adults, ultimately helping the design of appropriate clinical and rehabilitative programs for mobility in this population.

Health policy response to mobility during the pandemic: Evaluating the effectiveness using location-based services big data.

As an emergent health policy response, the population mobility restriction policy was implemented to cope with the unprecedented pandemic that outbroke in early 2020, but its effectiveness showed vast disparities even within a single country. Using multisource data from Baidu mobility big data and the statistics of novel coronavirus disease in China, mobility restrictions (including restrictions on inflow-mobility, outflow-mobility, and intra-city mobility) were examined. It was found that the mobility restriction had contained the development of pandemic, but such effect would gradually recede over time. Moreover, there existed region-specific policy effectiveness. Specifically, outflow-mobility restrictions were ineffective in reducing death cases in population influx areas, and restrictions on inflow-mobility (or intra-city mobility) were ineffective in reducing confirmed cases (or death cases) in population outflow areas. It was concluded that the mobility restriction policy can be effective in epidemic prevention and control in spatial-temporal pattern. However, there was a remarkable disparity in policy effectiveness between different regions with different population mobility patterns.

Mobility restrictions and their implications on the rental housing market during the COVID-19 pandemic in China's large cities.

The COVID-19 pandemic has caused significant mobility restrictions and generated profound impacts on global socio-economic development. Mobility restrictions can generate significant impacts on the demand and supply sides of the rental housing market. By taking 77 large Chinese cities as cases, this research establishes a stepwise mediation effect test to evaluate the impacts of the pandemic on the rental housing market during Q1 2020. The results show that the confirmed cases were negatively associated with rental unit transactions, and the inter-city and intra-city movement played a significant role of mediating effects. Meanwhile, the impact of pandemic on rents lagged behind rental transaction in China's large cities, and the strict mobility controls caused the high vacancy rate of rental housing, leading to the bankruptcy of many housing rental agencies. Our research add to the burgeoning literature examining the mediating effect of mobility control between confirmed case and housing rental market. It demonstrates that the change of housing rental market induced by pandemic in China is the short-term influence on rental unit transaction, which is different from western countries. In China, a country with the most strict mobility control, the challenges come from the impact of pandemic on housing rental agencies.

How mobility restrictions policy and atmospheric conditions impacted air quality in the State of São Paulo during the COVID-19 outbreak.

Mobility restrictions are among actions to prevent the spread of the COVID-19 pandemic and have been pointed as reasons for improving air quality, especially in large cities. However, it is crucial to assess the impact of atmospheric conditions on air quality and air pollutant dispersion in the face of the potential variability of all sources. In this study, the impact of mobility restrictions on the air quality was analyzed for the most populous Brazilian State, São Paulo, severely impacted by COVID-19. Ground-based air quality data (PM10, PM2.5, CO, SO2, NOx, NO2, NO, and O3) were used from 50 automatic air quality monitoring stations to evaluate the changes in concentrations before (January 01 - March 25) and during the partial quarantine (March 16 - June 30). Rainfall, fires, and daily cell phone mobility data were also used as supplementary information to the analyses. The Mann-Whitney U test was used to assess the heterogeneity of the air quality data during and before mobility restrictions. In general, the results demonstrated no substantial improvements in air quality for most of the pollutants when comparing before and during restrictions periods. Besides, when the analyzed period of 2020 is compared with the year 2019, there is no significant air quality improvement in the São Paulo State. However, special attention should be given to the Metropolitan Area of São Paulo (MASP), due to the vast population residing in this area and exposed to air pollution. The region reached an average decrease of 29% in CO, 28% in NOx, 40% in NO, 19% in SO2, 15% in PM2.5, and 8% in PM10 concentrations during the mobility restrictions period compared to the same period in 2019. The only pollutant that showed an increase in concentration was ozone, with a 20% increase compared to 2019 during the mobility restrictions period. Before the mobility restrictions period, the region reached an average decrease of 30% in CO, 39% in NOx, 63% in NO, 12% in SO2, 23% in PM2.5, 18% in PM10, and 16% in O3 concentrations when compared to the same period in 2019. On the other hand, Cubatão, a highly industrialized area, showed statistically significant increases above 20% for most monitored pollutants in both periods of 2020 compared to 2019. This study reinforces that the main driving force of pollutant concentration variability is the dynamics of the atmosphere at its various time scales. An abnormal rainy season, with above average rainfall before the restrictions and below average after it, generated a scenario in which the probable significant reductions in emissions did not substantially affect the concentration of pollutants.

COVID-19 in Indonesia: Where Are We?

Since the 1st case officially confirmed on the last March 2020, Indonesia recorded more than 1000 new cases daily. The national trend shows no sign of decrease as 19 September 2020 the report sets a new mark of 4000 new cases in a day. The concept of controlling disease transmission relies on contacts suppression; and on the longer end, relies on vaccinations. As 27 September 2020, no vaccine is approved for use in the general population. Until then, countries should implement early, widespread, and strict disease mitigation strategies. While much remains to be learned on COVID-19, global evidence assert at least three strategies at the population level contributes to flatten the curve: mobility restriction, testing and isolation and rigorous contact-tracing.Indonesia is not on entire absences of actions, but the epidemic calls for more. The central government called for social distancing two weeks after the first case confirmed and regulation on the large scale social distancing (Pembatasan Sosial Berskala Besar/ PSBB) that restrict non-essential population mobility is enacted by April 2020. Recent evidence outlines test, tracing and isolation are effective in suppressing COVID-19 transmission. Minimizing testing and tracing delay, less than four days with coverage of 80% close contacts could prevent and reduce onwards transmission.That we need to more is indisputable. The vaccine is not a magic bullet; it is a long-term control measure and should be a complete series of careful and precise examinations. Indonesia will also likely require high coverage of vaccination to achieve herd immunity. At present, if there is no significant improvement in the coverage of preventive measures in the population and disease surveillance system, our hospital will be overwhelmed, and case fatality will be devastating.

Evidence compendium and advice on social distancing and other related measures for response to an influenza pandemic.

The role of social distancing measures in mitigating pandemic influenza is not precisely understood. To this end, we have conducted a systematised review, particularly in light of the 2009 pandemic influenza, to better inform the role of social distancing measures against pandemic influenza. Articles were identified from relevant databases and the data were synthesised to provide evidence on the role of school or work place-based interventions, case-based distancing (self-isolation, quarantine), and restriction of mobility and mass gatherings. School closure, whether proactive or reactive, appears to be moderately effective and acceptable in reducing the transmission of influenza and in delaying the peak of an epidemic but is associated with very high secondary costs. Voluntary home isolation and quarantine are also effective and acceptable measures but there is an increased risk of intra-household transmission from index cases to contacts. Work place-related interventions like work closure and home working are also modestly effective and are acceptable, but likely to be economically disruptive. Internal mobility restriction is effective only if prohibitively high (50% of travel) restrictions are applied and mass gatherings occurring within 10 days before the epidemic peak are likely to increase the risk of transmission of influenza.

Impact of Human Mobility on COVID-19 Transmission According to Mobility Distance, Location, and Demographic Factors in the Greater Bay Area of China: Population-Based Study.

BACKGROUND: Mobility restriction was one of the primary measures used to restrain the spread of COVID-19 globally. Governments implemented and relaxed various mobility restriction measures in the absence of evidence for almost 3 years, which caused severe adverse outcomes in terms of health, society, and economy. OBJECTIVE: This study aimed to quantify the impact of mobility reduction on COVID-19 transmission according to mobility distance, location, and demographic factors in order to identify hotspots of transmission and guide public health policies. METHODS: Large volumes of anonymized aggregated mobile phone position data between January 1 and February 24, 2020, were collected for 9 megacities in the Greater Bay Area, China. A generalized linear model (GLM) was established to test the association between mobility volume (number of trips) and COVID-19 transmission. Subgroup analysis was also performed for sex, age, travel location, and travel distance. Statistical interaction terms were included in a variety of models that express different relations between involved variables. RESULTS: The GLM analysis demonstrated a significant association between the COVID-19 growth rate ratio (GR) and mobility volume. A stratification analysis revealed a higher effect of mobility volume on the COVID-19 GR among people aged 50-59 years (GR decrease of 13.17% per 10% reduction in mobility volume; P<.001) than among other age groups (GR decreases of 7.80%, 10.43%, 7.48%, 8.01%, and 10.43% for those aged ≤18, 19-29, 30-39, 40-49, and ≥60 years, respectively; P=.02 for the interaction). The impact of mobility reduction on COVID-19 transmission was higher for transit stations and shopping areas (instantaneous reproduction number [Rt] decreases of 0.67 and 0.53 per 10% reduction in mobility volume, respectively) than for workplaces, schools, recreation areas, and other locations (Rt decreases of 0.30, 0.37, 0.44, and 0.32, respectively; P=.02 for the interaction). The association between mobility volume reduction and COVID-19 transmission was lower with decreasing mobility distance as there was a significant interaction between mobility volume and mobility distance with regard to Rt (P<.001 for the interaction). Specifically, the percentage decreases in Rt per 10% reduction in mobility volume were 11.97% when mobility distance increased by 10% (Spring Festival), 6.74% when mobility distance remained unchanged, and 1.52% when mobility distance declined by 10%. CONCLUSIONS: The association between mobility reduction and COVID-19 transmission significantly varied according to mobility distance, location, and age. The substantially higher impact of mobility volume on COVID-19 transmission for longer travel distance, certain age groups, and specific travel locations highlights the potential to optimize the effectiveness of mobility restriction strategies. The results from our study demonstrate the power of having a mobility network using mobile phone data for surveillance that can monitor movement at a detailed level to measure the potential impacts of future pandemics.

Impact of mobility restrictions on NO2 concentrations in key Latin American cities during the first wave of the COVID-19 pandemic.

Between March and June 2020, activity in the major cities of Latin America declined due to containment efforts implemented by local governments to avoid the rapid spread of COVID-19. Our study compared 2020 with the previous year and demonstrated a considerable drop in tropospheric NO2 levels obtained by the SENTINEL 5P satellite in major Latin American cities. Lima (47.5%), Santiago (36.1%), São Paulo (27%), Rio de Janeiro (23%), Quito (18.6%), Bogota (17.5%), Buenos Aires (16.6%), Guayaquil (15.3%), Medellin (14.2%), La Paz (9.5%), Belo Horizonte (7.8%), Mexico (7.6%) and Brasilia (5.9%) registered statistically significant decreases in NO2 concentrations during the study period. In addition, we analyzed mobility data from Google and Apple reports as well as meteorological information from atmospheric reanalysis data along with satellite fields between 2011 and 2020, and performed a refined multivariate analysis (non-negative matrix approximation) to show that this decrease was associated with a reduction in population mobility rather than meteorological factors. Our findings corroborate the argument that confinement scenarios may indicate how air pollutant concentrations can be effectively reduced and managed.

Mental health problems among transition-aged youth with physical disabilities: an initial evaluation.

Aim: Decreased participation and complex transitions into adulthood among youth with disabilities may impede their well-being. To advance knowledge on the co-occurrence of mental health problems and physical disability, this brief report describes the frequency of mental health problems, measured by the Behavior Assessment System of Children (BASC-3), among transition-aged youth (14-25 years) with physical disabilities and examines the association between mental health problems and sex, age, and number of functional issues. Methods: Thirty-three participants completed a demographic questionnaire and the BASC-3. Frequency of BASC-3 scales falling within 3 categories: "within norms", "at risk", and "clinically significant" were described. Crosstabs and Chi-square tests were used to examine the association between BASC-3 scales and sex, age (< and ≥ 20), and number of functional issues (< and ≥ 6). Results: Overall, "somatization", "self-esteem", "depression" and "sense of inadequacy" were the most common subscales being at risk. Participants with a higher number of functional issues (≥6) were more likely to fall within "at risk" or "clinically significant" categories across 20 (out of 22) BASC-3 scales, and female participants tended to fall more within "at risk" or "clinically significant" categories for 8 of BASC-3 scales. Younger participants (<20) were ranked in the "at risk" or "clinically significant" categories for 7 scales. Conclusions: Findings lend further support for the occurrence of mental health problems emerging in youth with physical disabilities and highlight initial trends especially across functional levels. Further investigation of such co-occurrences and the factors that affect their development is needed.

Facilitators and barriers of preventive behaviors against COVID-19 during Ramadan: A phenomenology of Indonesian adults.

Introduction: Intercity mobility restriction, physical distancing, and mask-wearing are preventive behaviors to reduce the transmission of COVID-19. However, strong cultural and religious traditions become particular challenges in Indonesia. This study uses the Behavior Change Wheel to explore barriers and facilitators for intercity mobility restriction, physical distancing, and mask-wearing during Ramadan. Methods: Semi-structured in-depth interviews with 50 Indonesian adults were conducted between 10 April and 4 June 2020. Having mapped codes into the Capacity, Opportunity, Motivation - Behavior (COM-B), and Theoretical Domain Framework (TDF) model, we conducted summative content analysis to analyze the most identified factors to preventive behaviors and proposed interventions to address those factors. Results: Belief about the consequence of preventive behaviors was the most mentioned facilitator to all preventive behaviors among compliers. However, optimism as a TDF factor was commonly mentioned as a barrier to preventive behaviors among non-compliers, while environmental context and resources were the most commonly mentioned factors for intercity mobility restriction. Conclusions: Public health intervention should be implemented considering the persuasion and involvement of religious and local leaders. Concerning job and economic context, policy related to the intercity mobility restriction should be reconsidered to prevent a counterproductive effect.

COVID-19 pandemic and minority health disparities in New York City: A spatial and temporal perspective.

New York City (NYC) was the epicenter of COVID-19 pandemic for a long time, and the government introduced a city-wide lockdown policy to mitigate the spread of virus. Minority communities, however, suffered disproportionally high percentage of infection and mortality rates, a disturbing phenomenon that deserves scrutiny. Adopting a spatial and temporal perspective, this study aims to investigate health disparities in this pandemic by focusing on mobility in the city. Considering both public transit and the lockdown policy essential factors that impact infection and mortality, this study introduced a measure indicating mobility-restricted transit as the spatial factor. Additional factors include ethnic minorities based on their nativity and three categories of social vulnerability: socioeconomic status, household composition, and housing type. This study selects eight phases, each of which consists of 2 weeks to derive infection and mortality rates to investigate the impacts of those factors. As infection and mortality data are published based on ZIP code, this study further estimates the infection and mortality rates at a finer level of census tract through spatial apportionment. Results reveal the significant impact of mobility-restricted transit on both infection and mortality and show certain clusters of neighborhoods being highly impacted. In addition, this study identifies neighborhoods where native-born and foreign-born of each ethnic minority (Blacks, Hispanics, and Asians) have high risk of infection and mortality. Through a spatial and temporal perspectives, this study identifies the complexity of patterns in minority health disparities in COVID-19 pandemic, which can inform policy makers for localized support to vulnerable neighborhoods to alleviate minority health disparities.

Measuring human mobility in times of trouble: an investigation of the mobility of European populations during COVID-19 using big data.

Spatial mobility is a distinctive feature of human history and has important repercussions in many aspects of societies. Spatial mobility has always been a subject of interest in many disciplines, even if only mobility observable from traditional sources, namely migration (internal and international) and more recently commuting, is generally studied. However, it is the other forms of mobility, that is, the temporary forms of mobility, that most interest today's societies and, thanks to new data sources, can now be observed and measured. This contribution provides an empirical and data-driven reflection on human mobility during the COVID pandemic crisis. The paper has two main aims: (a) to develop a new index for measuring the attrition in mobility due to the restrictions adopted by governments in order to contain the spread of COVID-19. The robustness of the proposed index is checked by comparing it with the Oxford Stringency Index. The second goal is (b) to test if and how digital footprints (Google data in our case) can be used to measure human mobility. The study considers Italy and all the other European countries. The results show, on the one hand, that the Mobility Restriction Index (MRI) works quite well and, on the other, the sensitivity, in the short term, of human mobility to exogenous shocks and intervention policies; however, the results also show an inner tendency, in the middle term, to return to previous behaviours.

Mobility restriction and barrier-reduced housing among people aged 65 or older in Germany: Do those who need it live in barrier-reduced residences?

Introduction: Older people spend a lot of time at home and in the area near where they live. Housing conditions ensure their ability to participate in social life, especially when they suffer from mobility restrictions. Barrier-free access to the residence and to rooms within the residence is a key condition for their everyday mobility. As a result, this is what we define as minimal criteria for barrier-reduced residences. This article examines the extent to which people aged 65 and over (including people with mobility issues) live in barrier-reduced housing and what factors influence the chance of living in such residences. Data and method: Cross-sectional data from the German Ageing Survey (DEAS) 2020/21 (persons aged 65 and over, n = 2,854) were used. The DEAS is a representative cross-sectional and longitudinal survey of the population aged 40 and over in Germany. In our analyses, we used logistic regression models to investigate the probability of living in a barrier-reduced residence. We defined housing as barrier-reduced when the apartment/house and the rooms inside it can be reached without steps or stairs. As explanatory variable, we considered mobility restrictions, defined as limited ability to climb a flight of stairs. In addition, the model includes other individual factors (age, gender, equivalized household income), regional factors (living in East vs. West Germany, in urban vs. rural region) and moving to the current residence after the age of 65. Results and discussion: Of all individuals aged 65 or older, 19.3 percent live in a barrier-reduced residence. Also, of mobility-restricted elders, only 21.4 percent have such residences. The logistic regression results show that mobility restrictions are associated with a higher probability of living in a barrier-reduced residence. Compared to the lowest income group, older people in the highest income group are more likely to live in barrier-reduced housing. East Germans and people in urban areas are less likely to live in a barrier-reduced home. The likelihood of barrier-reduced living is higher among seniors who moved into their current residence after age 65. No significant differences were found for age groups and gender. The findings show that not enough seniors have barrier-reduced access to their homes and rooms, even if they suffer from mobility restrictions. Preventing functional restrictions must therefore also include improvements in the residential environment, especially in disadvantaged residential areas.

Musladin-Lueke Syndrome in a Dog: Case Report.

The aim of this study is to report the case of a 4-month-old Beagle dog diagnosed with Musladin-Lueke syndrome. The dog appeared to walk on the digits ("tiptoes") with all limbs during ambulation and rigid extension of the carpus, elbow, tarsus, and knee joints during ambulation. Thickening of the fur and auricular cartilage, reduction in radiocarpal, and tibiotarsal joint amplitude, macrocephaly, and lateralized eyes were noticed on physical examination. Echocardiography showed reduced mobility and altered (tortuous) valve morphology. Bilateral abdominal cryptorchidism was confirmed by ultrasonography. Musladin-Lueke syndrome was the presumptive diagnosis, based on the clinical signs presented. The diagnosis was confirmed after DNA testing performed by serial collection of saliva. This is the first paper that describes unprecedented cardiac and reproductive changes of Musladin-Lueke syndrome in which the dog was followed for 2 years, presenting a good quality of life.

App-Based Evaluation of Older People's Fall Risk Using the mHealth App Lindera Mobility Analysis: Exploratory Study.

BACKGROUND: Falls and the risk of falling in older people pose a high risk for losing independence. As the risk of falling progresses over time, it is often not adequately diagnosed due to the long intervals between contacts with health care professionals. This leads to the risk of falling being not properly detected until the first fall. App-based software able to screen fall risks of older adults and to monitor the progress and presence of fall risk factors could detect a developing fall risk at an early stage prior to the first fall. As smartphones become more common in the elderly population, this approach is easily available and feasible. OBJECTIVE: The aim of the study is to evaluate the app Lindera Mobility Analysis (LIN). The reference standards determined the risk of falling and validated functional assessments of mobility. METHODS: The LIN app was utilized in home- and community-dwelling older adults aged 65 years or more. The Berg Balance Scale (BBS), the Tinetti Test (TIN), and the Timed Up & Go Test (TUG) were used as reference standards. In addition to descriptive statistics, data correlation and the comparison of the mean difference of analog measures (reference standards) and digital measures were tested. Spearman rank correlation analysis was performed and Bland-Altman (B-A) plots drawn. RESULTS: Data of 42 participants could be obtained (n=25, 59.5%, women). There was a significant correlation between the LIN app and the BBS (r=-0.587, P<.001), TUG (r=0.474, P=.002), and TIN (r=-0.464, P=.002). B-A plots showed only few data points outside the predefined limits of agreement (LOA) when combining functional tests and results of LIN. CONCLUSIONS: The digital app LIN has the potential to detect the risk of falling in older people. Further steps in establishing the validity of the LIN app should include its clinical applicability. TRIAL REGISTRATION: German Clinical Trials Register DRKS00025352; https://tinyurl.com/65awrd6a.

Half-hearted policies on mobility restrictions during COVID-19 in Indonesia: A portrait of large informal economy country.

This study measures the effectiveness of government's transportation policy on mobility restriction during the COVID-19 pandemic using publicly available big datasets. Using a causal difference-in-difference (DiD) analysis and regression discontinuity design (RDD), we examine the impact of non-pharmaceutical interventions (NPIs) on the aggregate population mobility of cities and regencies across Indonesia. Our results show that during the period of the first so-called "Large-scale Social Restrictions" or "Pembatasan Sosial Berskala Besar" (PSBB I) from April to May 2020, NPIs reduced mobility by 5.4% relative to pre-pandemic baseline and accounted for a small portion of mobility decline in cities or regencies that instituted mobility restrictions. The impact of the second PSBB policy (PSBB II) from September to November 2020 was smaller, with a mobility reduction of only 1.8%-2.9%, depending on the window of observation and sample. Lastly, the "Imposition of Restriction on Social Activity" or Pemberlakuan Pembatasan Kegiatan Masyarakat (PPKM) policy beginning in January 2021 has had a more negligible impact, with mobility reduction of approximately 0.6-2.1%. These findings indicate that the effectiveness of mobility restrictions tend to decrease over time. The decline in effectiveness may be the result of the increased cost of social distancing over long periods of time and the declining stringency of the mobility restrictions being imposed, which may be particularly pronounced for emerging countries with a large informal sector, such as Indonesia.

The Effect of Governmental Health Measures on Public Behaviour During the COVID-19 Pandemic Outbreak.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic resulted in radical changes in many aspects of life. To deal with this, each country has implemented continuous health measures from the beginning of the outbreak. Discovering how governmental actions impacted public behaviour during the outbreak stage is the purpose of this study. METHODS: This study uses a hybrid large-scale data visualisation method to analyse public behaviour (epidemic concerns, self-protection, and mobility trends), using the data provided by multiple authorities. Meanwhile, a content analysis method is used to qualitatively code the health measures of three countries with severe early epidemic outbreaks from different continents, namely China, Italy, and the United States. Eight dimensions are coded to rate the mobility restrictions implemented in the above countries. RESULTS: (1) Governmental measures did not immediately persuade the public to change their behaviours during the COVID-19 epidemic. Instead, the public behaviour proceeded in a three-phase rule, which is typically witnessed in an epidemic outbreak, namely the wait-and-see phase, the surge phase and the slow-release phase. (2) The strictness of the mobility restrictions of the three countries can be ranked as follows: Hubei Province in China (with an average score of 8.5 out of 10), Lombardy in Italy (7.125), and New York State in the United States (5.375). Strict mobility restrictions are more likely to cause a surge of population outflow from the epidemic area in the short term, whereas the effect of mobility restrictions is positively related to the stringency of policies in the long term. CONCLUSION: The public showed generally lawful behaviour during regional epidemic outbreaks and blockades. Meanwhile public behaviour was deeply affected by the actions of local governments, rather than the global pandemic situation. The contextual differences between the various countries are important factors that influence the effects of the different governments' health measures.

Lifespace metrics of older adults with mild cognitive impairment and dementia recorded via geolocation data.

OBJECTIVE: Lifespace, the physical area in which someone conducts life activities, indicates lived community mobility. This study explored the feasibility of technology-based lifespace measurement for older people with dementia and mild cognitive impairment (MCI), including the generation of a range of lifespace metrics, and investigation of relationships with health and mobility status. METHODS: An exploratory study was conducted within a longitudinal observational study. Eighteen older adults (mean age 86.7 years (SD: 3.2); 8 men; 15 MCI), participated. Lifespace metrics were generated from geolocation data (GPS and Bluetooth beacon) collected through a smartphone application for one week (2015-2016). Cognitive and mobility-related outcomes were compared from study data sets at baseline (2005-2007) and 6-year follow-up (2011-2014). RESULTS: Lifespace data could be collected from all participants, and metrics were generated including percentage of time at home, maximum distance from home, episodes of travel in a week, days in a week participants left home, lifespace area (daily, weekly and total), indoor lifespace (regions in the home/hour), and a developed lifespace score that combined time, frequency of travel, distance and area. Results indicated a large range of lifespace areas (0.1 - 97.88 km2 ; median 6.77 km2 ) with similar patterns across lifespace metrics. Significant relationships were found between lifespace metrics and concurrent driving status and anteceding scores on the sit-to-stand test (at baseline and follow-up). CONCLUSIONS: Further longitudinal exploration of lifespace is required to develop an understanding of the nature of lifespace of older community-dwelling people, and its relationship with health, mobility and well-being outcomes.

Does the COVID-19 lockdown improve global air quality? New cross-national evidence on its unintended consequences.

Despite a growing literature on the impacts of the COVID-19 pandemic, scant evidence currently exists on its impacts on air quality. We offer an early assessment with cross-national evidence on the causal impacts of COVID-19 on air pollution. We assemble a rich database consisting of daily, sub-national level data of air quality for 164 countries before and after the COVID-19 lockdowns and we analyze it using a Regression Discontinuity Design approach. We find the global concentration of NO2 and PM2.5 to decrease by 5 percent and 4 percent, respectively, using data-driven optimal bandwidth selection. These results are consistent across measures of air quality and data sources and robust to various model specifications and placebo tests. We also find that mobility restrictions following the lockdowns are a possible explanation for improved air quality.

COVID-19 lockdown measures and travel behavior: The case of Thessaloniki, Greece.

In this paper, we investigate the travel behavior changes in Thessaloniki, Greece aiming to understand them and explore the factors that affect them under the COVID-19 mobility restriction measures. Socioeconomic and mobility data from two questionnaire surveys, one year before and during the COVID-19 lockdown of April 2020 (with 1462 and 196 responses respectively), were compared by utilizing a wide variety of inductive statistical tests. Ordinary Least-Squares regression models and Cox proportional hazards duration models were employed to explore any concurrent socioeconomic effect on travel behavior patterns. Results showed that the number of daily trips per person was on average decreased by 50% during the lockdown. This decrease was much greater for the non-commuting trips. Trips on foot were increased, private car was mainly used for commuting and public transport modal shares were heavily reduced. Trip durations were generally increased, as travelling was considered a recreational activity per se. The starting times of the first trips of the day were more evenly distributed throughout the day and many travelers only started their first trips late in the afternoon. Older travelers generally maintained their mobility behavior patterns despite their higher vulnerability to COVID-19 disease. Lower-income travelers were likely to make more daily trips. Male travelers tended to make higher-duration trips compared to their female counterparts. Since pandemics may become recurring events in the future, our findings provide for a better understanding of their influence on mobility and support the design of customized policies to fulfill sustainable mobility objectives during lockdown circumstances.