Rapid exchange of a percutaneous gastrostomy tube during an early episode of COVID-19

We retrospectively report a case of rapid exchange of a percutaneous radiologic gastrostomy tube (balloon-occluded type catheter) via off-label use of a pigtail catheter for nutrition supply during a very early episode of coronavirus disease 2019 (COVID-19) in an outpatient clinic. This case demonstrates that minimally invasive percutaneous procedures might be provided safely and effectively under appropriate precautions for preventing COVID-19 transmission during the pandemic.Copyright © 2023, Society of Gastrointestinal Intervention.

Psychopharmacological assessment of antidepressant-like, anxiolytic, and sedative-hypnotic effects of tilia platyphyllos scop. Extract using experimental animal models

The prevalence of psychiatric disorders namely depression, anxiety, and sleep disturbances has been increased worldwide, particularly during the COVID-19 pandemic. In this regard, the interest of recent investigations is moved toward phytomedicines and bioactive substances derived from natural sources. Although Tilia platyphyllos Scop. contains high amounts of phenolic compounds such as quercetin, kaempferol, and catechin, there is no study on the possible effects of its extract on psychological disorders. The present study was carried out to determine the antidepressant-like, anxiolytic, and sedative-hypnotic effects of the hydroethanolic extract of T. platyphyllos leaves using forced swimming test (FST), tail suspension test (TST), elevated plus maze test (EPMT), pentobarbital-induced loss of righting reflex test and open field test (OFT). Following the ethanolic extraction of T. platyphyllos leaves, the extraction yield was 14% and the total phenolic and total flavonoid contents were found to be 135.23 +/- 0.14 mg gallic acid equivalent/g dry extract and 19.02 +/- 0.03 mg rutin equivalent/g dry extract, respectively. Both FTS and TST revealed a significant antidepressant-like activity for the tested extract at 400 mg/kg compared to the control group. In addition, the anxiolytic activity of the extract was proven through OFT and EPMT in the same dose. Finally, T. platyphyllos extract at 200 mg/kg and 400 mg/kg significantly increased the sleeping time when compared to the control group reflecting its potential hypnotic activity. Co-administration of T. platyphyllos extract at 400 mg/kg and flumazenil as the GABA-A receptor antagonist decreased the sleeping time but the observed effect was not statistically significant. Therefore, we cannot completely rule out the GABA-A receptor's involvement in the hypnotic activity of the extract. The biological results presented here led us to conclude that T. platyphyllos extract can be a prominent source of antidepressant, anxiolytic and hypnotic agents. Probably, the main phenolic compounds of T. platyphyllos such as quercetin, kaempferol, and catechin are involved in the observed effects. However, there is still a great need for additional investigations on the exact mechanisms.Copyright © 2022, Iranian Association of Pharmaceutical Scientists. All rights reserved.

"I froze for fear of contaminating myself": treating a case of chronic PTSD with tonic immobility in a physiotherapist frontline during COVID-19 pandemic / "Congelei com medo de me contaminar": tratando um caso de TEPT crônico com imobilidade tônica em uma fisioterapeuta da linha de frente na pandemia de COVID-19

RESUMO Objetivo: Neste estudo relatamos o caso de uma profissional de saúde com vivência de imobilidade tônica (IT) e posterior desenvolvimento de transtorno de estresse pós-traumático (TEPT) crônico em decorrência de trauma laboral por conta da COVID-19 que recebeu tratamento remoto com terapia cognitivo-comportamental focada no trauma (TCC-FT). Métodos: Relato de caso de uma paciente acompanhada por seis meses após o recebimento de TCC-FT remota. Resultados: Paciente do sexo feminino, de 36 anos, fisioterapeuta, que desenvolveu TEPT crônico e experienciou IT por medo da contaminação por coronavírus. As escalas psicométricas demonstraram que a TCC-FT reduziu consideravelmente os sintomas de TEPT e depressão e aumentou o apoio social e a resiliência. De acordo com o relato, o tratamento melhorou a concentração e a motivação, e reduziu o sentimento de culpa, a irritabilidade, a insegurança e o desconforto em lidar com outras pessoas. Conclusão: Este artigo demonstra que traumas decorrentes da COVID-19 podem ser capazes de desencadear IT e exemplifica um favorável desempenho da TCC-FT na melhoria global da saúde mental dos pacientes com TEPT crônico com vivência de IT.

ABSTRACT Objective: In this study, we report the case of a health professional with experience of tonic immobility (TI) and subsequent development of post-traumatic stress disorder (PTSD) as a result of occupational trauma due to COVID-19 who received remote treatment with Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Methods: A case report of a patient followed for six months after receiving remote TF-CBT. Results: A 36-year-old female patient, the physiotherapist who developed chronic PTSD and experienced TI for fear of coronavirus contamination. Psychometric scales demonstrated that TF-CBT considerably reduced PTSD and depression symptoms and increased social support and resilience. According to the report, the treatment improved concentration and motivation, and reduced feelings of guilt, irritability, insecurity, and discomfort in dealing with other people. Conclusion: This article demonstrates that trauma resulting from COVID-19 can trigger TI and exemplifies a favorable performance of TF-CBT in the global improvement of the mental health of patients with chronic PTSD who experience TI.

Unique times, unequal mobilities: Daily mobility during the de-escalation of the COVID-19 pandemic

Scholars have highlighted drastic reductions in daily mobility during the early stages of the COVID-19 pandemic lockdown. But what happened when restrictions were relaxed though risk remained ubiquitous? How did patterns of mobility change and how were they structured by socioeconomic resources and social roles? We address these questions using a cross-sectional representative sample (n = 2942) of the population of Andalusia, Spain, after a month and a half of severe lockdown in 2020. We find that older people were the least mobile group and that people living with children and in extended households were less likely to move to take care of others, unlike before the pandemic. Men were more likely to carry out daily mobilities for which women had been traditionally responsible, such as care mobilities. Women were also more likely to be immobile and less likely to commute. Finally, manual and nonqualified workers were more likely to commute, but they were just as likely as any other group to carry out other types of mobility. These results highlight the social character of mobility in a unique context. We emphasize the need to disaggregate daily mobility based on different purposes as well analysing how these are practised by different sociodemographic groups if we want to provide rigorous descriptions of a core component of individuals' daily life.

Migration aspirations and polymorphic identifications of the homeland: (im)mobility trajectories amongst Chinese international students amidst COVID-19

Drawing on longitudinal research with 33 Chinese international students in 10 European countries, this article examines their polymorphic identifications towards homeland and asks how these changing perceptions constitute the underlying logic of their particular migration aspirations during the COVID-19. Specifically, the article explores how homeland identifications function as a driving force to facilitate ‘voluntary immobility' in the study destination while being used as a tackling strategy to adapt to their ‘involuntary immobility' overseas. It also examines how these identifications articulate with the students' mixing and shifting migration aspirations formulated during the pandemic. In doing so, the article demonstrates that polymorphic perceptions closely relate to the generation, exercise and reproduction of their migration aspirations that are temporally distributed.

Cholelithiasis Causing Asymptomatic Cholecystoenteric Fistula

Introduction: Biliary fistulas are a rare complication of gallstones. Fistula formation can occur in a number of adjacent sites;even more rare complication is the formation of a cholecystocolonic fistula. Case Description/Methods: A 74-year-old man who had recently undergone an extensive hospitalization secondary to inflammatory demyelinating polyneuropathy (IDP) and COVID-19 infection. During his hospitalization, he required ICU admission and mechanical ventilation with subsequent PEG tube placement. He was discharged to an inpatient rehabilitation facility when he developed worsening respiratory distress. Laboratory examinations were pertinent for ALT of 252, AST of 140 and ALP of 401 without hyperbilirubinemia. Blood cultures revealed Escherichia coli bacteremia. Given transaminitis and bacteremia, an MRCP was performed which demonstrated evidence absent space between gallbladder and hepatic flexure of the colon suggesting a CCF (Figure A). An ERCP with sphincterotomy was performed which showed extravasation of contrast from the gallbladder into the colon at the hepatic flexure (Figure B). He underwent cholecystectomy and fistula repair without any complications and gradual improvement in liver function test. He was discharged to a rehabilitation facility. Discussion(s): Complications of gallstones are well established, which include the common bile duct obstruction, but also include the rare occurrences of acute cholangitis, malignancy, and fistula formation. CCF is a rare complication of gallstones which can occur in the stomach, duodenum, or colon with a variable clinical presentation. Complications from an undiagnosed fistula can be life threatening including colon perforation and fecal peritonitis. This case highlights the diagnostic challenge and the high degree of clinical suspicion involved in establishing the diagnosis of CCF in patient without abdominal symptoms suggestive of gallbladder disease. We hypothesize that stone formation resulting in the development of the fistula may be secondary to the underlying history of IDP and subsequent immobility. Although rare, CCF should be considered in patients presenting with unexplained pneumobilia and bacteremia. A timely diagnosis should be made to proceed with immediate treatment including cholecystectomy and fistula closure to prevent fatal complications.

Immobility: The Relational and Experiential Qualities of an Ambiguous Concept

In this article, I discuss immobility as both an analytical concept and a lived experience. I review contemporary scholarly understandings of immobility and disentangle the unavoidable relational dynamics with its positive linguistic opposite, mobility. Concrete illustrations from migration studies and the global coronavirus crisis illustrate how immobility, at various scales of analysis and experience, is not only theoretically but also socially, economically, and politically relevant. Together with the in-depth review of existing scholarship, these examples confirm that the conceptual distinction made between immobility and mobility is often purely heuristic. In the messiness of people's lives, mobility and immobility are not mutually exclusive categories but, rather, two dynamic sides of the same coin.

Guillian-Barre Syndrome Post Covid-19 Vaccination

Case Report: This is a 50-year-old man that presented to the ED complaining of generalized weakness and acute loss of ability to ambulate which has been progressing for a month. Patient began having left arm and leg weakness, which started in his fingertips of his left upper extremity and soon moved proximally to upper left arm. Symptoms then progressed to right upper and lower arms. Symptoms further continued to progress making the patient bedridden. On presentation, CT head showed a C1/C2 subluxation possibly chronic without significant focal soft tissue swelling. CT cervical spine showed C1-C2 subluxation, possibly chronic. MRI of brain was unremarkable pre and postcontrast without focal findings or abnormal enhancement and showed redemonstration of the C1-C2 subluxation as described on CT scan. MRI of cervical spine showed at the level of C1 there is spinal canal stenosis. However, there is no direct pressure upon the cord/medulla. Upon evaluation, patient had significant motor weakness and required maximal assistance for movement. Patient was moreover noted to have flaccidity of muscles associated with weakness with no bulbar weakness. Patient had no difficulty in breathing or with speech. A lumbar tap was performed which showed elevated protein, WBC, and glucose. Upon further investigation, patient stated that he received his (3rd dose) of the Moderna Vaccine for Covid-19 about a month before the onset of symptoms and felt fine. Two weeks later, he began experiencing subjective fevers, diarrhea, abdominal pain, and fatigue that lasted for a week and then self-resolved. Approximately another two weeks later is when patient began noticing his neurological symptoms. Possible Guillain-Barre Syndrome post Campylobacter Jejuni (C. Jejuni) infection vs. post Covid-19 vaccine induced GBS was suspected at this point and patient was started on Intravenous Immunoglobulin (IVIG). Stool cultures were collected for C.Jejuni which came back negative. Gastrointestinal Pathogen Panel PCR Feces also came back negative. Patient was discharged to a rehab center and planned to receive another round of IVIG for 5 days. Conclusion(s): Guillain Barre Syndrome (GBS) is a rare immune-mediated neurological disorder affecting peripheral nerves and nerve roots, that presents as acute sensorimotor neuropathy starting with distal paresthesia that progresses to weakness of legs and arms, noteably, flaccid paralysis. GBS has several triggers namely infections such as C. jejuni, cytomegalovirus, M. pneumoniae, Epstien-Barr virus and Zika virus. There has also been several case reports and studies that have shown increased incidence of GBS vaccines such as influenza vaccine. Furthermore, there has been several studies that have linked GBS to COVID-19 vaccine. With COVID-19 cases continuing to persist, and increasing advocacy for vaccination against the disease, GBS should be considered as very rare but possible side effect of the vaccine.

Nearly mobile: pandemic im/mobilities and lockdown strategies amongst Asian migrant professionals in England

This article proposes ‘nearly mobile' as a productive concept to illustrate the im/mobility experiences amongst Asian skilled migrants in England during a global health crisis. The concept of ‘nearly mobile' describes how mobility practices and aspirations have been heavily restricted during national lockdowns, while still remaining fluid and relational, with both debilitating and empowering potentials. The ambiguity of ‘nearly' offers both frustration and hope, when the desired ‘mobility as normal' seems just out of reach. The concept of 'nearly mobile' offers two main dimensions. First, it highlights how migrants navigate through ‘shock precarities' by safe-zoning–utilising and spatialising voluntary immobility to create unique work and living spaces based on daily assessments of risk and responsibility. Second, ‘nearly mobile' reflects a continuous yearning for a return to normality, where forecasting and imagining become practical ways of seizing opportunities that emerge amidst crisis and uncertainty. We propose 'nearly mobile' as a productive framework for revaluing im/mobility in times of rising localism, protectionism, and the normalisation of transnational biopolitical regimes, which underpin a possible ‘new normal' beyond the pandemic. © 2023 Informa UK Limited, trading as Taylor & Francis Group.

Management of Metastatic CA (Cancer) Pancreas Pain in Post Chemotherapy, Radiotherapy Patient With Combination of Neural Interventions (Oral Neuromodulators, Peripheral Nerve Blocks) and Muscular Intervention USGDN (Ultrasonography Guided Dry Needling): A Case Report

Aims: To describe combined neural and muscular interventions in post covid exacerbations of cancer pain with disabilities.To present a new perspective of neuromyopathy to explain Intractable CA pancreas pain. Introduction: Additional challenges in cancer pain management are due to cancer treatment complications (chemotherapy, radiotherapy). CA Pancreas pains routinely addressed with oral neuromodulators, opioids neurolytic coeliac plexus block (NCPB) or splanchnic nerve radiofrequency ablation (SRF). 75 years male, CA pancreas with spine, pelvic bone metastasis, post chemotherapy radiotherapy. 6 months bedridden with post covid exacerbations in pain (vas 10/10) received prior painkillers. Started oral pregabalin 75mg od, ultracet bd, myospaz bd. Result(s): With 15 days medications vas 6/10, patient could sit on wheelchair. Given sciatico-femoral block, pain reduced vas 2/10 but recurred in 7 day vas 5/10. Started USGDN of tight back and lower limb muscles with 32G solid needles.post3 sessions vas 2/10, able to walk with support after 4 weeks. Discussion(s): Viscerosomatic convergence at the dorsal horn neurons produces visceral pain referred to back and abdominal muscles led to muscle spasm with generation of myofascial trigger points(MTrPs)and pain. USGDN addresses MTrPs. Needle insertion produces local twitch reflex (LTR) followed by muscle relaxation with pain relief. Neural interventions addresses only visceral nociceptive afferents from celiac plexus which forms 10% of total spinal cord afferent input which sensitizes peripheral and central motor nociceptive pathway processing neuromyopathy. Conclusion(s): Viscerosomatic convergence with muscles involvement (neuromyopathy) proved to be effectively managed by using combined approaches, neuromoduation and USGDN in Ca pancreas pain with disabilities.Copyright © 2023

Countering stuckness: international doctoral students' experiences of disrupted mobility amidst COVID-19

The paper, through the lens of positioning and agency theories, examines the experiences of being stranded in the home country due to the restricted mobility caused by the COVID-19 pandemic of 10 international doctoral students of different nationalities (Chinese, Vietnamese, Malaysian, and Indian), majoring in different disciplines (Education, Linguistics, Applied linguistics, Economics, Public health, and Civil engineering), and studying in different countries (New Zealand, Australia, and the United States). With an aim to explore the abrupt immobility and its subsequent impacts on the students' learning, the article highlights the challenges that the students had to tackle including the feelings of being in limbo, nostalgia, and detachment, and faced with academic challenges due to the physical distance from the study destination. Accordingly, they had to self-position and reposition themselves and enact different forms of agency to confront the difficulties, including agency for becoming, needs-response agency, and agency as struggle and resistance. The findings highlight how the international PhD students mobilized resources to develop their independence as future researchers, as well as their connection with the academic communities in their home countries in various ways. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Greek doctors during the COVID-19 pandemic: Transnational migration or stasis?

In this article, we investigated how the pandemic actually influenced decisions of migration/mobility of highly skilled EU migrants. We took a closer look at physicians in Greece and Germany, because they can be seen as a very mobile migrant group, which is highly demanded by the labour market of the health industry as doctors in hospitals, clinics or universities in both countries and beyond. Based on the opposed theoretical concepts of ‘transnational mobility or migration' and ‘stasis,' we conducted in-depth interviews with selected Greek doctors before and during the COVID-19 pandemic. The results of this study indicate that the pandemic has mainly had little impact on the migration/mobility of interviewed Greek doctors. Rather, economic demand on the health market seems to be more important than the impact of the pandemic on mobility, long-term migration or stasis. © 2022 Intellect Ltd Article. English language.

Poor nutritional status and dynapenia are highly prevalent in post-acute COVID-19

Malnutrition estimates range between 5 and 69% in acute Coronavirus disease 2019 (COVID-19) patients. With respect to body composition (BC) and muscle function, low values of phase angle (PhA) and handgrip strength (HGS) have been related to poor disease outcomes. Little evidence is available in post-acute patients. We aimed to combine the evaluation of nutritional status, BC, and muscle strength in a real-life cross-sectional cohort of post-acute COVID-19 patients referred to a rehabilitation center after hospital discharge. The study population included 144 patients (M=95;mean age 64.8yrs), of which 37% bedridden (M=60%). Nutritional status was evaluated with the Mini-Nutritional Assessment (MNA) and Controlling Nutritional status (CONUT) scores. Fat-free mass (FFM), skeletal muscle (SM), and raw variables, i.e. PhA, were estimated with bioelectrical impedance analysis. HGS was measured with a digital handle dynamometer for both dominant and non-dominant body sides. Dynapenia was identified according to the 2019 EWGSOP criteria. According to MNA, 18% of patients were malnourished and 62% at risk of malnutrition. As for CONUT, 21% of patients had moderate-severe malnutrition, while 58%light malnutrition. Overall, malnutrition was highly prevalent in older patients with more comorbidities. Marked abnormalities of PhAand HGSwere more frequent in bedridden or malnourished patients, and when FFM or SM were low. Dynapenic patients were 65% males and 47% females. Malnutrition, BC alterations, and low HGS occur in post-acute COVID-19 patients. Future studies will help to tailor screening algorithms for full nutritional status assessment to appropriate care processes and rehabilitation strategies.

Redefining immobility with mediated mobilities: Reflections from South Korean quarantine vlogs

This article challenges the notion that mediated mobilities are mere substitutes to physical mobilities. It proposes that practising mediated mobilities, especially in the form of vlogging, is a generative process by which individuals can redefine their experience of immobility during quarantine. To support this argument, the article analyses quarantine vlogs uploaded by individuals who were quarantined in South Korean quarantine facilities in 2020. The vlogs reveal that individuals turn to mediated mobilities as an adaptive strategy, but also shows that the practice of vlogging itself emerges as a means to redefine quarantine in vloggers' own terms. Ultimately, the article demonstrates how some vloggers turn the quarantine experience as a resource to be mobilized and how the practice of vlogging itself becomes a strategy to capitalize on the immobility. © The Author(s) 2023.

Transjugular Approach for Recurrent Intracranial Glomus Vagale Tumors: An Ideal Approach to Preserve Hearing and Facial Nerve Function

Lateral skull base paragangliomas (glomus tumors) are rare skull base tumors arising from neuroendocrine cells. These benign tumors can be locally aggressive with potential for intracranial extension and significant morbidity as they compromise cranial nerve structures. Treatment is highly patient dependent. Herein, we present a case of recurrent glomus vagale paraganglioma requiring a multidisciplinary transjugular and transcervical approach for complete resection. A 64-year-old male was referred to the neurotology clinic in 2019 for a left skull base tumor causing progressive dysphonia and dysphagia. Exam revealed left true vocal fold weakness and no other abnormalities. Hearing was normal on the left. Magnetic resonance imaging (MRI) revealed a large hyperintense lesion of the left jugular foramen with intracranial cerebellopontine angle extension and normal flow through the sigmoid sinus and jugular vein. The patient elected for surgical removal and near-total resection was achieved via retrosigmoid craniotomy. A small portion was intentionally left in the jugular foramen to preserve the intact eleventh cranial nerve, internal jugular vein, and sigmoid sinus. Surgical pathology confirmed glomus paraganglioma. Postoperative radiation was strongly recommended, but the patient was lost to follow-up due to the COVID-19 pandemic. The patient re-presented in late 2021 with worsened dysphonia and dysphagia. Exam confirmed left true vocal fold immobility consistent with vagal nerve paralysis and a new finding of left tongue weakness consistent with hypoglossal nerve injury. MRI revealed recurrence of the lesion to dimensions larger than original presentation and complete occlusion of the sigmoid-jugular system. Hearing and facial nerve function remained fully intact, thus a transjugular approach with hearing preservation and complete surgical resection was utilized. After combined retrosigmoid and transcervical incision, the transjugular approach was utilized to resect the sigmoid sinus, the tumor of the jugular foramen, and the intracranial extension. The ear canal and facial nerve canal were preserved. The sigmoid sinus was ligated with surgical clips and the jugular vein was ligated with suture thread. Intracranially, the hypoglossal nerve was identified and preserved, and the vagus nerve was seen eroded by tumor. Pathology confirmed recurrent paraganglioma. Postoperatively, the patient recovered well but continues to endorse persistent dysphonia. His treatment plan includes radiation and thyroplasty. Multiple surgical approaches for the treatment of skull base paragangliomas have been reported including infratemporal types A to D, among others. This report identifies a rare case of recurrent paraganglioma which necessitated removal via transjugular approach. While uncommon in skull base surgery, this approach allowed identification and preservation of important neck and skull base structures (e.g., facial nerve, ear canal, spinal accessory nerve) while achieving complete gross resection. Radiation techniques have become popular alternatives for treatment of glomus tumors of the skull base due to high levels of surgery-related adverse events. Thus, skull base surgeons should be aware of the utility of the transjugular surgical technique for patients with intact hearing and facial nerve function who seek removal of intracranial jugular foramen tumors.

Mobility in times of immobility: international students in portugal during the COVID-19 pandemic

The aim of this article is to understand the impact of the coronavirus (COVID-19) crisis on teaching and learning by international students in Portuguese higher education. It also focuses on how new student mobility projects have been re-designed and re-negotiated during the pandemic. The methodology includes analysing the results of an online survey and individual online interviews. The former was answered by 703 international students enrolled at higher education institutions in Portugal;the latter was conducted with 22 of those students, as well as with students planning to study in Portugal. While for some students, the pandemic represented the possibility of enjoying "mobility” while being "immobile” (in their countries of origin or even in Portugal, provided they have a computer and an internet connection);for others, it enhanced social and economic inequalities, making this sort of mobility difficult, and often impossible. © 2022 Associação Nacional de Pós-Graduação e Pesquisa em Educação – ANPEd

Physical immobility and virtual mobility: Mediating everyday life from a Karen refugee camp in Thailand

This article reflects on how offline and online everyday life coexists for encamped, young Karen living in protracted displacement. As part of the special issue ‘Cultures of (im)mobile entanglements', edited by Earvin Cabalquinto and Koen Leurs, I centre the voices of young Karen living in Mae La refugee camp in Thailand and unpack how personal and social relationships are built and maintained physically in the camp, as well as in digitally mediated spaces. I focus on the tensions of (im)mobility and how life and presence were mediated before and during the Covid-19 pandemic. I emphasise the influence of culture, society, and infrastructure on my participants' living trajectories and find how social media expands their lived reality far beyond the confinement of the camp. © The Author(s) 2023.

Constrained to be (im)mobile? Refugees' and Asylum seekers' practices to integrate in restrictive socio-economic urban contexts in Northern Italy.

This article comparatively examines forms of (im)mobility among refugees and asylum seekers (RAS) in coping with dispersal process, restrictive migration policies and local socio-economic characteristics in three cities of Northern Italy. Drawing on qualitative data, it sheds light on the everyday forms of (im)mobility of RAS to resist structural barriers limiting their opportunities to access jobs and welfare services. The Results show that people's capacity to overcome barriers depends upon individual characteristics and informal networks, and is shaped by particularities of local contexts. While people's regular legal status is considered an important resource in achieving goals, refugees and holders of international protection often have to adopt (im)mobility practices to access resources in contexts that do not facilitate their integration. This article highlights the inefficiency of integration and reception policies and advances the theoretical debate on the link between being (im)mobile and agency by calling authors to pay more attention to the (in)voluntary nature of spatial (im)mobility. Finally, it shows the ambivalent outcome of (im)mobilities in terms of agency, highlighting the implications for individuals before and during the COVID-19 pandemic.

Negative impact of behavior restriction amidst a clustered COVID-19 infection on immobility syndrome in older patients negative for COVID-19: report from a chronic care hospital in Japan.

Previous studies have reported on associations between immobility syndrome and the COVID-19 pandemic. However, little is known about the aggravation of this syndrome in older patients negative for COVID-19 infection amidst behavior restriction due to a clustered COVID-19 infection. Patients hospitalized one month before a clustered COVID-19 infection occurred in our hospital were recruited. Rehabilitation therapy was suspended for 25 days during behavior restriction. The ability of daily living of the patients was evaluated with the functional independence measure and Barthel index. Chronological changes in the functional independence measure and Barthel index scores were evaluated monthly, beginning one month before the clustered COVID-19 infection to one month after re-initiation of rehabilitation therapy. Patients with minimum scores in the functional independence measure (18) and Barthel index (0) prior to the clustered COVID-19 infection were excluded. Functional independence measure scores of 73 older patients and the Barthel index scores of 48 patients were analyzed. The mean total functional independence measure score amidst the behavior restriction significantly changed from 36.3 to 35.1 (p = 0.019), while statistical significance was not detected in the mean motor subtotal (from 21.6 to 20.9 with p = 0.247) or cognitive subtotal functional independence measure scores (from 14.6 to 14.2 with p = 0.478). During the behavior restriction, the mean Barthel index scores declined from 25.8 to 23.2 without statistical significance (p = 0.059). Behavior restriction due to a clustered COVID-19 infection may aggravate immobility syndrome in older patients who are negative for COVID-19.

Nowhere to go? A study of marginalization, social connection, and mental health outcomes among young adults experiencing the COVID-19 pandemic.

Background: The COVID-19 pandemic onset necessitated large-scale closures of third places, potentially exacerbating social barriers experienced by young adults in the United States. To better understand the role of urban form in facilitating socialization, we examine the effects of pandemic-based third place closures on mental health outcomes as mediated by changes in social connection. Because identifying as a racial, gender, or sexual minority can compound baseline disadvantages rooted in systemic inequities, we investigate outcome differences for non-white, woman/nonbinary, and LGBTQ+ young adults to disentangle identity-based nuances of the pandemic experience. Methods: In February 2021, we administered a web-based survey with retrospective name and place generators to 313 18-to-34-year-olds in California, Illinois, and Texas. A structural equation model is estimated showing the direct and indirect effects of physical and virtual mobility constraints on mental health. Results: Both the closure of third places and dissatisfaction with alternative social spaces are associated with the deterioration of social connections and mental health. The strongest direct predictor of mental health decline is dissatisfaction with virtual socialization (more significant for women and nonbinary respondents). Surprisingly, two distinct categories of third places (i.e., 'civic' and 'commercial') reveal different relationships with social connections and mental health outcomes. Asian, other non-white, and non-heterosexual young adults experienced greater 'civic' visit reduction, while those with intersecting identities of low income and woman/nonbinary or Black experienced greater 'commercial' visit reduction. Conclusions: Physical and virtual mobility reductions contributed to the inequitable mental health outcomes experienced by young adults during the pandemic. This highlights the potential for a careful redesign of physical and virtual social spaces to support feelings of belonging/safety and spontaneous 'weak tie' interactions, encourages further investigation of social infrastructure's role in facilitating the maintenance of social connections and mental health, and reveals the value of examining differences in mobility-related experiences across social identities.