At the onset of the COVID-19 pandemic, more than 1500 cities around the world created or expanded public spaces for walking, bicycling, recreation and outdoor commerce to accommodate requirements for ...physical distancing. These interventions often involved the reallocation of street space dedicated to cars to facilitate active mobility. While research on efforts to adapt street space during the pandemic is burgeoning, there has yet to be an in-depth analysis of the motivations behind these responses. Our international qualitative study conducted a thematic review of existing research on active mobility responses to understand them better. Specifically, our review considered why responses were chosen (four motivations: risk reduction, impact mitigation, demand accommodation and opportunity) and how they were implemented (four typologies: opportunism, crisis reaction, business-as-usual was also a crisis and agility). Opportunism was most common both as motivation and typology of approach. However, elements of the other motivations and approach typologies were critical for developing and implementing responses that more directly addressed community needs and concerns during the crisis. Our findings help inform the work of transportation professionals to make cities more resilient by building their capacity to respond quickly and equitably to future disruptions and ongoing crises.
This study summarizes the evidence from quantitative systematic reviews that assessed the association between urban environment attributes and physical activity. It also documents sociopolitical ...barriers and facilitators involved in urban interventions linked with active living in the ten most populated urban settings of Latin America. The synthesis of evidence indicates that several attributes of urban environments are associated with physical activity, including land-use mix and cycling infrastructure. The documentary analysis indicated that despite the benefits and opportunities provided by the programs and existing infrastructure in the examined cities, an overall concern is the rising inequality in the coverage and distribution of the initiatives in the region. If these programs and initiatives are to achieve a real population level effect that helps to reduce health disparities, they need to examine their social and spatial distribution within the cities so they can reach underserved populations and develop to their full potential.
•Most research on physical activity and the environment was in high income countries.•There is an unequal distribution of supportive urban environments in Latin American.•The Ciclovia program may offset urban inequalities existing in public green areas.•Strong civil society leadership is needed for sustainable policy and programs.
Este artículo presenta parte del trabajo realizado en el marco del programa Modural “Las prácticas de movilidad sostenible en las metrópolis de América Latina: estudio comparativo de Bogotá y Lima”, ...iniciado en enero de 2020. Modural es un programa internacional y pluridisciplinario financiado por la anr(Agencia Nacional de la Investigación de Francia). Está enfocado en estudiar las prácticas de movilidad sostenible en la situación específica de las periferias populares. El artículo tiene dos objetivos. Primero, evidenciar los patrones socio-espaciales de desigualdad de movilidad y las dificultades en las periferias en Lima y Bogotá. Segundo, presentar la metodología de selección de las zonas con mayor desventaja social y mayores dificultades de movilidad cotidiana.
Motorcycle use for utilitarian trips in Latin American cities has grown significantly in recent years. The researchers used qualitative methods to understand the motivations of motorcycle users that ...might contribute to this growth in six cities: Barranquilla, Bogotá (Colombia), São Paulo, Recife (Brazil), Caracas (Venezuela), and Buenos Aires (Argentina). Researchers used semi-structured interviews and focus groups to gather data from six categories of motorcycle users: motorcycle taxi drivers, motorcycle taxi users, motorcyclists for delivery, motorcyclists for private use, owners in the process of selling their motorcycles, and potential motorcyclists (those seeking to buy motorcycles). Common themes emerged across the six cities, including the time advantage that motorcycles offered versus deficient public transportation and congested auto traffic, the low cost of motorcycles versus other transport modes, the vulnerability of motorcyclists to traffic injury and death, and cultural aspects of motorcycle use. Policy implications include the need to make motorcycle travel safer and improve public transportation in Latin American cities.
•We carried out interviews and focus groups with urban motorcycle transport users.•Motorcycles offered participants important time and cost advantages.•Participants recognized the high risk of traffic injury and other health issues.•The research revealed important social aspects of motorcycle use.•Policy implications include the need to improve public transportation.
A new methodology for universal accessibility is proposed to identify barriers in public transport accessibility and travel experience. The methodology focuses on the travel experience of people with ...disabilities and people with temporary restrictions in physical mobility. The methodology not only focuses on aspects of the planning, design, and operation of public transport systems, but also emphasizes sensitive aspects of user experience, considering satisfaction and emotions. The methodology maps tavel experiences using ethnographic methods and provides a graphical depiction of the trip. This helps in identifying key elements for improving accessibility when planning, implementing, and operating public transport systems. The methodology has two parts: (i) traveling along and observing a complete and common trip of people with a permanent or temporary disability or mobility restrictions, and (ii) analyzing and observing the travel experience. The methodology was applied in Bogotá, Santiago de Chile, and Medellín. The results of the methodology allowed us to formulate policy recommendations to improve the transportation systems of these cities in the short, medium, and long term. The methodology is applicable to other transit systems.
This article presents part of the work carried out as part of the Modural programme "Sustainable mobility practices in Latin American metropolises: a comparative study of Bogotá and Lima", launched ...in January 2020. Modural is an international and multidisciplinary programme funded by the ANR (French National Research Agency). It focuses on the study of sustainable mobility practices of households living more specifically in deprived outskirts. This article has two objectives. First, to highlight the socio-spatial patterns of mobility inequalities in Lima and Bogotá and the transport problems that affect the outer districts. Second, to detail the methodology for selecting the most socially disadvantaged areas with the most difficult daily travel conditions. It is in these areas that 1600 household surveys will be implemented in the first half of 2022.
Este artículo presenta parte del trabajo realizado en el marco del programa Modural "Prácticas de movilidad sostenible en las metrópolis latinoamericanas: un estudio comparativo de Bogotá y Lima", iniciado en enero de 2020. Modural es un programa internacional y multidisciplinar financiado por la ANR (Agencia Nacional de Investigación francesa). Se centra en el estudio de las prácticas de movilidad sostenible de los hogares que residen más específicamente en las periferias populares. Este artículo tiene dos objetivos. En primer lugar, evidenciar las configuraciones socioespaciales de las desigualdades de movilidad en Lima y Bogotá y los problemas de transporte que afectan a las zonas periféricas. En segundo lugar, detallar la metodología de selección de las zonas socialmente más desfavorecidas y con condiciones de desplazamiento más difíciles a diario. En estas zonas se llevarán a cabo 1.600 encuestas a hogares en el primer semestre de 2022.
Cet article restitue une partie des travaux menés dans le cadre du programme Modural "Les pratiques de mobilité durable dans les métropoles latino-américaines : une étude comparative de Bogotá et Lima", lancé en janvier 2020. Modural est un programme international et multidisciplinaire financé par l'ANR (Agence Nationale de la Recherche). Il porte sur l'étude des pratiques de mobilité durable des ménages résidant plus spécifiquement dans les périphéries populaires. Cet article poursuit deux objectifs. Premièrement, mettre en évidence les configurations socio-spatiales des inégalités de mobilité à Lima et à Bogotá et les problèmes de transport qui concernent les quartiers excentrés. Deuxièmement, détailler la méthodologie de sélection des zones les plus défavorisées socialement et présentant les conditions de déplacements parmi les plus difficiles au quotidien. C'est dans ces zones que seront mises en œuvre 1600 enquêtes ménages au cours du premier semestre 2022.
Este artigo apresenta parte do trabalho realizado como parte do programa Modural "Práticas de mobilidade sustentável nas metrópoles da América Latina: um estudo comparativo de Bogotá e Lima", lançado em janeiro de 2020. O Modural é um programa internacional e multidisciplinar financiado pela ANR (Agência Nacional de Pesquisa da França). Concentra-se no estudo das práticas de mobilidade sustentável dos domicílios que residem mais especificamente nas periferias populares. Este artigo tem dois objetivos. Primeiramente, destacar as configurações sócio-espaciais das desigualdades de mobilidade em Lima e Bogotá e os problemas de transporte que afetam as áreas periféricas. Em segundo lugar, detalhar a metodologia para selecionar as áreas socialmente mais desfavorecidas com as mais difíceis condições de locomoção. Nessas áreas, serão realizadas 1.600 pesquisas domiciliares na primeira metade de 2022.
The effect of high-flow oxygen therapy vs conventional oxygen therapy has not been established in the setting of severe COVID-19.
To determine the effect of high-flow oxygen therapy through a nasal ...cannula compared with conventional oxygen therapy on need for endotracheal intubation and clinical recovery in severe COVID-19.
Randomized, open-label clinical trial conducted in emergency and intensive care units in 3 hospitals in Colombia. A total of 220 adults with respiratory distress and a ratio of partial pressure of arterial oxygen to fraction of inspired oxygen of less than 200 due to COVID-19 were randomized from August 2020 to January 2021, with last follow-up on February 10, 2021.
Patients were randomly assigned to receive high-flow oxygen through a nasal cannula (n = 109) or conventional oxygen therapy (n = 111).
The co-primary outcomes were need for intubation and time to clinical recovery until day 28 as assessed by a 7-category ordinal scale (range, 1-7, with higher scores indicating a worse condition). Effects of treatments were calculated with a Cox proportional hazards model adjusted for hypoxemia severity, age, and comorbidities.
Among 220 randomized patients, 199 were included in the analysis (median age, 60 years; n = 65 women 32.7%). Intubation occurred in 34 (34.3%) randomized to high-flow oxygen therapy and in 51 (51.0%) randomized to conventional oxygen therapy (hazard ratio, 0.62; 95% CI, 0.39-0.96; P = .03). The median time to clinical recovery within 28 days was 11 (IQR, 9-14) days in patients randomized to high-flow oxygen therapy vs 14 (IQR, 11-19) days in those randomized to conventional oxygen therapy (hazard ratio, 1.39; 95% CI, 1.00-1.92; P = .047). Suspected bacterial pneumonia occurred in 13 patients (13.1%) randomized to high-flow oxygen and in 17 (17.0%) of those randomized to conventional oxygen therapy, while bacteremia was detected in 7 (7.1%) vs 11 (11.0%), respectively.
Among patients with severe COVID-19, use of high-flow oxygen through a nasal cannula significantly decreased need for mechanical ventilation support and time to clinical recovery compared with conventional low-flow oxygen therapy.
ClinicalTrials.gov Identifier: NCT04609462.
Complex abdominal wall defects are important conditions with high morbidity, leading to impairment of patients' physical condition and quality of life. In the last decade, the abdominal wall ...reconstruction paradigm has changed due to the formation of experienced and excellence groups, improving clinical outcomes after surgery. Therefore, our study shows the perspective and outcomes of an abdominal wall reconstruction group (AWRG) in Colombia, focused on the transverse abdominis release (TAR) procedure. A retrospective review of a prospectively collected database was conducted. All the patients older than 18 years old that underwent TAR procedures between January 2014-December 2020 were included. Analysis and description of postoperative outcomes (recurrence, surgical site infection (SSI), seroma, hematoma, and re-intervention) were performed. 47 patients underwent TAR procedure. 62% of patients were male. Mean age was 55 ± 13.4 years. Mean BMI was 27.8 ± 4.5 kg/m
. Abdominal wall defects were classified with EHS ventral Hernia classification having a W3 hernia in 72% of all defects (Mean gap size of 11.49 cm ± 4.03 cm). Mean CeDAR preoperative risk score was 20.5% ± 14.5%. Preoperative use of BOTOX Therapy (OR 1.0 P 0.00 95% CI 0.3-1.1) or pneumoperitoneum (OR 0.7 P 0.04 95% CI 0.3-0.89) are slightly associated with postoperative hematoma. In terms of hernia relapse, we have 12% of cases; all of them over a year after the surgery. TAR procedure for complex abdominal wall defects under specific clinical conditions including emergency scenarios is viable. Specialized and experienced groups show better postoperative outcomes; further studies are needed to confirm our results.
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