Moving Toward Gender-Equitable Transportation in Post-COVID-19 Urban South Asia

This research examines the impacts of COVID-19 on the mobility of resource-poor women and its linkage with livelihoods in urban South Asia, and how gender-responsive transport measures could be adopted. The study, conducted in Delhi between October 2020 and May 2021, used a mixed methods, multi-stakeholder, and reflexive approach. A literature review was conducted on the gender and mobility context in Delhi, India. Quantitative data were collected through surveys with resource-poor women, while qualitative research methods consisted of in-depth interviews with them. Different stakeholders were engaged through round tables and key informant interviews before and after data collection to share the findings and recommendations. The sample survey (n = 800) revealed that only 1.8% of working resource-poor women have access to a personal vehicle, making them dependent on public transport. While 81% of their trips are by bus, 57% of their peak hour trips are by paratransit, despite free travel on buses. Only 10% of the sample have access to a smart phone, which restricts their access to digital initiatives based on smart phone applications. The women expressed concerns such as poor bus frequencies and buses not stopping for them under the free ride scheme. These were consistent with issues faced before the COVID-19 pandemic. These findings highlight the need for targeted strategies for resource-poor women to achieve equity in gender-responsive transport. These include a multimodal subsidy, short messaging service to obtain real-time information, increased awareness on filing complaints, and an effective grievance redressal system.

Moving Toward Gender-Equitable Transportation in Post-COVID-19 Urban South Asia.

This research examines the impacts of COVID-19 on the mobility of resource-poor women and its linkage with livelihoods in urban South Asia, and how gender-responsive transport measures could be adopted. The study, conducted in Delhi between October 2020 and May 2021, used a mixed methods, multi-stakeholder, and reflexive approach. A literature review was conducted on the gender and mobility context in Delhi, India. Quantitative data were collected through surveys with resource-poor women, while qualitative research methods consisted of in-depth interviews with them. Different stakeholders were engaged through round tables and key informant interviews before and after data collection to share the findings and recommendations. The sample survey (n = 800) revealed that only 1.8% of working resource-poor women have access to a personal vehicle, making them dependent on public transport. While 81% of their trips are by bus, 57% of their peak hour trips are by paratransit, despite free travel on buses. Only 10% of the sample have access to a smart phone, which restricts their access to digital initiatives based on smart phone applications. The women expressed concerns such as poor bus frequencies and buses not stopping for them under the free ride scheme. These were consistent with issues faced before the COVID-19 pandemic. These findings highlight the need for targeted strategies for resource-poor women to achieve equity in gender-responsive transport. These include a multimodal subsidy, short messaging service to obtain real-time information, increased awareness on filing complaints, and an effective grievance redressal system.

Key Levers to Reform Non-Motorized Transport: Lessons From the COVID-19 Pandemic

The objective of this research was to understand key levers that enabled city, regional, and national governments to improve non-motorized transport (NMT) infrastructure during the lockdowns necessitated by the COVID-19 pandemic. The research focused primarily on cycling and adopted a case study approach focusing on three cities: Bengaluru (India), Bogota (Colombia), and London (UK). The selected cities were chosen for diversity across geographies, country income levels, and the scale of interventions. Eight key levers were identified to understand how cycling interventions can be supported, implemented, sustained, and scaled up. These included institutional and organizational arrangements;technical capacity;financing;leadership;policy and regulatory framework;plans, strategies, and technical resources;role of civil society;and communications, messaging, and outreach. The research used secondary literature reviews and key informant interviews, which were validated through an online round table. Research revealed that certain levers were necessary in initiating and continuing successful NMT interventions. These included supportive leadership, participative civil society, and adequate financial and technical capacity. Communications and outreach helped bring behavioral change amongst residents while a coordinated institutional framework and plans and strategies were necessary to sustain momentum. This research contributes to urban mobility and public administration literature in understanding processes and enablers of sustainable mobility interventions. It is relevant for cities in low- and middle-income countries beginning to focus on NMT interventions to combat climate change and public health challenges.

Successful use of telemedicine for evaluation of infantile hemangiomas during the early COVID-19 pandemic: A cross-sectional study.

BACKGROUND/OBJECTIVES: The COVID-19 pandemic prompted a rapid expansion in the use of telemedicine. This study aimed to assess the experiences of hemangioma specialists utilizing telemedicine during the COVID-19 pandemic to evaluate and manage infantile hemangiomas (IH), including perceived effectiveness of different modalities and barriers to care delivery. METHODS: Multicenter cross-sectional study asking providers to describe their experiences using telemedicine for initial evaluation of IH from March to September 2020. RESULTS: The study included 281 patients from 15 medical centers internationally. Median time from referral to evaluation was 17 days. Median physician confidence in performing evaluations via telemedicine was 95.0 (IQR 90.0-100.0). Most evaluations were performed via video communication with photographs or audio communication with photographs; when not initially available, photographs were requested in 51.4%. Providers preferred follow-up modalities that included photographs. CONCLUSIONS: Physicians with extensive expertise in managing IH are confident in their abilities to assess and manage IH via telemedicine including initiating treatment in patients without risk factors for beta-blocker therapy. There was a preference for hybrid modalities that included photographs. The data suggest that telemedicine can be effective for managing IH and may decrease wait times and improve specialist reach to underserved areas.

Systemic immunosuppressive therapy for inflammatory skin diseases in children: Expert consensus-based guidance for clinical decision-making during the COVID-19 pandemic.

BACKGROUND/OBJECTIVES: The COVID-19 pandemic has raised questions about the approach to management of systemic immunosuppressive therapies for dermatologic indications in children. Change to: Given the absence of data to address concerns related to SARS-CoV-2 infection and systemic immunosuppressive therapies in an evidence-based manner, a Pediatric Dermatology COVID-19 Response Task Force (PDCRTF) was assembled to offer time-sensitive guidance for clinicians. METHODS: A survey was distributed to an expert panel of 37 pediatric dermatologists on the PDCRTF to assess expert opinion and current practice related to three primary domains of systemic therapy: initiation, continuation, and laboratory monitoring. RESULTS: Nearly all respondents (97%) reported that the COVID-19 pandemic had impacted their decision to initiate immunosuppressive medications. The majority of pediatric dermatologists (87%) reported that they were pausing or reducing the frequency of laboratory monitoring for certain immunosuppressive medications. In asymptomatic patients, continuing therapy was the most popular choice across all medications queried. The majority agreed that patients on immunosuppressive medications who have a household exposure to COVID-19 or test positive for new infection should temporarily discontinue systemic and biologic medications, with the exception of systemic steroids, which may require tapering. CONCLUSIONS: The ultimate decision regarding initiation, continuation, and laboratory monitoring of immunosuppressive therapy during the pandemic requires careful deliberation, consideration of the little evidence available, and discussion with families. Consideration of an individual's adherence to COVID-19 preventive measures, risk of exposure, and the potential severity if infected must be weighed against the dermatological disease, medication, and risks to the patient of tapering or discontinuing therapies.

Management of infantile hemangiomas during the COVID pandemic.

The COVID-19 pandemic has caused significant shifts in patient care including a steep decline in ambulatory visits and a marked increase in the use of telemedicine. Infantile hemangiomas (IH) can require urgent evaluation and risk stratification to determine which infants need treatment and which can be managed with continued observation. For those requiring treatment, prompt initiation decreases morbidity and improves long-term outcomes. The Hemangioma Investigator Group has created consensus recommendations for management of IH via telemedicine. FDA/EMA-approved monitoring guidelines, clinical practice guidelines, and relevant, up-to-date publications regarding initiation and monitoring of beta-blocker therapy were used to inform the recommendations. Clinical decision-making guidelines about when telehealth is an appropriate alternative to in-office visits, including medication initiation, dosage changes, and ongoing evaluation, are included. The importance of communication with caregivers in the context of telemedicine is discussed, and online resources for both hemangioma education and propranolol therapy are provided.