Road Traffic Injuries and the Built Environment in Bogotá, Colombia, 2015-2019: A Cross-Sectional Analysis.

Nine in 10 road traffic deaths occur in low- and middle-income countries (LMICs). Despite this disproportionate burden, few studies have examined built environment correlates of road traffic injury in these settings, including in Latin America. We examined road traffic collisions in Bogotá, Colombia, occurring between 2015 and 2019, and assessed the association between neighborhood-level built environment features and pedestrian injury and death. We used descriptive statistics to characterize all police-reported road traffic collisions that occurred in Bogotá between 2015 and 2019. Cluster detection was used to identify spatial clustering of pedestrian collisions. Adjusted multivariate Poisson regression models were fit to examine associations between several neighborhood-built environment features and rate of pedestrian road traffic injury and death. A total of 173,443 police-reported traffic collisions occurred in Bogotá between 2015 and 2019. Pedestrians made up about 25% of road traffic injuries and 50% of road traffic deaths in Bogotá between 2015 and 2019. Pedestrian collisions were spatially clustered in the southwestern region of Bogotá. Neighborhoods with more street trees (RR, 0.90; 95% CI, 0.82-0.98), traffic signals (0.89, 0.81-0.99), and bus stops (0.89, 0.82-0.97) were associated with lower pedestrian road traffic deaths. Neighborhoods with greater density of large roads were associated with higher pedestrian injury. Our findings highlight the potential for pedestrian-friendly infrastructure to promote safer interactions between pedestrians and motorists in Bogotá and in similar urban contexts globally.

STRIDE: Street View-based Environmental Feature Detection and Pedestrian Collision Prediction.

This paper introduces a novel benchmark to study the impact and relationship of built environment elements on pedestrian collision prediction, intending to enhance environmental awareness in autonomous driving systems to prevent pedestrian injuries actively. We introduce a built environment detection task in large-scale panoramic images and a detection-based pedestrian collision frequency prediction task. We propose a baseline method that incorporates a collision prediction module into a state-of-the-art detection model to tackle both tasks simultaneously. Our experiments demonstrate a significant correlation between object detection of built environment elements and pedestrian collision frequency prediction. Our results are a stepping stone towards understanding the interdependencies between built environment conditions and pedestrian safety.

Effectiveness and adherence to closed face shields in the prevention of COVID-19 transmission: a non-inferiority randomized controlled trial in a middle-income setting (COVPROSHIELD).

BACKGROUND: The use of respiratory devices can mitigate the spread of diseases such as COVID-19 in community settings. We aimed to determine the effectiveness of closed face shields with surgical face masks to prevent SARS-CoV-2 transmission in working adults during the COVID-19 pandemic in Bogotá, Colombia. METHODS: An open-label non-inferiority randomized controlled trial that randomly assigned participants to one of two groups: the intervention group was instructed to wear closed face shields with surgical face masks, and the active control group was instructed to wear only surgical face masks. The primary outcome was a positive reverse transcription polymerase chain reaction test, IgG/IgM antibody test for SARS-CoV-2 detection, or both during and at the end of the follow-up period of 21 days. The non-inferiority limit was established at - 5%. RESULTS: A total of 316 participants were randomized, 160 participants were assigned to the intervention group and 156 to the active control group. In total, 141 (88.1%) participants in the intervention group and 142 (91.0%) in the active control group completed the follow-up. PRIMARY OUTCOME: a positive SARS-CoV-2 test result was identified in one (0.71%) participant in the intervention group and three (2.1%) in the active control group. In the intention-to-treat analysis, the absolute risk difference was - 1.40% (95% CI [- 4.14%, 1.33%]), and in the per-protocol analysis, the risk difference was - 1.40% (95% CI [- 4.20, 1.40]), indicating non-inferiority of the closed face shield plus face mask (did not cross the non-inferiority limit). CONCLUSIONS: The use of closed face shields and surgical face masks was non-inferior to the surgical face mask alone in the prevention of SARS-CoV-2 infection in highly exposed groups. Settings with highly active viral transmission and conditions such as poor ventilation, crowding, and high mobility due to occupation may benefit from the combined use of masks and closed face shields to mitigate SARS-CoV-2 transmission. TRIAL REGISTRATION: ClinicalTrials.gov NCT04647305 . Registered on November 30, 2020.

Geographic Distribution of the Ciclovia and Recreovia Programs by Neighborhood SES in Bogotá: How Unequal is the Geographic Access Assessed Via Distance-based Measures?

Ciclovia, also known as Open Streets initiatives in other countries, are city streets that are closed to motorized traffic and opened during certain times to residents for engaging in physical activity (PA). These initiatives are viewed by policy makers and health and community advocates as being beneficial to social, environmental, and community health. This study explores the geographic distribution of Ciclovia and Recreovia and the differences in geographic access assessed via distance-based measures, based on the socioeconomic status (SES) of the area. Results from this study show that the median distance to the Ciclovia according to SES ranges from 2930 m for SES 1 (most disadvantaged) to 482 m for SES 6 (wealthiest). The median distance to the Recreovia sites ranges from 5173 m for SES 1 to 3869 m for SES 6. This study found revealing urban inequities in the distribution of Ciclovia, whereas there was less inequalities within the Recreovia sites. This study shows that urban interventions are needed to promote recreational activity and reduce health disparities in under resourced, low SES areas.

Consumo de alcohol en entornos urbanos alrededor de una universidad en Bogotá. Resultados de un estudio piloto / Consume of Alcohol in Urban Settings around a University in Bogotá. Results of a Pilot Study

Introducción: El objetivo de este estudio piloto fue caracterizar las percepciones de estudiantes universitarios sobre el consumo de alcohol y la disponibilidad de establecimientos que expenden licor en el perímetro urbano de una universidad de Bogotá. Métodos: Se llevó a cabo un estudio transversal y mixto en 201 estudiantes seleccionados por una muestra no probabilística. Se usó una encuesta autodiligenciada para evaluar percepciones respecto al consumo de alcohol alrededor de la universidad y sistemas de información geográfica para identificar los establecimientos que vendían alcohol. Resultados: El 66% de los participantes informó haber consumido alcohol alrededor del campus universitario. El 26% se mostraba de acuerdo o muy de acuerdo con la implementación de medidas estrictas para restringir el consumo, siendo mayor en personas que no consumieron (41,2%). El análisis geográfico encontró un patrón de concentración de oferta y consumo de alcohol en las inmediaciones de la universidad. Conclusión: Este estudio muestra la potencial relevancia que tiene la oferta y consumo de alcohol alrededor de un campus universitario para la salud pública. Se deben llevar a cabo estudios complementarios para entender, de mejor manera, posibles vínculos entre contextos urbanos universitarios y consumo de alcohol.

Background: The aim of this pilot study was to characterize the perceptions of university students in relation to alcohol consumption and the availability of alcohol outlets in the urban perimeter of a university in Bogotá. Methods: A mixed cross-sectional study was conducted among 201 undergraduate students ages 18 to 27 years using a non-probabilistic sampling design. The perceptions regarding alcohol consumption in the university's surroundings were assessed via a self-reported questionnaire. Geographic Information Systems were used to identify the outlets that sell alcohol. Results: 66% of participants reported alcohol consumption in in the university's surroundings. The proportion of students who agreed with implementing strict measures to control alcohol consumption was 26%, with higher percentages in those who didn't consume alcohol (41,2%). Geographic analysis showed that several urban attributes were correlated with alcohol consumption. Conclusión: The results of this study show the potential relevance that has the availability' of alcohol outlets near a university' campus as a public health issue. Further studies should be conducted in order to better understand the links between urban contexts around universities and alcohol consumption.

TransMilenio, a Scalable Bus Rapid Transit System for Promoting Physical Activity.

Transport systems can play an important role in increasing physical activity (PA). Bogotá has been recognized for its bus rapid transit (BRT) system, TransMilenio (TM). To date, BRTs have been implemented in over 160 cities worldwide. The aim of this study was to assess the association between PA and the use of TM among adults in Bogotá. The study consists of a cross-sectional study conducted from 2010 to 2011 with 1000 adults. PA was measured using the International Physical Activity Questionnaire. In a subsample of 250 adults, PA was objectively measured using ActiGraph accelerometers. Analyses were conducted using multilevel logistic regression models. The use of TM was associated with meeting moderate-to-vigorous PA (MVPA). TM users were more likely to complete an average of >22 min a day of MVPA (odds ratio [OR] = 3.1, confidence interval [CI] = 95 % 1.4-7.1) and to walk for transportation for ≥150 min per week (OR = 1.5; CI = 95 % 1.1-2.0). The use of TM was associated with 12 or more minutes of MVPA (95 % CI 4.5-19.4, p < 0.0001). Associations between meeting PA recommendations and use of TM did not differ by socioeconomic status (p value = 0.106) or sex (p value = 0.288). The use of TM is a promising strategy for enhancing public health efforts to reduce physical inactivity through walking for transport. Given the expansion of BRTs, these results could inform the development of transport PA programs in low- to high-income countries.

Social conditions and urban environment associated with participation in the Ciclovia program among adults from Cali, Colombia.

The Ciclovia program (CP) has emerged as an effective initiative to promote active living in urban spaces in Latin America. This study assessed the association between social conditions, the urban environment and participation in the CP among adults living in the city of Cali, Colombia. A cross-sectional study was conducted in 2011 and 2012 among 719 adults aged 18 to 44. Urban environment measures were obtained using Geographic Information Systems. A multilevel logistic regression was used for the analysis. Slightly more than 7% of participants had participated in the CP in the previous four weekends. Being male and having a high school degree were positively associated with participation in the CP. Participation in the CP was positively associated with living in neighborhoods with Ciclovia lanes. In contrast, a negative association was found among those living in neighborhoods with a presence of traffic fatalities. This study provides new insights about a recreational program that has potential health benefits in a region marked by urban inequalities in terms of opportunities for physical activity.

Social conditions and urban environment associated with participation in the Ciclovia program among adults from Cali, Colombia / Condiciones sociales y ambientes urbanos asociados con la participación al programa de Ciclovía en adultos en Cali, Colombia / Condições sociais e ambientes urbanos associados à participação no programa Ciclovia entre adultos em Cali, Colômbia

Abstract The Ciclovia program (CP) has emerged as an effective initiative to promote active living in urban spaces in Latin America. This study assessed the association between social conditions, the urban environment and participation in the CP among adults living in the city of Cali, Colombia. A cross-sectional study was conducted in 2011 and 2012 among 719 adults aged 18 to 44. Urban environment measures were obtained using Geographic Information Systems. A multilevel logistic regression was used for the analysis. Slightly more than 7% of participants had participated in the CP in the previous four weekends. Being male and having a high school degree were positively associated with participation in the CP. Participation in the CP was positively associated with living in neighborhoods with Ciclovia lanes. In contrast, a negative association was found among those living in neighborhoods with a presence of traffic fatalities. This study provides new insights about a recreational program that has potential health benefits in a region marked by urban inequalities in terms of opportunities for physical activity.

Resumen El programa de Ciclovía (PC) ha surgido como una iniciativa efectiva para promover actividad física en el contexto urbano de América Latina. Este estudio evaluó la asociación entre las condiciones sociales, el ambiente urbano y la participación en el PC en adultos que vivían en Cali, Colombia. Se llevó a cabo un estudio transversal en 2011 y 2012 en 719 adultos de 18 a 44 años. Se obtuvieron medidas del ambiente urbano utilizando Sistemas de Información Geográfica. Un poco más del 7% de las personas participaron en el PC en los últimos 4 fines de semana. Ser hombre y tener un nivel de escolaridad de secundaria se asoció positivamente con la participación en el PC. Así mismo, se encontró una asociación positiva con residir en barrios con existencia de corredores con este programa. Por el contrario, la existencia de muertes por accidentes de tránsito fue negativamente asociada. Este estudio brinda nuevos conocimientos acerca de un programa recreativo que tiene beneficios potenciales para la salud, en una región marcada por desigualdades urbanas relacionadas con actividad física.

Resumo O programa Ciclovia (PC) surgiu como uma iniciativa eficaz para promover a atividade física no contexto urbano da América Latina. Este estudo avaliou a associação entre as condições sociais, o ambiente urbano e participação no PC em adultos que vivem em Cali, Colômbia. Um estudo transversal foi realizado em 2011 e 2012, em 719 adultos com idades entre 18 e 44 anos. Medidas do ambiente urbano utilizando SIG foram obtidos. Pouco mais de 7% das pessoas participaram do PC nos últimos quatro finais de semana. Ser do sexo masculino e ter um nível de ensino médio foi positivamente associado com a participação no PC. Da mesma forma, uma associação positiva com residência em bairros com corredores existência desse programa foi encontrada. Pelo contrário , a existência de mortes no trânsito foi negativamente associado . Este estudo fornece novos conhecimentos sobre um programa de lazer que tem benefícios de saúde potenciais em uma região marcada por desigualdades urbanas em atividade física.

Costos directos e impacto sobre la morbimortalidad hospitalariade eventos adversos prevenibles a medicamentosen una institución de tercer nivel de Bogotá / Direct costs and impact on hospital morbidity and mortality of preventable adverse drug events in a tertiary institution in Bogota

Introducción. La implementación de actividades de farmacovigilancia permite supervisar y evaluar aspectos relacionados con la atención médica. Es necesario que la información recolectada permita identificar oportunidades para mejorar la calidad de la atención en salud. Se propone un análisis de los eventos adversos a medicamentos desde la óptica preventiva y económica, estableciendo su impacto local.Objetivo. Determinar el porcentaje de eventos adversos prevenibles a medicamentos, reportados en una institución de tercer nivel, para establecer su impacto sobre la morbimortalidad y el económico desde la óptica del pagador y mostrando la relevancia de usar un método que permita identificarlos y evitar o disminuir su presentación. Materiales y métodos. A partir de los reportes generados durante actividades de farmacovigilancia en el año 2007 en un hospital de tercer nivel de Bogotá, se revisaron las historias clínicas de los pacientes involucrados y se evaluó la relación de causalidad, la gravedad y el carácter prevenible de los eventos adversos a medicamentos. Se calcularon los costos directos generados, agrupándolos en pruebas diagnósticas, tiempo de estancia adicional, procedimientos y medicamentos adicionales. Resultados. Se revisaron 448 reportes de eventos adversos a medicamentos en 283 pacientes y se encontró que 24,8 % de los eventos reportados eran prevenibles, con mortalidad de 1,1 % y costos totales asociados con su atención entre $ 33´620.346 (US$ 16.687) y $ 37´754.856 (US$ 18.739). Los factores más frecuentemente asociados con la prevención fueron las interacciones farmacológicas y las dosis o frecuencias inadecuadas de administración.Conclusiones. Es importante tomar medidas tendientes a disminuir la presentación de eventos adversos prevenibles a medicamentos, ya que repercuten negativamente tanto sobre la salud de los pacientes, como en el consumo de recursos.

Introduction. Implementing pharmacovigilance activities consists of monitoring and assessment of activities related to medical attention. However, additional data are necessary to identify conditions where care quality can be improved. Therefore, a focus on adverse drug events analysis from a prevention and economic perspective is needed, with emphasis on its local impact.Objective. Preventable adverse drug events were summarized to establishing their impact on morbidity and mortality, as well as to estimate the ensuing economic burden. Materials and methods. The data were gathered from a level 3 hospital (high complexity), located in Bogotá, Colombia, where specific pharmacovigilance activities were recorded in 2007. Patient charts were reviewed to characterize adverse drug events according to their causality, severity and preventability. Direct costs were estimated by grouping diagnostic tests, length of hospitalization, procedures and additional drugs required. Results. The charts of 283 patients and 448 reports were analyzed. These data indicated that 24.8% of adverse drug events were preventable and that an associated mortality of 1.1% had occurred. The associated direct costs were between USD $16,687 and $18,739. Factors more commonly associated with preventability were drug-drug interactions, as well as inappropriate doses and unsuitable frequencies at which the drugs were administrated. Conclusions. The data recommended that actions be taken to decrease preventable adverse drug events, because of negative impact on patient’s health, and unnecessary consumption of healthcare resources.

[Direct costs and hospital morbimortality impact from preventable adverse drug events]. / Costos directos e impacto sobre la morbimortalidad hospitalaria de eventos adversos prevenibles a medicamentos en una institución de tercer nivel de Bogotá

INTRODUCTION: Implementing pharmacovigilance activities consists of monitoring and assessment of activities related to medical attention. However, additional data are necessary to identify conditions where care quality can be improved. Therefore, a focus on adverse drug events analysis from a prevention and economic perspective is needed, with emphasis on its local impact. OBJECTIVE: Preventable adverse drug events were summarized to establishing their impact on morbidity and mortality, as well as to estimate the ensuing economic burden. MATERIALS AND METHODS: The data were gathered from a level 3 hospital (high complexity), located in Bogotá, Colombia, where specific pharmacovigilance activities were recorded in 2007. Patient charts were reviewed to characterize adverse drug events according to their causality, severity and preventability. Direct costs were estimated by grouping diagnostic tests, length of hospitalization, procedures and additional drugs required. RESULTS: The charts of 283 patients and 448 reports were analyzed. These data indicated that 24.8% of adverse drug events were preventable and that an associated mortality of 1.1% had occurred. The associated direct costs were between USD $16,687 and $18,739. Factors more commonly associated with preventability were drug-drug interactions, as well as inappropriate doses and unsuitable frequencies at which the drugs were administrated. CONCLUSIONS: The data recommended that actions be taken to decrease preventable adverse drug events, because of negative impact on patient´s health, and unnecessary consumption of healthcare resources.

Quality of life, physical activity, and built environment characteristics among colombian adults.

BACKGROUND: Studies assessing the association between health-related quality of life (HR-QOL) with physical activity (PA) and built environment (BE) characteristics are limited. METHODS: A cross-sectional study was conducted among 1,334 adults from Bogotá, to assess the associations between HR-QOL with PA and BE characteristics. HR-QOL was measured using the World Health Organization and the Centers for Disease Control and Prevention instruments. PA was measured using the International PA Questionnaire. BE characteristics included the dimensions of density, diversity, design, and access to mass-transit. Analysis included multilevel modeling. RESULTS: Adults who reported meeting PA recommendations and participating in the Ciclovía were more likely to have a high mean score of HR-QOL and were more likely to perceive their health status as good/excellent. Adults who reported biking for transportation were more likely to have a high mean score of HR-QOL. Regarding BE characteristics, land-use heterogeneity was associated with HR-QOL, perceived good health status and being positive about the future. Park density was associated with HR-QOL, perceived health status good/excellent and being positive about the future. Mass-transit stations availability was negatively associated with HR-QOL. CONCLUSION: This study provides preliminary evidence that HR-QOL is associated with PA and BE characteristics among adults in an urban setting of the developing world.

Characteristics of the built environment associated with leisure-time physical activity among adults in Bogotá, Colombia: a multilevel study.

BACKGROUND: Even though there is increasing evidence that the built environment (BE) has an influence on leisure-time physical activity (LTPA), little is known about this relationship in developing countries. The objective of this study was to assess the associations between objective built environment characteristics and LTPA. METHODS: A cross-sectional multilevel study was conducted in 27 neighborhoods in which 1315 adults aged 18-65 years were surveyed. An adapted version of the IPAQ (long version) was used to assess LTPA. Objective BE characteristics were obtained using Geographic Information Systems. Associations were assessed using multilevel polytomous logistic regression. RESULTS: Compared with inactive people, those who resided in neighborhoods with the highest tertile dedicated to parks (7.4% to 25.2%) were more likely to be regularly active (POR = 2.05, 95% CI = 1.13-3.72; P = 0.021). Those who resided in neighborhoods with presence of TransMilenio stations (mass public transportation system) were more likely to be irregularly active (POR = 1.27, 95% CI = 1.07-1.50, P = 0.009) as compared with inactive people. CONCLUSIONS: These findings showed that park density and availability of TransMilenio stations at neighborhood level are positively associated with LTPA. Public health efforts to address physical inactivity should consider the potential influences of urban planning and mass public transportation systems on health.

Built environment characteristics and perceived active park use among older adults: results from a multilevel study in Bogotá.

OBJECTIVE: Examine the associations between selected built environment (BE) attributes and perceived active park use among older adults in Bogota. METHODS: A cross-sectional multilevel study was conducted. Participants included 1966 older adults in 50 neighborhoods. Socio-demographic covariates and BE attributes were measured. Multilevel logistic regression models were used for the analyses. RESULTS: Residents from areas with higher park density and high land-use mix were more likely to report active park use while those from areas with high connectivity were less likely. CONCLUSIONS: This study suggests that objective attributes of the residential BE are associated with perceived active park use. However, our study also points to the importance of surrounding environment, with the result of an inverse relationship between connectivity and physical activity, which highlights the potentially necessary interventions in the realm of traffic and pedestrian safety.

Built environment attributes and walking patterns among the elderly population in Bogotá.

BACKGROUND: There is increasing evidence that the built environment has an influence on physical activity; however, little is known about this relationship in developing countries. PURPOSE: This study examined the associations between attributes of the built environment and walking patterns among the elderly. METHODS: A multilevel cross-sectional study was conducted in 2007. Fifty neighborhoods were selected and 1966 participants aged > or =60 years were surveyed. Objective built environment measures were obtained in a buffer of 500 m using GIS. Environmental perceptions were assessed via questionnaire. RESULTS: People who lived in areas with middle park area (4.53%-7.98% of land) were more likely to walk for at least 60 minutes during a usual week (prevalence OR [POR]=1.42, 95% CI=1.02, 1.98). Those who lived in areas with the highest connectivity index (1.81-1.99) were less likely to report walking for at least 60 minutes (POR=0.64, 95% CI=0.44, 0.93). Participants who reported feeling safe or very safe from traffic were more likely to report walking for at least 60 minutes (POR=1.50, 95% CI=1.11, 2.03). The presence of Ciclovía (recreational program) was marginally associated with having walked at least 150 minutes in a usual week (POR=1.29, 95% CI=0.97, 1.73). CONCLUSIONS: This study showed that certain built and perceived environment characteristics were associated with walking among older adults living in Bogotá. Further studies should be conducted to better understand the potential influence of the built environment on physical activity among the elderly population in the context of Latin American cities.

Dedo en resorte en adultos y niños

Se analizan 105 pacientes con 143 dedos en resorte, en un lapso de 19 años(1969-1987) en la ciudad de Cúcuta y para una mejor compresión y por ser diferente su etiología, menifestaciones clínicas y tratamiento, se clasifican en adultos y niños. 94 adultos y 11 niños. El tratamiento en los adultos se hace inicialmete con infiltraciones de Corticoides, con resultados satisfactorios en el 65 por ciento; por no mejorar en el 35 por ciento se procede al tratamiento quirúrgico (sección de la vaina tendinosa) con resultados excelentes. En los niños el tratamiento fue quirúrgico en el 100 por ciento de los casos. Destacamos el manejo de un paciente adulto con 10 Dedos en Resorte, situación no reportada en la literatura revisada por nosostros y el de un niño con 8 Dedos en Resorte Congénitos, de lo cual sólo han sido publicados 3 casos en la Literatura Inglesa hasta 1983

Síndromes Dolorosos del Codo en el Adulto

Al revisar 12500 historias clínicas de pacientes de la práctica privada, que consultaron entre 1969 y 1984, encontramos 119 casos con dolor en el codo, debido a epicondilitis lateral y medial, bursitis olecraniana y calcificaciones periarticulares. Practicamos controles entre 2 y 16 años. Encontramos 89 pacientes con epicondilitis: el 92 por ciento recibió tratamiento médico con antiinflamatorios, infiltraciones con corticoides y venda elástica por debajo del codo; el 8 por ciento restante fue tratado quirúrgicamente mediante la técnica de Bosworth III modificada. La bursitis olecraniana se presentó en 23 pacientes, siendo el trauma la primera causa etiológica seguida de la infecciosa, gotosa y reumatoidea; 48 por ciento recibieron tratamiento médico y 52 por ciento tratamiento quirúrgico, mediante la resección de la bursa. Siete pacientes presentaron calcificaciones periarticulares dolorosas; el 71 por ciento recibieron tratamiento quirúrgico: resección de las calcificaciones. Los resultados fueron satisfactorios para cada caso, con retorno del paciente a sus actividades habituales