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Urban mobility has been severely impacted by the coronavirus pandemic, with public transport (PT) particularly affected due to infection risks and fears. The promotion of alternative modes of transport such as bike sharing systems (BSS) has gained a new drive as a possible way of providing an alternative to PT and limit a potential surge in private car use. In this study, we provide insights on the motivations for using bike sharing during the COVID-19 pandemic through a survey to the BSS users of Lisbon (entitled GIRA ). Before the coronavirus pandemic, the most influential motivations were those connected to the BSS’ Service Coverage & Quality (such as the convenient location of BSS stations near the users’ destinations or the availability of shared e-bikes) as well as to the Personal Interests & Well-being of BSS users (namely the pleasure of cycling as well as the perceived environmental and health benefits). With the emergence of the COVID-19 pandemic, although the motivations of Service Coverage & Quality continue to be the most valued by respondents, the motivations associated with using BSS to avoid PT and to maintain a social distance during the trip are now as important as the motivations linked to Personal Interests & Well-being . Furthermore, new users who have joined bike sharing during COVID-19 give more importance to the Social Influence (such as seeing other people using the system or the influence of their social circle) comparatively to those who were already users before the pandemic and continue to use BSS. This research provides evidence on the importance of bike sharing to the resilience of urban transport systems, particularly during disruptive public health crises. It supports that BSS should continue to operate during the coronavirus pandemic as such systems offer a transport alternative to PT that is perceived to be capable of preserving a physical distance.

Background The adherence to inhaled controller medications is of critical importance for achieving good clinical results in patients with chronic respiratory diseases. Self-management strategies can result in improved health outcomes and reduce unscheduled care and improve disease control. However, adherence assessment suffers from difficulties on attaining a high grade of trustworthiness given that patient self-reports of high-adherence rates are known to be unreliable. Objective Aiming to increase patient adherence to medication and allow for remote monitoring by health professionals, a mobile gamified application was developed where a therapeutic plan provides insight for creating a patient-oriented self-management system. To allow a reliable adherence measurement, the application includes a novel approach for objective verification of inhaler usage based on real-time video capture of the inhaler's dosage counters. Methods This approach uses template matching image processing techniques, an off-the-shelf machine learning framework, and was developed to be reusable within other applications. The proposed approach was validated by 24 participants with a set of 12 inhalers models. Results Performed tests resulted in the correct value identification for the dosage counter in 79% of the registration events with all inhalers and over 90% for the three most widely used inhalers in Portugal. These results show the potential of exploring mobile-embedded capabilities for acquiring additional evidence regarding inhaler adherence. Conclusion This system helps to bridge the gap between the patient and the health professional. By empowering the first with a tool for disease self-management and medication adherence and providing the later with additional relevant data, it paves the way to a better-informed disease management decision.

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