Evolution of fibrotic interstitial lung diseases (ILD) after COVID-19

Introduction: Data about the impact of COVID-19 on patients with fibrotic ILD are limited. These patients have impaired lung function and increased risk of acute exacerbation driven by viral infection, so COVID-19 is of particular concern. Aim(s): To evaluate the impact of SARS-CoV-2 infection on patients with previous fibrotic ILD. Method(s): Single-center retrospective study including adult patients with previous fibrotic ILD and SARS-CoV-2 infection. Clinical, imaging, and respiratory functional data, pre and post infection, were revised. Result(s): A total of 49 patients (median age 68.4+/-11.1 years, 61.2% male) were analysed and major comorbidities included dyslipidaemia (69.4%), hypertension (53.1%) and obesity (29.9%). Hypersensitivity pneumonitis was the most frequent diagnosis (22.4%) followed by CTD-ILD (20.4%). Non-corticosteroid immunosuppression was present in 38.8% of the cases. Regarding COVID-19 severity, most cases were mild (55.1%) and 34.7% were severe disease requiring hospitalization. Fifteen patients died and 14 patients experienced progression of fibrosis, which was associated with a significant clinical (mean mMRC 0.86+/-0.53 vs 1.57+/-1.09, p=0.015) and DLCO decline (5.12+/-2.57 vs 4.54+/-2.96, p=0.002). Independent predictor of fibrotic worsening was the absence of non-corticosteroid immunosuppression (OR 0.072, p=0.019). Mortality correlated with OSA (p=0.011), heart failure (p=0.032), previous hypoxemic respiratory failure (p=0.013), severe COVID-19 disease (p<0.001) and hospitalization (p=0.004). Conclusion(s): Non-corticosteroid immunosuppression may have a protective role in fibrotic ILD patients. Mortality associated with COVID-19 severity, OSA, heart failure and previous hypoxemic respiratory failure.

COVID-19 in interstitial lung diseases: are fibrotic ILDs associated with worse outcomes?

Introduction: Few studies have evaluated the impact of COVID-19 on interstitial lung diseases (ILDs). Our aim was to compare outcomes in patients with fibrotic-ILDs (F-ILDs) and non-fibrotic-ILDs (NF-ILDs) after COVID-19. Method(s): We reviewed patients with ILD followed in a Portuguese university hospital. Patients' features and COVID- 19 outcomes were compared between F-ILDs and NF-ILDs groups. We used Kaplan-Meyer analysis to estimate overall survival (OS) and cox-proportional-hazards regression models to identify factors associated with OS. Result(s): A total of 103 patients (49.5% were male;mean age of 61.5+/-14.5 years) were included. The most prevalent ILDs were sarcoidosis (26.2%), HP (14.6%), CTD-ILD (14.6%), OP (8.7%), IPF (7.8%) and unclassifiable idiopathic interstitial pneumonia (7.8%). 47.6% of patients had F-ILD, and they had a higher prevalence of dyslipidemia (p=0.006) and immunosuppressive therapy (p<.001). Regarding the severity of COVID-19, 64.7% had mild, 11.7% moderate and 24.3% severe disease. There was a higher proportion of severe disease among F-ILDs patients (34.7% vs 14.8%, p=0.019). Post-COVID-19 mortality (median follow-up of 44 weeks) was significantly higher in FILD than NF-ILD cases (30.6% vs 5.6%, p=0.001). The median OS was significantly lower for patients who had severe disease (18.0 vs 45.5 weeks;p<.001) and F-ILD (41 vs 45 weeks;p=0.001). According to multivariate analysis, F-ILD (HR:4.00, p=0.042) and severe disease (HR:6.98, p=0.008) were the factors associated with worse OS. Concluding: In our analysis, COVID-19 was associated with worse outcomes in patients with F-ILDs and severe COVID-19, regardless of cardiovascular risk factors.

Perfil Dos Gastos Hospitalares De Pacientes Internados Com Doenca De Hodgkin No Estado Do Piaui De Janeiro De 2017 a Maio De 2022

Objetivo: Analisar de forma comparativa os aspectos relativos aos gastos referentes a saude para o tratamento de pacientes hospitalizados com doenca de Hodgkin no estado do Piaui. Materiais e metodos: O estudo ecologico e de carater descritivo e retrospectivo. Sendo utilizado os dados fornecidos pelo Departamento de Informatica do Sistema Unico de Saude (DATASUS) na secao do Sistema de Informacoes Hospitalares do SUS (SIH/SUS). As informacoes analisadas foram: o perfil de internacoes pelo linfoma de Hodgkin, total de internacoes, os gastos hospitalares das internacoes, a media do tempo de permanencia dos pacientes, alem do numero de obitos no periodo entre janeiro 2017 e maio de 2022. Para melhor organizacao destes dados, os mesmos foram agrupados no aplicativo Microsoft Excel, onde se realizou a analise estatistica descritiva e a frequencia absoluta junto a relativa. Resultados: No intervalo de 2017 a 2021, houve uma queda no numero de internacoes de 37,3% (94 em 2017 e 59 em 2021). De forma simultanea, se observou variacoes dos gastos hospitalares das internacoes: de 2017 a 2019 reduziu-se cerca de 27% (R$ 94.605,98 em 2017 e R$ 68.994,17 em 2019), em 2020 (periodo da pandemia da COVID-19) aumentou cerca de 38,7% em relacao ao ano anterior (R$ 95.706,10 em 2020), decaindo 5,8% em 2021 (R$ 90.120,19), seguido de um aumento aproximado de 12% ate maio de 2022 (R$ 100.903,05). Alem disso, em relacao ao periodo medio de permanencia dos pacientes entre janeiro de 2018 a maio de 2022, se evidenciou um prolongamento: 4,8 dias em 2018;5,2 em 2019;6,5 em 2020;6 em 2021 e 7,9 ate maio de 2022. Por fim, analisando o numero de obitos, o ano de 2017 apresentou o maior numero de obitos (8 mortes), discrepando do que foi observado em 2020 (periodo de pandemia de COVID-19) com notificacao de apenas uma morte (reducao de 25% em relacao a 2019 - 4 mortes). Discussao: Observa-se que o numero de internacoes no estado do Piaui esta inversamente proporcional ao valor total das despesas (aumento dos gastos com a diminuicao de internacoes), tendo em vista que a media de permanencia nos hospitais vem aumentando. Durante a pandemia da COVID-19, os valores totais dos custos foram significativos, podendo suspeitar de uma maior gravidade do quadro clinico nos pacientes com linfoma de Hodgkin pela imunossupressao, necessitando de maiores suportes. Os obitos apresentaram uma tendencia decrescente, principalmente durante o periodo da pandemia, na qual muitos casos podem ter sido subnotificados. Conclusao: Dessa forma, a partir desta pesquisa descritiva, e possivel concluir que os hospitais tiveram um gasto maior com o passar dos anos, bem como um aumento da media de permanencia dos pacientes. Alem disso, infere-se que a pandemia da COVID-19 contribuiu para que esses gastos crescessem de forma exponencial. Copyright © 2022

The role of anxiety about appearance on the practice of physical exercise and use of image-and performance-enhancing drugs (IPEDs) during the COVID-19 lockdown: A multicultural study

Background: The literature has been showing evidence about the impact of restrictive measures during the COVID-19 pandemic on different psychological variables and behaviours. This study aims to assess the contribution of anxiety about appearance on the practice of physical exercise and use of image-and performance-enhancing drugs (IPEDs) during the COVID-19 lockdown. Method: An online survey was carried out comprising the Exercise Addiction Inventory, and the Appearance Anxiety Inventory in addition to questions on the use of IPEDs. Results: The sample consisted of 3.161 (65% female) adults from seven countries (Italy, Spain, the United Kingdom [UK], Lithuania, Portugal, Japan and Hungary). Mean age was 35.05 years (SD = 12.10). Overall, 4.3% of the participants were found to engage in excessive or problematic exercise during the COVID-19 lockdown with peaks registered in the UK and Spain. Participants across all countries also reported the use of drugs and medicines to boost image and performance, and this use was maintained or started during the lockdown. Significant appearance anxiety levels were found across the sample. Logistic regression models revealed that anxiety about appearance was a non-significant predictor of engaging in physical exercise but increased the probability of using IPEDs significantly. This was despite the strong association found between physical exercise and IPEDs use. Conclusions: This study identified risks of appearance anxiety associated with the unsupervised use of IPEDs among the general population during the COVID-19 lockdown period across all the participating countries. The risks of appearance anxiety associated with excessive physical exercising were non-significant.

Problematic internet use during COVID-19 pandemic

Background: Experts in the field raised concerns about the rise of the Problematic Usage of the Internet (PUI) during the Coronavirus pandemic (COVID-19), however, specific online behaviours and how they are presented cross-culturally were explored to a lesser extent. In this study, we aimed to explore the cross-cultural manifestation of specific online behaviours and their associations with self-compassion, appearance anxiety, image and performance enhancing drugs (IPEDs) use, and specific online behaviours. Methods: An international survey was conducted in eight countries including Italy, Lithuania, Portugal, Spain, Japan, United Kingdom, Brazil and Hungary comprising in total 2223 individuals with a mean age of 33±11 years old. Participants were surveyed for specific type of Internet use severity (the Internet Activities Scale from the Internet Severity and Activities Addiction Questionnaire), selfcompassion (the Self-Compassion Scale, SCS), appearance anxiety (the Appearance Anxiety Inventory, AAI), and IPEDs use. Results: After adjustment for demographic factors, hours online, and country, self-compassion remained associated with higher levels of skill games and time wasters (β=-.073;p<.002), streaming (β=-.053;p=.018), digital hoarding (β=-.065;p=.006) and cyberchondria (β=-.153;p<.001). Appearance was associated with general surfing (β=.136;p<.001), online shopping (β=.137;p<.001), online gambling (β=.067;p=.003), social networking (β=.131;p<.001), pornography use (β=.102;p<.001), digital hoarding (β=.079;p<.001) and cyberchondria (β=.120;p<.001). IPEDs use also remained associated with various online behaviours during the COVID-19 pandemic Conclusions: Our exploratory study demonstrates that self-compassion, appearance anxiety, and IPEDS use contribute to various forms of PUI.

Knowledge about COVID-19 Best Practices in the North of Portugal and the Importance of Health Education in the Prevention of Pandemic Events

Introduction: The rapid global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has made COVID-19 one of the biggest pandemics of all time, with several devastating public health challenges. In this study, we investigated the knowledge towards COVID-19 best practices in the north of Portugal. Methods: A descriptive cross-sectional study was performed with a convenience sample of the population of northern Portugal to assess their knowledge about COVID-19, SARS-CoV-2 and measures to prevent and mitigate pandemics. An online validated questionnaire was completed by 411 participants, from September to October 2020. Results: The overall correct knowledge was 81.3%, which indicates a good knowledge by the northern Portuguese respondents about COVID-19. The correct answer score differed considerably between men and women, being significantly higher among the latter (12.28 +/- 1.22;p = 0.011). Moreover, the highest knowledge was observed in participants who attended high school or above (12.27 +/- 1.21;p < 0.000). Conclusion: This study contributes to the analysis of COVID-19 knowledge by the northern Portuguese population, emphasizes the crucial role of health education in the control and mitigation of the COVID-19 pandemic, and provides field-based evidence to prevent the next pandemic event.

Pre- and post-pandemic travel behaviour and intentions: Clustering: Portuguese Generations

The paper examines generational travel behaviour and intentions of Portuguese tourists before and after the pandemic. The comparisons established a framework to understand what really has changed. The sample includes 490 Portuguese tourists. Our analysis revealed three clusters which are distinct in terms of generation belonging and distance travelled, among other variables. The results suggest that the willingness to travel is higher than previously, working as a kind of revenge to mitigate the isolation times. Strategical implications for practitioners are outlined.

THE COVID-19 IMPACTS ON THE HOSPITALITY INDUSTRY HIGHLIGHTS FROM EXPERTS IN PORTUGAL

Purpose - To better understand the impact of COVID -19 on the tourism sector, with a focus on the hospitality industry, and how these changes will affect the sector and business responsiveness. Design - This is research focusing on the COVID-19 impacts on the hospitality sector in Portugal. The study reports in detail how a group of experts perceived this critical situation caused by the pandemic. Methodology - For data collection, a focus group was conducted with six experts in the field. A thematic analysis was conducted to interpret the data and NVivo software was used to organise and define the themes. Findings - Experts emphasised the massive collective dismissals in large hotel chains, the possible loss of 50 million jobs in the tourism sector, and the negative impact on the entire value chain. The low occupancy rate had a negative financial impact, as total revenues in the sector plummeted by more than 70% compared to the previous year. This pandemic required significant adjustments from operations to ensure safe operations. Participants not only stressed the importance of motivating and bringing teams together, but also described strategies to increase employee engagement. Another area of growth during the pandemic was food delivery platforms. Originality of the research - This is the first time research describing economic, financial, organizational, operational, and technological impact of COVID-19 on the hospitality industry. Hopefully these study results will help hotel and restaurant managers better plan their strategy following this pandemic.

THE PANDEMIC OF DOMESTIC VIOLENCE AGAINST WOMEN IN the STATES OF MARANHÃO: AN ANALYSIS OF THE CASA DA MULHER BRASILEIRA AND ITS ACTIONS DURING THE COVID-19

Objective: This paper aims to investigate the intersectoral activity of the Casa da Mulher Brasileira (CMB) in the State of Maranhão (CMB/MA), as well as the effectiveness of its actions in combating domestic violence in this pandemic context. Methodology: The main intellectual thesis behind this article is Pierre Bourdieu’s Reflexive Sociology. It has an exploratory nature, with a qualitative approach. To achieve its objectives, it chooses techniques such as content and speech analysis, bibliographic research, both document and data assemblage, as well as visits to the CMB/MA”. Results: It is of general understanding that domestic violence is that carried out at home, which is marked by a symbolic structure of domination, intensified by social distancing and/or isolation imposed by the pandemic. In the meantime, even if the “CMB/MA” has taken actions to reduce the distance between the victim and the services offered, there are still possibilities that influence the increase in occurrences and disfavor a more active attitude by CM”. Contributions: The research shows the need to combat domestic violence with public policies that match the dimensions of this problem in Maranhão. Thus, even with adequate normative protection, institutions such as the Casa da Mulher Brasileira are important for the formulation of concrete fighting strategies. That is why, during the pandemic, it is mandatory to provide the necessary conditions for intersectoral activities to reach women effectively and corroborate for the reduction of state indices. © 2021, Centro Universitario Curitiba - UNICURITIBA. All rights reserved.

Impact of the COVID-19 pandemic on Radiation Oncology Departments in Brazil

Purpose or Objective: The COVID-19 pandemic brought several challenges to cancer practice, especially to ensure continuity of treatment during this period, minimizing the risks of transmission to a vulnerable population. For Radiation Oncology departments in Brazil, this contingency has become even more complex due to the significant impact observed in different sectors of society, the large number of cases and deaths by COVID-19. This study estimated the impact of the COVID-19 pandemic on Brazilian Radiation Oncology departments and the coping measures used in the country. Materials and Methods: The Brazilian Radiotherapy Society (SBRT) developed a questionnaire with 14 questions, sent to all heads of Radiation Oncology departments in the country, between May and June 2020. These data were evaluated regarding cases confirmed and deaths by COVID-19 in epidemiological week 28, on July 11, 2020. Results: One hundred twenty-six questionnaires from different regions were answered, representing 44% of the country’s services. A drop in the number of patients was observed in 61% of services. This drop was observed both in patients from the public and supplementary private health insurance systems. Regarding patients and employees with COVID-19, we observe that services that primarily treat SUS patients reported significantly fewer cases of the disease. About half of the services had collaborators and patients during radiotherapy with a positive diagnosis of COVID-19. Among the coping measures, the services used intensified hygiene and cleanliness, distance, restrictions on access to companions, and other changes in daily practice. (Figure Presented) Conclusion: There was an important drop in the number of radiotherapy patients in the country during the pandemic, and this impact happened in a similar way among the services, regardless of their characteristics and coping measures adopted during the pandemic.

Web-based tools applied to therapy and counseling during the COVID-19 pandemic

IntroductionWeb-based tools allowed the provision of psychological counseling and therapy at-distance during the COVID-19 lockdown. Nevertheless, psychologists’ attitudes towards the adoption of these tools and its impact in their professional practices need to be further explored.ObjectivesThe objective was to study the use of web-based tools on psychological practices before and during COVID-19 lockdown, trying to identify changes on psychologists’ professional practices related to the pandemic, as well as to explore factors that could have affected such changes.MethodsOne-hundred and eight psychologists filled-in an online survey, developed for the purposes of this study, during mandatory lockdown. The study was disseminated by mailing list, social networks, and by the Portuguese Psychologists Association.ResultsThe results have shown that psychologists kept providing their services during lockdown thanks to the adoption of web-based tools. Although psychologists have recognized that additional precautions were needed for at-distance practice in comparison to in-person interventions, the experience of using IC technologies in clinical practice was described as positive, ensuring clients’ adherence with positive results. Additionally, despite psychological services were maintained on a larger scale by psychologists with more years of experience, professionals with average experience stated more favorable attitudes towards the use of web-based tools in counseling and therapy.ConclusionsAlthough the implementation of ICT based practice was enforced by current circumstances, the experience that psychologists gathered and shared during the lockdown can guide future professional practice, improving and fostering the replication of best practices at distance.

Exercise addiction, body dysmorphic disorder, and use of enhancement drugs during the COVID-19 pandemic confinement period: A transcultural study

IntroductionThe Coronavirus pandemic has originated unprecedented sanitary control measures that have conditioned people’s lifestyles and habits. Little is known about the impact of such measures, especially the most restrictive, on recent and growing phenomena such as exercise addiction, use of enhancement drugs, and Body Dysmorphic Disorder (BDD).ObjectivesThe objective was to investigate the above-mentioned phenomena during COVID-19 pandemic and how they relate.MethodsThe sample consisted of 3161 participants (65% women), from Portugal (11%), Italy (41%), Spain (16%), the UK (12%), Lithuania (12%), Japan (6%), and Hungary (4%). Mean age was 35.05 (SD = 12.10). Participants responded online to the Exercise Addiction Inventory (EAI), the Appearance Anxiety Inventory (AAI), and questions about use of enhancement drugs.Results4.3% of the participants scored above the cut-off point of the EAI, with higher values registered in the UK and Spain. Exercise addiction was higher among men. Appearance anxiety and body satisfaction problems were found in participants of all participating countries, with 15.2% scoring over the cut-off point for BDD. Higher numbers of those at risk of BDD were found in Italy, Japan, and Portugal. About 29% reported the use of fitness supplements to make them look better, with 6.4% starting a new use during the lockdown. Change in supplements use and exercise are predicted by EAI scores. Change in mental health is predicted by AAI scores.ConclusionsThis study helps to shed light on how COVID-19 lookdown induced behavioral changes and how they affect physical and mental health-related aspects in different countries.

The tourist guide profession and the impact of the COVID-19

Tour guides are one of the professions that suffered the most from the health crisis and is one of the professions that will have the most difficulty in recovering. This difficulty arises not only from the fact that modern tourism has developed in other ways, more individualistic, supported by new technologies and today also encouraged by insecurity, but because this profession works mainly with the foreign market, very dependent on mobility much limited now by the pandemic. We found interesting to see how these professionals experienced the crisis caused by the Coronavirus and the possible strategies they consider to adopt in order to resume safe activity, since one of the main differentiating characteristics of the profession is the strong human relationship. Through telephone contact established during quarantine, we made several interviews to professionals from Lisbon and Porto were. We intend to make this profession a little more known, which reveals to be very little known and much less recognized or valued, taking into account the importance that its performance has for a good image of the country, which is now intended to be safe and reliable. © 2020, Universidade de Aveiro. All rights reserved.

Measures to be implemented in the hotel buffets during the COVID-19 pandemic

Under the covid-19 pandemic, the profitability of the hotels will decrease, and the costs of the buffets will increase. It is essential to implement more efficient processes, while ensuring the safety of guests. The purpose of this study is to understand the future of hotel buffets amidst the COVID-19 pandemic. Four professionals from the Accor group were interviewed. They were purposefully chosen, due to their know-how in the F&B department. These professionals provided key recommendations and predictions on how hotels can adjust the buffet to a new reality. Their recommendations range from the transformation of the traditional buffet into an assisted buffet, to the implementation of new techniques to enhance the customer experience, and the growth of a healthy trend. The implementation of more efficient processes will also be essential for economic recovery. According to these professionals, the main challenge will be to generate a feeling of trust among customers.