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The novel coronavirus disease 2019 (COVID-19) was declared a global pandemic on March 2020, emerging as a major stressful life event with a significant impact on mental health, particularly in pregnant and postpartum women. Perinatal mental disorders are common health problems during child-bearing period and are associated with adverse maternal and fetal/infant outcomes. Thus, it is important to understand how women experienced their pregnancy and transition to motherhood while dealing with concerns about their health, risk of infection, as well as the social distancing and confinement measures implemented worldwide to contain the spread of the virus. This chapter aims to summarize the evidence available so far regarding changes in perinatal practices and mental health treatment during the COVID-19 pandemic, characterization of the psychological impact assessed in terms of perinatal depression, anxiety and post-traumatic stress disorder symptoms, pregnancy loss, and risk factors that have been associated with greater perinatal psychopathology during COVID-19 pandemic. Finally, we will present the major practical implications of COVID-19 pandemic on perinatal mental health and future steps that need to be undertaken. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022. All rights reserved.
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This study aimed to characterize the impacts that the Covid-19 pandemic caused in patients undergoing treatment for substance use disorders, in the outpatient psychiatric service of a teaching hospital in the interior of the State of Sao Paulo. A documentary research was carried out on 123 medical records of patients who received care at the Psychiatry Outpatient Clinic in the years 2019, 2020 and 2021. Data analysis showed that the largest portion of patients who abandoned treatment did so before the beginning of the pandemic and that there was no significant increase in substance use by patients who remained under follow-up during the pandemic period. It was concluded that the scenario of the Covid-19 pandemic was not the main variable that interfered with substance consumption and treatment adherence and that possibly intrinsic and extrinsic determinants also affected consumption and adherence. More research will be needed to assess other factors that affect substance use and treatment adherence in the population studied.
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Background: SARS-Cov- 2 is a new respiratory virus that causes COVID-19 disease. It is a new infectious agent and knowledge is still very limited, particularly its interaction with allergic disease. The aim of this study was to assess the effect of allergic disease on the risk of hospitalization for COVID-19. Method(s): A total of 7542 SARS-CoV- 2 infections were diagnosed from 1 March to 31 December 2020 at the Centro Hospitalar Universitario de Sao Joao. A total of 1727 (22.9%) patients were hospitalized (31% in intensive care) and 5815 were followed up by an outpatient clinic. Of this group, 3479 (65%) answered a telephone questionnaire, 3 to 6 months after acute infection, about sociodemographic, clinical, behavioral and psychological characteristics. They were also asked about a previous diagnosis of allergic disease. Individuals aged < 18 years and those with asymptomatic infection were excluded. Result(s): A sample of 2702 participants was analyzed, 33.5% reported allergic disease prior to the diagnosis of COVID-19: 215 (8%) asthma, 517 (19.2%) rhinitis, 138 (5.1%) drug allergy, 36 (1.3%) food allergy, 22 (0.8%) atopic dermatitis and 2 (0.1%) hymenoptera venom allergy. The proportion of participants with asthma is not statistically different across age groups, but when grouping other allergic diseases other than asthma, a reduction was observed with age (21.5% of 18-29 years old vs. 4.9 % with >=80 years, p > 0.001). Allergic disease was significantly more prevalent in women (asthma 9.8% vs. 5.2%;other allergies: 17.9% vs. 12.7%, p < 0.001). In a univariate analysis, the risk of hospitalization of patient with COVID-19 was significantly lower in those with allergic disease (OR = 0.7;95% CI: 0.55-0.92), but for asthma the effect was not significant. Gender was an interaction factor in this association, so in a separate multivariate model for women and men and adjusted for the other significant risk factors -age, obesity and comorbidities -the effect on risk reduction remained only in the men (adjusted OR = 0.6;95% CI:0.33-1.07). Conclusion(s): In this study, allergic disease, excluding asthma, was associated with a decrease in the severity of COVID-19, especially in men. However, further studies, namely prospective studies, are needed to better characterize this effect and the underlying mechanisms.
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Background: Colorectal cancer (CCR) is the third most common and the second most deadly cancer with 1.9 million new diagnoses worldwide in 2020. COVID-19 pandemic placed an unprecedented burden on health systems worldwide, directly impacting cancer patients’ management. Health-care systems reorganization led to a decrease on all non-urgent surgical and medical procedures, delaying cancer screening protocols. This study aims to access the impact of COVID-19 on Colorectal Cancer management in a Portuguese Oncology Department. Methods: A retrospective cohort study comparing the new colorectal cancer diagnosis between March/2019 and March/2022. New diagnosis between March/2019 and March/2020 were assigned to Cohort 1 “Before COVID-19 Pandemic” and new diagnosis between March/2020 and March/2022 assigned to Cohort 2 “During COVID-19 Pandemic”. Data was collected from digital medical records and statistical analysis performed using SPSS V.25 IBM®. Results: Between March/19 and March/22 were diagnosed 313 new colorectal cancers, 116 (37%) assigned to Cohort 1 “Before COVID-19 Pandemic” and 197 (63%) to Cohort 2 “During COVID-19 Pandemic”. Analysing the new diagnosis in Cohort 2, 105 (34%) occurred between March/20-21 and 92 (29%) between March/21-22. Mean age at diagnosis of 69 (30-96) years for Cohort 1 and 68 (32-94) years for Cohort 2. 42% (n=49) females and 58% (n=68) males in Cohort 1 compared to 38% (n=77) females and 62% (n=123) males in Cohort 2. Colorectal cancer screening diagnosed 36% (n=42) patients in Cohort 1 and 35% (n=69) in Cohort 2. Clinical presentation with bowel obstruction was seen in 25% (n=29) in Cohort 1 and 37% (n=74) in Cohort 2 (p=0.02). Metastatic disease at diagnosis in 13% (n=14) for Cohort 1 and 26% (n=52) for Cohort 2 (p=0.07). Regarding management, 39% (n=46) underwent adjuvant systemic treatment in Cohort 1 compared to 28% (n=55) in Cohort 2 (p=0.03). Palliative systemic treatment was agreed for 7% (n=10) in Cohort 1 and 17% (n=36) in Cohort 2 (p=0.02). At diagnosis, best supportive care was decided for 2% (n=2) in the first Cohort and 15% (n=30) (p=0.03). Overall survival of 25 (1-36) months for Cohort 1 and 10 (1-23) months for Cohort 2. Conclusions: Comparison between pre-pandemic and in-pandemic periods revealed a numeric reduction on new cases of colorectal cancer in each 12 months period. Despite similar rate of diagnosis by colorectal cancer screening, statistical significance was found when comparing clinical presentation with bowel obstruction or metastatic disease. Despite that, less patients underwent adjuvant systemic treatment in cohort 2 and more were evaluated for best supportive care at diagnosis. These findings may be explained by more advanced disease in more fragile patients in the Cohort 2 population. The results of our study contribute to the evidence on the impact of COVID-19 pandemics on colorectal cancer with fewer diagnosis, more advanced disease, and lack of re-establishment of pre-pandemic rate of new diagnosis. Legal entity responsible for the study: The author. Funding: Has not received any funding. Disclosures: All authors have declared no conflicts of interest.
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The pandemic caused by COVID-19 triggered a severe disruption in businesses worldwide, with pressing changes aimed business survival and striving. In this context, the pace of the digital transformation of business was tremendously accelerated, launching managers and employees into a new world of digital challenges. In this work, we explore the dynamic capabilities of businesses to cope with the COVID-19 contingencies, focusing on survival and success measures, dynamic digital capabilities and emerging management skills. We interviewed 24 business managers using semi-structured interviews and mixed-methods research to reveal how these businesses have coped during the second wave of COVID-19 in the country. Our results show that little to no governmental and financial support was received, and overall negative impact on the business potential to succeed at several levels, with little exceptions. Most businesses reveal having dynamic digital capabilities in place and ability to take advantage of their digital presence to foster business survival and growth. These capabilities are, however, heavily built on what we believe to be core emerging business management skills, as they are associated with several areas of expertise in the domain of digital communication. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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COVID-19 brought a lot of disruption into the business world. To cope with the challenges, companies tried to adopt new work formats, embracing the digital transformation as a possible solution to survive. Together with this change, owners and workers had to adapt and in several circumstances, learning new competencies and developing new capabilities. As this is a recent alteration, it is not complete yet, the effects of the pandemic crisis in businesses and people. Additionally, there are some initiatives to help entrepreneurs to start their own business or deal / improve their actual one. As such, this study intends to contribute to characterize the situation in Portugal and understand the role of one of these initiatives—the YBS—your business success—project. A small number of interviews were carried out with some companies in order to understand how they have faced the COVID-19 challenge. Results show that people responded to the challenge, and for some of them, these are even better than before. As this is just an exploratory study, more research about these changes and the process of innovation is needed as future work. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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During the first confinement caused by COVID-19 pandemic education shifted to what was coined as Emergency Remote Learning/Instruction/Teaching, trying to balance the need to continue the provision of educational content and the enormous challenges of coping with multiple issues that an unforeseen, unplanned, and urgent situation brought worldwide. At that period, we developed research to understand how HE students were living this situation for what we built a close-ended questionnaire comprising six dimensions of issues that may impact ERL: educational and organizational issues, technological and working conditions, social, family-related, psychological, and financial issues. Previous results, collected right after the first month of ERL revealed that the most severe problems reside in the pedagogical and psychological domains. The present research followed the evolution of the situation and confronts research results obtained during the first confinement with the conditions and students’ perception that we collected during the second confinement and its multidomain repercussions. The current results show that while the improvements reside mainly in contextual aspects, such as the family dynamics, working conditions, and financial safety, the worsening is primarily felt in the input and process element issues which concern the remote learning environment and social interactions with teachers and peers. However, the set of persistent issues reveals a scenario of perpetuation of the problems/concerns detected in the first confinement, such as sleeping disorders, exhaustion, lack of engaging classes, and lack of motivation. © 2022, Springer Nature Switzerland AG.
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Background: The onset of COVID-19 pandemic forced lockdown and halted breast cancer screening programs. We aimed to investigate the impact of COVID-19 on the new diagnosis and staging of breast cancer. Methods: In this cohort study, we included all patient with new diagnosis of breast cancer who were admitted to our Hospital (Hospital Pedro Hispano, Matosinhos, Portugal), between March 2019 and March 2021. We collected data on baseline clinical conditions such as age, stage at diagnosis and treatment. We created two different groups were created: 1st group- before COVID-19 pandemia (March 1, 2019 to March 16, 2020);2nd group - COVID-19 pandemia (March 17, 2020 to March 31, 2021). A comparative assessment between groups was carried out. Results: Were included 483 patients;n=289 in the 1st group and n= 194 in the 2nd group. The median age was 60 years old in the 1st group and 59 years old in the 2nd group. In the 1st group, 13% patients were diagnosis with ductal in situ carcinoma (DCIS), 51% in stage I, 24% in stage II, 9.5% in stage III and 3% in stage IV. In 2nd group, 9% had DCIS, 30% were in stage I, 40% in stage II, 11% in stage III and 10% in stage IV. Stage at diagnosis was significantly higher in the 2nd group (p< 0.001) This situation was mainly due to tumour size (T). In the 1st group, most patients (n=91;38%) had tumour size between 10 e 20mm (T1c in TNM classification). One the other hand, 40% (n=78) of patients included in the 2nd group had tumour size between 20 e 50mm (T2), with significant differences between them (p=0.004). No difference was found between groups in nodular involvement (p=0.189), with the majority of patients (∼50% in both groups) presenting without nodular involvement (N0 in TMN classification). 10% of patients in 2nd group and 3% in 1st group had metastatic disease at diagnosis, with differences between them (p=0.006). 49% (n=119) of patients in 1st group and 52% (n=100) in the 2nd group were treated with chemotherapy, without differences between those groups. Conclusions: Our results show that during one year after COVID-19 pandemia the incidence of breast cancer decreased, and patients were diagnosis in more advanced stages. This situation could have been related to patient referral to non COVID-19 Hospitals or correspond to a true sub-diagnosis. Legal entity responsible for the study: M. Vilaça. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
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Due to the pandemic crisis caused by COVID-19, people started performing their professional tasks remotely. This transition from the off-line and face-to-face work to online and remote work did not happen without pain, anxiety and some frustration as there was a need for accelerated learning and the frontiers between private and professional life were blurred. In this paper, we report on the preliminary findings of a survey-based research aimed at evaluating the main impacts and challenges faced by professionals in this transition process, in Portugal. Results show that respondents believe they work more, they feel more motivated, have better control over time, easily create methods and pace of work, and have more focus on tasks. Savings on fuel are offset by increased expenses in electricity, water, and food. Increased work-life balance but not increased leisure time are recognised. The most negative impact is social/professional seclusion, despite recognising fewer professional conflicts. © Atas da Conferencia da Associacao Portuguesa de Sistemas de Informacao 2020.
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The text addresses how the pandemic affects women differently. In particular, we analyze how violence against women finds a favorable scenario for its expansion in these times, which bring social isolation, adopted worldwide, as a measure to reduce contagion. Thus, women start to live 24 hours with those subjects who historically were and are their aggressors. Another element that contributes to the silencing of these women is that isolation removes them from the wider family and community relationships, in which they usually seek support to file a complaint and get out of the condition of violence. There is also a reduction in social and health services, configured as a gateway for women who suffer violence, who were restricted to more immediate actions of care and treatment of infected people, leaving educational work on hold to avoid agglomerations.
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In Spring 2020, the world moved from traditional classes to what was coined as ERL (Emergency Remote Teaching/Learning/Instruction), posing real challenges to all actors involved, requiring an immediate, unprecedented, and unplanned devising of mitigation strategies. The impacts of this transition cannot, however, be studied only at the educational level, as it consists of a broader social shift with multidomain repercussions. In this paper, we use the CIPP model (Context, Input, Process and Product evaluations) to further investigate interrelations among the context, input and process elements of ERL during the first wave of COVID-19, as the second wave presses towards reconfining. A correlation analysis of 46 variables, based students’ responses (N = 360) to a closed-ended questionnaire shows the crucial importance of motivation and engagement in online classes, as learning enablers or constrainers. These also shape the students’ perception of the role that online classes play in helping them to stay more positive during ERL. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Traditionally, there have been many reasons and factors contributing to the disbelieve in remote work as a large-scale efficient work format. But with the social distancing imposed by the COVID-19 pandemic, remote work (RW) emerged as an adequate solution to continue labor at a large scale, even in the situations where remote work was unforeseeable and, in many cases, happened under inappropriate conditions. Despite some advantages, which are mainly identified by employees, there are other issues, pointed out by organizations, such as required technology infrastructure, HR training, etc. In any case, opting for remote work present some gains and losses for both employers and employees. With the end of the mandatory confinement, organizations reorganized the work format and, in some cases, it consisted in restoring the previous one. At this point, many questions arise being important to evaluate the perspectives of both sides – workers and companies – as well as their perceptions retrieved from the RW during the Spring confinement period, to understand how was the transition period and preview the future in terms of RW becoming part of the work model or even the way the pandemic situation is influencing future changes in businesses models. To achieve that goal, an exploratory survey-based research, and interviews will be carried out. The sample consists of the top 100 private companies of the Great Place To Work (GPTW) Portuguese ranking. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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The pandemic caused by COVID-19 is not just a global crisis, it is ‘the first’ global crisis, and as the mandatory confinement shifted all education to Emergency Remote Instruction/Teaching/Learning, Higher Education Institutions were faced with the heavy task of balancing the immediate massive technological-pedagogical request by teachers and providing students with the socio-educational support that they need. This paper analyses the socio-educational impacts of the current confinement period on student’s lives and how they are responding to implemented ERL solutions, specifically in a stage of abundant pressing changes in which critical challenges are mostly felt. A close-ended questionnaire was built, comprising six dimensions of issues that may impact ERL: educational and organizational issues, technological and working conditions, social issues, family-related issues, psychological issues, and financial issues. Results were collected right after the first month of ERL and reveal that the most severe problems reside on the pedagogical and psychological domains. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Introduction: Ever since the first positive case was identified on March 2nd in Lousada, a region close to the border of our catchment area, we reacted immediately by systematically repurposing our surgical wards. Objective: Describe the changed made by our Vascular Surgery Department from March 13 to May 14. Methods: We collected clinical, operative, and consultation volume data from March 13 to May 14 and we compared it with the historical averages. We also reviewed the documents related to the planification activity. Results: At the peak of the outbreak, weadopted a split-team policy and encouraged completeteam segregation to reduce the risk of intradepartmental cross-contamination. Non-ambulatory surgical volume decreased by 54.8% (from 31 cases to 14 cases), and the ambulatory surgical activity was cancelled. Our in-person consultation volume decreased 86.4%;73 consultations were completed by phone, in which the patient was never evaluated in-person. In the emergency room the main difference between the pre-pandemic to the pandemic was in the number of patients observed without vascular pathology (82 versus 28). Conclusions: The adaptation to C0VID-19 pandemic reduced significantly the surgical production of our Vascular Surgery Department.
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The recent pandemic caused by COVID-19 has forced unprecedented professional and social changes that affect the way people work, learn and live. Even in an era in which the digitalization of the workplace had been already widely announced, employers and employees had not expected such an urgent digital immersion of jobs with broad impacts on the professional, personal, financial and social dimensions of the workforce. In this paper, the main consequences, challenges, and effects of remote work in Portugal are reported, together with a set of recommendations for employers and workers, which were captured in survey-based research. Results show that professionals are not unanimous towards the benefits of remote work, and while some would like to resume in-person work, a substantial amount of professional, personal and financial benefits are associated to the possibility of working from home. Additionally, and according to pressing changes, professionals put forward several recommendations for employers and peers regarding workload and time management, employee assistance and self-regulated work. © 2021, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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The world changed with the spreading of the new Coronavirus, considered by the World Health Organization as a Pandemic. Economies stopped, hospitals and morgues got overcrowded, economic indicators abruptly deteriorated, people found themselves confined to their houses. This times challenge organizations by guiding them to reinvent themselves in order to survive. This study focuses on the identification and explanation of the Systematic Literature Review Methodology, to survey the State of the Art regarding the adoption of E-Business Models by Portuguese Small and Medium-Sized Enterprises, forced to rethink their activity, given the restrictive measures taken to face the Pandemic. It is explained how the works in this area will be researched, selected and referred in the future study of investigation. The aim of the study is to evaluate the idea of how an e-business model can become vital, if implemented, in a Portuguese SME, with the current situation. © 2021, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Background: On March 11, 2020, COVID-19 was declared a global pandemic. Caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), this infection may remain asymptomatic. The European Society of Medical Oncology and the Portuguese Health Authority recommended both a symptomatic survey and laboratory testing in all cancer patients (pts) undergoing immunosuppressive treatment (IT). The impact of this measure is still unknown. We report our experience in a Portuguese center. Methods: Since March 2020, a symptomatic survey has been performed at our institution before each hospital visit. From April 6 through May 8, 2020, reverse-transcriptase polymerase chain reaction (RT-PCR) SARS-CoV-2 testing was added on cancer pts before undergoing IT. The impact of this intervention was evaluated comparing the hospitalization rate of cancer pts due to COVID-19, before and after the introduction of RT-PCR testing. Retrospective analysis of clinical data was performed. Results: 444 tests were carried out on 244 pts and laboratory SARS-CoV-2 infection was confirmed in 11 (5%);5 were male, with a median age of 65 years [34-76]. Breast and colorectal cancer were prevalent;2 pts had lung cancer;6 advanced disease. Ongoing IT in these pts was temporarily suspended: 9 pts under chemotherapy, 1 atezolizumab and 1 rituximab. Only 1 patient was symptomatic (9%) and previously hospitalized. No admission due to COVID-19 was registered in this group. Since March 7, 179 pts were admitted due to COVID-19 at our center: 12 were active cancer pts (6.7%) of which 4 were under IT. 6 of the oncological pts passed away, all of them had advanced diseases, 1 was under IT. Of the dead pts, lung and breast tumors were prevalent. Among all COVID-19 hospitalizations, the prevalence of pts under IT was similar before and after the implementation of the RT-PCR testing (2.2% vs. 2.4%). Conclusions: We found a significant percentage of active cancer pts diagnosed with asymptomatic COVID-19. Due to the small sample size of COVID-19 pts under IT, it is difficult to evaluate the impact of RT-PCR testing. However, on a long-term analysis, this intervention may reduce the risk of severe complications related to COVID-19 in cancer pts. Health education and dynamic organization are also important measures. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.