ABSTRACT
We study the impact of the pandemic crisis using monthly data covering the universe of individuals registered as unemployed in mainland Portuguese municipalities, complemented with electronic payments, linked employer-employee data, and furlough records. Event study designs identify a sharp increase in unemployment, driven mostly by termination of temporary contracts, and a decrease in new job placements. With triple difference-in-differences, we show that the effects are stronger in more dual municipal labour markets, i.e. with a higher share of temporary jobs, concentrated in young workers and middle educated individuals. The asymmetries are exacerbated by the duality of the municipal labour market. © 2023 Walter de Gruyter GmbH, Berlin/Boston 2023.
ABSTRACT
Objective: The COVID-19 pandemic posed innumerous challenges to the Portuguese National Health Service (NHS), including the absence of essential workers for health organizations. Therefore, the present work intended to quantify the absenteeism among the NHS workers during the period of COVID-19 pandemic (2019-2020). Method(s): This work used data from the NHS Transparency Portal, regarding the number of healthcare professionals and the number of absence days in the period of analysis. Absenteeism was compared, before and during the pandemics, in absolute numbers and as a percentage of workforce working days. Additionally, this work analyzed the main reported absence categories. Result(s): Results showed an 25% increase in absenteeism among NSH workers, from 2019 to 2020. The highest number of absence days were registered in May 2020, summing 598.323 days. Sickness, parental leaves and accident at work or an occupational disease were the most frequent absenteeism categories reported. Conclusion(s): Several factors might explain the excess of absence days among the NSH workers, during the pandemics, but some of them are likely to be associated with COVI-19 infection, either directly or indirectly. These absent rates might lead to increased difficulties and constraints in healthcare organizations, threatening the adequate response to the pandemics.
ABSTRACT
Objective: About 70% of cases of Acute Lymphoblastic Leukemia (ALL) affect children aged 1- 4 years. The incidence increases slightly again in adults over 50 years, characterizing a poor prognosis. According to data from the National Cancer Institute, for the year 2020 leukemias present in men as the fifth most frequent neoplasm in the Northeast Region with a risk of 8.20/100,000 inhabitants, occupying the fifth position. In the case of women, the risk in the Northeast region is 4.42/100,000 inhabitants and ranks tenth. This study aimed to identify the molecular and epidemiological profile of adult patients with ALL in the state of Ceara. Methodology: Sample collection was performed in patients with ALL treated at the General Hospital of Fortaleza (GHF), considered the main and largest hematology outpatient clinic in the metropolitan region of Fortaleza, as well as the State of Ceara. All patients participating in this study read and signed the informed consent form. Patients with other types of leukemias or other hematological diseases were excluded. This study was approved by the Research Ethics Committee of the Federal University of Ceara under protocol no. 38680520.9.0000.5054. Result(s): From July 2021 to July 2022, 25 patients with ALL were treated, of whom 9 are women and 16 are men. The mean age observed was 42.5 years. 44% of patients live in the capital (Fortaleza), while the other 56% of patients live in rural areas. Through immunophenotyping it was possible to verify that there were 22 patients (88%) compatible with ALL-B presenting CD19, CD10, CD45, CD38, CD22, CD79a, CD34, CD81 and CD58 as the main markers, while only 3 patients (12%) were compatible with ALL-T, expressing mainly CD3, CD45, CD5, CD7, CD2, CD11c and CD1a. Eleven patients (44%) had abnormal and complex karyotypes. Five patients had the BCR-ABL p190 mutation and two had the E2A-PBX1 mutation. A total of 9 patients died due to septic shock, COVID-19, or refractoriness to treatment. Discussion(s): The literature indicates a new peak of ALL cases after 50 years of age, however the highest incidence observed in the study participants was between 30 and 50 years. Studies indicate that immunophenotyping findings in patients with ALL B line are almost always CD19, CD79a, CD10, CD20 and CD22 positive, while T-strain ALL usually present CD7, CD3, CD1a and CD10 as the main markers, corroborating what was observed in the results. In addition, depending on the alteration observed in the karyotype, it may confer poor or good prognosis to the patient. The BCR-ABL1 and E2A-PBX1 mergers, for example, are alterations that give worse prognosis to patients and, therefore, may be targeted for treatment in an attempt to improve the survival of these patients. TEL-AML1 fusion, on the other hand, represents a good prognosis, being more incident in pediatric ALL. Conclusion(s): Epidemiological data from this preliminary study indicate that in the state of Ceara ALL is more common in male patients aged 30-50 years living in rural regions. In addition, the use of targeted therapies for patients with abnormal karyotypes as well as the adoption of stricter measures to prevent hospital infections may increase patient survival. Copyright © 2022
ABSTRACT
Objective: Acute myeloid leukemia (AML) is the second most common leukemia in adults and older patients represent most cases. The states of the Northeast of the country have stood out in the frequency of leukemia cases, and the frequencies are higher than the rate of 35% compared to other neoplasms, especially in the metropolitan regions of Fortaleza. In the State of Ceara, the number of cases of leukemia expected for the year 2020 is 6.17 cases/100,000 inhabitants in men and 4.29 cases/100,000 inhabitants in women. In view of this information, the aim of this study was to identify the molecular and epidemiological profile of patients with AML in the state of Ceara. Methodology: Sample collection was performed in patients with AML treated at the General Hospital of Fortaleza, considered the main and largest hematology outpatient clinic in the metropolitan region of Fortaleza, as well as the State of Ceara. All patients participating in this study read and signed the informed consent form. Patients with other types of leukemias or other hematological diseases were excluded. This study was approved by the Research Ethics Committee of the Federal University of Ceara under protocol no. 38680520.9.0000.5054. Result(s): From July 2021 to July 2022, 31 patients with AML were treated, of which 8 are women and 23 are men. The mean age observed was 50.4 years. 54.8% of patients live in the capital, while the other 45.2% of patients live in rural areas. Through immunophenotyping it was possible to verify that the main markers presented by LMA patients were CD33, CD13, CD117, CD45, MPO, CD34, CD64, HLA-DR, CD11c, CD11b e CD38. Thirteen patients (42%) had abnormal and complex karyotypes, of which six died. Five patients (16,1%) had the t(15;17)(q24;q21.3) corresponding to the PML-RARA fusion. Six patients (19,3%) had the FLT3 mutation that confers a poorer prognosis. During the clinical follow up, a total of 16 patients died due to septic shock, COVID-19, or refractoriness to treatment. Discussion(s): The incidence of cases of adults over 50 years of age with AML was 58%, as it corroborates the expected incidence of cases regarding the age described in the literature. Studies indicate that immunophenotyping is critical to the differential diagnosis among AML subtypes. AML is defined by the mainly expression of the markers MPO, CD117, CD13, CD33, HLA-DR and CD38, corroborating what was observed in the results. In addition, depending on the alteration observed in the karyotype, it may confer poor or good prognosis to the patient. The PML-RARA merger, for example, is known as M3 AML or acute promyelocytic leukemia (APL), a subtype of AML with a better prognosis for patients. The FLT3 mutation is present in 1 in 3 patients with AML. The presence of this altered gene may mean a worse prognosis and a greater possibility of recurrence but allows a specific and differentiated treatment. Conclusion(s): Epidemiological data from this preliminary study indicate that in the state of Ceara AML is more common in male patients aged 50-80 years. In addition, the use of targeted therapies for patients with abnormal karyotypes as well as the adoption of stricter measures to prevent hospital infections may increase patient survival. Copyright © 2022
ABSTRACT
Background By March 2020, the first Covid-19 cases were detected in Portugal. While the National Health Service (NHS) faced an increased demand for health care, anecdotal evidence showed that the NHS absenteeism rose. This might be explained by outbreaks in healthcare units, COVID-19 infection due to close contact with patients, self-isolation and quarantines, and family challenges originated by lockdowns. The present work aimed to quantify the absenteeism among NHS workers during the COVID-19 pandemic in Portugal. Methods This study used data for the number of NHS workers and absence days (2015-2021), from the Portuguese NHS Transparency Portal and the Strategy and Planning Office. Absenteeism was compared, before and after the pandemic onset, in absolute terms, and as absence rates (number of absent days as a percentage of potential workforce days). Additionally, we performed an interrupted time series analysis, by fitting a Poisson regression model with level change. We controlled for data seasonality using Fourier terms (pairs of sine and cosine functions). Results From 2015 until March 2020, the average monthly absence rate was of 12.2, rising to 14.4 in the remaining period. This represented an increase of 18% in the absence rate. The interrupted time series showed an increase of 10.8% in the NHS absenteeism after the pandemic onset [Relative risk =1.10;95% confidence interval (CI) 1.10-1.11;p < 0.01]. When accounting for seasonality in the data, the model showed an increase of 11.0% in the NHS absenteeism [Relative risk =1.11;95% CI 1.01-1.22;p < 0.05]. Conclusions These results highlight the excess of absence days among the NHS workers during the COVID-19 pandemic. In future healthcare crises, health professionals should be protected, by assuring a safe workplace and making protective equipment available. Only then will be possible to reduce constraints in healthcare assistance, guarantee the adequate response, and contain the absence costs. Key messages During the COVID-19 pandemic in Portugal, the NHS absenteeism increased by 11% (p < 0.05). The absence rates might have threatened healthcare assistance, and increased the healthcare costs.
ABSTRACT
OBJECTIVES: The SARS-CoV-2 virus has spread worldwide, leading governments to implement mitigation measures. Understanding the reluctance to adhere to non-pharmacological interventions might help promote adherence to these measures. This study aimed to identify factors associated with non-adherence to the first lockdown in Portugal. STUDY DESIGN: Cross-sectional study. METHODS: This study used data from a Portuguese community-based survey entitled 'COVID-19 Barometer: Social Opinion'. Data were collected on risk perception, health status and social experiences using a snowball sampling technique. The event of interest corresponded to participants who reported not staying home during the lockdown period, serving as a proxy for non-adherence to lockdown. Logistic regression was used to identify factors associated with non-adherence to the first lockdown. RESULTS: Responses from 133,601 individual questionnaires that were completed during the first week of the first lockdown in 2020 were analysed. A minority of participants (5.6%) reported non-adherence to lockdown (i.e. leaving home for reasons other than essential situations). Working in the workplace was the factor with the strongest association of non-adherence to the lockdown. Several other factors were also associated with non-adherence to the first lockdown; namely, being a man, being a student, having a low level of education, having a low income, living alone or with a high-infection-risk professional (e.g. doctor, nurse, pharmaceutical, health technician, firefighter, police officer, military, essential services worker), perceiving the risk of getting COVID-19 to be high, not having social support in case of infection, feeling agitated, sad or anxious every day, and considering the preventive measures to be unimportant or inadequate. CONCLUSIONS: Non-adherence to lockdown was associated with socio-economic, trust and perception factors. Future research should investigate the mechanisms underlying these associations to help identify the population groups who are most at risk of non-adherence.
Subject(s)
COVID-19 , COVID-19/prevention & control , Communicable Disease Control , Cross-Sectional Studies , Humans , Male , Portugal/epidemiology , Quarantine/methods , SARS-CoV-2 , Social IsolationABSTRACT
Background: The COVID-19 pandemic may affect youth's physical and mental well-being, partially because of the countries' rules to contain the virus from spreading. However, there is still uncertainty about the impact of physical distancing on youth's mental health. We aimed to estimate the prevalence of feeling agitated, anxious, down, sad, or low mood (FNF) due to physical distance measures and verify which factors are associated with young Portuguese and Brazilian people. Methods: We used cross-sectional data from the instrument "COVID-19 Barometer: Social Opinion"in Portugal (March 2020 and September 2021) and from "COVID-19 Social Thermometer"in Brazil (August 2020 to April 2021);these surveys included data regarding the health and socioeconomic impact on the population. The health and sociodemographic variables of the two countries were summarized as absolute and relative frequencies. A multivariable logistic regression model was fit by country to estimate the relation between FNF and selected variables of interest. Results: Approximately 36% of the sample studied reported anxiety, agitation, sadness, or low mood almost every day in Portugal and 52% in Brazil due to physical distancing. In Portugal, having more than two comorbidities represented a greater chance of experiencing FNF every day or almost every day (odds ratio [OR] = 1.51 [CI: 1.22-1.87]) than those without comorbidities. In contrast, having a university education level represented a protector factor (OR = 0.76 [CI: 0.67-0.88]). In Brazil, being unemployed increased the chance of FNF compared to students (OR = 11.2). Conclusions: Physical distancing measures have impacted the mental well-being of the young population in Portugal and Brazil. The countries must make a quick effort to attend to and protect young people's well-being and mental health in the changing context of the current pandemic.
ABSTRACT
Introduction: The inflammatory process and multisystemic manifestation caused by Covid-19 infection can involve multiple sequelae with damage on physical, cognitive, psychological, and biological aspects. This condition results on poor quality of life, fatigue, dyspnea and sleep difficulties. The focus on sleep difficulties, the most common symptoms are related to night drowsiness and insomnia, but little is known about the clinical characteristics of these patients who develop this complication. Objective: Evaluate the main complaints and clinical signs in patients after COVID-19. - Rate the quality of sleep in post-COVID-19 Syndrome patients who have had mild, moderate and/or severe symptoms of the disease. Methods: Observational study and descriptive, with a quantitative approach to data. A general and a specific sleep quality questionnaire were applied to patients undergoing rehabilitation after the diagnosis of COVID-19, who did or did not need to be hospitalized, with symptoms that had started at least 5 weeks before the questionnaire response date. Participants who were unable to answer the questionnaires due to a deficit in understanding the questions asked, or who gave up on completing the questionnaires without finishing, were excluded. Results: 177 participants participated in the research, 124 men (70%) and 53 women (30%). 62.7% of participants reported at least one comorbidity and only 23 people (12.9%) were not vaccinated with any dose until participation in this study. With regard to hospital admission, 109 participants (61.6%) required admission to the ICU and of these, 57.8% (63) required orotracheal intubation, with prolonged hospital stay for more than 12 days. The most common symptoms after covid-19 were muscle fatigue (78.3%), excessive daytime sleepiness (51.4%), persistent cough (47.4%) and headache (47.1%). 81.4% of participants reported that they felt their sleep quality had worsened after the diagnosis of COVID-19. And after applying a specific questionnaire (PSQI), 93.7% of participants were classified as poor sleepers. There was a very strong correlation (r>0.9) with participants who assessed hospitalized and in invasive mechanical ventilation, with bad sleep quality. Conclusion: The post-COVID-19 Syndrome, associated with age, comorbidities, length of stay and use of invasive mechanical ventilation, were factors that are associated with a higher prevalence of sleep disorders.
ABSTRACT
This article appears as an essential contribution for decision-makers in the Cape Verdean tourism sector given the impact that the number of overnight stays has on the economy of the country and the Sal Island, which until 2018 had been increasing every year. Since seasonality is a strong feature of the island’s tourism, decision-makers are interested in knowing the seasonal variation in tourism demand. Thus, this study focussed on the application of the Box-Jenkins method to the time series of the monthly number of nights stays in tourist establishments on the Sal Island, Cape Verde, over the period from January 2000 to December 2018, to find a model that better describes the series and with good forecast results for the year 2019. Several SARIMA models were studied using the Box-Jenkins method, with the SARIMA (1, 1, 1 ) (0, 1, 1 ) 12 and the SARIMA (2, 1, 0 ) (0, 1, 1 ) 12 demonstrating the best predictive performance in the test phase. However, in forecasting the series for the year 2019, the SARIMA (2, 1, 0 ) (0, 1, 1 ) 12 achieved the best results with a MAPE = 6.77%. This model can be used to simulate and analyze the number of overnight stays that be expected on the Island, if the tourism sector was not affected by the pandemic caused by COVID-19. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
ABSTRACT
This text seeks to present the data of a research carried out in the Territory of Identity of the Southwest Bahia - TISOBA on the conditions of teaching work in times of pandemic of CoWd-19. To this end, it used on online questionnaire disseminated among teachers who work in municipal schools belonging to TISOBA and who adhered to the research. The data were presented and reveal the reality experienced by teachers who hod to adopt to the remote teaching model mediated by technologies applied to education and which demonstrate the difficulties faced.
ABSTRACT
Background Avoiding an emergency department (ED) visit risks irreversible negative consequences for patients' health. EDs are a frequent access point to the Portuguese health system. Previous studies have shown that patients may avoid visiting ED during the pandemic. This study aims to identify factors associated with avoidance of ED visits in Portugal during the COVID-19 pandemic. Methods We used data from a community-based survey, “COVID-19 Barometer: Social Opinion”, which includes healthcare utilisation, health status, and risk perception in Portugal from 11th April 2020 to 16th April 2021. We included respondents that reported having needed ED care. Data were collected on sociodemographics, health status (comorbidities, mental health), risk perception (COVID-19 and complications), level of trust in health services and self-assessment of the severity of the reason for ED visit. The outcome of interest was the decision to avoid ED care. We used logistic regression to identify factors associated with the decision to avoid ED. Results Preliminary data showed that 914 respondents reported needing ED care (74.8% female;mean age 43 years). From those, 224 (25%) decided to avoid ED care. ED visits avoidance was higher during lockdowns (28%). People reporting specific comorbidities (cardiac, autoimmune, respiratory) avoided ED more than those without them. Perception of no severe reason for ED visit, poor mental health, perception of higher risk of COVID-19 and complications, and low trust in health services response to the pandemic were associated with higher odds of ED visit avoidance. Conclusions People avoiding ED visits represented a considerable share. The decision to avoid ED visit was associated with clinical characteristics, but the perception of risk and assessment of the context and health system response also played a role in decision making. Key messages The effect of avoided ED visits on health should be a research and policy concern. People with certain comorbidities or perception of high risk of COVID-19 and complications may be closely monitored.