ABSTRACT
In a profound ageing context, such as the Portuguese, fertility becomes a key variable for the analysis of population dynamics, with increased importance given the very low levels recorded in the country. According to INE [2020], Portugal has a total fertility rate (TFR) of 1.40 children per woman, one of the lowest in the EU [Eurostat, 2022]. The economic and financial crisis of 2008 and the Troika intervention (European Commission, European Central Bank, and the International Monetary Fund, the three authorities that monitored international bailout programs) in 2011, had impacted on the socioeconomic conditions of the Portuguese population, with repercussions in other behaviors as well as in fertility. Thus, the childbearing postponement led the TFR to fall to its lowest levels on record, reaching 1.21 children per woman in 2013. Although the economic recovery has allowed a slight recovery in fertility levels, the new crisis caused by COVID-19 was reflected in a new historic decline in births in the country in 2021, when the number of live births fell below 80 000, a decrease of 8% compared to 2019 [INE, 2022]. Although this downward trend is common to almost all developed European countries [Aassve et al., 2020;Aassve et al., 2021], for Portuguese society it is a new wake-up call and a cause for concern given the population decline confirmed in the provisional data release from the 2021 Population Census (-2.1% compared to 2011). However, fertility patterns are not uniform, as they involve regional heterogeneity, which highlights a multiplicity of factors and behavioral patterns. This paper aims to approach fertility from a regional perspective to distinguish the diversity of patterns across the territory in the last two decades, and to discuss the extent to which the crises were a point of change or reinforcement of the transformations that were taking place. In the analysis, in addition to the framework and contextualisation of fertility trends by NUTS 3, the policy responses that have emerged at a local/municipal scale will be analysed. Although the crisis has contributed to the fertility decline in Portugal, its decline goes beyond the crisis reflecting changes in behavioral patterns and social and economic constraints. Thus, there persist constraints in the population dynamics that have prevented the reversal or mitigation of the decline in the inland territories that currently are also felt at the country level. © 2022 Authors. All rights reserved.
ABSTRACT
Objective: The objective of the research is to verify the prevalence of psychological distress symptoms in medical students during the COVID-19 pandemic. Methods: This is a cross-sectional and exploratory study that evaluated 656 medical students in Brazil. Data were collected between May and June 2020, through two self-administered instruments. The first was a questionnaire prepared by the authors themselves to assess the social, demographic and cultural profile of the population. For the screening of signs of psychological distress, the Self-Report Questionnaire was used, a questionnaire with 20 items divided into four domains. During data analysis, associations between categorical variables were tested using Pearson’s chi-square test. The significance level adopted was 5%. Results: The results show that the prevalence of individuals with signs of psychological distress was 62.8%. Risk factors for mental illness during the COVID-19 pandemic are being female, being in the first two years of the course, reporting poor adaptation to Distance Learning, having difficulty concentrating, worrying about the delay of graduation, have a previous diagnosis of mental disorder, live with someone who needs to work outside the home, inability to maintain healthy habits and fear being infected by the virus. Conclusion: We conclude that the signs of psychological distress are high among medical students during the COVID-19 pandemic. In addition, it was also possible to conclude that there are protective factors for mental illness. © 2021, Editora Cientifica Nacional Ltda. All rights reserved.