The impact of remote work on worker's health O impacto do home office na saúde do trabalhador

Remote work was brought to the forefront with the arrival of the COVID-19 public health emergency. Although there is no evidence of a direct cause-and-effect relationship between venous disease and work, the current medical consensus is that work can severely intensify its progression. Here, we report the case of a worker at a financial institution, who had been working remotely for around one year and had stopped exercising regularly for the same period. In January 2021, he presented intense pain and marked edema in the soleus area of the right lower limb, which prompted a visit to the emergency department. Laboratory analyses showed slight increases in d-dimer (720 ng/mL) and C-reactive protein (5 mg/dL) levels. A venous Doppler ultrasound of the lower limbs revealed the presence of an occlusive thrombus in the right soleus veins, reaching the right popliteal vein with associated venous dilation. The diagnosis of right, popliteal-distal acute deep vein thrombosis was thus reached. It is clearly impossible to change some of the risk factors of chronic venous insufficiency;however, other aspects such as obesity and working conditions can be the object of preventive actions that generate changes. We thus highlight the importance and possibility of a multidisciplinary approach to this theme, which could evolve into the establishment of a protocol for the prevention and treatment of venous diseases according to each job position.

The impact of remote work on worker's health.

Remote work was brought to the forefront with the arrival of the COVID-19 public health emergency. Although there is no evidence of a direct cause-and-effect relationship between venous disease and work, the current medical consensus is that work can severely intensify its progression. Here, we report the case of a worker at a financial institution, who had been working remotely for around one year and had stopped exercising regularly for the same period. In January 2021, he presented intense pain and marked edema in the soleus area of the right lower limb, which prompted a visit to the emergency department. Laboratory analyses showed slight increases in d-dimer (720 ng/mL) and C-reactive protein (5 mg/dL) levels. A venous Doppler ultrasound of the lower limbs revealed the presence of an occlusive thrombus in the right soleus veins, reaching the right popliteal vein with associated venous dilation. The diagnosis of right, popliteal-distal acute deep vein thrombosis was thus reached. It is clearly impossible to change some of the risk factors of chronic venous insufficiency; however, other aspects such as obesity and working conditions can be the object of preventive actions that generate changes. We thus highlight the importance and possibility of a multidisciplinary approach to this theme, which could evolve into the establishment of a protocol for the prevention and treatment of venous diseases according to each job position.

O home office ganhou um papel de destaque com a chegada da emergência de saúde pública relativa à COVID-19. Embora não haja evidência da relação direta de causa e efeito de doença venosa com o trabalho, existe consenso atual, na opinião médica, de que o trabalho pode agravar seriamente o seu desenvolvimento. É relatado o caso de um profissional de instituição bancária, em teletrabalho há cerca de 1 ano, momento em que suspendeu também a prática de exercício físico. Em janeiro de 2021, iniciou quadro de dor intensa e edema acentuado na região solear do membro inferior direito, motivo pelo qual recorreu ao Serviço de Urgência. No estudo analítico, foram destacadas ligeiras elevações dos D-dímeros (720 ng/mL) e proteína C-reativa (5 mg/dL). A ecografia com estudo de Doppler venoso dos membros inferiores revelou presença de trombo oclusivo nas veias soleares direitas com extensão à veia poplítea direita com dilatação venosa associada. Admitiu-se, então, o diagnóstico de trombose venosa profunda poplíteo-distal direita de características agudas. É evidente que é impossível modificar alguns dos fatores de risco para a insuficiência venosa crônica; porém, outros fatores como obesidade e condições de trabalho podem ser alvo de ações preventivas que gerem modificações. Assim, ressaltam-se a importância e a possibilidade da abordagem multidisciplinar ao tema, o que poderia evoluir para o estabelecimento de um protocolo de prevenção e tratamento de doenças venosas em função do posto de trabalho executado.

Violence against Women during the COVID-19 Pandemic: From Children to the Elderly

Women of all ages can be exposed to violence both within and outside of the home, especially in the context of the COVID-19 pandemic. The purpose of this study is to analyze violence against women (VAW) before and during the first year of the pandemic in Portugal. Crimes perpetrated against female victims from 17 years old and younger to 65 years old and older were analyzed by comparing requests for help in 2019 and 2020. A total of 12,045 requests for help for VAW were received by the Portuguese Association for Victim Support and analyzed in the current study. The findings reveal a 16% increase in requests for help in 2020 and a 95% increase when the lockdown was implemented. That said, the most reported, intimate partner violence (IPV), showed a decrease of 5% in 2020. Furthermore, compared to 2019, requests for help concerning criminal offenses involving psychological violence in non-IPV contexts increased 79% in 2020, especially for victims 17 years old or younger (116%), and attempted femicide/femicide requests for help increased 53%. We are still in the early stages of understanding how the pandemic will affect this situation. Future directions concerning support of female victims during the pandemic are outlined.

Psychosocial risks factors among victim support workers during the COVID-19 pandemic: a study with the Copenhagen Psychosocial Questionnaire.

BACKGROUND: Being a victim support worker (VSW) involves exposure to victims' suffering, pain, and traumatic events, which may trigger the risk of VSWs developing mental health problems. Psychosocial risks (PSR) and work-related stress are considered the most challenging issues in occupational safety and health, considering they impact individuals, organizations, and economies. METHODS: The purpose of the present study was to identify the PSR in a sample of 196 Portuguese victim support workers (VSW) (Mean age = 36.49; SD = 10.52). A questionnaire with socio-demographic characteristics, variables related to VSW's job, and the Portuguese medium version of the Copenhagen Psychosocial Questionnaire II (COPSOQ II) were used to assess these professionals' perception of PSR factors. RESULTS: The results reveal that although VSW recognizes some psychosocial factors favourable to their health and well-being, they also identify some PSR that place them at intermediate and severe risk, i.e., emotional and cognitive demands, which are the main areas of risk to the VSW. VSW over 38 years old scored higher in job insecurity, burnout, and offensive behaviours. CONCLUSIONS: These findings give important insights into the areas that must be enhanced in this context involving VSW. Additionally, the results highlight the relevance of encouraging a healthy and supportive work environment, preventing and promoting the health and well-being of VSW, particularly when considering the coronavirus disease (COVID-19) pandemic.

Psychological Impact of the COVID-19 Pandemic on Families of People with Severe Mental Disorders Participating in Community Peer Support Groups in Brazil

People with severe mental disorders are at increased risk of dying from COVID-19 and more susceptible to the impacts of the pandemic. This study aims to understand how the families of patients with severe mental disorders followed up in community peer support groups experienced the beginning of the pandemic in Brazil and how they fared during the period of restricted physical contact. Family members (n = 82) and patients (n = 27) belonging to community groups in Rio de Janeiro responded to an online survey that included assessments of quality of life and well-being along with open-ended questions. Thematic analysis of the answers showed that the majority of remarks were positive, despite the concerns, fears, and feelings common at the time. Positive feelings were also mentioned significantly. These findings demonstrate that this population was adaptive and resilient in coping with the restrictions on physical contact. The main concerns and difficulties of this population are discussed.

Remote support to victims of violence against women and domestic violence during the COVID-19 pandemic

Purpose: This paper aims to characterize the type of support provided to victims of violence against women and domestic violence (VAWDV) during the first lockdown, assessing the training of professionals to use remote support (RS). Design/methodology/approach: This cross-sectional study involves a sample of 196 support professionals, mainly women (91.8%) and who integrate the Portuguese National Support Network for victims of domestic violence (NSNVDV) (Mean age = 36.49;SD = 10.52). Findings: Telephone emerges as the main RS communication media used in the lockdown (43.9%) and the emergency state periods (57.1%). Participants reported to have never used any social applications (41.8% vs 41.8%) or videoconference (46.4% vs 58.2%), in both periods assessed, i.e. lockdown and emergency state, respectively, and 82.7% assumed to have no training with RS to assist VAWDV victims. However, support professionals recognized several advantages in using RS such as dealing with isolation, reducing inhibition, fear and shame and in promoting the victims' empowerment. Research limitations/implications: Given the exploratory nature of this study, only descriptive analyzes were conducted. Originality/value: During the COVID-19 pandemic, little is known about effective RS given by professionals to victims of VAWDV in the Portuguese context. The paper aims to add knowledge to the studied field. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Longitudinal SARS-CoV-2 seroprevalence in Portugal and antibody maintenance 12 months after infection.

During the COVID-19 pandemic, Portugal has experienced three distinct SARS-CoV-2 infection waves. We previously documented the prevalence of SARS-CoV-2 immunity, measured by specific antibodies, in September 2020, 6 months after the initial moderate wave. Here, we show the seroprevalence changes 6 months later, up to the second week of March 2021, shortly following the third wave, which was one of the most severe in the world, and 2 months following the start of the vaccination campaign. A longitudinal epidemiological study was conducted, with a stratified quota sample of the Portuguese population. Serological testing was performed, including ELISA determination of antibody class and titers. The proportion of seropositives, which was 2.2% in September 2020, rose sharply to 17.3% (95% CI: 15.8-18.8%) in March 2021. Importantly, circulating IgG and IgA antibody levels were very stable 6 months after the initial determination and up to a year after initial infection, indicating long-lasting infection immunity against SARS-CoV-2. Moreover, vaccinated people had higher IgG levels from 3 weeks post-vaccination when compared with previously infected people at the same time post-infection.

Prevalence of SARS-CoV-2 Antibodies after First 6 Months of COVID-19 Pandemic, Portugal.

In September 2020, we tested 13,398 persons in Portugal for antibodies against severe acute respiratory syndrome coronavirus 2 by using a quota sample stratified by age and population density. We found a seroprevalence of 2.2%, 3-4 times larger than the official number of cases at the end of the first wave of the pandemic.

Gut Microbiota Diversity and C-Reactive Protein Are Predictors of Disease Severity in COVID-19 Patients.

The risk factors for coronavirus disease 2019 (COVID-19) severity are still poorly understood. Considering the pivotal role of the gut microbiota on host immune and inflammatory functions, we investigated the association between changes in the gut microbiota composition and the clinical severity of COVID-19. We conducted a multicenter cross-sectional study prospectively enrolling 115 COVID-19 patients categorized according to: (1) the WHO Clinical Progression Scale-mild, 19 (16.5%); moderate, 37 (32.2%); or severe, 59 (51.3%), and (2) the location of recovery from COVID-19-ambulatory, 14 (household isolation, 12.2%); hospitalized in ward, 40 (34.8%); or hospitalized in the intensive care unit, 61 (53.0%). Gut microbiota analysis was performed through 16S rRNA gene sequencing, and the data obtained were further related to the clinical parameters of COVID-19 patients. The risk factors for COVID-19 severity were identified by univariate and multivariable logistic regression models. In comparison to mild COVID-19 patients, the gut microbiota of moderate and severe patients have: (a) lower Firmicutes/Bacteroidetes ratio; (b) higher abundance of Proteobacteria; and (c) lower abundance of beneficial butyrate-producing bacteria such as the genera Roseburia and Lachnospira. Multivariable regression analysis showed that the Shannon diversity index [odds ratio (OR) = 2.85, 95% CI = 1.09-7.41, p = 0.032) and C-reactive protein (OR = 3.45, 95% CI = 1.33-8.91, p = 0.011) are risk factors for severe COVID-19 (a score of 6 or higher in the WHO Clinical Progression Scale). In conclusion, our results demonstrated that hospitalized patients with moderate and severe COVID-19 have microbial signatures of gut dysbiosis; for the first time, the gut microbiota diversity is pointed out as a prognostic biomarker of COVID-19 severity.

Reflections on the extinction of the National Council for Food and Nutrition Security and the confrontation of Covid-19 in Brazil

ABSTRACT The Provisional Measure 870/2019, which amended the Organic Law on Food and Nutrition Security and extinguished the Conselho Nacional de Segurança Alimentar e Nutricional (National Council for Food and Nutrition Security), has brought serious consequences to the Brazilian population, especially for the most vulnerable. This scientific note brings reflections on the trajectory of the Conselho Nacional de Segurança Alimentar e Nutricional, the repercussions of its extinction in the last year, and the project to dismantle social protection policies in Brazil, with serious consequences at a time when the country is going through a crisis in public health due to the Covid-19 pandemic. The absence of the Conselho Nacional de Segurança Alimentar e Nutricional and the weakening of the set of policies for Food and Nutritional Security has mobilized the civil society to defend the human rights to food, food sovereignty, and to democracy itself. The resistance of the different social movements in order to maintain the spaces of civil participation related to Food and Nutrition Security public policies are still going to be long and arduous, demanding the continued vocalization and strengthening of partnership networks within the different movements of the organized civil society. Finally, we highlight the urgent need for restoration of the National System of Food and Nutritional Security (Sistema Nacional de Segurança Alimentar e Nutricional) with all its instances, and of other social policies, so that the negative consequences of the pandemic are avoided or mitigated and the State complies with its obligations to guarantee the rights of the Brazilian population. RESUMO A Medida Provisória nº 870/2019, que alterou a Lei Orgânica de Segurança Alimentar e Nutricional e extinguiu o Conselho Nacional de Segurança Alimentar e Nutricional, tem trazido graves consequências à população brasileira, em especial, àqueles em situação de maior vulnerabilidade. Esta nota científica traz reflexões sobre a trajetória do Conselho Nacional de Segurança Alimentar e Nutricional, as repercussões de sua extinção no último ano e o projeto de desmonte das políticas de proteção social no Brasil, com graves desdobramentos no momento em que o país atravessa uma crise de saúde pública em decorrência da pandemia da Covid-19. A ausência do Conselho Nacional de Segurança Alimentar e Nutricional e a fragilização do conjunto de políticas de Segurança Alimentar e Nutricional tem mobilizado a sociedade civil para a defesa do direito humano à alimentação, da soberania alimentar e da própria democracia. A resistência dos diferentes movimentos sociais para manutenção dos espaços de participação da sociedade civil nas políticas públicas de Segurança Alimentar e Nutricional ainda será longa e árdua, demandando a continuidade da vocalização e fortalecimento de redes de parceria nos diferentes movimentos da sociedade civil organizada. Por fim, destaca-se que a recomposição do Sistema Nacional de Segurança Alimentar e Nutricional, com todas as suas instâncias, e das demais políticas sociais, constitui uma necessidade premente para que as consequências negativas da pandemia sejam evitadas ou atenuadas e o Estado cumpra com as suas obrigações para a garantia dos direitos da população brasileira.

Reflections on the extinction of the National Council for Food and Nutrition Security and the confrontation of Covid-19 in Brazil / Reflexões sobre a extinção do Conselho Nacional de Segurança Alimentar e Nutricional e o enfrentamento da Covid-19 no Brasil

ABSTRACT The Provisional Measure 870/2019, which amended the Organic Law on Food and Nutrition Security and extinguished the Conselho Nacional de Segurança Alimentar e Nutricional (National Council for Food and Nutrition Security), has brought serious consequences to the Brazilian population, especially for the most vulnerable. This scientific note brings reflections on the trajectory of the Conselho Nacional de Segurança Alimentar e Nutricional, the repercussions of its extinction in the last year, and the project to dismantle social protection policies in Brazil, with serious consequences at a time when the country is going through a crisis in public health due to the Covid-19 pandemic. The absence of the Conselho Nacional de Segurança Alimentar e Nutricional and the weakening of the set of policies for Food and Nutritional Security has mobilized the civil society to defend the human rights to food, food sovereignty, and to democracy itself. The resistance of the different social movements in order to maintain the spaces of civil participation related to Food and Nutrition Security public policies are still going to be long and arduous, demanding the continued vocalization and strengthening of partnership networks within the different movements of the organized civil society. Finally, we highlight the urgent need for restoration of the National System of Food and Nutritional Security (Sistema Nacional de Segurança Alimentar e Nutricional) with all its instances, and of other social policies, so that the negative consequences of the pandemic are avoided or mitigated and the State complies with its obligations to guarantee the rights of the Brazilian population.

RESUMO A Medida Provisória nº 870/2019, que alterou a Lei Orgânica de Segurança Alimentar e Nutricional e extinguiu o Conselho Nacional de Segurança Alimentar e Nutricional, tem trazido graves consequências à população brasileira, em especial, àqueles em situação de maior vulnerabilidade. Esta nota científica traz reflexões sobre a trajetória do Conselho Nacional de Segurança Alimentar e Nutricional, as repercussões de sua extinção no último ano e o projeto de desmonte das políticas de proteção social no Brasil, com graves desdobramentos no momento em que o país atravessa uma crise de saúde pública em decorrência da pandemia da Covid-19. A ausência do Conselho Nacional de Segurança Alimentar e Nutricional e a fragilização do conjunto de políticas de Segurança Alimentar e Nutricional tem mobilizado a sociedade civil para a defesa do direito humano à alimentação, da soberania alimentar e da própria democracia. A resistência dos diferentes movimentos sociais para manutenção dos espaços de participação da sociedade civil nas políticas públicas de Segurança Alimentar e Nutricional ainda será longa e árdua, demandando a continuidade da vocalização e fortalecimento de redes de parceria nos diferentes movimentos da sociedade civil organizada. Por fim, destaca-se que a recomposição do Sistema Nacional de Segurança Alimentar e Nutricional, com todas as suas instâncias, e das demais políticas sociais, constitui uma necessidade premente para que as consequências negativas da pandemia sejam evitadas ou atenuadas e o Estado cumpra com as suas obrigações para a garantia dos direitos da população brasileira.