ABSTRACT
This research intends to measure the quality of life (QoL) perception, from the perspective of residents and tourists towards Coimbra, a city with an important World Heritage Site, as classified by UNESCO. In these times, preserving tangible and intangible heritage is so important for future memories. Identifying the QoL perceptions through the eyes of residents and tourists allows the improvement of the community well-being of the destination for both stakeholders. Starting from this assumption, this study aims to: (i) measure the tourists' and residents' perceptions on quality of life (QoL);(ii) analyze the impact of the COVID-19 pandemic on QoL perceptions, both from the tourists' and residents' perspective. To achieve these objectives, a questionnaire was disseminated to residents and tourists in two different phases, before and during the COVID-19 pandemic. Results show that in general, residents and tourists exhibited, in both periods, medium and high perceptions of QoL, with an exception made for the Urban Issues domain that decreased even more during the pandemic. Furthermore, the results show, for residents and tourists, that the perception of Urban Issues, Way of Life, Community Pride and Awareness, Economic Strength, and Recreation Amenities impact significantly and positively their Community Well-Being perception. New paths for academics and for practitioners are presented at the end, as well as limitations and evidence for future research.
ABSTRACT
BackgroundTo investigate the impact of the COVID-19 pandemic and infection prevention measures on children visiting emergency departments across Europe. MethodsRoutine health data were extracted retrospectively from electronic patient records of children aged <16 years, presenting to 38 emergency departments (ED) in 16 European countries for the period January 2018 - May 2020, using predefined and standardized data domains. Observed and predicted numbers of ED attendances were calculated for the period February 2020 to May 2020. Poisson models and incidence rate ratios (IRR) were used to compare age groups, diagnoses and outcomes. FindingsReductions in pediatric ED attendances, hospital admissions and high triage urgencies were seen in all participating sites. ED attendances were relatively higher in countries with lower SARS-CoV-2 prevalence (incidence rate ratio (IRR) 2{middle dot}62, 95% CI 2{middle dot}19 to 3{middle dot}13) and in children aged >12 months (12-<24 months IRR 0{middle dot}89, 95% CI 0{middle dot}86 to 0{middle dot}92; 2-<5years IRR 0{middle dot}84, 95% CI 0{middle dot}82 to 0{middle dot}87; 5-<12 years IRR 0{middle dot}74, 95% CI 0{middle dot}72 to 0{middle dot}76; 12-<16 years IRR 0{middle dot}74, 95% CI 0{middle dot}71 to 0{middle dot}77; vs. age <12 months as reference group). The impact on pediatric intensive care admissions (IRR 1{middle dot}30, 95% CI 1{middle dot}16 to 1{middle dot}45) was not as great as the impact on general admissions. Lower triage urgencies were reduced more than higher triage urgencies (urgent triage IRR 1{middle dot}10, 95% CI 1{middle dot}08 to 1{middle dot}12; emergent and very urgent triage IRR 1{middle dot}53, 95% CI 1{middle dot}49 to 1{middle dot}57; vs. non-urgent triage category). Reductions were highest and sustained throughout the study period for children with communicable infectious diseases. InterpretationReductions in ED attendances were seen across Europe during the first COVID-19 lockdown period. More severely ill children continued to attend hospital more frequently compared to those with minor injuries and illnesses, although absolute numbers fell. FundingRGN was supported by National Institute of Health Research, award number ACL-2018-021-007. Trial registryISRCTN91495258