Psychological Impact of the COVID-19 pandemic and social determinants on the portuguese population: protocol for a web-based cross-sectional study

BackgroundThe COVID-19 outbreak and consequent physical distance measures implemented worldwide have caused significant stress, anxiety, and mental health implications among the general population. Unemployment, working from home, and day-to-day changes may lead to a greater risk of poor mental health outcomes. ObjectiveThis paper describes the protocol for a web-based cross-sectional study that aims to address the impact of the COVID-19 pandemic on mental health. MethodsIndividuals from the general population aged 18 years or more and living in Portugal were included in this study. Data collection took place between November 10, 2020, and February 10, 2021. An exponential, nondiscriminative, snowball sampling method was applied to recruit participants. A web-based survey was developed and shared on social media platforms (eg, Facebook, Instagram, Twitter, LinkedIn, and WhatsApp groups) and through e-mail lists for recruitment of the seeds. ResultsData analysis will be performed in accordance with the different variables and outcomes of interest by using quantitative methods, qualitative methods, or mixed methods, as applicable. A total of 929 individuals had completed the web-based survey during the 3-month period; thus, our final sample comprised 929 participants. Results of the survey will be disseminated in national and international scientific journals in 2021-2022. ConclusionsWe believe that the findings of this study will have broad implications for understanding the psychological impact of the COVID-19 pandemic on Portuguese residents, as well as aspects related to the informal economy. We also hope that the findings of this study are able to provide insights and guidelines for the Portuguese government to implement action. Finally, we expect this protocol to provide a roadmap for other countries and researchers that would like to implement a similar questionnaire considering the related conclusions. International Registered Report Identifier (IRRID)DERR1-10.2196/2807

Risk assessment methodology in wastewater safety plans. A case study

Na prossecução dos objetivos do milénio da ONU, o aumento e melhoraria do acesso a sistemas de saneamento básico seguros e sustentáveis continuam a ser uma prioridade de intervenção crítica e essencial para salvaguarda da saúde humana e qualidade de vida das populações. O desenvolvimento, implementação e monitorização de Planos de Segurança, aplicados às diferentes fases do ciclo urbano da água, são uma estratégia crucial, recomendada pela OMS, para prevenção, análise e mitigação do risco associado a perigos e eventos perigosos com impacto nocivo na saúde pública e no meio ambiente. O objectivo deste trabalho é dar um contributo metodológico para a análise do risco em Planos de Segurança de Águas Residuais (PSAR), por meio quer da formulação de um novo método semiquantitativo de avaliação do risco em PSAR e sua aplicação a um caso de estudo, quer de uma abordagem integrada do sistema de saneamento, incluindo as suas interações com a respectiva bacia hidrográfica. Concluiu-se que o nível e tipologia do risco dependem da abrangência geográfica da bacia hidrográfica considerada, a qual influencia não só a diversidade dos perigos e eventos perigosos identificados, mas também a definição das medidas de controle do risco a implementar, resultantes da necessária abordagem de barreiras múltiplas, no sentido de eliminar ou minimizar os riscos para os diversos utilizadores e operadores de um sistema urbano de águas residuais.In pursuit of the UN's millennium goals, increasing and improving access to safe and sustainable sanitation systems remains a critical intervention priority to safeguard human health, life quality and population wellness. The development, implementation and monitoring of Safety Plans, applied to the different sections of the urban water cycle, is a crucial strategy, recommended by WHO, for the prevention, analysis and risk mitigation due to hazards and dangerous events with a harmful impact on public health and the environment. This work intends to make a methodological contribution for risk analysis in Wastewater Safety Plans (WWSP), through a comprehensive approach to the full sanitation system, including its catchment watershed interaction, and the proposal of a new semi-quantitative risk assessment method applied to a case study. It was concluded that the risk level and typology depends on the geographical scope of the considered watershed, which significantly influences not only the diversity of identified hazards and dangerous events, but also the definition of risk control measures to be implemented, arising from a multiple barriers approach, in order to provide a risk mitigation for the several wastewater system users and operator

Anxiety and Depression Symptoms During the COVID-19 Pandemic: A Cluster Analysis of Individuals Living in Portugal

Introduction: The COVID-19 pandemic is an illustration of how a physical illness can damage people's minds. In this regard, the goal of this study was to see how different sociodemographic and behavioral factors were linked to anxiety and depression symptoms in a group of individuals living in PortugalMethods: Between November 2020 and February 2021, a cross-sectional, snowball online study was conducted. The study's target population was adults over the age of 18, residents of the country. For the statistical analysis, the clustering technique - K-means algorithm was applied. The chi-squared test was used to determine the relationships between clusters and sociodemographic and behavioral characteristics. Statistical analyses were conducted in R language, with a significance level of 0.05. A total of 453 participants were included.Results: The majority were female (69.8%), under the age of 40 (60.8%), with a higher education degree (75.3%), and not married (54.4%). Furthermore, the majority were from the country's north region (66%). Cluster 1 (n = 194) was characterized by low or nonexistent levels of anxiety and depression symptoms, which means normal; cluster 2 by severe symptoms (n = 82), meaning case; and cluster 3 by mild symptoms (n = 177), which means border-line. Younger participants (p-value 0.024), female (p-value 0.041), with drinking habits (p-value 0.002), food insecurity (p-value < 0.001), food affordability exacerbation (p-value < 0.001), comorbidity (p-value < 0.001), use of anxiolytics (p-value < 0.001), insufficient household income (p-value 0.017) and income change (p-value < 0.001) were significantly associated with the anxiety-depression clusters. From the three clusters, cluster 2 was mainly repre-sented by younger participants, with more persons stating that their household income was insufficient and that their income has changed as a result of COVID-19 and that they had the highest probability of food insecurity. Conclusion: The impacts of a crisis on mental health extend longer than the event itself. We were able to observe that younger women with insuf-ficient household income who suffered a change in income due to COVID-19 and were classified as food insecure presented higher levels of anxiety and depression symptoms. These results highlight the presence of a social gradient where we saw that people who were less advantaged in terms of socioeconomic position presented worse mental health outcomes, stressing, in this sense, the need to bring the best public health responses for these specific groups of the population.This work was financed by Portuguese Funds through FCT -Foundation for Science and Technology, I.P., under the projects UIDB/04750/2020 and LA/P/0064/2020.Ana Aguiar PhD Grant (Reference: 2020.09390.BD), co-funded by the Fundacao para a Ciencia e a Tecnologia (FCT) and the Fundo Social Europeu (FSE) Program, was also used to assist this research.Rita Gaio has received support from CMUP, which is financed by national funds through FCT - Fundacao para a Ciencia e a Tecnologia, I.P., under the project with reference UIDB/00144/2020.& nbsp;& nbsp

Getting entangled with body image: Development and validation of a new measure.

Ferreira, C., Trindade, I. A., Duarte, C. & Pinto-Gouveia, J. (2015). Getting entangled with body image: Development and validation of a new measure. Psychology and Psychotherapy: Theory, Research and Practice, 88(3), 304–316. doi: 10.1111/papt.12047Objectives. Several studies have highlighted the role of cognitive fusion on human suffering and a wide range of psychopathological conditions. Namely, this process has been regarded as a core aspect in eating disorders. Nevertheless, the study of cognitive fusion on eating psychopathology is scarce and a measure that specifically concerns body image was still to be created. The present study aimed therefore at developing and validating such measure, the Cognitive Fusion Questionnaire Body Image (CFQ-BI). Design and methods. The current study was conducted using different samples of both genders, collected in the general and student populations. The dimensionality of the CFQ-BI was tested through an exploratory factor analysis and a confirmatory factor analysis (CFA). The scale’s internal reliability and other psychometric qualities were also analysed. Results. The CFQ-BI’s final structure was one-dimensional and comprised 10 items that assess body image-related cognitive fusion. This final structure explained a total of 73.41% of the variance. The adequacy of the questionnaire was corroborated through a CFA which revealed that CFQ-BI presents good global and local adjustment values and goodness-of-fit indices. Results also showed that the CFQ-BI holds a very good internal consistency (a = .96), convergent, divergent and temporal reliabilities, and is able to discriminate cases from non-cases of eating psychopathology. Conclusions. The CFQ-BI was thus established as a short, robust, and reliable measure of body image-related cognitive fusion. This new measure may correspond to a significant contribution to research and clinical practice in the field of body image and eating-related difficulties

Sistemas de abastecimento de água: avaliação da vulnerabilidade

O objectivo deste trabalho de investigação é apresentar a Teoria da Vulnerabilidade de Redes Hidráulicas de Abastecimento de Água (TVRHAA) e, em particular, os seus principais fundamentos teóricos. Esta teoria preconiza que quanto maior for a qualidade de forma de uma rede menor será a sua vulnerabilidade. O conceito de vulnerabilidade é aqui traduzido pela desproporcionalidade existente entre um esforço e o dano resultante numa rede hidráulica de abastecimento de água (RHAA). A aplicação desta teoria permite identificar as partes mais vulneráveis de uma RHAA através de diversos cenários de dano vulneráveis nomeadamente o cenário de dano de colapso total, o cenário de dano de máxima vulnerabilidade, o cenário de dano de mínima vulnerabilidade, o cenário de menor esforço para haver dano e qualquer cenário de dano de interesse específico para o utilizador. Esta teoria poderá ser aplicada como suporte ao projecto de RHAA, pretendendo-se desta forma obter RHAA mais robustas, reforçando ou redimensionando as zonas da RHAA estruturalmente ou hidraulicamente mais vulneráveis. Por outro lado, entende-se que esta ferramenta também poderá apoiar na gestão destes sistemas tornando-os mais seguros e eficientes

Avaliação da vulnerabilidade de redes de abastecimento de água

A teoria da vulnerabilidade de redes hidráulicas de abastecimento de água (TVRAA) é uma teoria emergente que tem vindo a ser desenvolvida no Departamento de Engenharias, da Universidade de Trás-os-Montes e Alto Douro (UTAD). O conceito de vulnerabilidade é traduzido pela desproporcionalidade existente entre um esforço e o dano resultante numa rede de abastecimento de água (RAA). Esta teoria tem como principal objectivo identificar os elementos mais vulneráveis de uma RAA e, desta forma, dar um contributo quer na fase de projecto quer na fase de gestão e de exploração dos sistemas. Na fase de projecto ajudará o projectista a decidir acerca do reforço ou redimensionamento das zonas da rede estruturalmente ou hidraulicamente mais vulneráveis. Na fase de gestão e exploração da RAA auxiliará na elaboração de planos de manutenção e de reabilitação, bem como na selecção das componentes da rede mais importantes em termos das consequências produzidas por um ou mais cenários de dano, permitindo a sua monitorização e uma priorização criteriosa das intervenções mais adequadas. A aplicação da TVRAA a um sistema de abastecimento de água permite identificar diferentes tipos de cenários de dano, sendo o cenário de dano de máxima vulnerabilidade aquele em que um pequeno esforço origina um dano desproporcional na RAA. A acção que provoca o esforço na rede pode ser de vários tipos, tais como: excesso de pressão hidráulica, envelhecimento das condutas, agressividade do meio envolvente, erro de projecto, erro de construção, sabotagem, alteração da qualidade da água. O dano é considerado como sendo uma perda da RAA ou de parte da RAA, correspondente a um ou mais troços. A TVRAA proposta neste trabalho efectua uma análise da vulnerabilidade de RAA independentemente do tipo de acção que pode originar-lhe dano e tendo como premissa fundamental que a vulnerabilidade de uma RAA será tanto menor quanto melhor for a sua qualidade de forma. Esta teoria utiliza a construção de um modelo hierárquico e, como tal, não necessita de estudar todas as combinações possíveis de danos na rede. Neste artigo far-se-á uma breve descrição da TVRAA, focando essencialmente o processo de desaglutinação no qual se utiliza o conceito de extensão da sub-rede de referência

Diabetic Foot Infection: Causative Pathogens and Empiric Antibiotherapy Considerations-The Experience of a Tertiary Center

Most moderate-to-severe diabetic foot infections (DFIs) require hospitalization with urgent surgical approach and administration of empiric antibiotherapy. To ensure optimal antibiotic coverage, regular microbiological background updates are imperative. The purpose is to characterize the microbiological profile and the antibiotic sensitivity pattern of the DFI causative pathogens isolated within a specialized DFI unit of a tertiary hospital, in order to establish evidence-based policies regarding empirical antibiotic use. A cross-sectional study was conducted. Microbiological cultures and corresponding antibiotic sensitivity tests collected from moderate-to-severe DFIs as a first approach to the hospitalized patient were retrieved and analyzed during a 12-month period. Two groups were analyzed: inpatients that had been previously followed at the diabetic foot clinic of the hospital and inpatients without a previous contact with the hospital services. A total of 125 isolates obtained from 87 patients were deemed for analysis. Globally, a predominance of Gram-positive bacteria was observed (60%). Staphylococcus aureus was the most common pathogen. The global ratio of methicillin-sensitive S aureus to methicillin-resistant S aureus (MRSA) was 1.3:1, with similar findings in both groups. According to the antibiotic sensitivity test results, and within the recommended empiric antibiotic regimens for DFI, piperacillin/tazobactam seems to be the most suitable option. Gram-positive bacteria prevail as the main isolates in DFIs. Screening for MRSA-specific risk factors is mandatory. When going for a first empiric therapy, piperacillin/tazobactam is recommended in this institution, and an anti-MRSA agent should be added early, if necessary. We encourage continuous monitoring for the bacterial prevalence in Portuguese diabetic foot centers as it is paramount for the decision making regarding DFI protocols.info:eu-repo/semantics/publishedVersio

Changes to TB care in an outpatient centre during the COVID‐19 pandemic

info:eu-repo/semantics/publishedVersio