different delays, different risk factors

Funding Information: The study was supported by the Foundation for Science and Technology—FCT (Portuguese Ministry of Science, Technology and Higher Education) under the National School of Public Health, Universidade NOVA de Lisboa, Lisboa, Portugal (PTDC/SAU-PUB/31346/2017). Publisher Copyright: © 2021, The Author(s).Background: Delay in Tuberculosis (TB) diagnosis affects foreign-born and nationals in different ways, especially in low-incidence countries. This study characterises total delay and its components amongst foreign-born individuals in Portugal. Additionally, we identify risk factors for each type of delay and compare their effects between foreign-born and nationals. Methods: We analysed data from the Portuguese TB surveillance system and included individuals with pulmonary TB (PTB), notified between 2008 and 2017. We described patient, healthcare, and total delays. Cox regression was used to identify factors associated with each type of delay. All analyses were stratified according to the origin country: nationals (those born in Portugal) and foreign-born. Results: Compared with nationals, foreign-born persons presented statistically significant and longer median total and patient delays (Total: 67 vs. 63; Patient: 44 vs. 36 days), and lower healthcare services delays (7 vs. 9 days). Risk factors for delayed diagnosis differed between foreign-born and nationals. Being unemployed, having drug addiction, and having comorbidities were identified as risk factors for delayed diagnosis in national individuals but not in foreigners. Alcohol addiction was the only factor identified for healthcare delay for both populations: foreign-born (Hazard Ratio 1.34 [95% confidence interval 1.17;1.53]); nationals (Hazard Ratio 1.20 [95% confidence interval 1.13;1.27]). Conclusions: Foreign-born individuals with PTB take longer to seek health care. While no specific risk factors were identified, more in-depth studies are required to identify barriers and support public health intervention to address PTB diagnosis delay in foreign-born individuals.publishersversionpublishe

potential risk factors for patient and healthcare delays in Portugal

Funding Information: Fundação para a Ciência e Tecnologia provided financial support to conduct this research [Grant: PTDC/SAU-PUB/31346/2017]. Publisher Copyright: © 2021, The Author(s).Background: Early diagnosis and treatment of pulmonary tuberculosis (PTB) is essential for an effective control of the tuberculosis (TB) epidemic. Delayed diagnosis and treatment of TB increases the chance of complications and mortality for the patients, and enhances TB transmission in the population. Therefore, the aim of this study was to characterize patient, healthcare and total delay in diagnosing PTB and assess the effect of clinical and sociodemographic factors on the time until first contact with healthcare or reaching a PTB diagnosis. Methods: Retrospective cohort study that included active PTB patients notified in the National Tuberculosis Surveillance System (SVIG-TB), between 2008 and 2017. Descriptive statistics, Kaplan-Meier estimates, logrank test and Cox proportional hazards model were used to characterize patient, healthcare and total delay and estimate the effect of clinical and sociodemographic variables on these delays. Significance level was set at 0.05. Results: Median patient, healthcare and total delays was 37 days (Interquartile range (IQR): 19–71), 8 days (IQR: 1–32) and 62 days (IQR: 38–102), respectively. The median patient delay showed a constant increase, from 33 days in 2008 to 44 days in 2017. The median total delay presented a similar trend, increasing from 59 days in 2008 to 70 days in 2017. Healthcare delay remained constant during the study period. More than half of the PTB cases (82.9%) had a delay > 1 month between symptom onset and diagnosis. In the final Cox model, alcohol abuse, unemployment and being from a high TB incidence country were factors significantly associated with longer patient delay, while being female, having more than 45 years, oncologic and respiratory diseases were associated with longer healthcare delay. Being female, having more than 45 years and being from a high TB incidence country were associated with longer total delay. Conclusions: Patient delay and total delay have increased in recent years. Older patients, patients with alcohol problems, other comorbidities, unemployed or from countries with high TB incidence would benefit from the development of specific public health strategies that could help reduce the delay in TB diagnosis observed in our study. This study emphasizes the need to promote awareness of TB in the general population and among the healthcare community, especially at ambulatory care level, in order to reduce the gap between beginning of symptoms and TB diagnosis.publishersversionpublishe

Mortars with incorporation of PCM based in different binders: mechanical and thermal behavior

Currently we are witnessing a huge concern of society with the parameters of comfort of the buildings and the energetic consumptions. It is known that there is a huge consumption of non-renewable sources of energy. Thus, it is urgent to develop and explore ways to take advantage of renewable sources of energy by improving the energy efficiency of buildings. The mortars with incorporation of phase change materials (PCM) have the ability to regulate the temperature inside buildings, contributing to the thermal comfort and reduction of the use of heating and cooling equipment, using only the energy supplied by the sun. However, the incorporation of phase change materials in mortars modifies its characteristics. The main purpose of this study was mechanical and thermal characterization of mortars with incorporation of PCM in mortars based in different binders. The binders studied were aerial lime, hydraulic lime, gypsum and cement. For each type of binder a reference composition (0% PCM) and a composition with incorporation of 40% of PCM were developed. It was possible to observe that the incorporation of PCM in mortars caused differences in properties such as workability, compressive strength, flexural strength and adhesion, however leads to an improvement of thermal behavior.Foundation for Science and Technology(FCT

A case-control study of contextual factors for SARS-CoV-2 transmission

Funding Information: This study has been partially funded by the Regional Administration of Health of Lisbon and Tagus Valley, the NOVA National School of Public Health, and National Funds through Foundation for Science and Technology, I.P., within the scope of the Epidemiology Research Unit–Institute of Public Health, University of Porto (EPIUnit) [UIDB/04750/2020]. Funding Information: The authors thank Dire??o-Geral da Sa?de and Servi?os Partilhados Minist?rio da Sa?de for data sharing, Administra??o Regional de Sa?de de Lisboa e Vale do Tejo for funding, Public Health Units in the area for informing potentially eligible cases of the study, and the participants for their valuable time. We also thank all interviewers for their perseverance, which was essential to collect these data. Publisher Copyright: © Copyright © 2021 Leite, Leão, Soares, Severo, Moniz, Lucas, Aguiar, Meireles, Lunet, Nunes and Barros.Background: Knowledge on the settings and activities associated with a higher risk of SARS-CoV-2 transmission is essential to inform decision-making. We thus designed a case-control study to identify relevant settings for community transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Portugal. Methods: We evaluated 1,088 cases, identified through the national surveillance system, and 787 community controls, recruited using random digit dialing. Sociodemographic characteristics, individual protective measures, and activities or visited settings were obtained through telephone interview. We report sex-, age-, education-, and citizenship-adjusted odds ratios (aOR) with 95% confidence intervals (95% CI). Results: Household overcrowding (aOR = 1.47; 95% CI 1.14–1.91) and work in senior care (4.99; 1.30–33.08) increased while working remotely decreased the risk of infection (0.30; 0.22–0.42). Going to restaurants/other dining spaces (0.73; 0.59–0.91), grocery stores (0.44; 0.34–0.57) or hair salons (0.51; 0.39–0.66), or the use of public transportation did not present a higher risk of infection (0.98; 0.75–1.29), under existing mitigation strategies. Lower education (≤ 4 years vs. tertiary education: 1.79; 1.33–2.42) and no Portuguese citizenship (5.47; 3.43–9.22) were important risk factors. Conclusions: The utilization of public transportation, restaurants, and commercial spaces was not associated with increased risk of infection, under capacity restrictions, physical distancing, use of masks, and hygiene measures. Overcrowding, foreign citizenship, low education and working on-site were positively associated with SARS-CoV-2 infection.publishersversionpublishe

Factors associated with the patient’s decision to avoid healthcare during the COVID-19 pandemic

Funding Information: Funding: The present publication was funded support through CHRC (UIDP/04923/2020). Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.The COVID-19 pandemic has resulted in changes in healthcare use. This study aimed to identify factors associated with a patient’s decision to avoid and/or delay healthcare during the COVID-19 pandemic. We used data from a community-based survey in Portugal from July 2020 to August 2021, “COVID-19 Barometer: Social Opinion”, which included data regarding health services use, risk perception and confidence in health services. We framed our analysis under Andersen’s Behavioural Model of Health Services Use and utilised Poisson regression to identify healthcare avoidance associated factors. Healthcare avoidance was high (44%). Higher prevalence of healthcare avoidance was found among women; participants who reported lower confidence in the healthcare system response to COVID-19 and non-COVID-19; lost income during the pandemic; experienced negative emotions due to physical distancing measures; answered the questionnaire before middle June 2021; and perceived having worse health, the measures implemented by the Government as inadequate, the information conveyed as unclear and confusing, a higher risk of getting COVID-19, a higher risk of complications and a higher risk of getting infected in a health institution. It is crucial to reassure the population that health services are safe. Health services should plan their recovery since delays in healthcare delivery can lead to increased or worsening morbidity, yielding economic and societal costs.publishersversionpublishe

sensitivity analysis

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O PROGRAMA CIÊNCIA SEM FRONTEIRAS SOB O OLHAR DOS ESTUDANTES DO IFPB: EXPERIÊNCIA E PERSPECTIVAS

Esta pesquisa teve por objetivo analisar o Programa Ciências sem Fronteiras enquanto política pública de internacionalização da educação superior, a partir da experiência de estudantes do Instituto Federal da Paraíba. Para isso, realizou-se uma pesquisa mista, em que se realizou, primeiramente, uma revisão bibliográfica sobre o contexto do Programa na Instituição. Posteriormente foi desenvolvida a pesquisa empírica, através da aplicação de questionário e de entrevista com os estudantes. O tratamento dos dados se deu através da análise descritiva e da análise de conteúdo. A partir das falas dos sujeitos referenciadas, identificou-se que a principal dificuldade dos alunos foi com relação ao conteúdo curricular das disciplinas e ao domínio do segundo idioma. Apesar disso, a maior parte dos entrevistados teve um aproveitamento considerável no Programa, que contribuiu em suas trajetórias acadêmicas e profissionais

Elaboração e Catalogação de Atividades com Objetos de Aprendizagem de Física no Repositório de Conteúdos Digitais InterRed

A crescente produção de Objetos de Aprendizagem motivou acriação de repositórios para sua catalogação na rede web. Neste trabalhoapresenta-se uma metodologia de desenvolvimento de atividades paraalimentar o repositório de conteúdos digitais denominado InterRed,coordenado pelo Centro Federal de Educação Tecnológica do Ceará (CEFETCE).A metodologia que se propõe é fruto de discussões do curso deLicenciatura em Física do CEFET-CE. Construída a atividade, têm-seconteúdos digitais prontos para dar suporte ao professor e possibilitar umaaprendizagem mais significativa ao aprendiz.

O SUPORTE DE GÊNEROS FACEBOOK

Este trabalho objetiva analisar o Facebook como um suporte de gêneros, para o que utiliza páginas de empresas que divulgam seus produtos. Como aporte teórico para a discussão de gênero e suporte, pauta-se em Bakhtin (2003), Marcuschi (2008), Bhatia (1993; 2004), Swales (1990; 2009), entre outros. Para o anúncio publicitário, toma como aporte teórico Gonzales (2003) e Carvalho (2014). Para análise do objeto, seleciona duas páginas de Facebook de duas marcas brasileiras, Havaianas e Natura. Os resultados mostram que o Facebook comporta-se como autêntico suporte de gêneros, capaz de veicular e modificar os gêneros que nele se inserem