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Following the Great Recession, many European countries implemented fiscal consolidation policies aimed at reducing government debt. Using three independent data sources and three different empirical approaches, we document a strong positive relationship between higher income inequality and stronger recessive impacts of fiscal consolidation programs across time and place. To explain this finding, we develop a life-cycle, overlapping generations economy with uninsurable labour market risk. We calibrate our model to match key characteristics of a number of European economies, including the distribution of wages and wealth, social security, taxes and debt, and study the effects of fiscal consolidation programs. We find that higher income risk induces precautionary savings behaviour, which decreases the proportion of credit-constrained agents in the economy. Credit-constrained agents have less elastic labour supply responses to fiscal consolidation achieved through either tax hikes or public spending cuts, and this explains the relationship between income inequality and the impact of fiscal consolidation programs. Our model produces a cross-country correlation between inequality and the fiscal consolidation multipliers, which is quite similar to that in the data.

Modern macroeconomics has evolved from focusing just on the dynamics of aggregates, such as income, consumption and savings, to the dynamics of the distributions that add up to those aggregates. This is a consequence of theoretical contributions and increasing data availability and computational power. Though contributions regarding heterogeneity in macroeconomics can be traced back to the first half of the 20th century, it is only by the 2010s that we evolved towards a framework where there is a rich interaction between macroeconomic aggregates and their distributions that goes both ways. This special edition focused on contributions that build on such framework to study open questions regarding the impact of fiscal shocks on output, the impact of investment -specific technological change on inequality, optimal tax structures, and the impact of the COVID -19 pandemic on the distribution of earnings. publishersversion published

This study aims to evaluate compliance of HIV patients to TB screening and treatment, identifying determinants for non-compliance.We reviewed clinical records of all HIV infected patients first attended in a Portuguese-Infectious-Unit from 2007 to 2010 (152 patients). Screening included: symptom inquiry, chest X-ray, TST/IGRA. In 2008 a protocol was established with a TB outpatient clinic allowing patients to choose where to perform screening (decentralization).All patients were offered screening; 69 (45.4%) accepted. Before decentralization, out of 78 patients, 20 (25%) accepted screening. After decentralization, out of 64 patients, 49 (76.6%) accepted screening. Decentralization was associated with higher levels of acceptance (p

The recent experience of a Great Recession has brought the effectiveness of fiscal policy back into focus. Fiscal multipliers do, however, vary greatly over time and place. Running VARs for a large number of countries, we document a strong correlation between wealth inequality and the magnitude of fiscal multipliers. To explain this finding, we develop a life-cycle, overlapping generations economy with uninsurable labor market risk. We calibrate our model to match key characteristics of a number of OECD economies, including the distribution of wages and wealth, social security, taxes and debt and study the effects of changing policies and various forms of inequality on the fiscal multiplier. We find that the fiscal multiplier is highly sensitive to the fraction of the population who face binding credit constraints and also negatively related to the average wealth level in the economy. This explains the correlation between wealth inequality and fiscal multipliers.

Introduction Benzodiazepines, sedative hypnotic drugs, are indiscriminately used in patients with insomnia, independently of the OSA exclusion. It’s well known these drugs may adversely affect the control of ventilation during sleep, leading to a worsening of various respiratory parameters, including peripheral O2 saturation. To evaluate the impact of use of benzodiazepines in AHI and O2 peripheral saturation on OSA patients. Materials and methods Methodology: We retrospectively analyzed 515 patients diagnosed in our Sleep Medicine Centre with obstructive sleep apnea syndrome (OSA) and collected polysomnography, demographic, clinical, and anthropometric data as well as Epworth Sleepiness Scale (ESS) value, and use of benzodiazepines (BZD) at diagnosis. Comparisons interesting the AHI and minSO2 and the presence of benzodiazepines were made. Results A total of 515 patients with OSA were included and had mean age of 52.6 ± 13.4 years, 67% men and a mean BMI of 28.8 ± 4.8 kg/m2. Of the 515 OSA patients, 39% had mild, 29% moderate and 32% severe OSA. Benzodiazepines were used by 26.6% (137) patients. Of these 137 patients, 55 had mild, 36 moderate and 46 severe OSA. In our population, AHI was associated with male gender, greater BMI and ESS value, but not with BZD use. The minSO2 was negatively correlated with AHI (p 0.05) and associated with the use of BZD (p 0.05). However, the relation between minSO2 and BZD use was observed only in those with mild and moderate OSA (p 0.05) and not in severe OSA. Conclusion These results show that the use of benzodiazepines is associated with a lower minSO2 during sleep among OSA patients, but the weight of these drugs effect is diluted with the severity index, which can be explain by the gain of impact of a higher number of apneas/hyponeas. This emphasize the importance of have caution with benzodiazepine prescription as they can increase the effects of other diseases in particular sleep disorders breathing. Acknowledgement We thank to Ricardo Reis who helps analysing the data.

Background Prevalence of allergic disease has increased in recent years all over the world. Asthma and rhinitis are the most prevalent in Portugal and, having them such a multi-factorial basis, atopy is the most important risk factor for its development. The authors aim to evaluate mono/polisensitization as risk factors for severity of allergic disease, if there is an impact in allergic disease manifestations number, the different treatment response, and if there is a relationship between VEMs, comorbilities and sensitization. Methods In a population of patients followed in asthma/allergology appointment were selected those with asthma and allergic rhinitis confirmed by cutaneous test and/or specific IgE. Clinical processes were reviewed and analyzed data related to the age of beginning, manifestations, atopic profile, severity, treatment, comorbilities and functional limitation. A descriptive analysis of the sample was made and used linear regression for variable correlations. Results 176 patients 30% men and 70% women, mean age 33,7 and mean age of early symptoms 12,7 Of these, 94% had asthma and 85% rhinitis. They were 53% monosensitized, 47% polisensisitized and 43% had comorbilities. 66,5% of patients has done specific immunotherapy (SIT). On linear regression analysis it was found that different sensitization has not been determinative for disease manifestations number neither of treatment response. It was observed that severity of asthma and rhinitis correlate with each other (P < 0,001), but no significant differences were verified in severity level between patients mono vs polisensitized. SIT demonstrate a positive and statistically significant correlation with treatment reduction (P < 0,001) and reduction on asthma and rhinitis severity (P = 0,015 and P < 0,001). SIT patients also demonstrate a decrease in asthma severity associated to the number of allergen sensitizations. It was found a positive correlation between the presence and number of comorbilities and asthma and rhinitis severity (P = 0,001/P < 0,001 and P = 0,007/P = 0,001), instead of individually, only nasal polyposis prove to be associated with statistical significance. Comorbilities were also related with a lower FEV1 (P = 0,02). Conclusions This study supports literature data, which says there is only one allergic disease and that severity of disease extends to its various manifestations. We confirmed that in atopic patients, SIT has benefit in the reduction on allergic disease severity and a better disease control with minor therapeutic use.

Resumo: Este estudo teve por objetivo avaliar a adesão dos doentes VIH ao rastreio e tratamento da TB, identificando fatores determinantes para a não adesão.Foram revistos os registos clínicos de todos os doentes infetados pelo VIH, observados pela primeira vez numa Unidade de Doenças Infeciosas Portuguesa entre 2007 e 2010 (152 doentes). O rastreio incluía: inquérito de sintomas, telerradiografia torácica e TST/IGRA. Em 2008, foi estabelecido um protocolo com um Centro Diagnóstico Pneumológico, que permitia aos doentes escolher o local para serem rastreados (descentralização).O rastreio foi oferecido a todos os doentes, 69 (45,4%) aceitaram. Antes da implementação do protocolo de descentralização, de 78 doentes, 20 (25%) aceitaram ser rastreados. Após a descentralização, de 64, 49 doentes (76,6%) aderiram ao rastreio. A descentralização dos cuidados de saúde mostrou estar associada a uma maior adesão ao rastreio (pÂ