Community seroprevalence of SARS-CoV-2 in children and adolescents in England, 2019-2021.

OBJECTIVE: To understand community seroprevalence of SARS-CoV-2 in children and adolescents. This is vital to understanding the susceptibility of this cohort to COVID-19 and to inform public health policy for disease control such as immunisation. DESIGN: We conducted a community-based cross-sectional seroprevalence study in participants aged 0-18 years old recruiting from seven regions in England between October 2019 and June 2021 and collecting extensive demographic and symptom data. Serum samples were tested for antibodies against SARS-CoV-2 spike and nucleocapsid proteins using Roche assays processed at UK Health Security Agency laboratories. Prevalence estimates were calculated for six time periods and were standardised by age group, ethnicity and National Health Service region. RESULTS: Post-first wave (June-August 2020), the (anti-spike IgG) adjusted seroprevalence was 5.2%, varying from 0.9% (participants 10-14 years old) to 9.5% (participants 5-9 years old). By April-June 2021, this had increased to 19.9%, varying from 13.9% (participants 0-4 years old) to 32.7% (participants 15-18 years old). Minority ethnic groups had higher risk of SARS-CoV-2 seropositivity than white participants (OR 1.4, 95% CI 1.0 to 2.0), after adjusting for sex, age, region, time period, deprivation and urban/rural geography. In children <10 years, there were no symptoms or symptom clusters that reliably predicted seropositivity. Overall, 48% of seropositive participants with complete questionnaire data recalled no symptoms between February 2020 and their study visit. CONCLUSIONS: Approximately one-third of participants aged 15-18 years old had evidence of antibodies against SARS-CoV-2 prior to the introduction of widespread vaccination. These data demonstrate that ethnic background is independently associated with risk of SARS-CoV-2 infection in children. TRIAL REGISTRATION NUMBER: NCT04061382.

Demystifying EFL Teachers' Experiences During the Pandemic: A Study of the Psychosocial Risks Resulting from COVID-19

This study aims to identify the main psychosocial risks that COVID - 19 has caused in Ecuadorian EFL teachers and determine the factors associated with developing these risks. This study employed a quantitative approach and a non-experimental cross-sectional design, with a sample of 980 teachers from different educational levels from Ecuador. The data analysis was done using Stata 16 statistical program and a multivariate binary logistic regression (LR). The results showed that teachers are emotionally drained, isolated, frustrated with teaching, and exhausted because of teaching during the pandemic, being the women the most affected. The main factors that increased the probability of suffering these psychosocial effects were extra activities beyond working hours, status in the teacher's institutions, and gender. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Healthcare Outcomes In Patients With Hiv Infection At A Tertiary Hospital During The COVID-19 Pandemic.

BACKGROUND: The COVID-19 pandemic has affected the care of patients with other diseases. Difficulty in access to healthcare during these months has been especially relevant for persons with HIV infection (PWH). This study therefore sought to ascertain the clinical outcomes and effectiveness of the measures implemented among PWH in a region with one of the highest incidence rates in Europe. METHODS: Retrospective, observational, pre-post intervention study to compare the outcomes of PWH attended at a high-complexity healthcare hospital from March to October 2020 and during the same months across the period 2016-2019. The intervention consisted of home drug deliveries and preferential use of non face-to-face consultations. The effectiveness of the measures implemented was determined by reference to the number of emergency visits, hospitalisations, mortality rate, and percentage of PWH with viral load >50 copies, before and after the two pandemic waves. RESULTS: A total of 2,760 PWH were attended from January 2016 to October 2020. During the pandemic, there was a monthly mean of 106.87 telephone consultations and 2,075 home deliveries of medical drugs dispensed to ambulatory patients. No statistically significant differences were found between the rate of admission of patients with COVID-HIV co-infection and that of the remaining patients (1,172.76 admissions/100,000 population vs. 1,424.29, p = 0.401) or in mortality (11.54% vs. 12.96%, p = 0.939). The percentage of PWH with viral load >50 copies was similar before and after the pandemic (1.20% pre-pandemic vs. 0.51% in 2020, p = 0.078). CONCLUSION: Our results show that the strategies implemented during the first 8 months of the pandemic prevented any deterioration in the control and follow-up parameters routinely used on PWH. Furthermore, they contribute to the debate about how telemedicine and telepharmacy can fit into future healthcare models.

Introducción: La pandemia causada por el SARS-CoV-2 ha afectado a la atención de pacientes con otras enfermedades. La dificultad en el acceso a la asistencia sanitaria durante estos meses es especialmente relevante en las personas con infección por VIH (PWH). El objetivo del estudio fue conocer los resultados clínicos y la efectividad de las medidas implementadas en PWH en una de las regiones con mayor incidencia de Europa.Métodos: Estudio observacional retrospectivo, pre-post intervención, comparando los resultados de PWH atendidos en un hospital de alta complejidad entre marzo-octubre de 2020 y el mismo periodo de 2016 a 2019. La intervención consistió en el envío a domicilio de medicamentos y la realización preferente de consultas no presenciales. La efectividad de las medidas implementadas se determinó por el número de visitas a Urgencias, hospitalizaciones, mortalidad y porcentaje de PWH con carga viral > 50 copias antes y después de dos olas pandémicas.Resultados: Se atendieron 2.760 PWH entre enero de 2016 y octubre de 2020. Durante la pandemia se realizaron una media mensual de 106,87 consultas telefónicas y 2.075 envíos a domicilio de medicamentos de dispensación ambulatoria. No se encontraron diferencias estadísticamente significativas en la frecuentación de pacientes con co-infección COVID-VIH respecto al resto (1.172,76 ingresos/100.000 habitantes vs. 1.424,29, p = 0,401), ni en su mortalidad (11,54% vs. 12,96%, p = 0,939). El porcentaje de PWH con carga viral > 50 copias fue similar antes y después de la pandemia (1,20% pre-pandemia vs. 0,51% en 2020, p = 0,078).Conclusión: Nuestros resultados revelan que las estrategias implementadas durante los 8 primeros meses de pandemia han evitado el deterioro en parámetros de control y seguimiento empleados habitualmente en PWH. Además, contribuyen a la reflexión sobre el encaje de la telemedicina y telefarmacia en modelos asistenciales futuros.

Hospitalisation and mortality risk of SARS-COV-2 variant omicron sub-lineage BA.2 compared to BA.1 in England.

The Omicron variant of SARS-CoV-2 became the globally dominant variant in early 2022. A sub-lineage of the Omicron variant (BA.2) was identified in England in January 2022. Here, we investigated hospitalisation and mortality risks of COVID-19 cases with the Omicron sub-lineage BA.2 (n = 258,875) compared to BA.1 (n = 984,337) in a large cohort study in England. We estimated the risk of hospital attendance, hospital admission or death using multivariable stratified proportional hazards regression models. After adjustment for confounders, BA.2 cases had lower or similar risks of death (HR = 0.80, 95% CI 0.71-0.90), hospital admission (HR = 0.88, 95% CI 0.83-0.94) and any hospital attendance (HR = 0.98, 95% CI 0.95-1.01). These findings that the risk of severe outcomes following infection with BA.2 SARS-CoV-2 was slightly lower or equivalent to the BA.1 sub-lineage can inform public health strategies in countries where BA.2 is spreading.

RARE CASE OF A NONTRAUMATIC LEFT MAIN BRONCHIAL TEAR

SESSION TITLE: Bad bugs and Mediastinal Madness SESSION TYPE: Case Reports PRESENTED ON: 10/19/2022 09:15 am - 10:15 am INTRODUCTION: Non-traumatic bronchial injury (NTBI) incidence is not well described but traumatic Tracheobronchial injury (TBI) incidence is 3% with a 70 -100% mortality3. Causes identified for NTBI are associated with vascular supply compromise2. TBI presents with dyspnea, subcutaneous emphysema, pneumothorax, and/or pneumomediastinum4. It can be missed up to 68% of the cases. Bronchoscopy is the study of choice and management is based on studies from traumatic TBI2, 3. This report describes a unique case of NTBI in a patient with recent COVID-19 infection, uncontrolled diabetes, and invasive pseudomembranous Aspergillosis presenting with a left bronchial tear (LBT). CASE PRESENTATION: A 41-year-old with uncontrolled diabetes and prior admission for COVID-19 infection and diabetic ketoacidosis (DKA) managed with steroids and antibiotics. Presenting cough, fever, intermittent chest pain, and palpitations. He was afebrile, tachycardic, and hypoxemic requiring supplemental oxygen. Chest examination revealed crackles and decreased breath sounds at the lung bases. Laboratory studies showed leukocytosis, hyperglycemia, and anion gap metabolic acidosis. SARS-CoV-2 PCR was negative. CT chest revealed an anterior wall defect of the left bronchus with a pneumomediastinum. Bronchoscopy showed pseudomembranous necrotic debris of the tracheobronchial tree and left main bronchus tear with visible rhythm-beating pericardium surrounding the heart. Cytopathological findings of the bronchoalveolar fluid were consistent with Aspergillus species (AS). DISCUSSION: NTBI are rare with a high mortality3. NTBI due to AS has been described in post-lung transplant patients. AS produces endotoxins and proteases that damage the epithelium, leading to erosion of surrounding structures2,3. Since COVID-19, invasive fungal infections (IFI) have risen due to lung damage and immunologic deficits associated with the virus or immunomodulatory therapy6. Our patient risk factors for IFI included recent COVID-19 infection, steroid use, and uncontrolled diabetes. This unholy trinity has coexisted during COVID-19 self-potentiating the problem of immune dysregulation leading to IFI and tissue necrosis7. This may cause NTBI as in our case presenting with LBT. Despite antimicrobial therapy, he died due to massive hemoptysis from erosion of the pericardium or angio-invasion of surrounding vessels. CONCLUSIONS: Rarity of NTBI constitutes a challenge for early diagnosis and management. Identifying predisposing risk factors, a high clinical suspicion, and appropriate diagnostic workup is of vital importance. During the COVID-19 pandemic, IFI have an increased incidence associated with high mortality rates. Despite more cases being described there are still knowledge gaps related to prevention, diagnosis, and management. Reference #1: Jones D, Nelson A, Ma OJ. Pulmonary Trauma. In: Tintinalli JE, Stapczynski JS, Ma OJ, Yealy DM, Meckler GD, Cline DM, eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 8e. McGraw-Hill Education;2016. accessmedicine.mhmedical.com/content.aspx?aid=1121516674 Reference #2: Aerni MR, Parambil JG, Allen MS, Utz JP. Nontraumatic Disruption of the Fibrocartilaginous Trachea: Causes and Clinical Outcomes. Chest. 2006;130(4):1143-1149. doi:https://doi.org/10.1016/S0012-3692(15)51151-3 Reference #3: AK AK, Anjum F. Tracheobronchial Tear. StatPearls Publishing;2022. Accessed March 13, 2022. https://www.ncbi.nlm.nih.gov/books/NBK560900/ DISCLOSURES: No relevant relationships by Jorge Alejandro Bernal No relevant relationships by Adriana Betancourth No relevant relationships by Reham Majzoub No relevant relationships by Juan Pablo Sarmiento Cano

Catastrophe, Care, and All That Remains

During 2020, a menacing sense of doom and anxiety proliferated by the Trump administration's shock-and-awe tactics compounded the brutally uneven distribution of exposure, social atomization, precarity, abandonment, and premature death under the COVID-19 pandemic. The pandemic has had especially lethal consequences for those who are impoverished, racially abjected, and deemed violable or disposable within economies of dispossession. For Indigenous peoples under US occupation, the mainstream news coverage of the pandemic's death toll in the Navajo Nation, Standing Rock, and other Indigenous nations came and went with little sustained inquiry into the conditions of colonization, critical for understanding the current moment. The obstinate negligence of the CARES Act toward peoples and communities most impacted by the pandemic is only one example of this intensified necropolitics. We focus here on conceptions and mobilizations of care and uncaring, and the catastrophe of the settler-capitalist state this time. With all the talk about the need for self-care and community care in this period of concentrated epic crises, we ask: How does the discourse of care operate within an imperial social formation? Is an otherwise possible? What are our obligations in kinship and reciprocity? And how do we attend to these obligations in times of imposed distance?. © 2021 Duke University Press. All Rights Reserved.

Towards Business Process Intelligence to Port2Port Governance Responsibility based on Learning Algorithms

This paper provides an approach to Port2Port Business Process Intelligence (BPIs) helping decision makers in tackling constant changes in governance responsibilities. This consideration leads to the need for Port2Port technological solutions among ports and development of capabilities on sharing information, planning and execution in a collaborative way. It is offered three Port2Port BPIs: 1) Control process for greenhouse gas emissions coming from ships, 2) The process for monitoring ballast Waters, 3) Sanitation Performance Compliance under COVID19 situation. The identification and selection of learning tasks have been integrated into the conceptualisation scheme, suggesting the exploitation of Deep reinforcement Learning (RL) to capture important aspects of the real problem facing the learning agents interacting with its environment to achieve the proposed goals. © 2021 IEEE.

Factors that Contribute to Teachers’ Burnout During the COVID 19 Pandemic in Ecuador

The main purpose of this study is to identify the factors that contribute to teachers’ burnout during the COVID 19 pandemic in Ecuador. Additionally, the research aims to analyze teachers’ working conditions, determine the teachers’ health problems associated with the new working conditions, and establish the complementary activities that affect male and female teachers. This is stratified descriptive research based on a survey applied to 843 individuals who belong to different educational levels (preschool, elementary, secondary, technological institute, and university). As a result of the analysis, some significant findings are that teachers are working more hours with undefined schedules. Additionally, a percentage of teachers claimed to have some ailments. For instance, 38,2% have had neck pain and 32% have one or more ailments similar to those of carpal tunnel syndrome. Interestingly, women are more affected than men in relation to workload, housework, and childcare. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Increased levels of soluble fms-like tyrosine kinase-1 are associated with adverse outcome in pregnant women with COVID-19.

OBJECTIVE: In addition to the lungs, the placenta and the endothelium can be affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) are markers of endothelial dysfunction and could potentially serve as predictors of severe coronavirus disease 2019 (COVID-19). We aimed to investigate the association of serum concentrations of sFlt-1 and PlGF with the severity of COVID-19 in pregnancy. METHODS: This was a prospective cohort study carried out in a tertiary care hospital in Mexico City, Mexico. Symptomatic pregnant women with a positive reverse-transcription quantitative polymerase chain reaction test for SARS-CoV-2 infection who fulfilled the criteria for hospitalization were included. The primary outcome was severe pneumonia due to COVID-19. Secondary outcomes were intensive care unit (ICU) admission, viral sepsis and maternal death. sFlt-1 levels were expressed as multiples of the median (MoM). The association between sFlt-1 and each adverse outcome was explored by logistic regression analysis, adjusted for gestational age for outcomes occurring in more than five patients, and the predictive performance was assessed by receiver-operating-characteristics-curve analysis. RESULTS: Among 113 pregnant women with COVID-19, higher sFlt-1 MoM was associated with an increased probability of severe pneumonia (adjusted odds ratio (aOR), 1.817 (95% CI, 1.365-2.418)), ICU admission (aOR, 2.195 (95% CI, 1.582-3.047)), viral sepsis (aOR, 2.318 (95% CI, 1.407-3.820)) and maternal death (unadjusted OR, 5.504 (95% CI, 1.079-28.076)). At a 10% false-positive rate, sFlt-1 MoM had detection rates of 45.2%, 66.7%, 83.3% and 100% for severe COVID-19 pneumonia, ICU admission, viral sepsis and maternal death, respectively. PlGF values were similar between women with severe and those with non-severe COVID-19 pneumonia. CONCLUSION: sFlt-1 MoM is higher in pregnant women with severe COVID-19 and has the capability to predict serious adverse pregnancy events, such as severe pneumonia, ICU admission, viral sepsis and maternal death. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

Comorbidity, poverty and social vulnerability as risk factors for mortality in pregnant women with confirmed SARS-CoV-2 infection: analysis of 13 062 positive pregnancies including 176 maternal deaths in Mexico.

OBJECTIVE: Mortality in pregnancy due to coronavirus disease 2019 (COVID-19) is a current health priority in developing countries. Identification of clinical and sociodemographic risk factors related to mortality in pregnant women with COVID-19 could guide public policy and encourage such women to accept vaccination. We aimed to evaluate the association of comorbidities and socioeconomic determinants with COVID-19-related mortality and severe disease in pregnant women in Mexico. METHODS: This is an ongoing nationwide prospective cohort study that includes all pregnant women with a positive reverse-transcription quantitative polymerase chain reaction result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from the Mexican National Registry of Coronavirus. The primary outcome was maternal death due to COVID-19. The association of comorbidities and socioeconomic characteristics with maternal death was explored using a log-binomial regression model adjusted for possible confounders. RESULTS: There were 176 (1.35%) maternal deaths due to COVID-19 among 13 062 consecutive SARS-CoV-2-positive pregnant women. Maternal age, as a continuous (adjusted relative risk (aRR), 1.08 (95% CI, 1.05-1.10)) or categorical variable, was associated with maternal death due to COVID-19; women aged 35-39 years (aRR, 3.16 (95% CI, 2.34-4.26)) or 40 years or older (aRR, 4.07 (95% CI, 2.65-6.25)) had a higher risk for mortality, as compared with those aged < 35 years. Other clinical risk factors associated with maternal mortality were pre-existing diabetes (aRR, 2.66 (95% CI, 1.65-4.27)), chronic hypertension (aRR, 1.75 (95% CI, 1.02-3.00)) and obesity (aRR, 2.15 (95% CI, 1.46-3.17)). Very high social vulnerability (aRR, 1.88 (95% CI, 1.26-2.80)) and high social vulnerability (aRR, 1.49 (95% CI, 1.04-2.13)) were associated with an increased risk of maternal mortality, while very low social vulnerability was associated with a reduced risk (aRR, 0.47 (95% CI, 0.30-0.73)). Being poor or extremely poor were also risk factors for maternal mortality (aRR, 1.53 (95% CI, 1.09-2.15) and aRR, 1.83 (95% CI, 1.32-2.53), respectively). CONCLUSION: This study, which comprises the largest prospective consecutive cohort of pregnant women with COVID-19 to date, has confirmed that advanced maternal age, pre-existing diabetes, chronic hypertension, obesity, high social vulnerability and low socioeconomic status are risk factors for COVID-19-related maternal mortality. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

Adopting a multidisciplinary telemedicine approach for falls prevention in Parkinson's disease

Objective: This multidisciplinary study aims to evaluate the effects of a home-based intervention programme delivered by a multidisciplinary health team using telemedicine, and wearable sensors to reduce the incidence of falls in PD Background: Falls in Parkinson's Disease (PD) are very frequent with often devastating consequences, increasing comorbidity, mortality, decreased quality of life (QoL), and increased socio-health costs. Healthcare services for chronically ill patients, including PD patients, have been compromised during the COVID-19 pandemic, owing to limited access to multidisciplinary care. Design/Methods: Ongoing, longitudinal, two-group randomized controlled trial, which will be including 38, non-demented patients with idiopathic PD, high risk of falling and restricted access to multidisciplinary care. Multidisciplinary telemedicine visits including neurologists, nurses, occupathional therapists and psychologists in addition to wearable sensors (study group) will be compared to in-office visits best medical practice (control group). Falls reduction, PDQ-39, motor (MDS-UPDRS) and non-motor symptoms (NMSS) severity and balance impairment will be compared. Results: Up to date, 12 PD patients without access to non-pharmacological interventions with a mean age 69.0 ± 7.4,50% males, median Hoehn Yhar of 2.0, were included (6 patients in the telemedicine group, 6 patients in the control group). At baseline, patients had a mean MDSUPDRS-III 45.3 ± 6.4, NMSS score 73.5 ± 6.7, PDQ-39 52.8 ± 23.4, 2.5 ± 0.7 falls in the past 6 months, and abnormal balance (Cognitive-TUG). Comparison of control vs. study groups outcomes and multivariate analyses will be performed. Conclusions: The findings of this study will allow us to study the feasibility of remote health care to prevent falls in patients with PD, to provide direction for health and lifestyle interventions, allowing equity in the distribution and access to specialized, multidisciplinary health care. The current findings will be specially relevant in the context of Covid-19 pandemic and the unusual situation of inaccessibility of in-person health services.

Are antimalarials safe for the heart of patients with systemic lupus erythematosus Analysis of factors associated with the development of heart failure in patients in the Spanish society of rheumatology lupus registry (RELESSER)

Background: Factors associated with the development of chronic heart failure (CHF) in systemic lupus erythematosus (SLE) have received little attention. On the other hand, recent data from the use of hydroxychloroquine in the treatment of SARS-CoV-2 infection during the COVID19 pandemic have cast some doubts on its cardiological safety. Objectives: To identify factors associated to CHF in SLE. Methods: Retrospective cross-sectional study, including all patients with SLE (≥4 ACR-1997 criteria) recruited in RELESSER registry. The objectives and methodology of the registry have been described previously (1). CHF was defined according to the Charlson index item. Patients with CHF before diagnosis of SLE were excluded. Cumulative damage was measured with the SLICC/ ACR index, excluding cardiovascular (CV) items (mSDI). Multivariate analysis exploring factors associated with CHF was carried out. Results: 117 patients (3% of the entire cohort) with SLE and CHF and 3,506 controls with SLE without CHF were included. 90% were women. Disease duration: mean (SD), 120.2 (87.7) months. CHF appeared after a median (P25-P75) of 9.40 (4.2-18.3) years from SLE diagnosis. Patients with CHF were older (59.8 ± 18.2 vs. 46.2 ± 4.3). In the bivariate analysis, the association of CHF with greater severity [Katz severity index: median (IQR): 4 (3-5) vs. 2 (1-3)], damage [mSDI: 3 (2-4) vs 0 (0-1)], comorbidity [modified Charlson-excluding CV items: 4 (3-6) vs 1(1-3)] and both CV (37.5% vs 6.7%) and overall mortality (43.2% vs 4.7%) (p<0.0001 for all comparisons). Also, CHF patients were more refractory to SLE treatments (33.3% vs 24%, p=0.0377) and were more frequently hospitalised due SLE [median 3 (1-5) vs 1(0-2), p<0.0001]. The results of the multivariable model are depicted in table 1. Conclusion: -CHF is a rather late complication of SLE. -Patients with SLE and CHF have more severe SLE, with greater refractoriness to SLE treatments and higher overall mortality. -Treatment with antimalarials, as routinely used in SLE patients, is not only safe to heart, but even appears to have a cardioprotective effect. (Table Presented).

Food and Nutrition Insecurity in Venezuelan Migrant Families in Bogotá, Colombia

Venezuela has had the largest migration in recent history, with 4.8 million people displaced due to sociopolitical, economic, electrical blackouts, and health crises. Nine out of 10 migrants are facing food insecurity during the COVID19 pandemic. Colombia has received the largest number of Venezuelans migrants, counting officially 1,764,883 to date. This study aims to analyze the changes in the migration process regarding the availability, access, and food consumption of Venezuelan migrants in Bogotá, before and after their arrival. This study uses a naturalistic approach, with a convenience sample (n = 15 families) who participated in in-depth semi-structured interviews about their experiences related to diet and nutrition, and the migratory process. Information was recorded, transcribed, and analyzed using grounded theory. Findings reflect that Venezuelan migrants leave the country due to severe lack of access to food which in turn affects the supply, acquisition, consumption, and nutritional status: “The main reason I left Venezuela was that I couldn't get groceries like milk to feed my granddaughter. When that happened, I couldn't stand it anymore.” After arrival in Colombia, dimensions of food and nutrition security, such as availability, physical and economic access, and consumption improved. However, families are still struggling to acquire basic food items. Households have access to a culturally adequate diet, but with insufficient nutritional quality, as noted by one participant: “The biggest difference is that in Venezuela you can't get the groceries to feed your whole family with the salary that you get. Here in Bogota, you can buy cheap food, to feed the whole family.” After their arrival, migrants still face difficulties that include legal issues, finding a place to stay, employment, access to high-quality foods, and xenophobia. They have regained the freedom to choose the food they want to buy in a dignified and socially accepted way;two elements that were no longer possible in Venezuela. © Copyright © 2021 Pico, del Castillo Matamoros and Bernal.

Recommendations for the teams that manage school canteens in the public health emergency of COVID-19 in Argentina

The impact of the pandemic caused by COVID-19 may deepen the situations of malnutrition, where it will be necessary to adapt food programs to this new context. The objective of this work was to present the methodology and the main results of the process of formulating a federal guide based on scientific evidence and adapted to the reality of the child and adolescent population that attend school canteens in the 24 jurisdictions of Argentina. It was observed that the modalities for the implementation of SC during the pandemic were: food modules (the most frequent);food modules delivered at school with regular SC support and, food and/or snacks delivered daily. There was little evidence at the global and regional level on specific recommendations applied to the implementation of SC, although recommendations on hygiene and food handling were found. Based on a participatory process among key actors, specific recommendations were obtained according to the dimensions of food and nutrition security (FNS). It is concluded that it is necessary to increase participatory experiences in the design of recommendations based on evidence, adapted to the territory and that assume a comprehensive approach from the dimensions of FNS. Arch Latinoam Nutr 2020;70(3): 215-234. © 2020 Archivos Latinoamericanos Nutricion. All rights reserved.

Refuge or Trench: Thinking about 'Home' in Pademic Times

Since the start of the pandemic caused by the COVID19 disease, the governments of the Global North have demanded policies aimed at "flattening the curve", mainly through social distancing, using tests and tracking where feasible and, in some cases, imposing almost total and indiscriminate confinements. This was the case in Spain, where a quarantine was imposed from March 15 to June 21, causing most of the citizenry to be confined to their home. In this text we try to reflect on this experience and the implications that it might have for the future. To do this, we carry out an analysis of the different functions of the "home" -as a refuge, a place of resistance and a place of hospitality and welcome, and the changes that the COVID19, understood in relation to the new climate regime, can imply. For this we will base our analysis on the reflections of Judith Butler, Sarah Ahmed, bell hooks and Isabelle Stengers.