Non-invasive mechanical ventilation in patients admitted to a provisional center for moderate COVID-19 patients

Introduction:Non-invasive mechanical ventilation is a ventilatory alternative for COVID-19 cases. Background:To describe the characteristics and evolution of non-invasive mechanical ventilation (NIMV) in patients discharged from Provisional Center for moderate COVID-19 patients in Figali, Panama. Methods:A descriptive, retrospective, longitudinal stu was carried out in all adult patients discharged from June to July 2021 and who received non-invasive mechanical ventilation. A questionnaire was used using the digital individual medical record as primary source. Descriptive statistics techniques were used. Results:35.9% of the patients (78/217) who were admitted required non-invasive mechanical ventilation on the ninth day of symptoms and the second day after admission. 62.8% (49/78) were obese and 29.5% (23/78) hypertensive. The respiratory rate 30 and the decrease in the PaO2/FiO2 ratio decided the begining of non-invasive mechanical ventilation in 56.4% (78/217) of those admitted. 62.8% (49/78) had moderate-severe acute respiratory distress syndrome, and the severity was related to ventilation failure out of the total number of ventilated patients. Ventilation was successful in 65.4% (51/78). PaO2/FiO2 <150 (62.9%), respiratory rate 30 (55.6%) and physical exhaustion (51.85%) decided ventilation failure. Conclusions:Non-invasive mechanical ventilation is an effective procedure in COVID-19 patients and moderate or severe respiratory distress;although its success is related to the less severe forms. Low PaO2/FiO2, together with symptoms, were key indicators to assess the begining, success or failure of NIMV;not so the values of PaO2, PaCO2 and SpO2.

COVID-19 and Food Insecurity in Latin America and the Caribbean

The objective was to determine the prevalence of household food insecurity (FI) in Latin America and the Caribbean (LAC) during the COVID-19 pandemic. Secondary analysis was performed using the waves 1 to 3 of the 2020 COVID-19 High Frequency Phone Surveys in 13 LAC countries. The countries with the highest FI in the first wave were Honduras (60.3%), Peru (58.1%) and Ecuador (57.9%). Likewise, the countries with the greatest differences in the prevalence of FI between the first and last waves in percentage points (PP) were Peru (-29), Guatemala (-27.7) and Bolivia (-21.8). LAC countries face a great burden of FI.Copyright © 2022 Taylor & Francis Group, LLC.

Declaration of Cuernavaca

The National Public Health Institutes (NPHI), members of the Latin American Regional Network of the International Association of National Institutes of Public Health, met face to face at the headquarters of the National Institute of Public Health of Mexico, in the City of Cuernavaca, from October 5 to 7, 2022, with the participation of the directors or their representatives of the NPHIs of Bolivia, Brazil, Colombia, Costa Rica, El Salvador, Mexico, Peru and Suriname and representatives of the South American Sub regional Program (SAM), and the Central American Sub regional Program (CAM) of the Pan American Health Organization (PAHO), the Organization of the Amazon Cooperation Treaty (OTCA), the Andean Health Agency/Hipolito Unanue Agreement (ORAS/CONHU) and the Central American Integration System (SICA/COMISCA), analyzing the role of the NPHI in combating health inequities;in confronting the global climate and environmental crisis;combating hunger, food insecurity and malnutrition;successes and challenges in responding to the Covid-19 pandemic;strengthening and continuous improvement of integrated disease surveillance and preparedness for health emergencies;as well as the various existing regional and sub-regional health cooperation programs, noticing that: 1. In the current scenario, the dominating development model is a generator of growing social inequalities, which determine serious inequities in the health conditions of our peoples. 2. Likewise, the current model of production and consumption, adopted at the global level, has increased hunger, food insecurity and malnutrition that possibly constitute nowadays the main health problem in our region. 3. The environmental crisis, which is also a product of the current global development model, has a significant impact on human and animal health and the interaction between both. 4. The NPHIs have played a role of major relevance in confronting the Covid-19 pandemic, not fully applying, however, their full potential for research and for proposing national plans for the disease control. 5. Health surveillance systems, in most of our countries, suffer from significant fragmentation between various sectors and within the health sector itself, implying, in any case, reactive actions that do not allow for anticipating the emergence of new pathologies or health emergencies. 6. The various regional and sub regional cooperation agencies and programs offer an enormous capacity for synergies and mutual cooperation.

Identification of Patients Diagnosed with Rare and Emerging Diseases Utilizing the Trinetx Network: A Case Study of African and American Trypanosomiasis

Objectives: Due to large sample sizes, electronic medical records (EMR) databases have the potential to provide pivotal insights into patients diagnosed with rare, orphan, or emerging diseases. This study aimed to explore the patient profile of African and American trypanosomiasis, both vector-borne parasitic diseases, pre-and post the COVID-19 pandemic using the TriNetX Network. Method(s): From Jan 1, 2018 - Nov 30, 2019 (pre-COVID) and Jan 1, 2020 - Nov 30, 2021 (post-COVID) patients were queried from the TriNetX Global health research network, inclusive of 88 million patients from the United States (US), Europe, the Middle East, Africa, Latin America, and Asia Pacific. Eligible patients with an ICD-10 diagnosis code of African trypanosomiasis or American trypanosomiasis were identified (2280 patients on 22-Dec-2022) and analyzed separately, pre- and post-COVID. Result(s): We identified 340 patients pre- and 960 patients post-COVID with African trypanosomiasis and 960 patients pre- and 190 patients post-COVID with American trypanosomiasis. Most patients resided in the US. Pre-COVID African trypanosomiasis patients had a mean age of 38 and were 59% female while post-COVID patients had a mean age of 34 and were 57% female. Pre-COVID American trypanosomiasis patients had a mean age of 49 and were 57% female while post-COVID patients had a mean age of 49 and were 53% female. Top co-diagnoses included diseases of the respiratory (85%, 84%) and nervous systems (82%, 79%) for patients with African trypanosomiasis and diseases of the digestive (69%, 54%) and circulatory systems (68%, 61%) for patients with American trypanosomiasis in both the pre- and post-COVID cohorts, respectively. Conclusion(s): Using real-world EMR data we were able to obtain patient profiles for a rare disease (African trypanosomiasis) and a common, emerging disease (American trypanosomiasis). This informationsupportsutilizing EMR data for describing patient populations in rare, orphan, or emerging diseases, which may aid drug development for these indications.Copyright © 2023

Tropical Conditions and Outbreak of COVID-19

Background: The new novel Coronavirus 2019 (nCOV-19 or COVID-19) has caused an unprecedented pandemic in humans. All nations have heightened their surveillances after the quick diagnosis of potential cases of the COVID-19. Objective(s): Recent statistics have mentioned that virus outbreak in tropical countries is relatively low compared to cold nations. To support this conclusion, we considered the six main tropical regions to investigate the pandemic distribution at the initial phase. Method(s): Chi-square test was applied to understand the correlation between outbreak and temperature changes. Significant probability P-value was set to P<0.01. P-values were calculated to both positive and death cases. Result(s): Out of 1211562 infected cases, 41776 cases (3.45%) were registered at hightemperature countries (P<0.0001) and 1161786 cases (96.55%) at other countries like European countries or the USA. Moreover, only 1433 mortality cases (2.2%) happened, and the remaining 97.8% of mortality happened among other nations. Conclusion(s): Similar to other respiratory viruses like flu and influenza, there is a low outbreak of COVID-19 in tropical nations compared to the other countries. Apart from weather conditions, it is also recommended to follow the serious preventive measures imposed by governments to survive this novel epidemic.Copyright © 2020

Do The Research Training Interests And Needs Of Medical Students Vary Internationally? A Global Study

Introduction: This study aims to understand the current landscape of global medical student knowledge, resources, and barriers pertaining to research compared with clinical experience. Method(s): A survey was created by a diverse focus group to ascertain medical student perceptions of clinical and research experience. The survey was distributed to medical students through social media networks via international partnerships from Nov 1st - Dec 31st 2020. The analysis included statistical characteristics and a comparison between regions. Result(s): A total of 357 medical students from 26 countries completed the survey. Respondents were majority female (60.8%) from Latin America (58.9%), North America (25.8%), and Sub-Saharan Africa or other regions (18.2%). 10.9% of students had an additional graduate-level degree. The majority of students were interested in conducting research as medical students (87.1%) and as future physicians (58%). Overwhelmingly, students felt that research was an important component of medical training (88.5%). The majority of students were not required to participate in research to graduate from training (59%) and had not participated in the research (53%). There were several reported barriers to research, including lack of research opportunities (68.7%), lack of mentors (56.6%), lack of formal training (56.3%), and barriers due to the COVID-19 (49.9%). Conclusion(s): Despite significant interest in research, medical students globally report a lack of formal research training, opportunities, and several barriers to conducting research, including the COVID-19 pandemic. This survey demonstrates a need for student research training internationally, as well as highlights a possible role for further evaluation of research training needs.

Three Challenges Facing Guatemala's COVID-19 Crisis: Mobility, Violence and Governance

Guatemala, located at the head of the Northern Triangle of Central America, suffered relatively low levels of contagion compared to more developed Latin American countries. At the beginning of the COVID-19 crisis, it imposed a series of strict measures, including closing its borders and imposing a curfew and confinement. Nevertheless, given its longstanding problems-violence, endemic poverty, and rampant corruption, among others-the COVID-19 crisis proved catastrophic for Guatemala. Measures deemed necessary to stem the spread of coronavirus, for instance, worsened an economic downturn by impeding commerce and workflow. Although endemic violence decreased in some areas, it increased in others. Finally, poor levels of government transparency and of the citizenry's trust in government took a turn for the worse. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Increasing polio coverage with safer vaccines: a pressing need in Latin America

Given the actual risk of poliomyelitis outbreaks in the region due to poliovirus derived from the Sabin vaccine or the importation of wild poliovirus, the Latin American Society of Pediatric Infectious Diseases commissioned an ad hoc group of experts from the institution's Vaccines and Biologicals Committee, to draft an official position paper on the urgent need to increase immunization levels against the disease in the region and incorporate inactivated polio vaccine exclusive schedules in all national immunization programs. This publication discusses the main conclusions and recommendations generated as a result of such activity.Copyright © 2022, Sociedad Chilena de Infectologia. All rights reserved.

Vaccination in Patients with Inflammatory Rheumatic Diseases: Preliminary Results of an International, Real-World Life Panlar's Register

Objectives: To evaluate vaccination among patients with inflammatory rheumatic diseases initiating disease-modifying antirheumatic drugs (DMARD) Methods: Data from the real-world life PANLAR's register of consecutive patients diagnosed with RA, PsA, and axSpa (2010 ACR-EULAR /2006 CASPAR-2009 ASAS) from Dec 2021 to Dec 2022 were analyzed. Prevalence of recommended vaccinations were compared between different inflammatory rheumatic diseases. Categorical variables were expressed as %. Tables were analyzed with chi2 or Fisher tests, continuous variables (median, IQR)with the Kruskal-Wallis test, according with the variables type. A p value <=0.05 was considered significant. Result(s): 608 patients were included. Among patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial Spondyloarthritis (axSpA) are presented in the table. RA and axSpA seemed to have lower vaccination rate of pneumococcal vaccines than PsA. (p = 0.045 for conjugate anti pneumococcal vaccine in RA vs PsA). A large percentage of the population was vaccinated against COVID-19. There was a high rate of influenza vaccination in all three diseases. Conclusion(s): In Latin America, anti-pneumococcal vaccination is low, especially in patients with RA and axSpA. For other vaccines there was an acceptable level of vaccination without differences between diseases.

Week 48 results of a phase 3 randomized controlled trial of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) vs dolutegravir 1 emtricitabine/tenofovir disoproxil fumarate (DTG 1 F/TDF) as initial treatment in HIV-1/HBV-coinfected adults (ALLIANCE)

Background/Aims: The clinical course of hepatitis B virus (HBV) infection in individuals with HIV-1 coinfection is marked by accelerated disease progression. A tenofovir-containing antiretroviral regimen is recommended in most people with HIV-1/HBV-coinfection, but there have not been randomized studies of tenofovir disoproxil fumarate (TDF) vs tenofovir alafenamide (TAF) in treatment- naive HIV-1/HBV-coinfected individuals. We report primary endpoint results from a Phase 3 study comparing bictegravir/emtricitabine/ TAF (B/F/TAF) vs dolutegravir + emtricitabine/TDF (DTG + F/TDF) at Week (W)48 in participants initiating treatment for both viruses. Method(s): Adults with HIV-1/HBV coinfection were randomized 1:1 to initiate blinded treatment with B/F/TAF or DTG + F/TDF (with placebo). Primary endpoints were the proportion of participants with HIV-1 RNA<50 copies/mL (FDA Snapshot) and plasma HBV DNA<29 IU/mL (missing = failure) at W48. Noninferiority was assessed with 95% CI (12% margin). Secondary and other endpoints included change from baseline cluster of differentiation 4 (CD4) count, proportion with hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) loss/seroconversion, and alanine transaminase (ALT) normalization (AASLD criteria). Result(s): Participants (N = 243) were randomized and treated (B/F/ TAF [n = 121], DTG + F/TDF [n = 122]) from 11 countries in Asia, Europe, North, and Latin America. Baseline characteristics were median age of 32 years, 4.5% female, 88% Asian, 30% HIV-1 RNA>100,000 c/mL, 40% CD4<200 cells/lL, median HBV DNA 8.1 log10 IU/mL, 78% HBeAg+. At W48, B/F/TAF was noninferior to DTG + F/TDF at achieving HIV-1 RNA<50 copies/mL (95% vs 91%, difference 4.1%;95% CI -2.5%-10.8%;P = 0.21), with mean CD4 gains of + 200 and + 175 cells/lL, respectively. B/F/TAF was superior to DTG + F/TDF at achieving HBV DNA<29 IU/mL (63% vs 43%, difference 16.6%;95% CI 5.9%-27.3%;P = 0.0023). Participants treated with B/F/TAF vs DTG + F/TDF had numerically higher HBsAg loss (13% vs 6%;P = 0.059), HBeAg loss (26% vs 14%;P = 0.055), HBeAg seroconversion (23% vs 11%;P = 0.031), and ALT normalization (73% vs 55%;P = 0.066). The most frequent adverse events among participants treated with B/F/TAF vs DTG + F/TDF were upper respiratory tract infection (17% vs 11%), COVID- 19 (13% vs 11%), pyrexia (9% vs 12%), ALT increase (7% vs 11%), and nasopharyngitis (11% vs 4%). ALT flares (elevations at >= 2 consecutive postbaseline visits) occurred in 11 participants (7 B/F/ TAF, 4 DTG + F/TDF), and all resolved. Conclusion(s): Among adults with HIV-1/HBV-coinfection starting antiviral therapy, both B/F/TAF and DTG + F/TDF had high HIV-1 suppression at year 1, with B/F/TAF resulting in superior HBV DNA suppression and significantly more HBeAg seroconversion. Safety findings were similar between groups.

COVID-19 and Protracted Displacement: a Scoping Review of Migration Policies in Mexico and Central America.

By the end of 2020, more than 500,000 migrants from Central America, Haiti, Africa, and Asia sought asylum along the US-Mexico border despite COVID-19-related travel restrictions and public health measures. A scoping review was conducted to understand the role of COVID-19-related policies on irregular migration flows through Central America and Mexico and to examine the experiences of asylum seekers traversing this region. Peer-reviewed literature, policy briefs, and commentaries were screened for inclusion, resulting in 33 documents selected for this review. This review identified three dominant themes: border closures due to multiple national migration policies, delays in asylum procedures, and increased risks to migrant wellbeing. This article argues that border closures were a punitive policy measure to deter irregular migration during the COVID-19 pandemic. Implications for future research and policy include prioritizing the health needs of asylum seekers and advocating the appropriateness and effectiveness of immigration and public health policy.

The irruption of the political after the pandemic: The case of Panama.

This article analyzes the emergence of new political agendas as a result of the social mobilization that took place in Panama during the pandemic and how these were finally translated into a new institution for the negotiation of public policies –The Single Roundtable for Dialogue (Mesa Única de Diálogo). Analytical narratives are used based on secondary sources. To this end, the literature and various indicators were examined and a newspaper search was conducted on the phenomenon studied. The hypothesis is that, although there have been previous protests in the Panamanian nation, there is a before and an after in relation to the one that occurred in July, 2022, in terms of the meaning and scope of the demands of mobilized actors. It was a moment of political irruption, in which those who do not usually have a voice demonstrated that they have one. This text characterizes the conditions of public policies in the Panamanian political system;describes the social and economic effects of COVID-19;and describes the process of political irruption and emergence of new agendas during the mobilization. The conclusions illustrate how the aforementioned protests constituted an interruption of the previous equilibrium of the country, where the notion of the public had been distorted and needed to be reformulated. (English) [ FROM AUTHOR] En este artículo se analiza la emergencia de nuevas agendas políticas producto de la movilización social ocurrida en Panamá durante la pandemia y cómo estas se tradujeron, finalmente, en una nueva institución para las negociaciones de las políticas públicas: la Mesa Única de Diálogo. Se emplean las narrativas analíticas basadas en fuentes secundarias;para ello se revisó la literatura y distintos indicadores y se realizó una búsqueda hemerográfica sobre el fenómeno estudiado. Como hipótesis se plantea que, si bien han ocurrido protestas previas en la nación panameña, existe un antes y un después en relación con la ocurrida durante julio de 2022 en términos del sentido y el alcance de las reivindicaciones de los actores movilizados: se trata de un momento de irrupción de lo político, en el cual quienes no suelen tener voz se manifiestan por tenerla. En el texto se caracterizan las condiciones en que se han dado las políticas públicas en el sistema político panameño, se describen los efectos sociales y económicos de la covid-19, así como el proceso de irrupción de lo político y la emergencia de nuevas agendas durante las movilizaciones. En las conclusiones se ilustra cómo las mencionadas protestas constituyen una interrupción de los equilibrios previos de un país, donde la noción de lo público ha estado deformada y requiere ser replanteada. (Spanish) [ FROM AUTHOR] Copyright of Íconos. Revista de Ciencias Sociales is the property of FLACSO Ecuador (Facultad Latinoamericana de Ciencias Sociales) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Relationship between acne and the use of mask in doctors during the COVID-19 pandemic.

OBJECTIVE: To identify the characteristics of the use of masks and features of acne lesions and acne-like eruptions, among doctors involved in various clinical settings. MATERIALS AND METHODS: An observational, prospective, cross-sectional study was conducted from June to September 2020. The main tool of the study was a form designed with the Google forms platform, which has 17 items. RESULT(S): The responses of 150 participants from Mexico and Latin America were analyzed: 84 participants (56%) were female. The most frequent academic degree among the participants was Doctor of Medicine. The mask with the highest frequency of use was the N95 mask in 98 participants (65.3%);84% of the participants presented typical acne lesions, nodules were the most frequent lesions, only 24 patients did not present characteristic lesions. The topographic region where these lesions most frequently occurred was the chin region. CONCLUSION(S): The importance of the presence of acne and acne-like lesions in medical doctors who use personal protective equipment during their working hours is demonstrated, in order to issue future recommendations related to skin care during the SARS-CoV-2 pandemic.Copyright © 2022 Comunicaciones Cientificas Mexicanas S.A. de C.V.. All rights reserved.

Prevalence of Infant Regurgitation: Experience of the Working Group on Disorders of Gut-Brain Interaction of the Latin American Society of Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN).

Introduction. The prevalence of infant regurgitation in Latin American children is between 8.0% and 9.4% according to the Rome III criteria. Objective. To determine the prevalence of infant regurgitation in Latin American children according to the Rome IV criteria and its possible as-sociations. Materials and methods. A descriptive observational study of prevalence type was carried out in seven Latin American countries. The Functional International Digestive Epidemiological Research Survey database was used to select the sample. Children under 12 months of age who were diagnosed with infant regurgitation using the Pediatric Rome IV Gastrointestinal Symptoms Questionnaire were included in the study. Results. 1802 infants (80.7% from South America, 6.7 +/- 3.8 months of age) were analyzed. Infant regurgitation was diagnosed in 6.8% (52.5% women;39.8% mixed race;46.7% Colombians);peak age: 6 months. There was a greater chance to present infant regurgitation in infants between 1 and 6 months of age, of indigenous race, from Central America, born by C-section, premature, treat-ed in a public institution, by a pediatric gastroenterologist and during the Covid-19 pandemic. There was a lower chance to present infant regurgitation in infants with complementary feeding. Conclusion. Infant regurgitation is frequent in Latin American infants, its prevalence is lower compared to that described in other countries, with risk factors such as race, origin, C-section, prematurity, site and level of care, and the Covid-19 pandemic. The protective factor is complementary feeding.Copyright © 2023, Sociedad Argentina de Gastroenterologia. All rights reserved.

Reactive Arthritis

Reactive arthritis develops as a sequela of a remote infection, usually of the gastrointestinal or genitourinary tract. The presence of acute arthritis and absence of specific diagnostic test markers can lead to misdiagnosis. Prompt recognition and proper management prevent reactive arthritis from progressing to a chronic destructive arthritis. The nurse practitioner's familiarity with reactive arthritis, signs and symptoms, diagnostic criteria, and treatment regimen promote early intervention for achieving the best outcomes, including remission.

Disruption, Transformation, Resilience, and Hope: The Experience of a Belizean Community During COVID-19 Lockdown

This qualitative research explored the lived experience of teachers, school administrators, parents, and children in Belize, Central America during the COVID-19 lockdown. Through field notes, correspondence, and interviews, a narrative approach was leveraged to convey the impact of two years away from classrooms and from each other. Both the trauma and loss of this disruption on global literacy, along with three forces that nourished the capacity for resilience, were examined. [ FROM AUTHOR] Copyright of Qualitative Report is the property of Qualitative Report and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Aggression, mini-aggression, and abuse against health care workers during the COVID-19 pandemic

Introduction: COVID-19 pandemic brought multiple negative consequences that go beyond the direct damage caused by the disease and that affect health systems as well. Complaints of attacks against health care workers became frequent and concerning. The objective of this survey was to characterize the frequency and type of violent behavior against front-line professionals in Latin America. Material(s) and Method(s): A cross-sectional electronic survey was carried out between January 11th to February 28th, 2022. Different health care workers from Latin America who have been delivering care at least from March 2020, regardless of whether they assist or not patients with COVID- 19 were included. A non-probabilistic snowball sampling was performed, and the survey was Results: The survey was responded by 3,544 participants from 19 countries (Figure 1);58.5% were women, and the mean age was 41.9+/-11 years. The 70.8% were doctors, 16% nurses, 3.4% physiotherapists, and the remaining 9.8% had other functions within the health team. About 85.1% of physicians were specialists: 33.9% were cardiologists, 14.4% were intensivists or emergency physicians, 10.9% had some surgical specialty, 7.7% were pediatricians or related subspecialties, and the remaining 33.1% had other specialties. The 36.3% and 28.8% worked in public and private practice respectively, the remaining worked in both. Direct and regular care to COVID-19 patients was provided by 74.7% of all contestants. Among the participants, 54.8% reported acts of violence: 95.6% suffered verbal violence, 11.1% physical violence, and 19.9% other types. 39.5% of respondents experienced it at least once a week. The acts of violence involved patients' relatives (32%), or patients together with their relatives (35.1%). The victims rated the stress level of these events with an average of 8.2+/-1.8 points (scale from 1 to 10). Approximately half of the health personnel who suffered an assault experienced psychosomatic symptoms after the traumatic event (Figure 2). Among the victims of violence, 56.2% considered changing their care tasks, and 33.6% abandoning their profession. However, only 23% of the health personnel attacked stated that they had made some type of legal action regarding these acts. In a logistic regression model, doctors (OR 1.95, p<0.01), nurses (OR 1.77, p=0.001), and administrative staff (OR 3.20, p<0.01) suffered more violence than other health workers. Women more frequently suffered violence (OR 1.56, p<0.01), as well as those who worked with patients with COVID-19 (OR 3.59, p<0.01). Conversely, a lower probability of violence was observed at older ages (OR 0.96, p<0.01). Conclusion(s): We detected a high prevalence of violence against health personnel in Latin America during the current pandemic. Those caring for COVID-19 patients, younger staff, and women were found to be more vulnerable. It is imperative to develop strategies to mitigate these acts and their repercussions on the health team. (Figure Presented) .

Migración climática y fronteras militarizadas: seguridad humana, de género y ambiental

En este artículo se aborda la migración climática centroamericana desde un enfoque de seguridad humana, de género y ambiental (seguridad HUGE). Se examinan documentos, reportes gubernamentales, publicaciones de prensa, datos estadísticos internacionales y nacionales, así como entrevistas para establecer interrelaciones complejas entre migración, desastres, pobreza, pandemia y dilema de supervivencia. Las fronteras militarizadas, las presiones del gobierno estadounidense y el crimen organizado transnacional han incrementado los peligros y el costo de la migración indocumentada. ¿Pudiera una reforma migratoria en Estados Unidos superar esta vorágine de migración ilegal y generar desarrollo en el norte de Centroamérica por medio del envío de remesas a las familias que se quedan? El artículo explora la multiculturalidad, la restauración de ecosistemas, la adaptación al cambio climático, el reconocimiento de género y una cultura del cuidado que ofrecería a personas vulnerables de Centroamérica una agenda alternativa de vida en sus lugares de origen.Alternate abstract:This article addresses Central American climate migration from a human, gender, and environmental (HUGE security) approach. It examines documents, government reports, press publications, international and national statistical data, and interviews to establish complex interrelationships between migration, disasters, poverty, pandemic, and survival dilemma. Militarized borders, pressure from the U.S. government, and transnational organized crime have increased the dangers and costs of undocumented migration. Could a U.S. immigration reform overcome this maelstrom of illegal migration and generate development in northern Central America by sending remittances to their families? The article explores multiculturalism. ecosystem restoration, climate change adaptation, gender recognition, and a culture of care that would offer vulnerable people in Central America an alternative livelihood agenda in their country of origin.