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La norma establece las disposiciones para la vigilancia epidemiológica de la COVID-19 en el país, durante la fase endémica

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INTRODUCTION: The COVID-19 pandemic altered the epidemiology of respiratory viruses other than SARS-CoV-2. This study investigated the clinical-epidemiological pattern of hospitalized pediatric patients with acute lower respiratory tract infections (ALRI) and influenza in Argentina, comparing prepandemic and postpandemic periods. MATERIALS AND METHODS: This multicenter, cross-sectional study included patients under 18 years old admitted for ALRIs in five tertiary centers of Argentina before (2018 and 2019) and after (2022 and 2023) COVID-19. Changes in viral detection rates, seasonality, and case fatality rate (CFR), along with epidemiological and clinical characteristics, were analyzed. Indirect immunofluorescence assay (IFA) or RT-PCR was used for virological diagnosis pre-pandemic, and only RT-PCR in post-pandemic. Epi Info 7 and SPSS 15.0 was used for data analysis. RESULTS: A total of 5838 cases of ALRI were included (mean age: 9.5 months; IQR: 4-22 months); 96.6% were tested for viral detection, and 66.4% were positive (3877 cases). Respiratory syncytial virus (RSV) was the most prevalent. Influenza showed typical winter seasonality in 2018, 2019, and 2023. However, 2022 exhibited a bimodal pattern: late summer and spring, with co-circulation of influenza A and B in the second peak. CFR varied by viral diagnosis; influenza showed the highest CFR, all deaths related to influenza A. Among 354 influenza cases, 81% were < 5 years old, 53% were male, 63% had comorbidities, and 14.1% required intensive care. Mean of influenza vaccine coverage (6-24 months) was 21.4%. In both periods, patients with influenza were more likely to have pneumonia. Additionally, in the postpandemic period, malnourishment or being 3 years of age or older was also associated with a higher likelihood of influenza infection compared with infection with other respiratory viruses. CONCLUSIONS: Influenza primarily affected children under 5 years old. Postpandemic cases involved older individuals, and increased circulation of influenza A H3N2 was observed. Vaccination coverage was notably low. Influenza returned to its usual seasonal pattern in 2023.

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The COVID-19 pandemic forced schools worldwide to change the delivery of the medical curriculum to an exclusively online format. Some important findings after this experience highlight the possibility of continuing with the online form of curriculum delivery, at least partially, to reinforce the learning experience of medical students. Our research goal was to analyze the benefits that medical students can gain after exposure to high-quality e-learning. Our primary aim was to analyze the gain of knowledge, as well as self-rated benefits and understanding, after exposure to high-quality e-learning. We conducted a retrospective study to report on the outcomes achieved after 3 years of experience with the online delivery of basic biomedical science courses. Measurements included knowledge gain based on pre-and post-course quizzes, self-rated evaluation of the benefit and understanding of topics on a per-lesson basis, and number and percentages of students obtaining specific certificate outcomes. We included results from 1,546 students and 2,613 course enrollments in two different medical programs. We found significant increases in self-reported benefit and understanding of topics, as well as significant increases in knowledge gain irrespective of students' pre-course knowledge levels, as measured by the pre-course quiz. The information presented here could be used to make decisions about the incorporation of e-learning into the medical curriculum.

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INTRODUCTION: The COVID-19 pandemic drastically changed people's lives. It had consequences at the individual and social level. The behavioral immune system predicts that when faced with the risk of contagion from pathogens, people tend to reduce their sociality, especially sociosexuality. We examine this prediction by evaluating decreases in the pandemic of the different dimensions of sociosexuality of young men (i.e., short and long-term mating orientation, sexual desire, and sociosexual behavior) and considering their relationship status (single or paired). METHODS AND MATERIALS: We compared data from two cross-sectional studies carried out in the laboratory with convenience sampling methods in the pre-pandemic period (in the years 2016 and 2018 with a sample size of N = 463) and pandemic (face-to-face panstudy N = 234,data online, N = 182), considering possible differences between samples of the same period. We reached an N = 879 young men who answered a sociodemographic questioarticipants answered a sociodemographic questionnaire that inclnnaire and the Multidimensional Sociosexual Orientation Inventory. To test our predictions, we fitted general linear models. RESULTS: Results point to a significant decrease in long-term mating orientation in paired and single men, but only when compared with the pandemic face-to-face study. In addition, no differences were found for short-term mating orientation. For sociosexual desire (i.e., sexual fantasies), we found a reduction in single pre-pandemic individuals to be compared with the sample of pandemic online study. Finally, we found a decrease in sociosexual behavior (i.e., number of partners in the last year) between pre-pandemic samples and the pandemic itself, regardless of their relationship status and samples inside of each period. In addition, we carry out analyses with a reduced sample to re-test our predictions based on the perception of contagion risk (measured by a survey from OMS). CONCLUSION: We find changes are maintained at the level of sociosexual desire and sexual behavior but mainly in those individuals with a greater perception of the risk of contagion. The hypotheses derived from the behavioral immune system regarding the decrease in sociosexuality in a context of risk of contagion by pathogens, as was the case in the initial period of COVID-19, are corroborated only in terms of desire and behavior, which suggests a certain stability in attitudes i.e., the menace of contagion modifies proximal aspects of sociosexuality, such as fantasies and behavior, but has no apparent effect on the calibration of the predisposition of individuals to varying levels of commitment in sexual relationships. These findings will allow us to understand better how the dimensions of sociosexuality (i.e., fantasies, attitudes and behavior) are affected when there are contexts of high risk of contagion, such as COVID-19. These findings will allow us to understand better how sociosexuality is affected when there are contexts of high risk of contagion, such as COVID-19.

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The COVID-19 pandemic has provoked a worldwide mental health crisis, affecting university students in an exacerbated way, exposing them to the risk of emotional isolation and development of eating disorders. The present study aimed to examine the quality of healthy lifestyle practices in university students from the Faculty of Human Medicine and the Faculty of Education of a Peruvian university during and after the COVID-19 pandemic. This study was conducted during the academic period 2020 and 2023. Data collection was performed between July and August 2020, during the first wave of the COVID-19 pandemic (M1) and between November and December 2023, post-pandemic (M2). In M1 and M2, 370 and 82 students participated, respectively. The results of the Mann-Whitney test revealed significant differences between the total healthy lifestyle score of students in M1 and M2. In the nutrition domain, there are significant differences between the scores obtained in M1 and M2, revealing a decrease in nutritional care. Significant differences were also found between both faculties in substance use in M1 and physical activity practice in M2. Although a trend toward the adoption of healthy habits was observed in the initial stages, the longitudinal analysis reveals a generalized decrease in concern for health and well-being. Medical students, on the other hand, showed greater resilience and more successful adaptation to new circumstances, evidencing the importance of academic training in the promotion of healthy lifestyles. These results underscore the need to implement intervention strategies aimed at promoting healthy habits in the student population, especially in contexts of health crisis.

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BACKGROUND: Women were more prone to consuming alcohol as a coping mechanism for COVID-19 pandemic stressors than men. Worldwide evidence shows increased consumption during the social restriction phases, adversely impacting women's health. The study aimed to describe women's alcohol use throughout the restriction phases of the COVID-19 pandemic in São Paulo, Brazil. METHOD: A cross-sectional self-report survey was conducted by telephone with women who sought primary health care services. The sample comprised 3252 women, and 1308 (40%) reported consuming alcohol. The independent variable was the timing of the COVID-19 pandemic's restriction phases. The AUDIT-C was used as a measurement instrument. The covariates included sociodemographic factors, lifestyle characteristics, and outcomes related to COVID-19 infection. Univariate and bivariate models were used for analysis. A negative binomial distribution with zero inflation was used for the AUDIT-C score as the outcome variable in the entire sample. FINDINGS: Women's alcohol consumption during the COVID-19 restriction phase was compatible with moderate-risk use 3.5 (SD = 2.9). Binge drinking was observed in 41.8% of the participants. Alcohol consumption was 28.9% higher in the transition phase of social restriction than in the restriction and flexibilization phases. Hospitalization for COVID-19 and losing a loved one due to COVID-19 were associated with alcohol consumption. CONCLUSIONS: Women presented a moderate-risk pattern of alcohol use. This consumption was higher during the restriction phase of the pandemic in South America's largest city. Therefore, this study provides critical reflections on women's patterns of alcohol consumption. It reveals this population's social and clinical vulnerability, which might be considered in future health policies and programs.

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Myiasis, a condition stemming from the parasitic infestation of Diptera fly larvae, constitutes a complication for cancer patients, particularly those with malignant skin wounds. The factors that contribute to myiasis include old age, inadequate hygiene, poor living conditions, vascular disease, and diabetes. Cases of myiasis in neoplastic wounds in the head and neck region are rare and guidelines or recommendations regarding the best treatment approach remain lacking. Herein, we describe a case of myiasis that developed into an extensive squamous cell carcinoma of the lip in an older male adult due to the delay in oncological treatment stemming from the COVID-19 pandemic. Patients with oral squamous cell carcinoma, especially those residing in rural areas, face a notable risk of developing oral myiasis. Therefore, it is imperative that patients and caregivers adopt strict preventive measures to avoid fly infestations in wounds. Maintaining optimal hygiene (including meticulous cleaning with antiseptic solutions before daily dressing changes) is essential to prevent myiasis. Adequate wound coverage is crucial, especially during warmer seasons.

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The COVID-19 pandemic revealed disparities in policy responses in Latin America. We examined the association between trust in the president and COVID-19 preventive behaviors in Brazil, Chile, Colombia, and Mexico. We used data from the Collaborative COVID-19 Response Survey by the McDonnell Academy at Washington University in St. Louis (United States), from September 2020 to March 2021. Nonprobabilistic sampling included adult citizens from the four countries. Multivariate negative binomial regression models were applied. The study included 8,125 participants, with Brazil showing the lowest adherence to preventive behaviors (65.5%). Increased adoption of preventive behaviors was linked with ages 18-26 (aIRR = 1.05; 95%CI: 1.01-1.09), 60 or more (aIRR = 1.10; 95%CI: 1.05-1.15), and high socioeconomic status (aIRR = 1.09; 95%CI: 1.05-1.13). Decreased engagement was linked to participants from Brazil (aIRR = 0.74; 95%CI: 0.71-0.78), Mexico (aIRR = 0.95; 95%CI: 0.92-0.99), basic education (aIRR = 0.75; 95%CI: 0.68-0.84), intermediate education (aIRR = 0.88; 95%CI: 0.85-0.91), low socioeconomic status (aIRR = 0.91; 95%CI: 0.87-0.94), lack of concern about contracting COVID-19 (aIRR = 0.93; 95%CI: 0.88-0.98), and poor knowledge about COVID-19 (aIRR = 0.92; 95%CI: 0.88-0.96). No significant association was found between trust in the president and preventive behaviors. Targeted communication, public education, and improved access to reliable information are crucial for fostering preventive behaviors. Public health practitioners should not overly concern themselves with political rhetoric, as our study suggests that trust in political authorities may not systematically affect compliance with directives.

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The COVID-19 pandemic has accelerated efforts to enhance pathogen detection using molecular biology techniques. This study examines the expansion of molecular testing capacity in Colombia, identifying strengths and areas for improvement in the existing infrastructure. The study began with the creation of a database inventorying laboratories based on publicly available data from government entities and active web searches. Ten laboratories were selected for detailed characterization. Structured surveys assessed their testing capacity and progress in implementing molecular-based diagnostic tests for various infectious diseases. The strategy for identifying laboratories showed a total of 311 laboratories. Of these, 65 % (n = 202) are private and 21 % (n = 65) are state-owned, mainly public health laboratories, and the remaining 14 % (n = 44) are affiliated with academic institutions. The highest concentration of these labs is in Bogotá, Antioquia, and Valle del Cauca, primarily in urban areas. Key limitations affecting testing laboratories in Colombia include: i) infrastructure (26.2 %), highlighting the need for standardized facility guidelines; ii) quality and documentation (16.7 %), requiring stronger quality management systems; iii) biosafety (14.3 %), emphasizing the need for continuous waste management, especially in public labs; and iv) human talent (10.7 %), needing better policies for staff retention, particularly in government institutions. Strengthening laboratories can establish a comprehensive national molecular testing system. Integrating molecular tests into health system diagnostic algorithms and implementing sustainable laboratory strategies will address human health challenges and support the "One Health" approach for animal and environmental health.

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The SARS-CoV-2 2019 pandemic prompted the emergence of collaborative initiatives within South America and the Caribbean, to tackle common challenges. Many initiatives included local government, international entities, military, academia, and research institutions, united to face the challenges brought by the pandemic. Some collaborations were new, but most were built on top of existing networks developed to prevent and control challenges like zoonotic diseases. In the last 40 years, the U.S. Naval Medical Research Unit (NAMRU) SOUTH has helped ensure the readiness and health of U.S. service members, Peruvian partners, and civilian population through research, surveillance, and global health, covering One Health interconnectedness of human, animal, and environmental health to address zoonotic diseases, antimicrobial resistance, and vector-borne diseases. This article puts together the different communications, data sharing, and initiatives developed throughout South America towards One Health surveillance, focusing on zoonotic pathogens, and to describe the best practices for these networks.

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The global circulation of SARS-CoV-2 has been extensively documented; however, the dynamics within Central America, particularly Nicaragua, remain underexplored. This study characterizes the genomic diversity of SARS-CoV-2 in Nicaragua from March 2020 through December 2022, utilizing 1064 genomes obtained via next-generation sequencing. These sequences were selected nationwide and analyzed for variant classification, lineage predominance, and phylogenetic diversity. We employed both Illumina and Oxford Nanopore Technologies for all sequencing procedures. Results indicated a temporal and spatial shift in dominant lineages, initially from B.1 and A.2 in early 2020 to various Omicron subvariants toward the study's end. Significant lineage shifts correlated with changes in COVID-19 positivity rates, underscoring the epidemiological impact of variant dissemination. Comparative analysis with regional data underscored the low diversity of circulating lineages in Nicaragua and their delayed introduction compared to other countries in the Central American region. The study also linked specific viral mutations with hospitalization rates, emphasizing the clinical relevance of genomic surveillance. This research advances the understanding of SARS-CoV-2 evolution in Nicaragua and provides valuable information regarding its genetic diversity for public health officials in Central America. We highlight the critical role of ongoing genomic surveillance in identifying emergent lineages and informing public health strategies.

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OBJECTIVE: to analyze the reproductive autonomy of women during the COVID-19 pandemic, considering sociodemographic, clinical, and reproductive factors. METHOD: a quantitative study with a cross-sectional design, conducted with 314 women aged 18 to 49 years old. Data were collected through an online questionnaire containing sociodemographic, clinical, and reproductive data, as well as the Reproductive Autonomy Scale. The Mann-Whitney and Student's t tests were used to compare variables. RESULTS: significant differences were found between the average scores of "decision-making" and marital status (p = <0.001); and "absence of coercion" and "communication" with age group (p = 0.03 e <0.001), residence (p = <0.001 and <0.01), schooling level (p = 0.02 e 0.02), pregnancy (p = <0.001 e 0.04) and contraception (p = 0.02 e <0.001). CONCLUSION: not having a sexual partner positively influenced autonomy in reproductive decision-making during the COVID-19 pandemic. Women of younger age, living in the capital, with higher education levels, who had never been pregnant, and who used contraceptives during the pandemic showed greater autonomy in the absence of coercion and communication. It was possible to identify the groups that require greater attention and interventions to support their sexual health and reproductive choices. BACKGROUND: (1) A high reproductive autonomy score was observed even during the pandemic. (2) Not having a stable partner positively influenced reproductive decision-making. (3) Women living in the capital, of younger age, and with lower education levels experienced less coercion. (4) Being nulligravida and using contraception were associated with less coercion and better communication. (5) The use of an online tool during the pandemic expanded the program's reach to women.

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BACKGROUND: Patients with chronic kidney disease (CKD) have many special needs in the areas of symptom management, advanced care planning, and end-of-life care. We aimed to evaluate the palliative care (PC) provided to patients with CKD admitted with severe coronavirus disease 2019 (COVID-19) at the Clinics Hospital of the University of Sao Paulo Faculty of Medicine during the first wave of the pandemic. METHODS: A retrospective observational study was conducted in a quaternary hospital. Patients assisted by the PC team with CKD in 2020 were selected according to a protocol for identifying patient at an elevated risk of death who require PC support. The clinical and demographic characteristics, as well as the outcomes, were assessed using electronic records. RESULTS: A total of 217 patients with CKD were included in the study, of whom 44.2% were admitted to the intensive care unit (ICU). Patients with CKD had an increased relative risk (RR) of death [1.31, 95% confidence interval (CI): 1.12-1.53] but were not assisted by the PC team to a higher degree. Eighty patients with CKD (83.3%) died without being assisted by the PC team. Dialysis treatment and CKD grades were not significantly associated with PC assistance. CONCLUSIONS: Although patients with CKD experienced higher mortality rates, they did not receive PC at a significantly greater frequency and many died without receiving adequate end-of-life care during the COVID-19 pandemic in Brazil.

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Wellbeing levels have been a global concern during the COVID-19 pandemic, but there is a lack of attention to invariance questions that allow a robust examination of wellbeing dynamics across cultures. Questions of temporal stability that are crucial for examining the impact of the pandemic on wellbeing have received even less attention. Some studies suggested that measures may not be stable after the onset of the pandemic. We examine invariance parameters, the factorial structure and variability of wellbeing variables (life satisfaction, pandemic worries, anxiety and depression screenings) across five different cultural contexts from 2020 to 2022 (N = 4387, total observations = 13,161). A three-factor model separating life satisfaction, worry and distress performed best in terms of model fit and parsimony. We observed scalar invariance across times and identified little variability of wellbeing measures during the pandemic, suggesting that wellbeing levels remained stable during the pandemic in each of the countries sampled. In contrast, we only identified metric invariance across countries at each time point, and found a weakening of correlations between life satisfaction and a depressive/anxious symptoms scale in lower income countries. We discuss implications of our findings for discussions of wellbeing dynamics.

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PURPOSE: To analyze the association between older people's health literacy and sociodemographic aspects, functioning, happiness, and perception of the COVID-19 pandemic. METHODS: This is a preliminary, cross-sectional, analytical, observational study with 37 older adults of both sexes. It used the Brazilian Economic Classification Criteria, WHODAS 2.0, SAHLPA-18, WHO-5 Well-Being Index, and Subjective Happiness Scale, estimated the perception of the pandemic through a questionnaire developed by the authors, and performed descriptive analysis, association analysis using the Pearson chi-square test, and Spearman correlation. RESULTS: Most participants had inadequate functional health literacy (FHL) results. A higher percentage of individuals from social classes C and D-E had inadequate FHL. The low education level was associated with an inadequate FHL. Most participants with adequate FHL reported feeling "calm and relaxed" for more than half the time or all the time. The SAHLPA-18 score was weakly negatively correlated with the Cognition and Self-Care domains of WHODAS 2.0, indicating that better health literacy is associated with better cognitive and self-care conditions. CONCLUSION: Older people with better health literacy had better cognitive ability, better self-care management, higher education levels, and better quality of life.

OBJETIVO: Analisar a associação entre o Letramento em saúde de pessoas idosas e funcionalidade, felicidade, percepção da pandemia de Covid-19 e aspectos sociodemográficos. RESULTADOS: A maioria dos participantes apresentou resultado inadequado no Letramento Funcional em Saúde (LFS). A porcentagem de pessoas das classes C e D-E foi maior entre as que apresentaram LFS inadequado. Houve associação entre baixo nível de escolaridade e LFS inadequado. A maioria dos participantes com LFS adequado respondeu permanecer mais da metade do tempo ou o tempo todo "calmo(a) e tranquilo(a)". Foi observado correlação negativa de magnitude fraca entre o escore do SAHLPA-18 e os domínios Cognição e Autocuidado WHODAS 2.0, que indica, quanto melhor o letramento em saúde melhores são as condições cognitivas e de autocuidado. CONCLUSÃO: As pessoas idosas que apresentaram melhor letramento em saúde demonstraram melhor capacidade cognitiva, melhor gestão do autocuidado, maior grau de instrução e melhor qualidade de vida.

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BACKGROUND: This is a pioneering study on the assessment of a Brazilian municipality entire, comparing alcohol-based hand sanitizer consumption before and during the COVID-19 pandemic. Vilas-Boas et al reported a rise from 24.2mL/PD in 2018 to 46.6 in 2020, being for adult intensive care units the municipality exceeded most of the Brazilian states. However, observed a decline in some hospitals in 2021. OBJECTIVE: Compare alcohol-based hand sanitizer use in intensive care units in a municipality in São Paulo state, before and during the coronavirus pandemic. METHODS: Analytical retrospective study using indirect documentation, with data obtained from a notification spreadsheet for epidemiological indicators of healthcare-associated infection in the state. Data on monthly alcohol-based sanitizer use were collected from the intensive care units of public and private general hospitals of the municipality. Analysis was conducted using descriptive statistics and graphically with run charts. The Mann-Whitney test was applied to compare the median consumption of public and private hospitals, at a 5% significance level. RESULTS: Adult, neonatal and pediatric intensive care units showed median increases in hand sanitizer use of 34.03 to 57.64, 31.53 to 48.66 and 34.38 to 60.35mL/patient-day, respectively. Private hospitals showed greater hand sanitizer use in the adult and pediatric intensive care units compared to public institutions. CONCLUSION: The pandemic contributed to increasing hand sanitizer use in municipal intensive care units, but there is still room for improvement. More effort is needed to ensure that hand sanitizer use remains high.

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BACKGROUND: Magdalon et al. demonstrated that excluding iRAT grades from the final grade calculation of the course negatively impacted student performance and attendance in team-based learning sessions. INTRODUCTION: The COVID-19 pandemic necessitated a shift from in-person to remote learning, including team-based learning activities. Many studies have explored several aspects of team-based learning; however, there is still a lack of knowledge regarding the factors affecting students' attitudes and performance. OBJECTIVE: To evaluate the impact of the COVID-19 pandemic on medical students' performance in individual readiness assurance tests during team-based learning activities, given that their grades were excluded from the final course grades. METHODS: We compared the number of team-based learning applications, student absences, and individual readiness assurance tests grades of medical undergraduate students in three different scenarios: Group 1, in-person individual readiness assurance tests before the pandemic; Group 2, remote individual readiness assurance tests during the lockdown period when their grades were excluded from the final grade calculation; and Group 3, in-person individual readiness assurance tests during the pandemic after lockdown restrictions eased. RESULTS: Remote team-based learning led to significantly lower grades than in-person evaluations. Moreover, the number of students with failing or insufficient grades (below seven) increased during the remote learning period, when their grades were excluded from the final grade calculation, compared to in-person individual readiness assurance tests before the pandemic. Furthermore, absenteeism was higher when the online strategy was applied. CONCLUSION: We observed lower academic performance by medical students during remote team-based learning sessions, likely owing to the exclusion of individual readiness assurance tests grades from the final course grade calculations during the COVID-19 pandemic.

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INTRODUCTION: Breastfeeding provides several benefits to the health of women and newborns and constituting a protective factor against infant morbidity and mortality in the short and long term. OBJECTIVES/RESEARCH QUESTIONS: The study aims to compare obstetric outcomes in women who did and did not breastfeed after birth. METHOD: Cross-sectional epidemiological study, nested in a cohort, carried out with secondary data from the survey "Birth and breastfeeding in children of mothers infected with SARS-CoV-2", carried out in 2020, in Brazil. The results obtained were compared with those of the study "Birth in Belo Horizonte: survey on childbirth and birth", carried out in 2011-2012. RESULTS: 1082 women were included in the sample of the survey carried out in the pandemic period and 382 in the pre-pandemic period. A total of 1,082 women were included in the sample of the research carried out during the pandemic period and 382 during the pre-pandemic period. A higher proportion of women who breastfed within the first hour after delivery and: did not have an indication for cesarean section in the pre-pandemic period and women without obstetric complications in the pre-pandemic period were observed when compared to the pandemic period. Regarding the comparison between infected/suspected and non-infected women, we observed: higher proportions of women who had a vaginal delivery and breastfed after delivery in non-infected women and higher proportions of non-infected women, with no indication for cesarean section at the time of admission and who breastfed within the first hour after delivery - when compared to infected/suspected women. Finally, regarding the multivariate analysis of the pre-pandemic period, we observed that women who had fewer than 7 prenatal consultations reduced, on average, 0.36 times the chance of breastfeeding after delivery (p = 0.007). Regarding the pandemic period, we observed that women who underwent cesarean section reduced, on average, 0.61 times the chance of breastfeeding after delivery (p = 0.027), women who had a newborn weighing less than 2500 g reduced, on average, 0.29 times the chance of breastfeeding after delivery (p = 0.031) and women who had a newborn with complications after delivery reduced, on average, 0.05 times the chance of breastfeeding after delivery (p < 0.001). CONCLUSIONS: These findings highlight the importance of prenatal monitoring and childbirth assistance, especially in times of crisis, to promote breastfeeding. Furthermore, these findings may provide important contributions to improving health and care related to labor, delivery, birth and the postpartum period.

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OBJECTIVE: To characterize nursing care management strategies for addressing the COVID-19 pandemic. METHOD: A descriptive, qualitative study conducted with 22 nurse professionals at a University Hospital in Southern Brazil. Data collection through interviews in June and August 2021, analyzed according to Bardin's Content Analysis and the theoretical framework of complex thinking. RESULTS: The identified strategies were organized into four categories: Reorganization of health services; People management and emergency admission; Multiprofessional articulation; and Bedside nursing care. FINAL CONSIDERATIONS: Professional performance revealed a complex interplay between leadership and care management practices, even in the face of working condition restrictions, and were understood as crucial in the pandemic scenario.

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OBJECTIVE: to analyze the association between participation in training activities and the adherence to and use of personal protective equipment by workers and professionals involved in Health Residency Programs in Primary Health Care during the COVID-19 pandemic. METHODS: a cross-sectional study in Brazil between August/2020 and March/2021. We utilized the EPI-APS COVID-19 instrument and its adapted version for resident professionals. RESULTS: 455 PHC workers and 102 residents participated in the study. Among them, 54.5% and 55.9%, respectively, engaged in training activities. We observed an association between participation in training activities and the proper use of gloves (p<0.001), gowns (p=0.009), goggles/face shields (p=0.002), and overall adherence (p<0.001) among PHC workers, and the proper use of surgical masks (p=0.028) among residents. Adherence rates of ≥75% were identified in 6.9% of PHC workers and none among the residents. CONCLUSION: training activities are associated with increased adherence to and proper use of PPE.