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      State of the art of nursing education and the challenges to use remote technologies in the time of corona virus pandemic Translated title: Estado da arte sobre o ensino de enfermagem e os desafios do uso de tecnologias remotas em época de pandemia do corona vírus

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          Abstract

          INTROODUCTION: The Corona virus (COVID-19) pandemic caused, among others, the need for colleges and universities managers around the world to reinvent new ways of providing education preserving its good quality at the same time. With the new ordinances of the Ministry of Education and Health, all courses can use remote methodologies for the continuity on the current school year. With new challenges and paradigms emerging from this methodological proposal: provide for the user the feeling of immersion, of being in the class room, from the navigation and interaction in this virtual environment, at the same time that the educator, respecting the educational principles and the pedagogical approach that he believes, does not transform this moment into a simple distance educationOBJECTIVE: To describe the state of the art on nursing education and the challenges of using remote technologies in the time of Corona virus pandemicMETHODS: This is a reflective study based on secondary sources of literature relevant to the theme, considering articles from national and international journals and recent productions on education, health training, remote technologies, COVId-19 and public healthRESULTS: It is evident that experiencing the effects of the corona virus pandemic (COVID-19) in the health educational sector, especially in the field of nursing, goes beyond a structural reorganization of courses. It implies change attitude of managers, teachers and students to reformulate educational practices (sometimes with traditional tools), with innovative practices preserving a methodology that provides to the student criticality reflection, dialogue, bonding and interaction; elements that are part of a training aimed at transformation, empowerment and not just the transmission of knowledge. In this context, the COVID-19 pandemic caused paradigm shifts perhaps not yet overcome by health science institutions , because when they perceived themselves within a reality that generated changes in the political, economic, cultural and social aspects at a global level, they had to reinvent and insert new ways of teaching in their work process; they had to discuss different educational approaches and, given the needs to readjust health teaching methods, they inserted remote technologies as essential tools to meet the real need for continuity of classes in non-face-to-face model. For many, it is a challenge, as it currently permeates a reflection on the attention of distance learning in the field of nursing and other courses in the health area. However, as it opened up to discussions about new ways of teaching mediated by innovation, it can be said that this will be one of the greatest impact of the pandemic in benefit the education: the contribution of new information and communication technologies in the teaching-learning process for training in health, as well as the reflection on distance education and its concepts, differentiating it from the concepts of remote methodology and the use of technologiesCONCLUSION: In nursing education, the discussion related to the use of remote technologies in the classroom has always been a point of debate. However, with the need to include these tools for the continuity of classes in the non-face-to-face model resulting from the social isolation strategy motivated by the pandemic of COVID-19, it can provide an opportunity to have a new look on the subject and perhaps there is an opportunity to expand the debate on the use of remote methodologies in health education, seeking a reflection on their interaction with the other teaching methods already implemented

          Translated abstract

          INTRODUÇÃO: A pandemia do Corona vírus (COVID-19) provocou em caráter emergencial a necessidade dos gestores das faculdades e universidades de todo mundo de reinventar novas formas de prover o ensino preservando a qualidade dele. Com as novas portarias do Ministério da Educação e Saúde, houve uma abertura para que todos os cursos utilizassem de metodologias remotas para continuidade do ano letivo, surgindo novos desafios e paradigmas com essa proposta metodológica: prover para o usuário, a sensação de imersão, de estar dentro do ambiente, a partir da navegação e interação nesse meio virtual, ao mesmo tempo que o educador, respeitando os princípios educacionais e a abordagem pedagógica que acredita, não transformar esse momento em uma simples educação à distânciaOBJETIVO: Descrever o estado da arte sobre o ensino de enfermagem e os desafios do uso de tecnologias remotas em época de pandemia do Corona vírusMÉTODO: Trata-se de estudo reflexivo consubstanciado por fontes secundárias da literatura pertinente à temática, considerando artigos de periódicos nacionais e internacionais e produções recentes sobre educação, formação em saúde, tecnologias remotas, o COVId-19 e saúde públicaRESULTADOS: Evidencia-se que vivenciar os efeitos da pandemia de corona vírus (COVID-19) no setor educacional na formação em saúde, em especial no campo da enfermagem, vai além de uma reorganização estrutural dos cursos, pois implica em mudança atitudinal dos gestores, docentes e discentes para que reformulem as práticas de ensino (por vezes com ferramentas tradicionais), em práticas inovadoras preservando um ensino que propicie ao estudante a criticidade, reflexão, diálogo, vínculo e interação; elementos que fazem parte de uma formação que visa a transformação, o empoderamento e não apenas a transmissão do conhecimento. Nesse contexto, a pandemia do COVID-19 provocou mudanças de paradigmas talvez ainda não superados pelas instituições na área da saúde, pois ao se perceberem dentro de uma realidade em que gerou mudanças nos aspectos políticos, econômicos, culturais e sociais em nível mundial, estas tiveram que se reinventar e inserir no seu processo de trabalho as novas formas de ensinar; tiveram que discutir sobre as diferentes abordagens educacionais e diante das necessidades do readequar os métodos de ensino em saúde, inseriram as tecnologias remotas como ferramentas essenciais para atender a real necessidade da continuidade das aulas no formato não presencial. Para muitos um desafio, pois permeia atualmente uma reflexão sobre o cuidado do ensino à distância no campo da enfermagem e demais cursos da área da saúde. Entretanto, à medida que se abriu para discussões sobre novas formas de ensinar mediadas pela inovação, pode-se dizer que esse será o maior impacto da pandemia para o ensino: a contribuição das novas tecnologias de informação e comunicação no processo ensino aprendizagem para formação em saúde, assim como a reflexão sobre a educação à distância e seus conceitos, diferenciando-a dos conceitos de metodologia remota e o uso das tecnologiasCONCLUSÃO: No ensino da enfermagem, a discussão relacionada ao uso de tecnologias remotas em sala de aula sempre foi um ponto de debate. Entretanto, com a necessidade da inclusão dessas ferramentas para a continuidade de aulas no formato não presencial decorrente da estratégia do isolamento social motivada pela pandemia do COVID-19, pode oportunizar a se ter um novo olhar sobre o assunto e que talvez com esse momento vivido se haja oportunidade de ampliar o debate sobre uso dessas metodologias remotas no ensino em saúde, buscando uma reflexão sobre a interação destas com os demais métodos de ensino já implementados

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          The effect of control strategies to reduce social mixing on outcomes of the COVID-19 epidemic in Wuhan, China: a modelling study

          Summary Background In December, 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, emerged in Wuhan, China. Since then, the city of Wuhan has taken unprecedented measures in response to the outbreak, including extended school and workplace closures. We aimed to estimate the effects of physical distancing measures on the progression of the COVID-19 epidemic, hoping to provide some insights for the rest of the world. Methods To examine how changes in population mixing have affected outbreak progression in Wuhan, we used synthetic location-specific contact patterns in Wuhan and adapted these in the presence of school closures, extended workplace closures, and a reduction in mixing in the general community. Using these matrices and the latest estimates of the epidemiological parameters of the Wuhan outbreak, we simulated the ongoing trajectory of an outbreak in Wuhan using an age-structured susceptible-exposed-infected-removed (SEIR) model for several physical distancing measures. We fitted the latest estimates of epidemic parameters from a transmission model to data on local and internationally exported cases from Wuhan in an age-structured epidemic framework and investigated the age distribution of cases. We also simulated lifting of the control measures by allowing people to return to work in a phased-in way and looked at the effects of returning to work at different stages of the underlying outbreak (at the beginning of March or April). Findings Our projections show that physical distancing measures were most effective if the staggered return to work was at the beginning of April; this reduced the median number of infections by more than 92% (IQR 66–97) and 24% (13–90) in mid-2020 and end-2020, respectively. There are benefits to sustaining these measures until April in terms of delaying and reducing the height of the peak, median epidemic size at end-2020, and affording health-care systems more time to expand and respond. However, the modelled effects of physical distancing measures vary by the duration of infectiousness and the role school children have in the epidemic. Interpretation Restrictions on activities in Wuhan, if maintained until April, would probably help to delay the epidemic peak. Our projections suggest that premature and sudden lifting of interventions could lead to an earlier secondary peak, which could be flattened by relaxing the interventions gradually. However, there are limitations to our analysis, including large uncertainties around estimates of R 0 and the duration of infectiousness. Funding Bill & Melinda Gates Foundation, National Institute for Health Research, Wellcome Trust, and Health Data Research UK.
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            COVID-19 control in China during mass population movements at New Year

            The outbreak of novel coronavirus disease 2019 (COVID-19) continues to spread rapidly in China. 1 The Chinese Lunar New Year holiday, the start of which coincided with the emergence of COVID-19, is the most celebratory time of the year in China, during which a massive human migration takes place as individuals travel back to their hometowns. People in China are estimated to make close to 3 billion trips over the 40-day travel period, or Chunyun, of the Lunar New Year holiday. 2 About 5 million people left Wuhan, 3 the capital city of Hubei province and epicentre of the COVID-19 epidemic, before the start of the travel ban on Jan 23, 2020. About a third of those individuals travelled to locations outside of Hubei province. 4 Limiting the social contacts of these individuals was crucial for COVID-19 control, because patients with no or mild symptoms can spread the virus. 5 Government policies enacted during the Chinese Lunar New Year holiday are likely to have helped reduce the spread of the virus by decreasing contact and increasing physical distance between those who have COVID-19 and those who do not. As part of these social distancing policies, the Chinese Government encouraged people to stay at home; discouraged mass gatherings; cancelled or postponed large public events; and closed schools, universities, government offices, libraries, museums, and factories.6, 7, 8, 9, 10 Only limited segments of urban public transport systems remained operational and all cross-province bus routes were taken out of service. As a result of these policies and public information and education campaigns, Chinese citizens started to take measures to protect themselves against COVID-19, such as staying at home as far as possible, limiting social contacts, and wearing protective masks when they needed to move in public. Social distancing has been effective in past disease epidemics, curbing human-to-human transmission and reducing morbidity and mortality.11, 12, 13, 14, 15, 16, 17 A single social distancing policy can cut epidemic spread, but usually multiple such policies—including more restrictive measures such as isolation and quarantine—are implemented in combination to boost effectiveness. For example, during the 1918–19 influenza pandemic, the New York City Department of Health enforced several social distancing policies at the same time, including staggered business hours, compulsory isolation, and quarantine, which likely led to New York City suffering the lowest death rate from influenza on the eastern seaboard of the USA. 17 During the current outbreak of COVID-19, government officials and researchers were concerned that the mass movement of people at the end of the Lunar New Year holiday on Jan 31, 2020, would exacerbate the spread of COVID-19 across China. Moreover, individuals typically return from their Lunar New Year holiday after only 1 week, which is shorter than the longest suspected incubation period of the disease. 18 Many of the 5 million people who left Wuhan before the travel ban was put into place 3 could still have been latently infected when their holiday ended. This situation, together with the resumed travel activities, would make it difficult to contain the outbreak. Facing these concerns, the Chinese Government extended the Lunar New Year holiday. The holiday end date was changed to March 10 for Hubei province 19 and Feb 9 for many other provinces, so that the duration of the holiday would be sufficiently long to fully cover the suspected incubation period of COVID-19.20, 21, 22 In addition, people diagnosed with COVID-19 were isolated in hospitals. In Wuhan, where the largest number of infected people live, those with mild and asymptomatic infection were also quarantined in so-called shelter or “Fang Cang” hospitals, which are public spaces such as stadiums and conference centres that have been repurposed for medical care. Finally, the Chinese Government encouraged and supported grassroots activities for routine screening, contact tracing, and early detection and medical care of COVID-19 patients, and it promoted hand washing, surface disinfection, and the use of protective masks through social marketing and media. As a result of the extended holiday and the additional measures, many people with asymptomatic infection from Hubei province who had travelled to other provinces remained in their homes until they developed symptoms, at which point they received treatment. It is this home-based quarantine of people who had been to the epicentre of the epidemic and travelled to other locations in China that is likely to have been especially helpful in curbing the spread of the virus to the wider community. © 2020 Kevin Frayer/Stringer/Getty Images 2020 Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. There are several lessons that can be drawn from China's extension of the Lunar New Year holiday. First, countries facing potential spread of COVID-19, or a similar outbreak in the future, should consider outbreak-control “holidays” or closure periods—ie, periods of recommended or mandatory closure of non-essential workplaces and public institutions—as a first-line social distancing measure to slow the rate of transmission. Second, governments should tailor the design of such outbreak-control closure periods to the specific epidemic characteristics of the novel disease, such as the incubation period and transmission routes. Third, a central goal of an outbreak-control closure period is to prevent people with asymptomatic infections from spreading the disease. As such, governments should use the closure period for information and education campaigns, community screening, active contact tracing, and isolation and quarantine to maximise impact. Such a combination approach is also supported by studies of responses to previous outbreaks, which showed that reductions in the cumulative attack rate were more pronounced when social distancing policies were combined with other epidemic control measures to block transmission. 23 As for COVID-19 in China, this combination of an outbreak-control closure period for social distancing and a range of accompanying epidemic control measures seems to have prevented new infections, especially in provinces other than Hubei, where new infections have been declining for more than 2 weeks. 1 As fearsome and consequential as the COVID-19 outbreak has been, China's vigorous, multifaceted response is likely to have prevented a far worse situation. Future empirical research will establish the full impact of the social distancing and epidemic control policies during the extended Chinese Lunar New Year holiday. As travel and work slowly resume in China, the country should consider at least partial continuation of these policies to ensure that the COVID-19 outbreak is sustainably controlled.
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              Concepts and movements in health promotion to guide educational practices

              INTRODUCTION: in health promotion, practices are necessary to trigger mechanisms aimed at the creation or recreation of a new mode of enhancing health, in order to overcome the still-oriented actions of the biological approach. Prevailing actions oh health care, although important to the sector, do not advance toward a positive concept OBJECTIVE: to analyse the historical process of health as a concept and care models in the search for a new model of health promotion METHODS: This is a reflective review designed to understand and appraise the international and national literature from Medline/PubMed, Lilacs and the Scientific Electronic Library (Scielo). For the organisation of data, articles were separated by themes, and the process of categorisation was conducted based on content analysis RESULTS: Despite having the knowledge that consistent actions with the assumptions of health promotion are of great importance to quality of life and equity in health, implementing them remains a challenge due to the predominance of curative practices and an individualistic approach. These practices, in turn, are revealed to be a reflection of the concept of health that has passed from the absence of disease to a process related to social, political, economic and cultural factors CONCLUSION: The concept of health has been transformed from historical ideas, reflecting the emergence of new formulations about thinking and doing and, consequently, new proposals for changes in welfare models of health. Therefore, although the new model of healthcare has been structured from a health promotion perspective; there are still features of hegemonic models with the predominance of curative practices
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                Author and article information

                Journal
                rbcdh
                Journal of Human Growth and Development
                J. Hum. Growth Dev.
                Centro de Estudos de Crescimento e Desenvolvimento do Ser Humano (São Paulo, SP, Brazil )
                0104-1282
                2175-3598
                April 2020
                : 30
                : 1
                : 141-147
                Affiliations
                [01] Vitória - ES orgnameEscola Superior de Ciências da Santa Casa de Misericórdia de Vitória Brasil
                Article
                S0104-12822020000100018 S0104-1282(20)03000100018
                10.7322/jhgd.v30.10087
                1b2bfd2e-2419-46e3-9713-fb2362f9e8e0

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : March 2020
                : February 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 25, Pages: 7
                Product

                SciELO Periódicos Eletrônicos em Psicologia

                Categories
                Original article

                COVID-19,mudanças,educação,formação em saúde,enfermagem,tecnologias,inovações,changes,education,health training,nursing,technologies,innovations

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