RESUMEN Introducción: el acceso a los servicios de salud en Paraguay, está determinado por varios tipos de barreras. Por ello, es preciso describir el impacto que tienen las políticas públicas y sus implicancias en la mitigación de las mismas. Objetivo: describir el acompañamiento diferenciado y su contribución al apoyo socio emocional, adhesión al tratamiento y acceso a servicios de salud en el área de atención a personas varones que viven con el VIH. Metodología: estudio de carácter cualitativo, descriptivo, con entrevistas semi estructuradas y muestra no probabilística, dirigida e intencional; Resultados: este estudio cualitativo exploró las experiencias de personas viviendo con VIH que recibieron acompañamiento psicosocial diferenciado en un servicio de atención integral. Los participantes destacaron la importancia del acompañamiento para afrontar la crisis posterior al diagnóstico. La orientación presencial, escucha empática y seguimiento facilitaron la vinculación y adherencia al servicio de salud y al tratamiento antirretroviral. El apoyo psicosocial fue clave para desmitificar ideas erróneas sobre el VIH/SIDA, empoderarse sobre su estado serológico y mejorar la calidad de vida. Se enfatizó el rol de los grupos de pares para brindar contención. Algunos participantes reportaron experiencias previas de revelación no consentida y vulneración de confidencialidad. El acompañamiento psicosocial diferenciado resultó fundamental para facilitar la inserción y permanencia de las personas con VIH en los servicios de atención integral (adhesión al tratamiento). Conclusiones: el acompañamiento psicosocial diferenciado resultó clave para facilitar la vinculación y adherencia en personas con VIH. La atención integral requiere identificar situaciones particulares, establecer relaciones de confianza y comunicación efectiva. El apoyo inicial es fundamental brindando contención ante el impacto emocional del diagnóstico. El seguimiento continuo es esencial dada la doble discriminación. La confidencialidad y capacidad de generar vínculos empáticos son elementos centrales. Los factores mencionados favorecen la adhesión al tratamiento. Los resultados sugieren que estas prácticas psicosociales pueden optimizar modelos de atención integral a personas con VIH.

ABSTRACT Introduction: access to healthcare services in Paraguay is influenced by various barriers. Thus, it is essential to describe the impact of public policies and their implications in mitigating these barriers. Objective: to describe the differentiated support and its contribution to socio-emotional support, therapeutic adherence, and access to healthcare services in the area of care for males living with HIV. Methodology: a qualitative, descriptive study with semi-structured interviews and a non-probabilistic, directed, and intentional sample. Results: this qualitative study explored the experiences of individuals living with HIV who received differentiated psychosocial support in an integrated care service. Participants emphasized the importance of support in coping with the post-diagnosis crisis. In-person guidance, empathetic listening, and follow-up facilitated engagement and adherence to healthcare services and antiretroviral treatment. Psychosocial support played a critical role in debunking misconceptions about HIV/AIDS, empowering individuals regarding their serostatus, and improving their quality of life. The role of peer groups in providing emotional support was emphasized. Some participants reported previous experiences of non-consensual disclosure and confidentiality breaches. Differentiated psychosocial support was essential in promoting the integration and retention of people with HIV in integrated care services (therapeutic adherence). Conclusions: differentiated psychosocial support was crucial in facilitating the engagement and adherence of individuals with HIV. Comprehensive care necessitates identifying specific situations, establishing trust-based relationships, and effective communication. Initial support is vital for providing emotional support in the face of the diagnostic impact. Ongoing follow-up is essential due to the dual discrimination faced. Confidentiality and the ability to build empathetic relationships are central elements. The aforementioned factors favor adherence to treatment. The results suggest that these psychosocial practices can enhance models of comprehensive care for people with HIV.

ABSTRACT As a result of the 2020 pandemic, an unexpected change occurred in university teaching, which mobilized higher education institutions to make a change in the way in-person teaching was conceived and consequently mobilized institutions towards a new educational paradigm, moving from face-to-face models to hybrid teaching and learning models with synchronous and asynchronous classes. This study aims to describe and analyze the impact of the implementation of evaluation strategies based on the empowerment and active participation of students. The methodology addressed complies with a qualitative approach with case studies. The results obtained show that the commitment of the students, from an evaluation process, which required them to make decisions, has a positive impact showing their expectations of academic achievement. Therefore, it is concluded that the possibility of generating and agreeing with the evaluation students in accordance with the learning results formally established in the program and the syllabus, promoting social justice at the time of evaluation, having each and every possibility to achieve the expected learning, it mobilized them towards a collective commitment among their peers, as well as the confidence of achieving the expected performances. The possibility of going beyond traditional tests, giving space to the generation of other products or evidence that confirms the achievement of learning implied placing students at the center of their own learning.

RESUMEN A raíz de la pandemia del año 2020, se produce un cambio inesperado en la docencia universitaria, que movilizó a las instituciones de educación superior, a realizar un cambio en la forma cómo se concebía la docencia presencial y en consecuencia movilizó a las instituciones hacia un nuevo paradigma educativo, pasando de modelos presenciales a modelos híbridos de enseñanza y aprendizaje con clases sincrónicas y asincrónicas. Este estudio tiene por objetivo analizar el impacto de la implementación de estrategias de evaluación basadas en el empoderamiento y participación activa de los estudiantes. La metodología abordada cumple con un enfoque cualitativo con estudios de casos. Los resultados que se obtienen dan cuenta que el compromiso de los estudiantes, desde un proceso de evaluación, que les demandó la toma de decisiones, impacta de manera positiva mostrando sus expectativas del logro académico. Por lo tanto, se concluye que la posibilidad de generar y acordar con los estudiantes de evaluación conforme a los resultados de aprendizaje formalmente establecidos en el programa y el syllabus, promoviendo en ello la justicia social en momento de evaluar, teniendo todos y todas las posibilidades de lograr los aprendizajes esperados, los movilizó hacia un compromiso colectivo entre sus pares, así como también en la confianza de lograr los desempeños esperados. La posibilidad de ir más allá de las pruebas tradicionales dando espacio a la generación de otros productos o evidencias que confirme el logro de aprendizajes implicó situar a los estudiantes en el centro de su propio aprendizaje.

RESUMO Em consequência da pandemia de 2020, ocorreu uma mudança inesperada no ensino universitário, que mobilizou as instituições de ensino superior para uma mudança na forma como o ensino presencial foi concebido e, consequentemente, mobilizou as instituições para um novo paradigma educativo, passando do presencial para o presencial. modelos presenciais até modelos híbridos de ensino e aprendizagem com aulas síncronas e assíncronas. Este estudo tem como objetivo analisar o impacto da implementação de estratégias de avaliação baseadas na capacitação e participação ativa dos estudantes. A metodologia abordada obedece a uma abordagem qualitativa com estudos de caso. Os resultados obtidos mostram que o comprometimento dos alunos, a partir de um processo avaliativo, que exigiu deles a tomada de decisões, tem um impacto positivo mostrando suas expectativas de desempenho acadêmico. Portanto, conclui-se que é possível gerar e pactuar com os alunos avaliados os resultados de aprendizagem formalmente estabelecidos no programa e no plano de estudos, promovendo a justiça social no momento da avaliação, tendo todas e cada uma das possibilidades de alcançar a aprendizagem esperada. , mobilizou-os para um compromisso coletivo entre os seus pares, bem como a confiança para alcançar os desempenhos esperados. A possibilidade de ir além dos testes tradicionais, dando espaço à geração de outros produtos ou evidências que confirmassem o alcance da aprendizagem implicava colocar os alunos no centro da sua própria aprendizagem.

In light of the need for social isolation caused by the pandemic, in-person classes were suspended, making way for emergency remote teaching (ERT). This abrupt transition allowed for no planning or preparation for the individuals involved in the teaching-learning process. In this context, it fell upon the educators to adapt to this new, atypical reality. The aim of this study was to describe the characteristics and challenges faced by teachers at IF Sudeste MG - Campus Rio Pomba during ERT and its impacts on the teaching-learning process. To achieve this, a structured questionnaire with the participation of 41 educators was used. Difficulties related to pedagogical training, use of technological tools and active teaching methodologies (ATM), and the adaptive process of educators were highlighted. Educators did not consider ERT capable of efficiently fulfilling the objectives of the disciplines, although they acknowledged the necessary institutional support. The self-assessment of teaching performance during ERT was predominantly positive. Prior to ERT, the use of ATM was lower, especially among educators above 40 years old and males; furthermore, difficulties in using ATM increased with age, with more males reporting not using them. The adaptation to ERT was considered moderate, and more educators aged 40 to 49 reported dissatisfaction with the work environment. Educators above 40 years old and females had a higher incidence of negative psychological symptoms during ERT. This study highlights the challenges educators faced during ERT, especially those over 40 years old and females.

Ante la necesidad de aislamiento social causada por la pandemia, las clases presenciales fueron suspendidas dando paso a la enseñanza remota de emergencia (ERE). Esta transición abrupta no permitió ningún tipo de planificación o preparación para los actores involucrados en el proceso de enseñanza-aprendizaje. En este contexto, a los docentes les correspondió el desafío de adaptarse a esta nueva realidad atípica. El objetivo de este estudio fue describir las características y desafíos enfrentados por los profesores del IF Sudeste MG - Campus Rio Pomba durante la ERE y sus impactos en el proceso de enseñanza-aprendizaje. Se aplicó un cuestionario estructurado con la participación de 41 docentes. Se evidenciaron dificultades relacionadas con la formación pedagógica, el uso de herramientas tecnológicas y de metodologías activas de enseñanza (MAE). Los docentes no consideraron que la ERE fuera capaz de cumplir eficientemente con los objetivos de las disciplinas, a pesar de reconocer el apoyo institucional necesario. La autoevaluación del desempeño docente durante la ERE fue predominantemente positiva. Antes de la ERE, el uso de MAE era menor, especialmente entre los docentes mayores de 40 años y los hombres; además, las dificultades en el uso de MAE aumentaron con la edad, siendo que más hombres informaron no utilizarlas. La adaptación a la ERE fue considerada moderada, y más docentes de 40 a 49 años informaron insatisfacción con el ambiente de trabajo. Los docentes mayores de 40 años y las mujeres tuvieron una incidencia de síntomas psicológicos negativos durante la ERE y enfrentaron mayores desafíos.

Diante da necessidade do isolamento social causada pela pandemia, as aulas presenciais foram suspensas dando lugar ao ensino remoto emergencial (ERE). Essa migração abrupta não permitiu nenhum planejamento ou preparação dos atores envolvidos no processo de ensino-aprendizagem. Nesse contexto, coube ao docente o desafio de adaptar-se a essa nova realidade atípica. Dessa forma, objetivou-se com o presente estudo, descrever as características e desafios enfrentados pelos professores do IF Sudeste MG - Campus Rio Pomba durante o ERE e seus impactos no processo de ensino-aprendizagem. Para isso, foi utilizado um questionário estruturado com participação de 41 docentes. Dificuldades relacionadas a formação pedagógica, uso de ferramentas tecnológicas e de metodologias ativas de ensino (MAE) e processo adaptativo dos docentes foram evidenciadas. Docentes não consideraram o ERE capaz de suprir eficientemente os objetivos das disciplinas, apesar de considerarem que houve apoio institucional necessário. A autoavaliação do desempenho docente durante o ERE foi predominantemente positiva. Antes do ERE, o uso de MAE era menor, especialmente entre os docentes acima de 40 anos e homens, além disso, as dificuldades do uso de MAE aumentaram com a idade, sendo que mais homens relataram não as utilizar. A adaptação ao ERE foi considerada mediana e, mais docentes de 40 a 49 anos relataram insatisfação com o ambiente de trabalho. Docentes acima de 40 anos e mulheres tiveram maior incidência de sintomas psicológicos negativos no ERE. Esse trabalho evidencia o desafio que os docentes passaram durante o ERE, especialmente para aqueles maiores de 40 anos e mulheres.

This paper discuss the meanings assigned to everyday educational experiences carried out within the subproject for Literacy in the Pedagogical Residency program (PRP), sponsored by Coordination for the Improvement of Higher Education Personnel (CAPES), developed by the Pedagogy program at the University of Campinas during the COVID-19 pandemic. For this, we present the political context of the program as well as the narratives produced from collective interviews with participating teachers-in-training who worked in the subproject in 2020, 2021 and 2022. For the theoretical and methodological framework, our base is the narratives of lived experience and the learned lessons from the research informed by the circulating meanings about the educational paths of these future elementary teachers. The discussion highlights the motivations and expectations regarding the program, the experiences of residents in remote teaching, the dialogues between the program and training in Pedagogy and the conflicts between emergency remote teaching and the in-person return of activities in education schools basic. We discuss the importance of these collective forms of work reported by teachers-in-training for their education and the limitation of the Pedagogical Residency as a program available to a restricted number of undergraduate students in teacher education programs.

El presente estudio discute los significados atribuidos a las experiencias formativas cotidianas, vividas en el contexto de la pandemia del COVID-19, en el subproyecto de alfabetización del Programa de Residencia Pedagógica (PRP), vinculado a la Coordinación para el Perfeccionamiento del Personal de Educación Superior (CAPES), desarrollado en el curso de Pedagogía de la Universidad de Campinas. Con este fin, se presentan las narrativas producidas a partir de entrevistas colectivas con los estudiantes-becarios del programa que trabajaron en el subproyecto en los años 2020, 2021 y 2022, así como el contexto político del programa. Como referencial teórico y metodológico, se asumen las narrativas de la experiencia vivida y la construcción de aprendizajes indicados por los sentidos que circulan sobre las trayectorias formativas de los futuros profesores de educación básica. Así, se esbozan lecturas respecto a las motivaciones y expectativas respecto del programa, las experiencias de los residentes en la enseñanza remota, los diálogos entre el programa y la formación en Pedagogía y las tensiones entre la enseñanza remota y el regreso presencial de las actividades en las escuelas de educación básica. Consideramos la importancia de las formas de acción colectiva destacadas en los reportes para la formación de los estudiantes como profesores y la limitación de la Residencia Pedagógica como programa dirigido a un número restringido de estudiantes de pregrado.

O presente estudo discute os sentidos atribuídos às experiências formativas cotidianas, vividas em contexto da pandemia de Covid-19, no subprojeto de Alfabetização do Programa Residência Pedagógica (PRP), vinculado à Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), desenvolvido no curso de Pedagogia da Universidade Estadual de Campinas. Para tanto, apresentam-se o contexto político do referido programa e as narrativas produzidas a partir de entrevistas coletivas com estudantes-bolsistas que atuaram no subprojeto nos anos de 2020 a 2022. Como referencial teórico-metodológico, assumem-se as narrativas de experiência do vivido e a construção de lições indiciadas pelos sentidos em circulação sobre os percursos formativos de futuras professoras da educação básica. Desse modo, são delineadas leituras referentes às motivações e às expectativas em relação ao programa, às experiências das residentes no ensino remoto, aos diálogos entre o PRP e a formação na Pedagogia e às tensões entre o ensino remoto emergencial e o retorno presencial das atividades nas escolas de educação básica. Considera-se a importância das formas coletivas de atuação destacadas nos relatos para a formação das estudantes como professoras e a limitação da Residência Pedagógica enquanto programa destinado a um número restrito de alunos das licenciaturas.

ABSTRACT Objective: To evaluate the level of COVID-19 risk perception (PCR-CV19) by returning to in-person classes and to analyze this perception with sociodemographic and health variables associated with such disease. Materials and methods: A cross-sectional and prospective study. The questionnaire was adapted to assess the PCR-CV19 among 532 university students. Moreover, an association analysis of the four dimensions of the PCR-CV19 (cognitive vulnerability, emotional vulnerability, risky-protective behaviors and severity) and the perception index was performed with sociodemographic and health variables. The following statistical methods were used: one-way analysis of variance (ANOVA), Shapiro-Wilk test for normality, Levene’s test for homogeneity of variances and Tukey’s honest significant difference or Games-Howell post hoc tests. These analyses were performed using the Jamovi statistical software, version 1.2.2. Results: A moderate level of PCR-CV19 was found, where the most relevant dimensions were risky-protective behaviors and severity. In addition, there was an association between the dimensions PCR-CV19 and perception index with the variables age, gender, alcohol consumption, physical and mental health indicators (anxiety and depression), and experiences with COVID-19. Cognitive vulnerability and emotional vulnerability were the most sensitive dimensions in the evaluation of the PCR-CV19. Conclusions: We continue to face constant risk conditions, thus making it necessary to maintain a surveillance scheme of the PCR-CV19 experienced by the population. In university students, cognitive vulnerability and emotional vulnerability were the most sensitive dimensions in the evaluation of PCR-CV19 and experiences with COVID-19 (illness or death). The fact that university students do not feel vulnerable and/or do not perceive the severity associated with COVID-19 transmission may affect their self-care behaviors. These results have key implications for public health; therefore, an intersectoral approach is required to have relevant information in order to face future pandemics.

RESUMEN Objetivo: Evaluar el nivel de percepción de riesgo de contagio de la COVID-19 frente al retorno a las clases presenciales y analizar esta percepción con variables sociodemográficas y de salud asociadas a esta enfermedad. Materiales y métodos: Estudio transversal y prospectivo. Se adaptó el cuestionario para evaluar la percepción de riesgo de contagio de la COVID-19 (PCR-CV19) en 532 universitarios. Además, se realizó un análisis de asociación de las cuatro dimensiones del PCR-CV19 (vulnerabilidad cognitiva, vulnerabilidad emocional, conductas de riesgo-protección y gravedad) y el índice de percepción con variables sociodemográficas y de salud. Se utilizaron técnicas estadísticas: análisis de varianza (ANOVA) de una vía (OneWay ANOVA), previa verificación de la prueba de normalidad Shapiro-Wilk y la prueba de Levene para la homogeneidad y la prueba post-hoc de Tukey o Ganes-Howell. Estos análisis se realizaron en el programa estadístico JAMOVI, versión 1.2.2. Resultados: Se evidenció un nivel moderado de percepción de riesgo de contagio, en donde las dimensiones de las conductas de riesgo-protección y gravedad se identificaron como las más relevantes; asimismo, se encontró asociación entre las dimensiones del PCR-CV19 y el índice de percepción con las variables edad, género, consumo de alcohol e indicadores de salud física y mental (ansiedad y depresión) y las experiencias vividas con la enfermedad de la COVID-19. Los aspectos de vulnerabilidad cognitiva y emocional fueron las dimensiones más sensibles en la evaluación de la percepción. Conclusiones: Seguimos enfrentando condiciones de riesgo que surgen de manera constante, lo que hace necesario mantener un esquema de vigilancia de la percepción de riesgo que experimenta la población. En los universitarios, los aspectos de vulnerabilidad cognitiva y emocional fueron las dimensiones más sensibles en la evaluación de la percepción del riesgo y las experiencias vividas con la COVID-19 (enfermedad o muerte). El hecho de que los universitarios no se sientan vulnerables y/o no perciban la gravedad asociada al contagio puede afectar sus conductas de autocuidado. Estos resultados tienen implicaciones claves para la salud pública, por lo que se requiere un abordaje intersectorial, con el objetivo de contar con información relevante para enfrentar futuras pandemias.

Abstract This article presents the analysis of a research carried out with higher education students about their experiences with remote teaching and hybrid modalities in the Covid-19 pandemic. The fieldwork consisted of interviews conducted individually and collectively, drawing on the relational and participatory perspective of ethnography. Participated in the research 44 students, in both in-person and online meetings held in 2022. The study also incorporates an autoethnographic dimension, as it began with situations experienced by the researcher herself as a teacher during the pandemic period. Considering the data related to the expansion of ODL (Open and Distance Learning) and the reports that indicate the acceleration and precariousness of life beyond social isolation, the research aimed to promote reflection on the insertion of digital technologies in educational practices that does not meet productivist and marketing demands, and that effectively situates pedagogical practices in contemporary languages and ways of existing.

Resumo Este artigo apresenta as análises decorrentes de uma pesquisa realizada com estudantes de ensino superior acerca das suas experiências com o ensino remoto e as modalidades híbridas na pandemia da Covid-19. O trabalho de campo constituiu-se de entrevistas individuais e coletivas, apoiando-se na perspectiva relacional e participativa da etnografia. Participaram da pesquisa 44 estudantes, em encontros presenciais e online realizados em 2022. O estudo também contempla uma dimensão autoetnográfica, pois teve como ponto de partida situações vivenciadas pela própria pesquisadora como docente no período da pandemia. Considerando os dados relativos à expansão do EaD, bem como os relatos que indicam a aceleração e precarização da vida para além do isolamento social, a pesquisa teve como objetivo promover a reflexão sobre uma inserção das tecnologias digitais nos fazeres educacionais que não atenda a demandas produtivistas e mercadológicas, e que efetivamente situe as práticas pedagógicas nas linguagens e modos de existir contemporâneos.

ABSTRACT The aim was to explore the scope and limitations of teleconsultation during the pandemic from the perspective of primary care physicians at the Hospital Italiano de Buenos Aires, a private institution located in the Autonomous City of Buenos Aires. A qualitative study was conducted with ten individual semi-structured interviews between January and April 2022. The three major emerging topics were the transition to virtuality, accessibility, and the new care model. Obstacles were related to the massive, forced, and unplanned implementation of teleconsultations. The main benefits included providing care during isolation-distancing and addressing epidemiological doubts. Changes were highlighted in care strategies, consultation frameworks, exchange among colleagues, referral criteria, requests for complementary studies, and in the profiles of those seeking consultations. A misuse of the system by individuals and a trivialization of the consultation moment emerged. The rise of communication and information technologies undoubtedly allowed the continuity of healthcare processes, but it does not replace in-person care, and normative guidelines are needed for its continuity.

RESUMEN El objetivo fue explorar alcances y limitaciones de la teleconsulta en pandemia, desde la perspectiva de médicos y médicas del primer nivel de atención del Hospital Italiano de Buenos Aires, una institución privada ubicada en la Ciudad Autónoma de Buenos Aires. Se realizó un estudio cualitativo con diez entrevistas semiestructuradas individuales entre enero y abril de 2022. Los tres grandes tópicos emergentes fueron la transición a la virtualidad, la accesibilidad y el nuevo modelo de atención. Los obstáculos se relacionaron con la implementación masiva, forzada y no planificada de las teleconsultas. Los principales beneficios fueron brindar atención durante el aislamiento-distanciamiento y evacuar dudas epidemiológicas. Se destacan cambios en estrategias de atención, encuadre de las consultas, intercambio entre colegas, criterios de derivación y de pedido de estudios complementarios, y en los perfiles de consultantes. Surgió un sobreuso del sistema por parte de las personas, y una banalización del momento de la consulta. El auge de las tecnologías de la comunicación e información indudablemente permitió dar continuidad a los procesos asistenciales en salud, pero no reemplaza la presencialidad y se requieren lineamientos normativos para su continuidad.

ABSTRACT OBJECTIVE To describe the methodological challenges and strategies of a web survey on the working conditions and health among delivery workers. METHODS The study population consisted of Brazilian delivery workers operating in the national territory. Procedures include building solid and ongoing collaboration with worker representatives and conducting a four-month data collection from February to May 2022, sharing the link to the online questionnaire on social media such as social networks (Facebook, Instagram) and messaging apps (WhatsApp, Telegram). RESULTS The recruitment of 41 leaders or influencers of delivery workers increased the dissemination of the study, some of whom participated in the consensual validation of the questionnaire; the production of content for social media for the dissemination of the questionnaire link on social networks and applications, and the in-person dissemination of the study at the delivery workers’ meeting points during the workday played a fundamental role, totaling around 132 hours in 45 shifts. The strategies adopted for data collection with a hybrid approach to dissemination made it possible to carry out the web survey. After four months of the web survey, 564 delivery workers, 543 men and 18 women, responded to the online questionnaire. CONCLUSION The web survey presented methodological strategies to overcome the challenge of reaching workers, including hybrid work, to increase the participation of workers, on whom epidemiological research is still scarce.

RESUMO OBJETIVO Apresentar os resultados da análise de custos para a modalidade de consulta remota (teleconsulta) em comparação à consulta presencial, em pacientes com diabetes do tipo 2, no Sistema Único de Saúde (SUS) brasileiro, na cidade Joinville, Santa Catarina. Para além dos custos, sob a perspectiva do gestor local, o artigo também apresenta estimativas sob perspectiva do paciente, a partir dos custos de transporte associados a cada modalidade de consulta. MÉTODO Foram coletados dados de 246 consultas, remotas e presenciais, entre 2021 e 2023, no contexto de um ensaio clínico randomizado sobre o impacto da teleconsulta realizado na cidade de Joinville, SC. As teleconsultas foram realizadas em Unidades Básicas de Saúde (UBS) e as consultas presenciais no Centro de Saúde Especializada. Para o cálculo dos custos, foi utilizado o método de custos baseado em tempo e atividade (TDABC) e, para o cálculo dos custos relativos aos transportes dos pacientes, foram coletados dados diretamente com os participantes da pesquisa. Foram analisados e comparados descritivamente os custos médios e o tempo de realização de cada modalidade de consulta em diferentes cenários e perspectivas. RESULTADOS Considerando apenas a perspectiva do gestor local do SUS, os custos para a realização da teleconsulta se mostraram 4,5% maiores do que para uma consulta presencial. Contudo, quando considerados os custos de transporte associados a cada paciente, o valor estimado da consulta presencial passa a ser 7,7% maior e, no caso de consultas em outros municípios, 15% maior do que a teleconsulta. CONCLUSÃO Os resultados demonstram que a incorporação da teleconsulta dentro do SUS pode trazer vantagens econômicas, a depender da perspectiva e do cenário considerado, além de ser uma estratégia com potencial para aumentar o acesso à atenção especializada na rede pública.

ABSTRACT OBJECTIVE To present the results of a cost analysis of remote consultations (teleconsultations) compared to in-person consultations for patients with type 2 diabetes, in the Brazilian public healthcare system (SUS) in the city of Joinville, Santa Catarina (SC). In addition to the costs from the local manager’s perspective, the article also presents estimates from the patient’s perspective, based on the transportation costs associated with each type of consultation. METHOD Data were collected from 246 consultations, both remote and in-person, between 2021 and 2023, in the context of a randomized clinical trial on the impact of teleconsultation carried out in the city of Joinville, SC. Teleconsultations were carried out at Primary Health Units (PHU) and in-person consultations at the Specialized Health Center. The consultation costs were calculate by the method time and activity-based costing (TDABC), and for the estimate of transportation costs data was collected directly from the research participants . The mean costs and time required to carry out each type of consultation in different scenarios and perspectives were analyzed and compared descriptively. RESULTS Considering only the local SUS manager’s perspective, the costs for carrying out a teleconsultation were 4.5% higher than for an in-person consultation. However, when considering the transportation costs associated with each patient, the estimated value of the in-person consultation becomes 7.7% higher and, in the case of consultations in other municipalities, 15% higher than the teleconsultation. CONCLUSION The results demonstrate that the incorporation of teleconsultation within the SUS can bring economic advantages depending on the perspective and scenario considered, in addition to being a strategy with the potential to increase access to specialized care in the public network.

Discipleship is a responsibility of the Church. It is an outlet in which the regeneration of Church leadership to the younger generation is conducted. Before the COVID-19 pandemic, discipleship and mentoring of youth leaders, especially key persons of GKII (Gereja Kemah Injil Indonesia) youth were provided by means of in-person activities. During the pandemic, digital media has been utilised for various church activities, including mentoring these key persons. Hence, this research intends to explore: (1) the method by which key persons practise digital discipleship and (2) the benefits of digital media in youth discipleship to facilitate faith growth. This research is a qualitative research. Data were collected by means of interviews and observations on several key persons' digital media accounts. The research shows that social media significantly benefits the discipleship process. It was found that digital discipleship was quite often carried out during the pandemic, especially in urban areas, with WhatsApp and Zoom meetings as its two primary means. However, it slightly declined along with the lifting of social gathering restrictions. The main themes explored in the mentoring sessions were discipleship, soteriology, spiritual life, motivational and digital media materials, and youth ministry in the digital era. The discipleship practice used was the NM-SM (Nurtured, Matured, Served, Mission) pattern. CONTRIBUTION: The results of this research contribute to the development of knowledge, especially in the field of youth discipleship, and digital media-based discipleship. This research also shows that digital media has become an effective theological space during the pandemic and post-pandemic periods

RESUMEN El objetivo fue explorar alcances y limitaciones de la teleconsulta en pandemia, desde la perspectiva de médicos y médicas del primer nivel de atención del Hospital Italiano de Buenos Aires, una institución privada ubicada en la Ciudad Autónoma de Buenos Aires. Se realizó un estudio cualitativo con diez entrevistas semiestructuradas individuales entre enero y abril de 2022. Los tres grandes tópicos emergentes fueron la transición a la virtualidad, la accesibilidad y el nuevo modelo de atención. Los obstáculos se relacionaron con la implementación masiva, forzada y no planificada de las teleconsultas. Los principales beneficios fueron brindar atención durante el aislamiento-distanciamiento y evacuar dudas epidemiológicas. Se destacan cambios en estrategias de atención, encuadre de las consultas, intercambio entre colegas, criterios de derivación y de pedido de estudios complementarios, y en los perfiles de consultantes. Surgió un sobreuso del sistema por parte de las personas, y una banalización del momento de la consulta. El auge de las tecnologías de la comunicación e información indudablemente permitió dar continuidad a los procesos asistenciales en salud, pero no reemplaza la presencialidad y se requieren lineamientos normativos para su continuidad.

ABSTRACT The aim was to explore the scope and limitations of teleconsultation during the pandemic from the perspective of primary care physicians at the Hospital Italiano de Buenos Aires, a private institution located in the Autonomous City of Buenos Aires. A qualitative study was conducted with ten individual semi-structured interviews between January and April 2022. The three major emerging topics were the transition to virtuality, accessibility, and the new care model. Obstacles were related to the massive, forced, and unplanned implementation of teleconsultations. The main benefits included providing care during isolation-distancing and addressing epidemiological doubts. Changes were highlighted in care strategies, consultation frameworks, exchange among colleagues, referral criteria, requests for complementary studies, and in the profiles of those seeking consultations. A misuse of the system by individuals and a trivialization of the consultation moment emerged. The rise of communication and information technologies undoubtedly allowed the continuity of healthcare processes, but it does not replace in-person care, and normative guidelines are needed for its continuity.

Objetivo: to assess the effect of an educational intervention performed by nurses for blood pressure control in people with arterial hypertension, when compared to usual care. Método: a systematic review with meta-analysis of randomized clinical trials, conducted in six databases. The studies included were those in which an educational intervention was performed by nurses on people with arterial hypertension. The risk of bias was assessed by means of the Risk of Bias Tool, the meta-analysis was performed in the Review Manager software and certainty of the evidence was calculated in the Grading of Recommendations Assessment, Development and Evaluation system. Resultados: a total of 1,692 studies were found, which were peer-reviewed, including eight of them in the meta-analysis. The meta-analysis was calculated for the “systolic blood pressure” and diastolic blood pressure” outcomes, in subgroups by time and by intervention performance type. For the in-person educational intervention, performed individually combined with a group activity, the effect estimate was -12.41 mmHg (95% Confidence Interval: from -16.91 to -7.91, p<0,00001) for systolic pressure and -5.40 mmHg (95% Confidence Interval: from -7.98 to -2.82, p<0,00001) for diastolic pressure, with high certainty of evidence. Conclusión: the educational intervention performed by nurses, individually and combined with a group activity, presents a statistically significant clinical effect. PROSPERO registration No.: CRD42021282707.

Objetivo: evaluar el efecto de la intervención educativa que realizan los enfermeros para controlar la presión arterial en personas con hipertensión arterial, en comparación con los cuidados habituales. Método: revisión sistemática con metaanálisis de ensayos clínicos aleatorizados realizada en seis bases de datos. Se incluyeron estudios en los cuales el enfermero llevó a cabo la intervención educativa en la persona con hipertensión arterial. El riesgo de sesgo se evaluó mediante la herramienta Risk of Bias Tool, el metaanálisis se hizo utilizando el software Review Manager y la certeza de la evidencia se calculó usando el sistema Grading of Recommendations Assessment, Development and Evaluation. Resultados: se encontraron 1692 estudios revisados por pares y se incluyeron ocho artículos en el metaanálisis. El metaanálisis se calculó para el resultado presión arterial sistólica y presión arterial diastólica, subagrupados por tiempo y tipo de implementación de la intervención. Para la intervención educativa presencial, realizada d forma individual combinada con actividad grupal, la estimativa del efecto fue -12,41 mmHg (Intervalo de Confianza 95%, -16,91 a -7,91, p<0,00001) para la presión sistólica y -5,40 mmHg (Intervalo 95% Confianza, -7,98 a -2,82, p<0,0001) para la presión diastólica, con certeza de evidencia alta. Conclusión: a intervención educativa realizada por el enfermero, de forma individual combinada con la actividad grupal, tiene efecto clínico y estadísticamente significativo. Registro PROSPERO: CRD42021282707.

Objetivo: avaliar o efeito da intervenção educativa realizada por enfermeiros para controle da pressão arterial em pessoas com hipertensão arterial, comparada com cuidado habitual. Método: revisão sistemática com metanálise de ensaios clínicos randomizados realizada em seis bases de dados. Foram incluídos estudos em que a intervenção educativa foi realizada pelo enfermeiro à pessoa com hipertensão arterial. O risco de viés foi avaliado pela Risk of Bias Tool, a metanálise no software Review Manager e a certeza da evidência no sistema Grading of Recommendations Assessment, Development and Evaluation. Resultados: foram encontrados 1692 estudos, revisados por pares, e oito artigos foram incluídos na metanálise. A metanálise foi calculada para o desfecho pressão arterial sistólica e pressão arterial diastólica, em subgrupo por tempo e por tipo de execução da intervenção. Para a intervenção educativa presencial, realizada de modo individual combinada com atividade de grupo, a estimativa de efeito foi de -12.41 mmHg (Intervalo de Confiança 95%, -16.91 a -7.91, p<0.00001) para pressão arterial sistólica e -5.40 mmHg (Intervalo de Confiança 95%, -7.98 a -2.82, p<0.0001) para pressão arterial diastólica, com certeza da evidência alta. Conclusão: a intervenção educativa realizada pelo enfermeiro, de modo individual combinada com atividade de grupo, apresenta efeito clínico e estatisticamente significativo. Registro PROSPERO: CRD42021282707.

ABSTRACT The teaching of national history in correspondence with the locality where the course takes place demands a unique didactic alternative. Bringing the content of local history to the communicative scenario in which young people seek different ways to interact with knowledge and information constituted the central theme of applied pedagogical research at the University of Medical Sciences of Cienfuegos. A differentiated work was carried out with local history, inserted into the national one, combining the in-person scenario with the virtual scenario. The objective of the article was to evaluate the effect of a didactic alternative to bring the teaching of local history to the communicative scenario where young people interact. An initial diagnosis showed that 65.2% of the students surveyed could not make a comment about the history of their locality. The identified problem was contrasted through a broad search that covered national and international academic discourse. It was demonstrated that a coherent didactic alternative supported by the link between the in-person and the virtual, bringing local history to the communicative scenario where young people seek different ways of interacting transformed the 65.2% of uncertainty reflected in the initial diagnosis of the research.

RESUMEN La enseñanza de la historia nacional en correspondencia con la localidad donde se desarrolla el curso demanda una singular alternativa didáctica. Llevar el contenido de la historia local al escenario comunicativo en el que los jóvenes buscan maneras diferentes de interactuar con el conocimiento y la información constituyó el tema central de la investigación pedagógica aplicada en la Universidad de Ciencias Médicas de Cienfuegos. Se realizó un trabajo diferenciado con la historia local, insertada en la nacional, simultaneando el escenario presencial con el escenario virtual. El objetivo del artículo fue evaluar el efecto de una alternativa didáctica para llevar la enseñanza de la historia local al escenario comunicativo donde interactúan los jóvenes. Un diagnóstico inicial demostró que el 65,2 % de los estudiantes encuestados no pudo elaborar un comentario sobre la historia de su localidad. El problema identificado fue contrastado mediante una amplia búsqueda que abarcó el discurso académico nacional e internacional. Se demostró que una coherente alternativa didáctica sustentada en la vinculación de lo presencial y lo virtual llevando la historia local al escenario comunicativo donde los jóvenes buscan maneras diferentes de interactuar transformó el 65,2 % de incertidumbre reflejado en el diagnóstico inicial de la investigación.

For learners with complex communication needs (CCN), teachers in special schools are encouraged to use a variety of communication techniques to help them participate in various classroom activities. Studies show limited data on the use of effective augmentative and alternative communication (AAC) strategies in special schools. The primary purpose of this study was to describe teacher perspectives on the use of AAC devices that they use in their classrooms in rural areas. We employed a qualitative methodology that included in-person interviews and focus groups. The focus group and face-to-face sessions each had 3 and 8 participants, respectively. Three main themes, namely modes of communication, training, and challenges and 12 subthemes were identified. We found that teachers employed pictures to improve communication of learners with CCN. We also discovered that since teachers didn't use speech generating devices (SGD) frequently, they had trouble using them. The use of SGDs, one of the assistive technology tools that could be used to improve communication of learners with CCN, requires extensive teacher training, according to research. Further research is required to establish the efficacy on the use of AAC devices in special schools in rural areas.

Resumo Introdução: As pesquisas qualitativas surgiram para potencializar o estudo dentro das ciências metodológicas, buscando um aprofundamento detalhado e subjetivo nas visões individuais do grupo acerca do objeto de pesquisa. Com a revolução informacional, essas pesquisas também sofreram influências, tornando possível o uso de ferramentas virtuais para a realização de análises. Com a pandemia da SARS-COV-22 e a adoção de lockdowns, artifícios como o Google Meet, Zoom e CAQDAS entraram em evidência. Observou-se, com a adoção dessas, uma maior riqueza, além da compreensão mais aprofundada e completa da temática estudada, fazendo-se crucial seu estudo; Objetivos Refletir sobre as aplicações de metodologias tradicionais e virtuais nas pesquisas qualitativas; Métodos Trata-se de um estudo de caráter qualitativo baseado em uma tese de pesquisa-ação que, através da utilização de recursos metodológicos tradicionais, por meio de obras literárias, música, reuniões e palestra, e também os inovadores, utilizando- se ambientes virtuais, resumos em vídeos e CAQDAS, buscou promover um impulsionamento nas análises reflexivas - de modo on-line e presencial - entre os grupos participantes acerca de um conflito coletivo; Resultados Foi visto que a integração do método tradicional às ferramentas virtuais facilitou o alcance de mais participantes, além de apoiar a comunicação e convite deles, ainda, auxiliou na obtenção e processamento de dados obtidos nos debates realizados. Ademais, observou-se que não houve déficit subjetivo na pluralidade dos discursos e temáticas, posteriormente transcritos e analisados ainda com o uso dessas, aumentando a precisão dos dados; Considerações finais A integração entre a modalidade virtual e presencial mostra-se vantajosa no enriquecimento de debates mais rápidos e sem limites geográficos, não deixando de apresentar um caráter plural e dialético, além de mostrar-se mais eficiente na coleta e registro de dados para análises e discussões.

Abstract Introduction Qualitative research has emerged to enhance the study within methodological sciences, seeking a detailed and subjective depth into individual views of the research object. With the information revolution, these types of research have also been influenced, making it possible to use virtual tools for analysis. With the SARS-COV-2 pandemic and the adoption of lockdowns, tools such as Google Meet, Zoom and CAQDAS have become prominent. It has been observed that with the adoption of these tools, there is a greater richness, as well as a more in-depth and complete understanding of the theme being studied, making their study crucial; Goals To reflect on the applications of traditional and virtual methodologies in qualitative research. Methods: This is a qualitative study based on a research-action thesis that, through the use of traditional methodological resources such as literature, music, meetings and lectures, as well as innovative resources such as virtual environments, video summaries and CAQDAS, sought to promote a boost in reflective analyses - both online and in-person - among the participating groups regarding a collective conflict; Results It was seen that the integration of traditional methods with virtual tools facilitated the reach of more participants, in addition to supporting their communication and invitation, and also assisted in the collection and processing of data obtained during the debates. Furthermore, it was observed that there was no subjective deficit in the plurality of speeches and themes, which were later transcribed and analyzed with the use of these tools, increasing the precision of the data; Final considerations The integration between virtual and in-person modalities proves to be advantageous in enriching faster and geographically unlimited debates, while still presenting a plural and dialectical character, in addition to being more efficient in collecting and registering data for analysis and discussions.