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OBJECTIVE: to report the experience of developing pedagogical mediations in a Virtual Learning Environment implemented in a nursing faculty during the COVID-19 pandemic. METHODS: an experience report on the construction of a distance course aimed at graduates and residents of a nursing faculty at a public university located in the city of Rio de Janeiro. RESULTS: the course's conception, operationalization and implementation were the result of a collective work that culminated in a non-formal, virtual and problematic teaching process, which reached a participation rate of 82% of enrolled students. FINAL CONSIDERATIONS: even in times of social isolation, the course promoted collaborative learning of knowledge about COVID-19 and strengthened the relationship between professors and students. The possibility of carrying out distance activities based on solid methodological proposals that contradict the content logic often observed in distance learning is emphasized.

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ABSTRACT Objective: to report the experience of developing pedagogical mediations in a Virtual Learning Environment implemented in a nursing faculty during the COVID-19 pandemic. Methods: an experience report on the construction of a distance course aimed at graduates and residents of a nursing faculty at a public university located in the city of Rio de Janeiro. Results: the course's conception, operationalization and implementation were the result of a collective work that culminated in a non-formal, virtual and problematic teaching process, which reached a participation rate of 82% of enrolled students. Final considerations: even in times of social isolation, the course promoted collaborative learning of knowledge about COVID-19 and strengthened the relationship between professors and students. The possibility of carrying out distance activities based on solid methodological proposals that contradict the content logic often observed in distance learning is emphasized.

RESUMEN Objetivo: reportar la experiencia de desarrollo de mediaciones pedagógicas en un Ambiente Virtual de Aprendizaje implementado en una facultad de enfermería durante la pandemia de COVID-19. Métodos: relato de experiencia en la construcción de un curso a distancia dirigido a estudiantes ​​y residentes de una facultad de enfermería de una universidad pública ubicada en la ciudad de Río de Janeiro. Resultados: la concepción, operacionalización e implementación del curso fue el resultado de un trabajo colectivo que culminó en un proceso docente no formal, virtual y problemático, que alcanzó una tasa de participación del 82% de los estudiantes matriculados. Consideraciones finales: incluso en tiempos de aislamiento social, el curso promovió el aprendizaje colaborativo de conocimientos sobre COVID-19, fortaleciendo las relaciones entre profesores y alumnos. Se enfatiza la posibilidad de realizar actividades a distancia basadas en propuestas metodológicas sólidas que contradicen la lógica de contenido frecuentemente observada en Educación a Distancia.

RESUMO Objetivo: relatar a experiência do desenvolvimento de mediações pedagógicas em Ambiente Virtual de Aprendizagem implementadas em uma faculdade de enfermagem durante a pandemia de COVID-19. Métodos: relato de experiência da construção de um curso a distância voltado para graduandos e residentes de uma faculdade de enfermagem de uma universidade pública situada no município do Rio de Janeiro. Resultados: a concepção, operacionalização e implementação do curso foi fruto de um trabalho coletivo que culminou em um processo de ensino não formal, virtual e problematizador, o qual alcançou taxa de participação de 82% dos educandos inscritos. Considerações finais: mesmo em tempos de isolamento social, o curso promoveu a aprendizagem colaborativa de conhecimentos acerca da COVID-19, estreitando as relações entre docentes e educandos. Ressalta-se a possibilidade de realizar atividades a distância baseadas em propostas metodológicas sólidas que contrariam a lógica conteudista frequentemente observada na Educação a Distância.

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Objetivo: identificar a compreensão dos familiares sobre a importância da técnica de higienização das mãos para a realização de diálise peritoneal em domicílio. Metodologia: estudo descritivo, abordagem qualitativa, método de pesquisa convergente-assistencial. O estudo foi realizado em um Hospital Universitário Estadual do Rio de Janeiro, no setor de Nefrologia. O estudo envolveu 06 familiares que realizam terapia de diálise peritoneal para seus familiares. A coleta de dados ocorreu no período de 13 de julho de 2017 a 31 de agosto de 2017. Principais resultados: dos 06 participantes do estudo 02 realizou-se o saneamento das mãos corretamente de acordo com o vídeo fornecido pela pesquisadora. Conclusão: Percebe-se que, para alguns participantes, ainda há receio e insegurança em relação à execução da técnica de higienização das mãos corretamente.(AU)

Objective: the present study has the following aims: to identify the family members' understanding of the importance of hand hygiene technique for peritoneal dialysis at home. Methods: a descriptive study, qualitative approach, using Convergence - Assistance Research as a method. The study was conducted at a State University Hospital located in the city of Rio de Janeiro, in the Nephrology sector. Sixty family members undergoing peritoneal dialysis therapy of their relative at home participated in the study. Data collection occurred from July 3, 2017 to August 31, 2017.Results: of the 06 participants in study 02 performed the hand hygiene correctly according to the video provided by the researcher. Conclusion: the study reached the proposed objectives; with this it was perceptible that for some participants there is still fear and insecurity about the execution of the technique of hand hygiene correctly.(AU)

Objetivo: identificar el entendimiento de los familiares sobre la importancia de la técnica de higienización de las manos para la realización de la diálisis peritoneal en el domicilio. Metodología: estudio descriptivo, abordaje cualitativo, método la Investigación Convergente-Asistencial. El estudio fue realizado en un Hospital Universitario Estadual de Río de Janeiro, en el sector de Nefrología. Participaron del estudio 06 familiares que realizan la terapia de diálisis peritoneal de su pariente. La recolección de datos ocurrió en el período de 13 de julio de 2017 al 31 de agosto de 2017. Resultados principales: de los 06 participantes del estudio 02 realizaron la higienización de las manos de forma correcta de acuerdo con el vídeo proporcionado por la investigadora. Conclusión principal: Fue perceptible que para algunos participantes aún exista el miedo y inseguridad con relación a la ejecución de la técnica de higienización de las manos de forma correcta. (AU)

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Objetivo: analisar a satisfação dos pacientes em tratamento dialítico com relação aos cuidados de enfermagem. Método: estudo descritivo, de abordagem quantitativa de campo, realizado de maio a agosto de 2016, em um hospital universitário do Rio de Janeiro. A amostra foi de 37 pacientes que realizam hemodiálise ou diálise peritoneal no hospital por tempo igual ou superior a três meses, maiores de 18 anos. Utilizou para a coleta de dados o Instrumento de Satisfação do Paciente. Resultados: a média de satisfação geral dos pacientes foi de 3,89 para os três itens: educação, confiança e teórico-prático, sendo que os pacientes da hemodiálise apresentaram a média de satisfação de 3,69 e os pacientes da diálise peritoneal de 4,44. Conclusão: os pacientes em tratamento dialítico do hospital se encontram satisfeitos com os cuidados de enfermagem que lhes são prestados.

Objective: to examine dialysis patient satisfaction with related nursing care. Method: this descriptive study was conducted, on a quantitative field approach, from May to August 2016, at a university hospital in Rio de Janeiro. The sample comprised 37 patients over 18 years old, who had been on hemodialysis or peritoneal dialysis at the hospital for three months or more. Data were collected using a patient satisfaction questionnaire. Results: overall patient satisfaction was 3.89 for the three items: education, trust, and theoretical and practical skill, with hemodialysis patients returning 3.69 overall satisfaction, and peritoneal dialysis patients, 4.44. Conclusion: patients in peritoneal dialysis at the hospital were satisfied with the nursing care provided.

Objetivo: analizar la satisfacción de los pacientes en tratamiento de diálisis en relación con los cuidados de enfermería. Método: estudio descriptivo, de abordaje cuantitativa de campo, realizado entre mayo y agosto de 2016, en un hospital universitario de Río de Janeiro. La muestra consistió en 37 pacientes en hemodiálisis o diálisis peritoneal en el hospital por tiempo igual o superior a tres meses, mayores de 18 años. Se utiliza, para la recolección de datos, el instrumento de satisfacción del paciente. Resultados: el promedio de satisfacción general de los pacientes fue de 3,89 para los tres ítems: educación, confianza y teórico-práctico. Los pacientes de hemodiálisis presentaron un promedio de satisfacción de 3,69 y los pacientes de diálisis peritoneal de 4,44. Conclusión: los pacientes en tratamiento de diálisis del hospital están satisfechos con la atención de enfermería que se les proporciona.

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Infecção persistente por HPV é condição necessária para ocorrência de câncer do colo de útero. Visando a reduzir sua incidência, foram desenvolvidas vacinas profiláticas contra HPV, existindo duas formulações comercialmente disponíveis: bivalente (subtipos 16 e 18) e quadrivalente (6, 11, 16 e 18). Realizou-se uma metanálise da eficácia dessas vacinas em mulheres, com foco na avaliação estratificada por desfechos clínicos. Ensaios clínicos randomizados (ECR) publicados entre 2000 e 2009 foram identificados com base em busca no MEDLINE, Biblioteca Cochrane e LILACS, e avaliados por dois revisores independentes. Seis ECR foram incluídos na metanálise. As vacinas reduziram o risco de ocorrência de lesões precursoras da neoplasia, com eficácia de 97% (IC95%: 90-99) para NIC 2 e 96% (IC95%: 89-99) para NIC 3, nas análises por protocolo. As eficácias nas análises por intenção de tratar foram menores: 63% (IC95%: 52-71) e 42% (IC95%: 26-55), respectivamente. Para avaliação de sua eficácia sobre a incidência e mortalidade por câncer do colo de útero são necessários estudos com maior tempo de seguimentos.

Persistent HPV infection is a necessary condition for the occurrence of cervical cancer. Prophylactic HPV vaccines have been developed to reduce the incidence of cervical cancer. Two vaccines are commercially available: bivalent (types 16, 18) and quadrivalent (6, 11, 16 and 18). This study aimed to perform a systematic review and metaanalysis of the HPV vaccines' efficacy in women, focusing its performance stratified by clinical outcomes. Randomized controlled trials (RCT) published between 2000 and 2009 were identified from searches of MEDLINE, LILACS and Cochrane Library, and evaluated by two independent reviewers. Six RCT were selected. The vaccines reduced the risk of precursor lesions of cervical cancer, presenting efficacy of 97% (95%CI: 90-99) for CIN 2 and 96% (95%CI: 89-99) for CIN 3, in the per protocol analysis. The efficacies in the analysis by intention to treat were smaller: 63% (95%CI: 52-71) and 42% (95%CI: 26-55), respectively. In order to evaluate its effectiveness on the incidence and mortality rates for cervical cancer, longer-term studies will be needed.

La infección persistente por VPH es una condición necesaria para la aparición de cáncer del cuello del útero. Con el fin de reducir la incidencia se han desarrollado vacunas profilácticas contra el VPH, existiendo dos formulaciones disponibles comercialmente: bivalentes (tipos 16, 18) y tetravalente (6, 11, 16 y 18). Se realizó un meta-análisis de la eficacia de estas vacunas en las mujeres, centrándose en la evaluación estratificada por los resultados clínicos. Se identificaron ensayos controlados aleatorios (ECA) publicados entre 2000 y 2009 en las basis MEDLINE, LILACS y Cochrane Library, y evaluados por dos revisores independientes. Seis ECA fueron incluidos. La vacuna reduce el riesgo de las lesiones precursoras del cáncer, con una eficacia de 97% (IC95%: 90-99) para CIN 2 y 96% (IC95%: 89-99) para CIN 3, en el análisis por protocolo. La eficiencia en el análisis por intención de tratar fue menor: 63% (IC95%: 52-71) y 42% (IC95%: 26-55), respectivamente. Para evaluar su efectividad en la incidencia y mortalidad del cáncer cervical, se necesitan estudios con un seguimiento más prolongado.

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Recent evidence has demonstrated that slow responders may benefit from antiviral treatment in HCV/HIV coinfection. This study aimed to evaluate the cost-effectiveness of HCV treatment in individuals with genotype 1 coinfected with HIV, with peg-interferon in combination with ribavirin, compared to the inclusion (versus non-inclusion) of slow responders. A Markov model was developed that simulated the progression of liver disease in a hypothetical cohort of one thousand men over 40 years of age, considering the Brazilian Unified National Health System (SUS) perspective and a 30-year timeline. The extension of treatment to slow responders provided a 60% increase in the number of individuals who eliminated HCV and an incremental cost-effectiveness ratio of 44,171 BRL/QALY, below the acceptability threshold proposed by World Health Organization. Sensitivity analysis did not alter the results. The inclusion of HCV/ HIV-coinfected slow virologic responders in the treatment protocol is shown to be a cost-effective strategy for the SUS.

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Persistent HPV infection is a necessary condition for the occurrence of cervical cancer. Prophylactic HPV vaccines have been developed to reduce the incidence of cervical cancer. Two vaccines are commercially available: bivalent (types 16, 18) and quadrivalent (6, 11, 16 and 18). This study aimed to perform a systematic review and metaanalysis of the HPV vaccines' efficacy in women, focusing its performance stratified by clinical outcomes. Randomized controlled trials (RCT) published between 2000 and 2009 were identified from searches of MEDLINE, LILACS and Cochrane Library, and evaluated by two independent reviewers. Six RCT were selected. The vaccines reduced the risk of precursor lesions of cervical cancer, presenting efficacy of 97% (95%CI: 90-99) for CIN 2 and 96% (95%CI: 89-99) for CIN 3, in the per protocol analysis. The efficacies in the analysis by intention to treat were smaller: 63% (95%CI: 52-71) and 42% (95%CI: 26-55), respectively. In order to evaluate its effectiveness on the incidence and mortality rates for cervical cancer, longer-term studies will be needed.

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A cost-effectiveness analysis was conducted in screening for breast cancer. The use of conventional mammography, digital and magnetic resonance imaging were compared with natural disease history as a baseline. A Markov model projected breast cancer in a group of 100,000 women for a 30 year period, with screening every two years. Four distinct scenarios were modeled: (1) the natural history of breast cancer, as a baseline, (2) conventional film mammography, (3) digital mammography and (4) magnetic resonance imaging. The costs of the scenarios modeled ranged from R$ 194.216,68 for natural history, to R$ 48.614.338,31, for screening with magnetic resonance imaging. The difference in effectiveness between the interventions ranged from 300 to 78.000 years of life gained in the cohort. The ratio of incremental cost-effectiveness in terms of cost per life-year gains, conventional mammographic screening has produced an extra year for R$ 13.573,07. The ICER of magnetic resonance imaging was R$ 2.904.328,88, compared to no screening. In conclusion, it is more cost-effective to perform the screening with conventional mammography than other technological interventions.

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