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      Massive health education through technological mediation: Analyses and impacts on the syphilis epidemic in Brazil

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          Abstract

          With syphilis cases on the rise, Brazil declared an epidemic in 2016. To address the consequent public health crisis, the Ministry of Health laid out a rapid response plan, namely, the “Syphilis No!” Project (SNP), a national instrument to fight the disease which encompasses four dimensions: (a) management and governance, (b) surveillance, (c) comprehensive care, and (d) strengthening of educommunication. In the dimension of education, the SNP developed the learning pathway “Syphilis and other Sexually Transmitted Infections (STIs)” to strengthen and promote Health Education. This pathway features 54 Massive Open Online Courses (MOOCs), delivered through the Virtual Learning Environment of the Brazilian Health System (AVASUS). This paper analyzes the impacts of the learning pathway “Syphilis and other STIs” on the response to the epidemic in Brazil, highlighting the educational process of the learning pathway and its social implications from the perspective of the United Nations' 2030 Agenda and its Sustainable Development Goals. Three distinct databases were used to organize the educational data: the learning pathway “Syphilis and other STIs” from AVASUS, the National Registry of HealthCare Facilities from the Brazilian Ministry of Health (MoH), and the Brazilian Occupation Classification, from the Ministry of Labor. The analysis provides a comprehensive description of the 54 courses of the learning pathway, which has 177,732 enrollments and 93,617 participants from all Brazilian regions, especially the Southeast, which accounts for the highest number of enrollees. Additionally, it is worth noting that students living abroad also enrolled in the courses. Data characterization provided a demographic study focused on the course participants' profession and level of care practiced, revealing that the majority (85%) worked in primary and secondary healthcare. These practitioners are the target audience of the learning pathway and, accordingly, are part of the personnel directly engaged in healthcare services that fight the syphilis epidemic in Brazil.

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          User's guide to correlation coefficients

          When writing a manuscript, we often use words such as perfect, strong, good or weak to name the strength of the relationship between variables. However, it is unclear where a good relationship turns into a strong one. The same strength of r is named differently by several researchers. Therefore, there is an absolute necessity to explicitly report the strength and direction of r while reporting correlation coefficients in manuscripts. This article aims to familiarize medical readers with several different correlation coefficients reported in medical manuscripts, clarify confounding aspects and summarize the naming practices for the strength of correlation coefficients.
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            Educação Permanente em Saúde: desafio ambicioso e necessário

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              Comparing the Pearson and Spearman correlation coefficients across distributions and sample sizes: A tutorial using simulations and empirical data.

              The Pearson product–moment correlation coefficient (rp) and the Spearman rank correlation coefficient (rs) are widely used in psychological research. We compare rp and rs on 3 criteria: variability, bias with respect to the population value, and robustness to an outlier. Using simulations across low (N = 5) to high (N = 1,000) sample sizes we show that, for normally distributed variables, rp and rs have similar expected values but rs is more variable, especially when the correlation is strong. However, when the variables have high kurtosis, rp is more variable than rs. Next, we conducted a sampling study of a psychometric dataset featuring symmetrically distributed data with light tails, and of 2 Likert-type survey datasets, 1 with light-tailed and the other with heavy-tailed distributions. Consistent with the simulations, rp had lower variability than rs in the psychometric dataset. In the survey datasets with heavy-tailed variables in particular, rs had lower variability than rp, and often corresponded more accurately to the population Pearson correlation coefficient (Rp) than rp did. The simulations and the sampling studies showed that variability in terms of standard deviations can be reduced by about 20% by choosing rs instead of rp. In comparison, increasing the sample size by a factor of 2 results in a 41% reduction of the standard deviations of rs and rp. In conclusion, rp is suitable for light-tailed distributions, whereas rs is preferable when variables feature heavy-tailed distributions or when outliers are present, as is often the case in psychological research.
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                Author and article information

                Contributors
                Journal
                Front Public Health
                Front Public Health
                Front. Public Health
                Frontiers in Public Health
                Frontiers Media S.A.
                2296-2565
                27 September 2022
                2022
                : 10
                : 944213
                Affiliations
                [1] 1Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN) , Natal, Brazil
                [2] 2Department of Biomedical Engineering, Federal University of Pernambuco , Recife, Brazil
                [3] 3International Council for Open and Distance Education , Oslo, Norway
                [4] 4Centre for Interdisciplinary Studies, Faculty of Arts and Humanities, University of Coimbra , Coimbra, Portugal
                [5] 5Faculty of Psychology and Education, University of Coimbra , Coimbra, Portugal
                [6] 6Multi-Professional Institute for Human Development with Technologies, State University of Rio de Janeiro , Rio de Janeiro, Brazil
                [7] 7Graduate Program in Education of the Federal University of Rio Grande do Norte , Natal, Brazil
                Author notes

                Edited by: Lynette Ruth Goldberg, University of Tasmania, Australia

                Reviewed by: Giacomo Rossettini, University of Genoa, Italy; Patricia Takako Endo, Universidade de Pernambuco, Brazil

                *Correspondence: Alexandre R. Caitano alexandre.caitano@ 123456lais.huol.ufrn.br

                This article was submitted to Public Health Education and Promotion, a section of the journal Frontiers in Public Health

                Article
                10.3389/fpubh.2022.944213
                9551019
                36238258
                0ac8d32f-4552-49db-a325-fb44712582a5
                Copyright © 2022 Caitano, Gusmão, Dias-Trindade, Barbalho, Morais, Caldeira-Silva, Romão, Valentim, Dias, Alcoforado, Oliveira, Coutinho, Rêgo and Valentim.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 14 May 2022
                : 08 September 2022
                Page count
                Figures: 10, Tables: 2, Equations: 1, References: 59, Pages: 18, Words: 11059
                Funding
                Funded by: Universidade Federal do Rio Grande do Norte, doi 10.13039/501100008532;
                Categories
                Public Health
                Original Research

                health education,massive education,massive health education,massive online open courses (mooc),syphilis,syphilis and other sti,learning path,syphilis epidemic in brazil

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