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ORIGINAL ARTICLE10-09-2023
Independent and combined effects of lifestyle behaviors on adolescent health-related quality of life
Revista Brasileira de Enfermagem. 2023;76(4):e20220780
Abstract
ORIGINAL ARTICLEIndependent and combined effects of lifestyle behaviors on adolescent health-related quality of life
Revista Brasileira de Enfermagem. 2023;76(4):e20220780
DOI 10.1590/0034-7167-2022-0780
Views0See moreABSTRACT
Objective:
To investigate the independent and combined effects of lifestyle behaviors, including physical activity, sedentary behavior, sleep duration and food intake, in the health-related quality of life (HRQoL) of Brazilian adolescents.
Methods:
Cross-sectional school-based study, with the participation of 306 adolescents aged 14 to 18 years. A questionnaire was applied with structured questions to collect lifestyle behaviors data. Perception of the HRQoL was identified using the Kidscreen-27. The study used covariance analysis and linear regression models for statistical analysis.
Results:
Adolescents who reported ≤ 2 hours/day of screen-based sedentary behavior and sleep duration equivalent to 8-10 hours/night presented significantly higher HRQoL. Adolescents who reported joint adherence ≥ 3 healthy lifestyle behaviors demonstrated approximately two [OR=2.12] to three times [OR=3.04] more chance of presenting higher perceptions of HRQoL.
Conclusion:
Although healthy lifestyle behaviors had a positive independent effect on HRQoL, joint adherence to healthy behaviors enhances the cumulative effect.
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ORIGINAL ARTICLE10-09-2023
Health care for people with tuberculosis/HIV co-infection from the multidisciplinary team’s perspective
- Eduarda Aguiar da Silva
, - Paula Hino ,
- Hugo Fernandes ,
- Maria Rita Bertolozi ,
- Aline Aparecida Monroe , [ … ],
- Lucimara Fabiana Fornari
Abstract
ORIGINAL ARTICLEHealth care for people with tuberculosis/HIV co-infection from the multidisciplinary team’s perspective
Revista Brasileira de Enfermagem. 2023;76(4):e20220733
DOI 10.1590/0034-7167-2022-0733
- Eduarda Aguiar da Silva ,
- Paula Hino ,
- Hugo Fernandes ,
- Maria Rita Bertolozi ,
- Aline Aparecida Monroe ,
- Lucimara Fabiana Fornari
Views0See moreABSTRACT
Objective:
to know the multidisciplinary team’s perspective about the health care of people with tuberculosis and human immunodeficiency virus co-infection in relation to treatment.
Methods:
this is a descriptive-exploratory study, with a qualitative approach, carried out in a health care service in São Paulo, from May to June 2019. Semi-structured interviews were conducted with nine professionals from the multidisciplinary team. Data were processed through discourse analysis with the support of webQDA.
Results:
Two empirical categories emerged: Health care interfaces for people with tuberculosis and human immunodeficiency virus co-infection; Barriers and facilitators for health care for people with co-infection.
Final considerations:
the health-disease process in co-infection is mediated by conditions that positively or negatively interfere with treatment compliance. People’s health care goes beyond exclusively clinical assistance and requires the recognition of needs in a broad perspective.
- Eduarda Aguiar da Silva
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ORIGINAL ARTICLE10-09-2023
Translation and validity of the Multidimensional Individual and Interpersonal Resilience Measure
- Jéssica Diniz Rodrigues Ferreira ,
- Mariana Figueiredo Miranda ,
- Millena Figueiredo Miranda ,
- Marco Aurélio Romano-Silva ,
- Maria Aparecida Camargos Bicalho , [ … ],
- Bernardo de Mattos Viana
Abstract
ORIGINAL ARTICLETranslation and validity of the Multidimensional Individual and Interpersonal Resilience Measure
Revista Brasileira de Enfermagem. 2023;76(4):e20220696
DOI 10.1590/0034-7167-2022-0696
- Jéssica Diniz Rodrigues Ferreira ,
- Mariana Figueiredo Miranda ,
- Millena Figueiredo Miranda ,
- Marco Aurélio Romano-Silva ,
- Maria Aparecida Camargos Bicalho ,
- Bernardo de Mattos Viana
Views0See moreABSTRACT
Objective:
to translate, culturally adapt and validate the Multidimensional Individual and Interpersonal Resilience Measure to Brazilian Portuguese.
Method:
after initial translation, the pre-final version underwent rigorous cultural adaptation procedures. As a result, the final adapted version was submitted to a validity study.
Results:
adaptation procedures provided equivalence between the pre-final and the original versions in semantic, idiomatic, experiential and conceptual terms. A total of 187 older adults were included in the validity study. Exploratory factorial analysis (EFA) generated a model of five factors ((RMSEA = 0.030; TLI = 0.959; X = 151.590 p> 0.05). Final version showed adequate consistency (Cronbach’s α = 0.705) and test-retest reliability (ICC=0.835). No statistically significant correlation was found between resilience and sociodemographic and epidemiological variables assessed in this study.
Conclusion:
EMRII-BR is a valid and reliable instrument for measuring resilience in Brazilian older adults.
- Jéssica Diniz Rodrigues Ferreira
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10-09-2023
Standard Operating Procedure validity on intramuscular vaccine administration in adults: a methodological study
- Elaine Aparecida da Cunha Lima ,
- Renata Oliveira Caetano ,
- Marisa Dibbern Lopes Correia ,
- Luana Vieira Toledo ,
- Thais Bitencourt Faria , [ … ],
- Luciene Muniz Braga Daskaleas
Abstract
Standard Operating Procedure validity on intramuscular vaccine administration in adults: a methodological study
Revista Brasileira de Enfermagem. 2023;76(4):e20220692
DOI 10.1590/0034-7167-2022-0692
- Elaine Aparecida da Cunha Lima ,
- Renata Oliveira Caetano ,
- Marisa Dibbern Lopes Correia ,
- Luana Vieira Toledo ,
- Thais Bitencourt Faria ,
- Daniela de Almeida Pereira ,
- Luciene Muniz Braga Daskaleas
Views0See moreABSTRACT
Objective:
to validate a Standard Operating Procedure on the intramuscular vaccine administration technique in adults using high frequency vibration associated with cryotherapy.
Methods:
a literature review on intramuscular vaccination practice using a vibration device associated with cryotherapy. Then, a form was created to validate the instrument, detailing the items that were assessed by judges following recommendations in the literature. Judges’ answers were assessed using the Content Validity Index, with items whose index was greater than or equal to 0.80 being validated.
Results:
twenty-five nurses participated in validity, identifying judges’ opinion regarding item relevance, clarity and accuracy. Judges validated the instrument, according to the values that remained between 0.88 and 1.0.
Conclusions:
the instrument developed and validated is a tool capable of guaranteeing safety and standardizing immunization practice in vaccine rooms.
- Elaine Aparecida da Cunha Lima
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ORIGINAL ARTICLE10-09-2023
Clinical supervision strategies, learning, and critical thinking of nursing students
- Angélica Oliveira Veríssimo da Silva ,
- António Luís Rodrigues Faria de Carvalho ,
- Rui Marques Vieira ,
- Cristina Maria Correia Barroso Pinto
Abstract
ORIGINAL ARTICLEClinical supervision strategies, learning, and critical thinking of nursing students
Revista Brasileira de Enfermagem. 2023;76(4):e20220691
DOI 10.1590/0034-7167-2022-0691
- Angélica Oliveira Veríssimo da Silva ,
- António Luís Rodrigues Faria de Carvalho ,
- Rui Marques Vieira ,
- Cristina Maria Correia Barroso Pinto
Views0See moreABSTRACT
Objective:
To identify the supervisory strategies that Nursing students consider facilitators of the development of critical thinking skills in clinical teaching.
Methods:
This is a qualitative study, within the interpretative paradigm, using the focus group methodology. Eight undergraduate nursing students participated in the study.
Results:
Participants recognized the indispensability of critical thinking for professional responsibility and quality of care and highlighted the importance of using supervisory strategies adapted to their needs, learning objectives, and the context of clinical practice.
Final considerations:
This study highlights the urgent need to establish, within the Nursing curricula, clinical supervision strategies that promote critical thinking and favor the development of skills for good clinical judgment, problem solving, and safe, effective, and ethical decision-making.
- Angélica Oliveira Veríssimo da Silva
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EXPERIENCE REPORT10-09-2023
Focus group in the development of concepts for a Nursing model: experience report
Revista Brasileira de Enfermagem. 2023;76(4):e20220689
Abstract
EXPERIENCE REPORTFocus group in the development of concepts for a Nursing model: experience report
Revista Brasileira de Enfermagem. 2023;76(4):e20220689
DOI 10.1590/0034-7167-2022-0689
Views0See moreABSTRACT
Objective:
To communicate the experience of developing concepts for the construction of a care model through focus groups.
Methods:
An experience report on the development of concepts through remote focus groups with members of a research group from a public university in southern Brazil.
Results:
Focus groups were developed in which homogeneity and heterogeneity criteria were observed among participants. In addition to the concepts of the nursing metaparadigm, the concepts of care and family-centered care were developed, relevant to the nursing care model in question.
Final considerations:
Despite the challenges of conducting remote focus groups, they were suitable for the collective construction of concepts for a nursing care model, allowing the interaction of participants from different locations.
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10-09-2023
Autocompaixão entre estudantes de enfermagem de uma Universidade Estadual da Indonésia durante a pandemia de COVID-19
Revista Brasileira de Enfermagem. 2023;76(4):e20220585
Abstract
Autocompaixão entre estudantes de enfermagem de uma Universidade Estadual da Indonésia durante a pandemia de COVID-19
Revista Brasileira de Enfermagem. 2023;76(4):e20220585
DOI 10.1590/0034-7167-2022-0585
Views0See moreRESUMEN
Objetivo:
Determinar el nivel de autocompasión e investigar las relaciones entre las variables sociodemográficas y la autocompasión entre estudiantes de pregrado de enfermería en una universidad estatal de Indonesia durante la pandemia de COVID-19
Métodos:
Este estudio utilizó un diseño transversal. Las muestras se seleccionaron mediante una técnica de muestreo aleatorio estratificado proporcional (n=260). Los datos se recopilaron utilizando una versión indonesia de la Escala de Autocompasión, que consta de 6 subescalas: bondad propia, autocrítica, humanidad común, aislamiento, atención plena y sobre identificación. Los datos se analizaron mediante análisis univariado y bivariado.
Resultados:
El 60% de los estudiantes tenían autocompasión moderada. Los estudiantes puntuaron más alto en amabilidad consigo mismos (3,93±1,02) y sobre identificación (3,58±0,94), lo que indica que a menudo intentaban amarse a sí mismos cuando sentían dolor emocional y a menudo se dejaban llevar cuando sucedió algo perturbador. Posteriormente, se encontró una correlación significativa entre la edad y la autocompasión (p<0,05).
Conclusión:
La autocompasión entre los estudiantes de enfermería debe mejorarse por medio de intervenciones como la alfabetización de la compasión, el entrenamiento en atención plena y las técnicas experienciales basadas en la compasión.
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10-09-2023
Tradução e validação do Multidimensional Individual and Interpersonal Resilience Measure
- Jéssica Diniz Rodrigues Ferreira ,
- Mariana Figueiredo Miranda ,
- Millena Figueiredo Miranda ,
- Marco Aurélio Romano-Silva ,
- Maria Aparecida Camargos Bicalho , [ … ],
- Bernardo de Mattos Viana
Abstract
Tradução e validação do Multidimensional Individual and Interpersonal Resilience Measure
Revista Brasileira de Enfermagem. 2023;76(4):e20220696
DOI 10.1590/0034-7167-2022-0696
- Jéssica Diniz Rodrigues Ferreira ,
- Mariana Figueiredo Miranda ,
- Millena Figueiredo Miranda ,
- Marco Aurélio Romano-Silva ,
- Maria Aparecida Camargos Bicalho ,
- Bernardo de Mattos Viana
Views0See moreRESUMEN
Objetivo:
traducir, adaptar culturalmente y validar el Multidimensional Individual and Interpersonal Resilience Measure para el portugués brasileño.
Método:
después de la traducción inicial, la versión pre-final pasó por rigurosos procedimientos de adaptación cultural. Como resultado, la versión final adaptada fue sometida a un estudio de validez.
Resultados:
los procedimientos de adaptación proporcionaron equivalencia entre las versiones pre-final y original en términos semánticos, idiomáticos, experienciales y conceptuales. Un total de 187 ancianos fueron incluidos en el estudio de validez. El análisis factorial exploratorio (AFE) generó un modelo de cinco factores ((RMSEA = 0,030; TLI = 0,959; X = 151,590 p> 0,05). La versión final mostró adecuada consistencia (α de Cronbach = 0,705) y confiabilidad prueba-reprueba (ICC=0,835). No se encontró correlación estadísticamente significativa entre la resiliencia y las variables sociodemográficas y epidemiológicas evaluadas en este estudio.
Conclusión:
EMRII-BR es un instrumento válido y confiable para medir la resiliencia en ancianos brasileños.
- Jéssica Diniz Rodrigues Ferreira
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04-14-2021
Nurse-midwives reconfiguring care in the scope of labor and births in COVID-19 times
- Paolla Amorim Malheiros Dulfe ,
- Valdecyr Herdy Alves ,
- Audrey Vidal Pereira ,
- Bianca Dargam Gomes Vieira ,
- Diego Pereira Rodrigues , [ … ],
- Maria Bertilla Lutterbach Riker Branco
Abstract
Nurse-midwives reconfiguring care in the scope of labor and births in COVID-19 times
Revista Brasileira de Enfermagem. 2021;74:e20200863
DOI 10.1590/0034-7167-2020-0863
- Paolla Amorim Malheiros Dulfe ,
- Valdecyr Herdy Alves ,
- Audrey Vidal Pereira ,
- Bianca Dargam Gomes Vieira ,
- Diego Pereira Rodrigues ,
- Giovanna Rosário Soanno Marchiori ,
- Maria Bertilla Lutterbach Riker Branco
Views0See moreABSTRACT
Objectives:
to analyze how the nurse-midwives of maternity wards that were fields of practice for an improvement course in obstetrics have reorganized care in the context of labor and birth amidst the COVID-19 pandemic.
Methods:
this is a descriptive, exploratory and qualitative study carried out with nine nurse-midwives who are preceptors and collaborators in maternity wards that were fields of practice for an improvement course, between February and April 2020, through a semi-structured interview through WhatsApp®. Content analysis was used to treat the information.
Results:
the pandemic brought the need to reorganize work, with a focus on service training and maintenance of good practices in labor and birth, whose movement was intensely experienced, interfering in nurse-midwives’ mental health.
Conclusion:
nurse-midwives have faced the pandemic with concerns about maintaining safe care, focused on practices based on updated scientific evidence.
- Paolla Amorim Malheiros Dulfe
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07-28-2021
The era of precision medicine and its impact on nursing: paradigm shifts?
Revista Brasileira de Enfermagem. 2021;74(5):e740501
Abstract
The era of precision medicine and its impact on nursing: paradigm shifts?
Revista Brasileira de Enfermagem. 2021;74(5):e740501
DOI 10.1590/0034-7167.2021740501
Views0INTRODUCTIONThe large investment and development of research in genomics and molecular biology in the last two decades, especially after the conclusion of the Human Genome Project (HGP), has generated many expectations regarding its impact on the transformation from the conventional medicine paradigm to the precision medicine paradigm(–). The term precision medicine (PM) was used for […]See more -
ORIGINAL ARTICLE07-06-2020
Knowledge and health promotion practice of Family Health Strategy nurses
- Nathália Cristina do Carmo da Silva ,
- Karen Sayuri Mekaro ,
- Rebeca Isis de Oliveira Santos ,
- Sílvia Carla da Silva André Uehara
Abstract
ORIGINAL ARTICLEKnowledge and health promotion practice of Family Health Strategy nurses
Revista Brasileira de Enfermagem. 2020;73(5):e20190362
DOI 10.1590/0034-7167-2019-0362
- Nathália Cristina do Carmo da Silva ,
- Karen Sayuri Mekaro ,
- Rebeca Isis de Oliveira Santos ,
- Sílvia Carla da Silva André Uehara
Views0See moreABSTRACT
Objectives:
to analyze the knowledge and health promotion practice carried out by Family Health Strategy nurses.
Methods:
a descriptive study and qualitative approach. The study was conducted with 18 Family Health Strategy nurses from the city of São Carlos. Data were collected through semi-structured interviews and analyzed through thematic analysis. The study was approved by the Research Ethics Committee.
Results:
the data revealed that nurses had difficulties to conceptualize health promotion, and it is common to describe the definition of disease prevention. Nurses also reported developing group activities for health promotion; however, individual actions and consultations were still predominant.
Final Considerations:
it is necessary to develop sustainable strategies for collective health-promoting activities, in addition to strengthening multidisciplinary work and Continuing Education actions.
- Nathália Cristina do Carmo da Silva
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05-21-2021
Quality of life and falls in elderly people: a mixed methods study
- Thainara Lopes da Silva ,
- Vanessa Vieira da Motta ,
- Willian José Garcia ,
- Cristina Arreguy-Sena ,
- Paulo Ferreira Pinto , [ … ],
- Elenir Pereira de Paiva
Abstract
Quality of life and falls in elderly people: a mixed methods study
Revista Brasileira de Enfermagem. 2021;74:e20200400
DOI 10.1590/0034-7167-2020-0400
- Thainara Lopes da Silva ,
- Vanessa Vieira da Motta ,
- Willian José Garcia ,
- Cristina Arreguy-Sena ,
- Paulo Ferreira Pinto ,
- Pedro Miguel Santos Dinis Parreira ,
- Elenir Pereira de Paiva
Views0See moreABSTRACT
Objective:
to assess elderly people’s quality of life, understanding the social representations of falls.
Methods:
a convergent mixed methods research carried out at homes, with a sample of 134 elderly people. A structured questionnaire was used, covering sociodemographic variables and factors that indicated frailty and risk of falling. For quality of life assessment, Medical Outcomes Study Short-Form 36 and Theory of Social Representations, Abric’s structural approach were used, with data treated by dictionary of equivalent terms, processed in Evoc 2000, converging analytically according to Neuman.
Results:
quality of life impairment was identified in terms of physical, emotional and functional capacity. The elements of the possible central nucleus were fall, fear, and bruised-broken-bone.
Final considerations:
quality of life impairment can contribute to increase the number of falls, which has been shown to be an event present in elderly people’s lives through evocations. Understanding elderly people’s individual demands allows planning actions.
- Thainara Lopes da Silva
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REFLECTION07-10-2020
In defense of the Unified Health System in the context of SARS-CoV-2 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200247
Abstract
REFLECTIONIn defense of the Unified Health System in the context of SARS-CoV-2 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200247
DOI 10.1590/0034-7167-2020-0247
Views0See moreABSTRACT
Objective:
To discuss the political and structural conditions for establishing the Unified Health System (UHS – Sistema Único de Saúde, SUS) in coping with the SARS-CoV-2 pandemic.
Methods:
Theoretical-reflection study.
Results:
At the first moment named “The global and the local in facing the SARS-CoV-2 pandemic” is presented the health crisis that took place worldwide and the government actions to combat COVID-19. A second moment named “Between dismantling actions and resistance, the UHS is the best way to face the SARS-CoV-2 pandemic”, reflects on the neoliberal attacks on the health system and how it resists, remaining the main pandemic response strategy.
Conclusion:
The strengthening of democracy and the defense of the UHS are the way out of the crisis. It is believed that this reflection generates – in everyone who deals with caretaking – the political action, the ethical attitude, the desire for valorization and the spirit of struggle in defense of the UHS and human life.
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08-20-2021
Historicity of nursing graduate studies in Brazil: an analysis of the Sociology of the Professions
- Fernanda Alves dos Santos Carregal ,
- Biannka Melo dos Santos ,
- Helena Pereira de Souza ,
- Fernanda Batista Oliveira Santos ,
- Maria Angélica de Almeida Peres , [ … ],
- Maria Itayra Coelho de Souza Padilha
Abstract
Historicity of nursing graduate studies in Brazil: an analysis of the Sociology of the Professions
Revista Brasileira de Enfermagem. 2021;74(6):e20190827
DOI 10.1590/0034-7167-2019-0827
- Fernanda Alves dos Santos Carregal ,
- Biannka Melo dos Santos ,
- Helena Pereira de Souza ,
- Fernanda Batista Oliveira Santos ,
- Maria Angélica de Almeida Peres ,
- Maria Itayra Coelho de Souza Padilha
Views0See moreABSTRACT
Objectives:
to analyze the scientific productions about the history of graduate studies in Brazilian nursing in the light of Eliot Freidson’s Sociology of the Professions.
Methods:
an integrative review, carried out in the databases indexed in Virtual Health Library. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations were followed. Thematic content analysis and Eliot Freidson’s concepts were adopted.
Results:
two categories emerged: “Institutionalization of graduate courses in Brazilian nursing”, highlighting the historical process of professionalization in nursing through transition from empirical to professional care, subsidized by the monopoly of the construction of one’s own knowledge; “The scientific production of graduate nursing in Brazil”, showing the strengthening of a new generation of nurse researchers, given the greater scientificity in teaching due to implementation of graduate studies.
Final Considerations:
the analyzes present the historicity of graduate studies’ institutionalization, supporting the understanding of professionalization outlines of Brazilian nursing.
- Fernanda Alves dos Santos Carregal
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ORIGINAL ARTICLE06-01-2020
Binge drinking and overweight in brazilian adults – CUME Project
- Luís Paulo Souza e Souza ,
- Aline Elizabeth da Silva Miranda ,
- Helen Hermana Miranda Hermsdorff ,
- Carla Silvana de Oliveira e Silva ,
- Dulce Aparecida Barbosa , [ … ],
- Adriano Marçal Pimenta
Abstract
ORIGINAL ARTICLEBinge drinking and overweight in brazilian adults – CUME Project
Revista Brasileira de Enfermagem. 2020;73:e20190316
DOI 10.1590/0034-7167-2019-0316
- Luís Paulo Souza e Souza ,
- Aline Elizabeth da Silva Miranda ,
- Helen Hermana Miranda Hermsdorff ,
- Carla Silvana de Oliveira e Silva ,
- Dulce Aparecida Barbosa ,
- Josefina Bressan ,
- Adriano Marçal Pimenta
Views0See moreABSTRACT
Objective:
To verify the association between heavy episodic alcohol consumption [binge drinking (BD)] and overweight in 2,909 adults from the Cohort of Universities of Minas Gerais (CUME Project) baseline, Brazil.
Method:
Cross-sectional study in which sociodemographic, anthropometric (BMI ≥ 25 kg/m2 = overweight) and dietary intake data were collected. This study evaluated the occurrence and monthly frequency of BD (≥ 4 drinks at one time for women; ≥ 5 drinks at one time for men, in the last 30 days).
Results:
The prevalence of BD and overweight were 41.3% and 40.8%, respectively. BD increased the prevalence of overweight by 19%, and, BD exposure by ≥ 5 days / month increased it by 31%.
Conclusion:
BD on a single or multiple occasion during the month was associated with a higher prevalence of overweight. Therefore, such a lifestyle should be considered in weight gain prevention strategies.
- Luís Paulo Souza e Souza
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REVIEW09-18-2020
Allocation of resources for health care in COVID-19 pandemic times: integrative review
- Karla Rona da Silva ,
- Fernanda Gonçalves de Souza ,
- Fátima Ferreira Roquete ,
- Shirlei Moreira da Costa Faria ,
- Bruno César Ferreira Peixoto , [ … ],
- Adriane Vieira
Abstract
REVIEWAllocation of resources for health care in COVID-19 pandemic times: integrative review
Revista Brasileira de Enfermagem. 2020;73:e20200244
DOI 10.1590/0034-7167-2020-0244
- Karla Rona da Silva ,
- Fernanda Gonçalves de Souza ,
- Fátima Ferreira Roquete ,
- Shirlei Moreira da Costa Faria ,
- Bruno César Ferreira Peixoto ,
- Adriane Vieira
Views0See moreABSTRACT
Objective:
To analyze information on resource allocation in the context of the COVID-19 pandemic, published in indexed scientific journals, from December 2019 to March 2020.
Methods:
This is an integrative literature review, which took place in March 2020. All databases were investigated and studies were found only in MEDLINE. After applying the established criteria, six articles were selected.
Results:
It was evident that the allocation of resources is carried out as the demands emerge. The fragility in presenting scientific-methodological evidence that can guide decision makers for assertive allocation of available resources is highlighted. The results showed that studies on this subject are incipient and need to be expanded.
Final considerations:
The need for health organizations and area authorities to be better prepared for the proper use of available resources, with allocation based on scientific evidence and maximization of resources is indicated.
- Karla Rona da Silva
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