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ORIGINAL ARTICLE
Cultural adaptation and validity evidence of the Student Nurse Stressor-15 (SNS-15) Scale for Brazil
- Agostinho Antônio Cruz Araújo
, - Simone de Godoy ,
- Natália Maria Freitas e Silva Maia ,
- Maria Eduarda Bonissoni Trevelin ,
- Kelly Graziani Giacchero Vedana , [ … ],
- Isabel Amélia Costa Mendes
03-15-2024
Abstract
ORIGINAL ARTICLECultural adaptation and validity evidence of the Student Nurse Stressor-15 (SNS-15) Scale for Brazil
Revista Brasileira de Enfermagem. 2024;77(1):e20230356
03-15-2024DOI 10.1590/0034-7167-2023-0356
- Agostinho Antônio Cruz Araújo ,
- Simone de Godoy ,
- Natália Maria Freitas e Silva Maia ,
- Maria Eduarda Bonissoni Trevelin ,
- Kelly Graziani Giacchero Vedana ,
- Carmem Beatriz Neufeld ,
- Neyson Pinheiro Freire ,
- Carla Aparecida Arena Ventura ,
- Patricia McAleer ,
- Isabel Amélia Costa Mendes
Views0See moreABSTRACT
Objectives:
to carry out the cultural adaptation and evaluation of validity evidence of the Student Nurse Stressor-15 (SNS-15) Scale for use in Brazil.
Methods:
psychometric study, conducted from the stages of translation, synthesis, back-translation, review by a committee of seven experts, pre-test and evaluation of measurement properties with 32 and 238 nursing students, respectively. Descriptive statistics, Exploratory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA) were performed. The reliability of the instrument was estimated using McDonald’s Omega (ω).
Results:
EFA subsidized the distribution of the fifteen SNS-15 items into four factors. Using AFC, satisfactory fit indices were achieved (Comparative Fit Index = 0.94; Tucker-Lewis Index = 0.93; Root Mean Square Error of Approximation = 0.06; Standardized Root Mean Square Residual = 0.16) and ω = 0.86.
Conclusions:
the Brazilian version of the SNS-15 presents evidence that confirms its validity and reliability.
- Agostinho Antônio Cruz Araújo
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ORIGINAL ARTICLE
Health Management of an HIV Testing and Counseling Center: Nursing Contributions
- Patrícia dos Santos Augusto ,
- Camila Pureza Guimarães da Silva ,
- Tânia Cristina Franco Santos ,
- Lilian Dias Ennes ,
- Carolina Fraga Paiva , [ … ],
- Antonio José de Almeida Filho
03-15-2024
Abstract
ORIGINAL ARTICLEHealth Management of an HIV Testing and Counseling Center: Nursing Contributions
Revista Brasileira de Enfermagem. 2024;77(1):e20230217
03-15-2024DOI 10.1590/0034-7167-2023-0217
- Patrícia dos Santos Augusto ,
- Camila Pureza Guimarães da Silva ,
- Tânia Cristina Franco Santos ,
- Lilian Dias Ennes ,
- Carolina Fraga Paiva ,
- Antonio José de Almeida Filho
Views0See moreABSTRACT
Objectives:
to analyze the role of nursing in the establishment of an HIV/AIDS Testing and Counseling Center in a Brazilian municipality.
Methods:
a historical study utilizing primary sources, including documents and oral accounts, involving a total of ten participants. The study encompasses the years 1997 and 1998. The research took place at the Testing and Counseling Center in São João de Meriti. Data was collected from March to May 2022.
Results:
nursing made significant contributions through the development of training initiatives led by nurses, who were also responsible for individual and group counseling, as well as HIV testing requests.
Final Considerations:
nursing played a crucial role in the center and in the management of Sexually Transmitted Infections, being involved in all stages of treatment in accordance with current public health policy.
- Patrícia dos Santos Augusto
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ORIGINAL ARTICLE
Effects of training Community Health Agents on dementia: a quasi-experimental study
- Aline Cristina Ramos Coelho ,
- Edmir Batista da Silva Cruz ,
- Helena Zacharias Radicchi ,
- Emanuela Bezerra Torres Mattos ,
- Marcia Maria Pires Camargo Novelli , [ … ],
- Corina Lopes Ribeiro
03-15-2024
Abstract
ORIGINAL ARTICLEEffects of training Community Health Agents on dementia: a quasi-experimental study
Revista Brasileira de Enfermagem. 2024;77(1):e20230027
03-15-2024DOI 10.1590/0034-7167-2023-0027
- Aline Cristina Ramos Coelho ,
- Edmir Batista da Silva Cruz ,
- Helena Zacharias Radicchi ,
- Emanuela Bezerra Torres Mattos ,
- Marcia Maria Pires Camargo Novelli ,
- Felipe Granado de Souza ,
- Rubens Goulart ,
- Corina Lopes Ribeiro
Views0See moreABSTRACT
Objectives:
to evaluate the knowledge of Community Health Agents about dementia before and after the training workshop for detecting signs of the disease.
Methods:
a quasi-experimental study with 33 community agents, in which sociodemographic information and knowledge about dementia were collected and assessed using the Alzheimer’s Disease Knowledge Scale before and after the workshop. There were 10 weekly, online, synchronous meetings. The Student’s t-test for related samples was used, and the effect size was calculated.
Results:
while the average score on the initial assessment, using the measurement instrument, was 16.3, it was 21.24 in the final assessment. An increase in the scale score was observed after participating in the workshop, with a value of 4.94.
Conclusions:
it is urgent to invest in the ongoing education of these professionals for greater awareness in the timely detection of dementia cases in primary care and awareness of potentially modifiable factors.
- Aline Cristina Ramos Coelho
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REVIEW
Factors associated with increased lactate levels in cardiac surgeries: scoping review
- Fernanda de Castro Teixeira ,
- Thatiane Evelyn de Lima Fernandes ,
- Karena Cristina da Silva Leal ,
- Katia Regina Barros Ribeiro ,
- Daniele Vieira Dantas , [ … ],
- Rodrigo Assis Neves Dantas
03-15-2024
Abstract
REVIEWFactors associated with increased lactate levels in cardiac surgeries: scoping review
Revista Brasileira de Enfermagem. 2024;77(1):e20230117
03-15-2024DOI 10.1590/0034-7167-2023-0117
- Fernanda de Castro Teixeira ,
- Thatiane Evelyn de Lima Fernandes ,
- Karena Cristina da Silva Leal ,
- Katia Regina Barros Ribeiro ,
- Daniele Vieira Dantas ,
- Rodrigo Assis Neves Dantas
Views0See moreABSTRACT
Objectives:
to map the factors associated with increased lactate levels in the postoperative period of cardiac surgery using extracorporeal circulation.
Methods:
this is a scoping review carried out in December 2022, across ten data sources. It was prepared in accordance with the recommendations of the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta Analyses Extension for Scoping Reviews checklist.
Results:
the most recurrent findings in studies regarding the factors responsible for the increase in lactate were: tissue hypoperfusion, cardiopulmonary bypass time and use of vasoactive drugs. In 95% of studies, increased lactate was related to increased patient mortality.
Conclusions:
discussing the causes of possible complications in cardiac surgery patients is important for preparing the team and preventing complications, in addition to ensuring quality recovery.
- Fernanda de Castro Teixeira
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ORIGINAL ARTICLE
Is there scientific relevance to the plot of films and documentaries about eating disorders?
- Alessandra Honorio Boroski ,
- Rosane Pilot Pessa ,
- Janaína Cristina Pasquini de Almeida ,
- Jacqueline de Souza
03-15-2024
Abstract
ORIGINAL ARTICLEIs there scientific relevance to the plot of films and documentaries about eating disorders?
Revista Brasileira de Enfermagem. 2024;77(1):e20220547
03-15-2024DOI 10.1590/0034-7167-2022-0547
- Alessandra Honorio Boroski ,
- Rosane Pilot Pessa ,
- Janaína Cristina Pasquini de Almeida ,
- Jacqueline de Souza
Views0See moreABSTRACT
Objectives:
to analyze films and documentaries about eating disorders from the last twenty years, identifying the way they approach the topic as well as their relevance for didactic use in teaching the health field.
Methods:
a descriptive study, whose data collection was carried out on the main streaming and video platforms, resulting in the survey of 60 media. Of these, only 25 had audio/subtitles in Portuguese (inclusion criteria). scientific relevance was analyzed considering psychopathological and epidemiological aspects of these disorders. A questionnaire about the plot, characters and descriptive data analysis were used.
Results:
most media were dramas about female teenagers who tried to conform to beauty stereotypes, whose symptoms portrayed converged with current medical diagnostic manuals.
Conclusions:
in practical terms, a classificatory list of 11 media was prepared that could be used as a teaching resource for teaching this topic in the health field.
- Alessandra Honorio Boroski
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REVIEW
Nursing care for parents who have experienced fetal demise: integrative review
- Nycarla de Araújo Bezerra ,
- Cibelle Nayara Sena dos Santos ,
- Adrian Thaís Cardoso Santos Gomes da Silva ,
- Francisca Márcia Pereira Linhares ,
- Sheila Coelho Ramalho Vasconcelos Morais
03-15-2024
Abstract
REVIEWNursing care for parents who have experienced fetal demise: integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20220811
03-15-2024DOI 10.1590/0034-7167-2022-0811
- Nycarla de Araújo Bezerra ,
- Cibelle Nayara Sena dos Santos ,
- Adrian Thaís Cardoso Santos Gomes da Silva ,
- Francisca Márcia Pereira Linhares ,
- Sheila Coelho Ramalho Vasconcelos Morais
Views0See moreABSTRACT
Objectives:
to identify scientific evidence regarding nursing care for parents who have experienced grief following fetal demise.
Methods:
an integrative review of original studies was conducted across six databases. The studies were classified according to the level of evidence.
Results:
the qualitative analysis of the nine studies comprising the sample involved thematic categories, exploring the impact of perinatal loss on families, inadequate communication by healthcare professionals, and the importance of a holistic approach in care. The role of the nurse is highlighted in making a positive contribution to the team, emphasizing participation in training and the provision of essential information.
Final Considerations:
grieving affects not only family dynamics but also the social environment, emphasizing the urgency of a more empathetic and comprehensive approach. Care should be holistic, going beyond technical nursing assistance, and addressing the biopsychosocial context of the parents.
- Nycarla de Araújo Bezerra
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EDITORIAL
O uso da ultrassonografia point-of-care na prática clínica do enfermeiro como alicerce para a segurança do paciente
- Vinicius Batista Santos ,
- Wesley Pinto da Silva ,
- Mónica Francisca Santana Apablaza ,
- Thiago Vital da Silva ,
- Fernanda Raphael Escobar Gimenes
03-11-2024
Abstract
EDITORIALO uso da ultrassonografia point-of-care na prática clínica do enfermeiro como alicerce para a segurança do paciente
Revista Brasileira de Enfermagem. 2024;77:e77suppl0201
03-11-2024DOI 10.1590/0034-7167.202477suppl0201pt
- Vinicius Batista Santos ,
- Wesley Pinto da Silva ,
- Mónica Francisca Santana Apablaza ,
- Thiago Vital da Silva ,
- Fernanda Raphael Escobar Gimenes
Views0Recentemente, mais um caso de dano grave associado ao cuidado em saúde foi reportado pela mídia. Uma jovem grávida teve a mão e o punho amputados depois de dar à luz ao terceiro filho em um hospital do Rio de Janeiro(). Após o incidente ocasionado pelo acesso vascular, a mulher apresentou hemorragia e foi reinternada.Os […]See more - Vinicius Batista Santos
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EDITORIAL
The use of point-of-care ultrasound in nurses’ clinical practice as a foundation for patient safety
- Vinicius Batista Santos ,
- Wesley Pinto da Silva ,
- Mónica Francisca Santana Apablaza ,
- Thiago Vital da Silva ,
- Fernanda Raphael Escobar Gimenes
03-11-2024
Abstract
EDITORIALThe use of point-of-care ultrasound in nurses’ clinical practice as a foundation for patient safety
Revista Brasileira de Enfermagem. 2024;77:e77suppl0201
03-11-2024DOI 10.1590/0034-7167.202477suppl0201
- Vinicius Batista Santos ,
- Wesley Pinto da Silva ,
- Mónica Francisca Santana Apablaza ,
- Thiago Vital da Silva ,
- Fernanda Raphael Escobar Gimenes
Views0Recently, another case of serious harm associated with healthcare was reported by the media. A young pregnant woman had her hand and wrist amputated after giving birth to her third child in a hospital in Rio de Janeiro(). After the incident caused by vascular access, the woman suffered hemorrhage and was readmitted.The harm caused to […]See more - Vinicius Batista Santos
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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
04-14-2021
Abstract
Nurse-midwives reconfiguring care in the scope of labor and births in COVID-19 times
Revista Brasileira de Enfermagem. 2021;74:e20200863
04-14-2021DOI 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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EDITORIAL
The era of precision medicine and its impact on nursing: paradigm shifts?
Revista Brasileira de Enfermagem. 2021;74(5):e740501
07-28-2021
Abstract
EDITORIALThe era of precision medicine and its impact on nursing: paradigm shifts?
Revista Brasileira de Enfermagem. 2021;74(5):e740501
07-28-2021DOI 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 ARTICLE
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
07-06-2020
Abstract
ORIGINAL ARTICLEKnowledge and health promotion practice of Family Health Strategy nurses
Revista Brasileira de Enfermagem. 2020;73(5):e20190362
07-06-2020DOI 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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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
05-21-2021
Abstract
Quality of life and falls in elderly people: a mixed methods study
Revista Brasileira de Enfermagem. 2021;74:e20200400
05-21-2021DOI 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
Views0ABSTRACT
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.
Keywords:Accident PreventionAccidental FallsCommunity Health NursingHealth Services for the AgedQuality of LifeSee more
- Thainara Lopes da Silva
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REFLECTION
In defense of the Unified Health System in the context of SARS-CoV-2 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200247
07-10-2020
Abstract
REFLECTIONIn defense of the Unified Health System in the context of SARS-CoV-2 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200247
07-10-2020DOI 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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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
08-20-2021
Abstract
Historicity of nursing graduate studies in Brazil: an analysis of the Sociology of the Professions
Revista Brasileira de Enfermagem. 2021;74(6):e20190827
08-20-2021DOI 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 ARTICLE
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
06-01-2020
Abstract
ORIGINAL ARTICLEBinge drinking and overweight in brazilian adults – CUME Project
Revista Brasileira de Enfermagem. 2020;73:e20190316
06-01-2020DOI 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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REVIEW
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
09-18-2020
Abstract
REVIEWAllocation of resources for health care in COVID-19 pandemic times: integrative review
Revista Brasileira de Enfermagem. 2020;73:e20200244
09-18-2020DOI 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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