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ORIGINAL ARTICLE11-11-2022
Analysis of midwives’ situation and the need to measure their workloads
- Lorena Gómez García
, - Ana Myriam Seva Llor ,
- María Fuensanta Hellín Gil ,
- María Dolores Roldán Valcárcel ,
- Pablo Paredes Cerezo , [ … ],
- Francisco Javier Navarro Guerrero
Abstract
ORIGINAL ARTICLEAnalysis of midwives’ situation and the need to measure their workloads
Revista Brasileira de Enfermagem. 2022;75:e20210920
DOI 10.1590/0034-7167-2021-0920
- Lorena Gómez García ,
- Ana Myriam Seva Llor ,
- María Fuensanta Hellín Gil ,
- María Dolores Roldán Valcárcel ,
- Pablo Paredes Cerezo ,
- Esperanza de la Iglesia Cano ,
- Guadalupe Ruiz Merino ,
- Francisco Javier Navarro Guerrero
Views0See moreABSTRACT
Objective:
to analyze midwives’ employment situation of midwives and detect their workload measurement needs.
Methods:
a mixed methodology (quantitative and qualitative), observational, descriptive and cross-sectional study. Two phases were carried out. The first methodological phase consisted of conducting semi-structured individual interviews. The second methodological phase analyzed the Nursing Intervention Classification (NIC) interventions that midwives perform in the labor room during daily practice.
Results:
90.3% of midwives have work overload, since for 80.6% the midwife-pregnant mother ratio is not well established, since the mean execution time of a Nursing Intervention Classification (NIC) intervention is 20 minutes. For this reason, 100% of the sample considers the development of workload measurement tools to be highly useful.
Conclusions:
the need to generate an instrument that considers the diversity of Nursing Intervention Classification (NIC) interventions that develop within the labor room is ratified.
- Lorena Gómez García
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ORIGINAL ARTICLE11-10-2022
Nursing care for the Amazon population: knowledge production and human resource development
- Zilmar Augusto de Souza Filho ,
- Antonia Margareth Moita Sá ,
- Linda Karolinne Rodrigues Almeida Cunha ,
- Tainan Fabrício da Silva ,
- Rafaela Barros dos Santos , [ … ],
- Marta Lenise do Prado
Abstract
ORIGINAL ARTICLENursing care for the Amazon population: knowledge production and human resource development
Revista Brasileira de Enfermagem. 2022;75:e20201084
DOI 10.1590/0034-7167-2020-1084
- Zilmar Augusto de Souza Filho ,
- Antonia Margareth Moita Sá ,
- Linda Karolinne Rodrigues Almeida Cunha ,
- Tainan Fabrício da Silva ,
- Rafaela Barros dos Santos ,
- Flávia Regina Souza Ramos ,
- Marta Lenise do Prado
Views0See moreABSTRACT
Objectives:
to analyze knowledge production adherence from a master’s course in nursing in the Amazon to care and health demands in the region, with an emphasis on neglected tropical diseases and traditional populations in the Amazon.
Methods:
a descriptive study, with a quantitative approach and documentary basis, analyzing dissertations defended in a Graduate Program in Nursing at the Universidade do Estado do Pará in association with the Universidade Federal do Amazonas, from 2012-2019. A descriptive statistical analysis was performed.
Results:
of the 105 dissertations analyzed, 30 (28.6%) were related to neglected tropical diseases. Of these, 11 (10.5%) dealt with Chagas disease, leishmaniasis, tuberculosis, malaria, and leprosy. Traditional populations in the Amazon participated in only 11 (10.5%) studies.
Conclusions:
knowledge production in a master’s course has adherence to care and health demands in the region; however, it needs to enhance its production to strengthen its identity.
- Zilmar Augusto de Souza Filho
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ORIGINAL ARTICLE11-10-2022
Content validation to support the monitoring of disclosure of HIV diagnosis in childhood
- Bruna Pase Zanon ,
- Cristiane Cardoso de Paula ,
- Aline Cammarano Ribeiro ,
- Stela Maris de Mello Padoin
Abstract
ORIGINAL ARTICLEContent validation to support the monitoring of disclosure of HIV diagnosis in childhood
Revista Brasileira de Enfermagem. 2022;75:e20210027
DOI 10.1590/0034-7167-2021-0027
- Bruna Pase Zanon ,
- Cristiane Cardoso de Paula ,
- Aline Cammarano Ribeiro ,
- Stela Maris de Mello Padoin
Views0See moreABSTRACT
Objectives:
to create and validate the content of a guide for monitoring the communication of the HIV diagnosis in childhood.
Methods:
methodological study, with a design guided by the Knowledge-to-Action (KTA) Framework, supported by a participatory approach. The guide’s content was structured according to the communication elements proposed by Lasswel from review studies.
Results:
the content was validated by 26 experts from nursing, medicine, psychology and pedagogy, using a Likert-type scale for relevance, clarity and precision. Data collection took place online and achieved a Content Validity Index of 0.94.
Conclusions:
the guide can contribute to the practice of professionals who care for children living with HIV, to support the family in communication and to the child’s right to know their diagnosis. For further research, it is recommended to create and validate the face of the technology in order to implement it.
- Bruna Pase Zanon
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ORIGINAL ARTICLE11-10-2022
Healthcare: action research with trans people living on the streets
Revista Brasileira de Enfermagem. 2022;75:e20210016
Abstract
ORIGINAL ARTICLEHealthcare: action research with trans people living on the streets
Revista Brasileira de Enfermagem. 2022;75:e20210016
DOI 10.1590/0034-7167-2021-0016
Views0See moreABSTRACT
Objectives:
to analyze the representations of healthcare provided to trans people living on the streets.
Methods:
ten women (three trans) and three cisgender men participated in this action research. Popular health education groups, focus groups, seminars and interviews were held, the data of which were organized in the software Nvivo®, submitted to content analysis and interpreted in the light of intersectionality theory.
Results:
healthcare was represented by the technical, relational, structural and citizenship dimensions. The relationship between gender and poverty determines the specific health needs of trans people living on the streets.
Final Considerations:
the need to expand conceptions and practices on healthcare to meet the specific health needs of trans people living on the streets was evidenced. Nursing, with competence and cultural sensitivity, can contribute to positive health outcomes and, consequently, break with the logic of exclusion, illness and poverty.
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ORIGINAL ARTICLE11-10-2022
Effect of educational video on newborn care for the knowledge of pregnant and postpartum women and their families
- Leilane Barbosa de Sousa ,
- Hévila Ferreira Gomes Medeiros Braga ,
- Aynoan de Sousa Amaro Alencastro ,
- Maria Jocelane Nascimento da Silva ,
- Brena Shellem Bessa de Oliveira , [ … ],
- Emanuella Silva Joventino Melo
Abstract
ORIGINAL ARTICLEEffect of educational video on newborn care for the knowledge of pregnant and postpartum women and their families
Revista Brasileira de Enfermagem. 2022;75:e20201371
DOI 10.1590/0034-7167-2020-1371
- Leilane Barbosa de Sousa ,
- Hévila Ferreira Gomes Medeiros Braga ,
- Aynoan de Sousa Amaro Alencastro ,
- Maria Jocelane Nascimento da Silva ,
- Brena Shellem Bessa de Oliveira ,
- Lydia Vieira Freitas dos Santos ,
- Emanuella Silva Joventino Melo
Views0See moreABSTRACT
Objectives:
to evaluate the effect of educational video on newborn care to increase the knowledge of pregnant, postpartum, and family members.
Methods:
a quasi-experimental study, with pre-intervention and post-intervention evaluation with a single group. Fifty-eight pregnant, postpartum, and family members treated in basic health units and a hospital in Ceará, Brazil, participated. The study used the McNemar and binomial tests for the analysis.
Results:
after the intervention, there was an increase in the frequency of hits, from 70.82% to 92.97%. Most of the questions presented a significant increase of hits (p < 0.05) with an emphasis on sleeping position, drying of clothes, free demand for breastfeeding, and things to avoid (such as accessories in the sleeping place and talc in diaper change).
Conclusions:
the educational video was effective to participants in acquiring knowledge on the care of newborns and can assist in health education activities carried out by nurses.
- Leilane Barbosa de Sousa
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ORIGINAL ARTICLE11-10-2022
Home care for children with gastrostomy
- Ana Paula Lopes Pinheiro Ribeiro ,
- Juliana Rezende Montenegro Medeiros de Moraes ,
- Ana Beatriz Azevedo Queiroz ,
- Fernanda Garcia Bezerra Góes ,
- Liliane Faria da Silva , [ … ],
- Tania Vignuda de Souza
Abstract
ORIGINAL ARTICLEHome care for children with gastrostomy
Revista Brasileira de Enfermagem. 2022;75:e20200699
DOI 10.1590/0034-7167-2020-0699
- Ana Paula Lopes Pinheiro Ribeiro ,
- Juliana Rezende Montenegro Medeiros de Moraes ,
- Ana Beatriz Azevedo Queiroz ,
- Fernanda Garcia Bezerra Góes ,
- Liliane Faria da Silva ,
- Tania Vignuda de Souza
Views0See moreABSTRACT
Objectives:
to describe home care practices performed by family members for maintaining the life of children with gastrostomy.
Methods:
qualitative research using the Sensitive Creative method, with the Criatividade e Sensibilidade Corpo Saber [Corpo Saber Creativity and Sensitivity] dynamics. The participation included ten family caregivers of children with gastrostomy. The outpatient clinic of a federal hospital in Rio de Janeiro was the setting. Lexical analysis was used through the IRaMuTeQ® software.
Results:
Theme 1, entitled “The care for maintaining life performed by family members of children with gastrostomy at home”, was analyzed, comprising three classes: “The gastrostomy tube home care routine”; “The care with the gastrostomy/stoma”; and “Food and medication home care routine of children with gastrostomy”.
Final Considerations:
family caregivers used strategies to maintain the device and acquired new knowledge in this field, and in nursing competence, regarding stoma care, food administration, medication, and syringes.
- Ana Paula Lopes Pinheiro Ribeiro
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ORIGINAL ARTICLE11-10-2022
Religious/spiritual coping in informal caregivers of children with cleft lip and/or dysphagic palate
- Francely Tineli Farinha ,
- Gesiane Cristina Bom ,
- Maila Meryellen Ferreira Garcia Manso ,
- Priscila Capelato Prado ,
- Claudia Regina Matiole , [ … ],
- Armando dos Santos Trettene
Abstract
ORIGINAL ARTICLEReligious/spiritual coping in informal caregivers of children with cleft lip and/or dysphagic palate
Revista Brasileira de Enfermagem. 2022;75:e20201300
DOI 10.1590/0034-7167-2020-1300
- Francely Tineli Farinha ,
- Gesiane Cristina Bom ,
- Maila Meryellen Ferreira Garcia Manso ,
- Priscila Capelato Prado ,
- Claudia Regina Matiole ,
- Armando dos Santos Trettene
Views0See moreABSTRACT
Objectives:
to identify the use of religious/spiritual coping in informal caregivers of children with cleft lip and/or palate, dysphagic, powered exclusively by probe.
Methods:
descriptive and cross-sectional study, including 30 informal caregivers. For data collection, a Sociodemographic Questionnaire and the Brief Religious/Spiritual Coping Scale were used. For statistical analysis, ANOVA, Student’s t and Spearman’s correlation tests were used, with a significance level of 5%.
Results:
the use of religious/spiritual coping was high among participants (mean=3.71), with a predominance of positive (mean=3.30) compared to negative (mean=1.88). It was evident that the greater the reported importance of religiosity/spirituality in the participants’ lives, the greater the positive coping (p=0.001).
Conclusions:
informal caregivers used positive religious/spiritual coping as a way of coping with care demands related to the child’s health condition. These findings point to the importance of including spirituality/religiosity as health indicators.
- Francely Tineli Farinha
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ERRATUM11-08-2022
ERRATUM
Revista Brasileira de Enfermagem. 2022;75(1):e2022n1e02
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2022;75(1):e2022n1e02
DOI 10.1590/0034-7167.20227501e02
Views0Article “Hemodialysis in the context of COVID-19: care, nursing protagonism and quality”, with number of DOI: https://doi.org/10.1590/0034-7167-2020-1077, published in the journal Revista Brasileira de Enfermagem, 75(Suppl 1): e20201077, on the front page:Figures 4 and 5 are in reverse order.[…]See more
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ORIGINAL ARTICLE06-14-2021
Continuity of neuro-psychomotor stimulation of children with congenital Zika syndrome
- Anna Tereza Alves Guedes ,
- Anniely Rodrigues Soares ,
- Daniele Beltrão Lucena de França ,
- Elenice Maria Cecchetti Vaz ,
- Neusa Collet , [ … ],
- Altamira Pereira da Silva Reichert
Abstract
ORIGINAL ARTICLEContinuity of neuro-psychomotor stimulation of children with congenital Zika syndrome
Revista Brasileira de Enfermagem. 2021;74(6):e20200694
DOI 10.1590/0034-7167-2020-0694
- Anna Tereza Alves Guedes ,
- Anniely Rodrigues Soares ,
- Daniele Beltrão Lucena de França ,
- Elenice Maria Cecchetti Vaz ,
- Neusa Collet ,
- Altamira Pereira da Silva Reichert
Views0See moreABSTRACT
Objective:
Understand the continuity of stimulation of neuro-psychomotor development in children with congenital Zika syndrome.
Method:
Descriptive-exploratory study with theoretical support in symbolic interactionism. Between August and November 2019, 12 health professionals were interviewed in depth; and to the focus group, seven caregivers of children with the syndrome. The analysis was thematic inductive.
Results:
The continuation of neuro-psychomotor stimulation of children with Zika syndrome goes through: organizational difficulties (lack of doctors, professional unpreparedness, dissatisfaction and search for other services); socioenvironmental aspects (low maternal education, low socioeconomic level, difficulty in moving and lack of support); and conditions inherent to children (hospitalizations for respiratory crises, seizures, hypoactivity and social stigma).
Final considerations:
A strengthened support network with qualified human resources is necessary in order to provide comprehensive care and avoid the discontinuity of neuro-psychomotor stimulation of children with congenital Zika syndrome.
- Anna Tereza Alves Guedes
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ORIGINAL ARTICLE08-20-2021
Risk of suicide among nursing students
- Stephane Marcele Almeida Braga Moraes ,
- Valquíria Farias Bezerra Barbosa ,
- Ana Carla Silva Alexandre ,
- Silvana Cavalcanti dos Santos ,
- Fernanda Jorge Guimarães, [ … ],
- Juliana Lourenço de Araújo Veras
Abstract
ORIGINAL ARTICLERisk of suicide among nursing students
Revista Brasileira de Enfermagem. 2021;74(6):e20200867
DOI 10.1590/0034-7167-2020-0867
- Stephane Marcele Almeida Braga Moraes ,
- Valquíria Farias Bezerra Barbosa ,
- Ana Carla Silva Alexandre ,
- Silvana Cavalcanti dos Santos ,
- Fernanda Jorge Guimarães,
- Juliana Lourenço de Araújo Veras
Views0See moreABSTRACT
Objectives:
to identify the risk and degree of risk of suicide in nursing students of a public institution in the countryside of Pernambuco, Brazil.
Methods:
this was a cross-sectional, quantitative research conducted with 150 students. For data collection, a sociodemographic questionnaire and the instrument, M.I.N.I. – Brazilian version 5.0.0 – Module C – Risk of suicide were used. Statistical analyses were performed with IBM(® )SPSS(®), version 23.
Results:
53.3% of nursing students had a risk of suicide, of which 20.7% had a high risk. Moreover, 22.67% reported previous suicide attempt. It is noteworthy that students without a partner have a higher risk of suicide (56.8%) than those with a partner (29.4%).
Conclusions:
it is perceived the need to develop programs that identify students at risk of suicide in higher education institutions, in order to raise awareness of the problem and implement policies to promote mental health in the academia.
- Stephane Marcele Almeida Braga Moraes
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REVIEW08-20-2021
Root Cause Analysis, Failures and Effects in pediatric total quality management: a scoping review
- Luciana Andrade de Lima ,
- Louise Constancia de Melo Alves Silva ,
- Joyce Karolayne dos Santos Dantas ,
- Maria Solange Moreira de Lima ,
- Daniele Vieira Dantas , [ … ],
- Rodrigo Assis Neves Dantas
Abstract
REVIEWRoot Cause Analysis, Failures and Effects in pediatric total quality management: a scoping review
Revista Brasileira de Enfermagem. 2021;74(6):e20200954
DOI 10.1590/0034-7167-2020-0954
- Luciana Andrade de Lima ,
- Louise Constancia de Melo Alves Silva ,
- Joyce Karolayne dos Santos Dantas ,
- Maria Solange Moreira de Lima ,
- Daniele Vieira Dantas ,
- Rodrigo Assis Neves Dantas
Views0See moreABSTRACT
Objectives:
to analyze the applicability of Root Cause Analysis and Failure Mode and Effect Analysis tools, aiming to improve care in pediatric units.
Methods:
this is a scoping review carried out according to the Joanna Briggs Institute guidelines, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes extension for Scoping Reviews. Search took place in May 2018 on 15 data sources.
Results:
search totaled 8,254 studies. After using the relevant inclusion and exclusion criteria, 15 articles were included in the review. Of these, nine were published between 2013 and 2018, 12 used Failure Mode and Effect Analysis and 11 carried out interventions to improve the quality of the processes addressed, showing good post-intervention results.
Final Considerations:
the application of the tools indicated significant changes and improvements in the services that implemented them, proving to be satisfactory for detecting opportunities for improvement, employing specific methodologies for harm reduction in pediatrics.
- Luciana Andrade de Lima
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ORIGINAL ARTICLE07-26-2021
Representations about sexuality of people diagnosed late with HIV infection
Revista Brasileira de Enfermagem. 2021;74(6):e20201028
Abstract
ORIGINAL ARTICLERepresentations about sexuality of people diagnosed late with HIV infection
Revista Brasileira de Enfermagem. 2021;74(6):e20201028
DOI 10.1590/0034-7167-2020-1028
Views0See moreABSTRACT
Objective:
to understand the representations about sexuality of people diagnosed late with HIV infection and its implications in the delayed search for diagnosis.
Methods:
this is a qualitative study, whose theoretical and methodological framework was Social Representation Theory. The research was carried out with 18 people diagnosed late with HIV infection through an open interview. For data analysis, Structural Narration Analysis was used, with support from MAXQDA 12®.
Results:
representations about sexuality contributed to delayed diagnosis, such as trust in a fixed partnership, sexual intercourse is natural, sexuality as a taboo, search for pleasure in sexual intercourse, regardless of risks, denial of risk for HIV infection.
Final considerations:
representations about sexuality participate in a web of stereotypes and riskier ways of living, which contribute to delayed diagnosis. Sexual health education remains necessary and essential throughout people’s lives.
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08-20-2021
Prevalence of central venous catheter salvage in newborn with staphylococcal bloodstream infection
- Izabela Linha Secco ,
- Mitzy Tannia Reichembach ,
- Higor Pacheco Pereira ,
- Regina Paula Guimarães Vieira Cavalcante da Silva
Abstract
Prevalence of central venous catheter salvage in newborn with staphylococcal bloodstream infection
Revista Brasileira de Enfermagem. 2021;74(6):e20201073
DOI 10.1590/0034-7167-2020-1073
- Izabela Linha Secco ,
- Mitzy Tannia Reichembach ,
- Higor Pacheco Pereira ,
- Regina Paula Guimarães Vieira Cavalcante da Silva
Views0See moreABSTRACT
Objectives:
to establish the prevalence of salvage of central venous catheters in newborns with bloodstream infection caused by coagulase-negative staphylococci.
Methods:
retrospective cross-sectional study with 136 newborns admitted to the Neonatal Intensive Care Unit between 2011 and 2017. The total of 143 infection events undergoing antibiotic therapy were evaluated.
Results:
among the 143 infection events, 39 catheters in which antibiotic therapy was used were saved and in 69 cases, the device was removed. Positive central blood culture and single lumen catheter were factors associated with salvage failure. The probability of salvage decreased with infections diagnosed from 15 days of using the catheter. Negative blood culture raised the chance of salvage by fourfold.
Conclusions:
the use of antibiotic therapy in the treatment of infections resulted in a low prevalence of salvage of the central venous catheter. The probability of salvage was associated with variables of the device.
- Izabela Linha Secco
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EXPERIENCE REPORT02-15-2021
Coronavirus infections: health care planning based on Orem’s Nursing Theory
- Tayomara Ferreira Nascimento ,
- Graziela Maria Ferraz de Almeida ,
- Marielle Poyo Bello ,
- Rosemary Pereira Lino da Silva ,
- Cassiana Mendes Bertoncello Fontes
Abstract
EXPERIENCE REPORTCoronavirus infections: health care planning based on Orem’s Nursing Theory
Revista Brasileira de Enfermagem. 2021;74:e20200281
DOI 10.1590/0034-7167-2020-0281
- Tayomara Ferreira Nascimento ,
- Graziela Maria Ferraz de Almeida ,
- Marielle Poyo Bello ,
- Rosemary Pereira Lino da Silva ,
- Cassiana Mendes Bertoncello Fontes
Views0See moreABSTRACT
Objective:
to report the experience of professors and students of a graduate course on nursing care in coping with the new coronavirus (COVID-19) based on Self-Care Theory.
Method:
the active methodologies used were a literature search and seminar presentations, with an understanding of Orem’s theoretical concepts: health; man; self-care; universal, developmental and health deviation requirements; self-care activities; self-care deficits; the required therapeutic demand; nursing systems. The pandemic was considered a health deviation that requires critical thinking and nursing care planning. Methodological frameworks to classify nursing diagnoses, interventions, and outcomes were used.
Results:
for each health deviation, nursing systems were identified; self-care deficits, diagnoses; actions, interventions; and the form of assessment, outcomes.
Final considerations:
theoretical-practical reflections of the academic context support nursing care planning.
- Tayomara Ferreira Nascimento
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REFLECTION03-05-2021
Reflections on patient safety incident reporting systems
- Maria de Jesus Castro Sousa Harada ,
- Ana Elisa Bauer de Camargo Silva ,
- Liliane Bauer Feldman ,
- Sheilla Siedler Tavares ,
- Luiza Maria Gerhardt , [ … ],
- Adriane Cristina Bernat Kolankiewicz
Abstract
REFLECTIONReflections on patient safety incident reporting systems
Revista Brasileira de Enfermagem. 2021;74:e20200307
DOI 10.1590/0034-7167-2020-0307
- Maria de Jesus Castro Sousa Harada ,
- Ana Elisa Bauer de Camargo Silva ,
- Liliane Bauer Feldman ,
- Sheilla Siedler Tavares ,
- Luiza Maria Gerhardt ,
- Antônio José de Lima Júnior ,
- Adriane Cristina Bernat Kolankiewicz
Views0See moreABSTRACT
Objective:
To reflect on the main characteristics and recommendations of Incident Reporting Systems, discuss the population’s participation in reporting, and point out challenges in the Brazilian system.
Method:
Reflection study, based on Ordinance No. 529/13, which instituted the National Patient Safety Program, under Collegiate Board Resolution (CBR) No. 36/13; reflections by experts were added.
Results:
Reporting systems are a source for learning and monitoring, allow early detection of incidents, investigations and, mainly, the generation of recommendations prior to recurrences, in addition to raising information for patients and relatives. There is little participation of the population in the reporting, regardless of the type of system and characteristics such as confidentiality, anonymity, and mandatory nature.
Final Considerations:
In Brazil, although reporting is mandatory, there is an urgency to advance the involvement and participation of the population, professionals, and institutions. To simplify data entry by improving the interface and importing data from the reporting system is an objective to be achieved.
- Maria de Jesus Castro Sousa Harada
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EXPERIENCE REPORT01-29-2021
Restructuring service at a mastology outpatient clinic during the COVID-19 pandemic
- Cristina Poliana Rolim Saraiva dos Santos ,
- Ana Fátima Carvalho Fernandes ,
- Denise Montenegro da Silva ,
- Régia Christina Moura Barbosa Castro
Abstract
EXPERIENCE REPORTRestructuring service at a mastology outpatient clinic during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2021;74:e20200571
DOI 10.1590/0034-7167-2020-0571
- Cristina Poliana Rolim Saraiva dos Santos ,
- Ana Fátima Carvalho Fernandes ,
- Denise Montenegro da Silva ,
- Régia Christina Moura Barbosa Castro
Views0INTRODUCTIONCOVID-19 is a disease caused by the SARS-CoV-2 coronavirus (Severe Acute Respiratory Syndrome Coronavirus 2) and has brought a threat to public health worldwide. In need of immediate changes, adaptations tend to be the way out to avoid contamination that potentially does not distinguish race, color, gender().The global numbers of suspected and confirmed cases are […]See more - Cristina Poliana Rolim Saraiva dos Santos
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