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ORIGINAL ARTICLE05-13-2024
Generalized Resistance Deficits in inmates with hypertension: missing resources that limit health
- Marta Cossetin Costa
, - Maria de Fátima Mantovani ,
- Fernanda Moura D’Almeida Miranda ,
- Ivonete Teresinha Schülter Buss Heidemann ,
- Aida Maris Peres
Abstract
ORIGINAL ARTICLEGeneralized Resistance Deficits in inmates with hypertension: missing resources that limit health
Revista Brasileira de Enfermagem. 2024;77(2):e20230246
DOI 10.1590/0034-7167-2023-0246
- Marta Cossetin Costa ,
- Maria de Fátima Mantovani ,
- Fernanda Moura D’Almeida Miranda ,
- Ivonete Teresinha Schülter Buss Heidemann ,
- Aida Maris Peres
Views0See moreABSTRACT
Objective:
to understand the Generalized Resistance Deficits of people deprived of liberty with hypertension in a Brazilian prison unit.
Method:
qualitative research, anchored in Salutogenesis, carried out with 38 people with hypertension from a Brazilian prison unit, from February to July 2022, with a semi-structured interview with open-ended questions, whose analysis was thematic, explaining the limitations to health in prison.
Results:
13 Generalized Resistance Deficits were reported, mostly related to the prison environment and, to a lesser extent, to the social group and the individual, respectively. Living in prison for people with hypertension implies living with a high number of Generalized Resistance Deficits, accentuating the movement towards the disease pole.
Final considerations:
knowing Generalized Resistance Deficits allows directing health promotion to support the use of available Generalized Resistance Resources and contributes to the expansion of intersectoral policies.
- Marta Cossetin Costa
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REVIEW05-13-2024
Lean methodology: contributions to improving work processes in health and nursing
- Fernanda Novaes Moreno Brancalion ,
- Lara Gonçalves de Souza ,
- Simone Berger ,
- Antônio Fernandes Costa Lima
Abstract
REVIEWLean methodology: contributions to improving work processes in health and nursing
Revista Brasileira de Enfermagem. 2024;77(2):e20230322
DOI 10.1590/0034-7167-2023-0322
- Fernanda Novaes Moreno Brancalion ,
- Lara Gonçalves de Souza ,
- Simone Berger ,
- Antônio Fernandes Costa Lima
Views0See moreABSTRACT
Objective:
to investigate the contributions of applying the Lean methodology to improve work processes in health and nursing and its impact on associated financial aspects.
Method:
an integrative review, carried out in six databases, whose sample of ten (100.0%) studies was analyzed and summarized descriptively.
Results:
the outcomes obtained were stratified into: benefits/barriers to Lean Healthcare implementation; economic aspects involving Lean Healthcare implementation; and process improvements through Lean Healthcare implementation. The majority of studies (60.0%) were carried out in university hospitals, contexts that need to continually improve the quality of services provided, generally with scarce and limited resources, which support the viability of maintaining the teaching, research and extension tripod.
Conclusion:
three (30.0%) studies highlighted the financial aspects associated with Lean methodology application. The others only mentioned the possibility of financial gains through improving processes and reducing waste.
- Fernanda Novaes Moreno Brancalion
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REVIEW05-13-2024
Stunting predictors among children aged 0-24 months in Southeast Asia: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20220625
Abstract
REVIEWStunting predictors among children aged 0-24 months in Southeast Asia: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20220625
DOI 10.1590/0034-7167-2022-0625
Views0See moreABSTRACT
Objective:
To identify predictors of stunting among children 0-24 months in Southeast Asia.
Methods:
This scoping review focused on articles with observational study design in English published from 2012 to 2023 from five international databases. The primary keyword used were: “stunting” OR “growth disorder” AND “newborn” AND “predict” AND “Southeast Asia”.
Results:
Of the 27 articles selected for the final analysis there are thirteen predictors of stunting in seven Southeast Asia countries. The thirteen predictors include the child, mother, home, inadequate complementary feeding, inadequate breastfeeding, inadequate care, poor quality foods, food and water safety, infection, political economy, health and healthcare, water, sanitation, and environment, and social culture factor.
Conclusion:
All these predictors can lead to stunting in Southeast Asia. To prevent it, health service providers and other related sectors need to carry out health promotion and health prevention according to the predictors found.
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05-13-2024
A influência da internet nas escolhas sobre a saúde e o bem-estar dos idosos
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
Abstract
A influência da internet nas escolhas sobre a saúde e o bem-estar dos idosos
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
DOI 10.1590/0034-7167-2023-0321
Views0See moreRESUMEN
Objetivos:
describir el perfil de los ancianos que acceden a internet para buscar información de salud e identificar los factores que pueden influir en las decisiones de los ancianos sobre su salud a partir de la información recopilada en línea.
Métodos:
391 ancianos respondieron a un cuestionario online sobre hábitos y satisfacción con la información de salud recogida en internet. El procesamiento de datos implicó regresión logística.
Resultados:
la educación superior reduce en un 44% la probabilidad de que un anciano siga las recomendaciones de salud en los sitios web. Sin embargo, las actividades sociales y la salud autopercibida aumentan la posibilidad de seguir las recomendaciones en un 83% y un 71%, respectivamente. La creencia de que internet promueve hábitos saludables aumenta 29,2 veces la probabilidad de que un anciano siga un consejo.
Consideraciones Finales:
conocer el perfil de los ancianos que utilizan internet puede ayudar a los profesionales a formular políticas públicas y construir buenas plataformas de información sobre salud y bienestar.
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ORIGINAL ARTICLE05-13-2024
The influence of the internet on choices about older adults’ health and well-being
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
Abstract
ORIGINAL ARTICLEThe influence of the internet on choices about older adults’ health and well-being
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
DOI 10.1590/0034-7167-2023-0321
Views0See moreABSTRACT
Objectives:
to describe the profile of older adults who access the internet to search for health information and identify the factors that can influence older adults’ decisions about their health based on information collected online.
Methods:
391 older adults answered an online questionnaire regarding habits and satisfaction with information about health collected on the internet. Data processing involved Logistic Regression.
Results:
higher education reduces by 44% the likelihood of an older adult following the health recommendations on internet sites. However, social activities and self-perceived health increase the possibility of following the recommendations by 83% and 71%, respectively. The belief that the internet promotes healthy habits increases by 29.2 times the probability of an older adult following the advice.
Final Considerations:
knowing the profile of older adults who use the Internet can help professionals formulate public policies and build good information platforms on health and well-being.
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REVIEW05-13-2024
Technologies used in the treatment of burn victims in intensive care: a scope review
- Kyohana Matos de Freitas Clementino ,
- Gabriela Duarte Bezerra ,
- Gleice Adriana Araujo Gonçalves ,
- Maria Corina Amaral Viana ,
- Luis Rafael Leite Sampaio , [ … ],
- Woneska Rodrigues Pinheiro
Abstract
REVIEWTechnologies used in the treatment of burn victims in intensive care: a scope review
Revista Brasileira de Enfermagem. 2024;77(1):e20220738
DOI 10.1590/0034-7167-2022-0738
- Kyohana Matos de Freitas Clementino ,
- Gabriela Duarte Bezerra ,
- Gleice Adriana Araujo Gonçalves ,
- Maria Corina Amaral Viana ,
- Luis Rafael Leite Sampaio ,
- Woneska Rodrigues Pinheiro
Views0See moreABSTRACT
Objectives:
to analyze the technologies used by the nursing team in the treatment of skin lesions caused by burns in patients under intensive care.
Methods:
this is a scope review conducted on the LILACS, Medline, PubMed, and CINAHL databases without temporal or language restrictions.
Results:
the highlighted technologies included the use of specialized dressings, biological agents such as probiotics and cyanobacteria, as well as negative pressure therapies and enzymes such as papain and collagenase. Some technologies, such as nanocrystalline silver, demonstrated efficacy in infection control.
Final Considerations:
the study identified essential technologies in burn care, emphasizing the need for further research on “soft” technologies. The findings support the promotion of evidence-based nursing care for burn patients in intensive care and enhance knowledge about effective treatments.
- Kyohana Matos de Freitas Clementino
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ORIGINAL ARTICLE05-03-2024
What is the burden of multimorbidity and the factors associated with its occurrence in elderly Brazilians?
- Danielle Samara Tavares de Oliveira-Figueiredo ,
- Matteus Pio Gianotti Pereira Cruz Silva ,
- Paula Yhasmym de Oliveira Feitosa ,
- Bruna Cardoso Leite ,
- Fabiana Lucena Rocha , [ … ],
- Luciana Dantas Farias de Andrade
Abstract
ORIGINAL ARTICLEWhat is the burden of multimorbidity and the factors associated with its occurrence in elderly Brazilians?
Revista Brasileira de Enfermagem. 2024;77(1):e20220809
DOI 10.1590/0034-7167-2022-0809
- Danielle Samara Tavares de Oliveira-Figueiredo ,
- Matteus Pio Gianotti Pereira Cruz Silva ,
- Paula Yhasmym de Oliveira Feitosa ,
- Bruna Cardoso Leite ,
- Fabiana Lucena Rocha ,
- Luciana Dantas Farias de Andrade
Views0See moreABSTRACT
Objective:
To estimate the prevalence of multimorbidity in elderly people and its association with sociodemographic characteristics, lifestyle, and anthropometry.
Methods:
This was a cross-sectional study using data from the National Health Survey, 2019. A total of 22,728 elderly individuals from all 27 Brazilian states were randomly selected. Poisson regression models with robust variance were employed, and a significance level of 5% was adopted.
Results:
The prevalence of multimorbidity was 51.6% (95% CI: 50.4-52.7), with the highest estimates observed in the South and Southeast. Multimorbidity was associated with being female (aPR = 1.33; 95% CI: 1.27-1.39), being 80 years old or older (aPR = 1.12; 95% CI: 1.05-1.19), having low education (aPR = 1.16; 95% CI: 1.07-1.25), past cigarette use (aPR = 1.16; 95% CI: 1.11-1.21), insufficient physical activity (aPR = 1.13; 95% CI: 1.06-1.21), and screen use for 3 hours or more per day (aPR = 1.13; 95% CI: 1.08-1.18).
Conclusion:
Multimorbidity affects more than half of the elderly population in Brazil and is associated with social, demographic, and behavioral factors.
- Danielle Samara Tavares de Oliveira-Figueiredo
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ORIGINAL ARTICLE05-03-2024
Cancer patient satisfaction regarding the quality of information received: psychometric validity of EORTC QLQ-INFO25
Revista Brasileira de Enfermagem. 2024;77(1):e20230358
Abstract
ORIGINAL ARTICLECancer patient satisfaction regarding the quality of information received: psychometric validity of EORTC QLQ-INFO25
Revista Brasileira de Enfermagem. 2024;77(1):e20230358
DOI 10.1590/0034-7167-2023-0358
Views0See moreABSTRACT
Objectives:
to psychometrically validate the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire EORTC QLQ-INFO25 instrument and identify the domains that influence patients’ perception of the information received.
Methods:
a cross-sectional methodology with cancer patients in a Brazilian philanthropic hospital institution. Sociodemographic and clinical instruments, EORTC QLQ-C30, EORTC QLQ-INFO25 and Supportive Care Needs Survey – Short Form 34 were used. Analysis occurred using Cronbach’s alpha coefficients, intraclass correlation, test-retest and exploratory factor analysis.
Results:
128 respondents participated. Cronbach’s alpha coefficient was 0.85. The test-retest obtained p-value=0.21. In the factor analysis, one item was excluded. Satisfaction with the information received was 74%, with three areas with averages below 70%. In open-ended questions, there was a greater desire for information.
Conclusions:
validity evidence was obtained with instrument reliability, consistency and stability. Respondents expressed satisfaction with the information received.
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ORIGINAL ARTICLE09-07-2020
HIV Care Continuum from diagnosis in a Counseling and Testing Center
- Angélica da Mata Rossi ,
- Silvia Paulino Ribeiro Albanese ,
- Ingridt Hildegard Vogler ,
- Flávia Meneguetti Pieri ,
- Edvilson Cristiano Lentine , [ … ],
- Elma Mathias Dessunti
Abstract
ORIGINAL ARTICLEHIV Care Continuum from diagnosis in a Counseling and Testing Center
Revista Brasileira de Enfermagem. 2020;73(6):e20190680
DOI 10.1590/0034-7167-2019-0680
- Angélica da Mata Rossi ,
- Silvia Paulino Ribeiro Albanese ,
- Ingridt Hildegard Vogler ,
- Flávia Meneguetti Pieri ,
- Edvilson Cristiano Lentine ,
- Marcela Maria Birolim ,
- Elma Mathias Dessunti
Views0See moreABSTRACT
Objective:
To analyze the HIV care continuum from the diagnosis in an HIV/AIDS Counseling and Testing Center (CTC), and the sociodemographic, clinical, and laboratory characteristics related to gender.
Method:
Epidemiological study, conducted with data of individuals assisted at a Counseling and Testing Center, and followed in an outpatient clinic for HIV/AIDS. Pearson’s Chi-square test and binary logistic regression were used to obtain odds ratios, considering alpha value <0.05.
Results:
The prevalence of HIV among 5,229 users was 5%. The highest chance of positive results was among men, aged 14 to 33 years old, who were not in a domestic partnership. In the analysis of TCD4+ lymphocytes and viral load (VL) of 238 cases, 56.1% had a late diagnosis. We have identified gaps in the care cascade, especially linkage to the care, retention in care, and viral load suppression.
Conclusion:
The results suggest a late diagnosis for both genders, as well as difficulty in reaching the viral suppression goal.
- Angélica da Mata Rossi
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ORIGINAL ARTICLE12-13-2019
Maternal care in the preterm child’s family context: A comprehensive look towards the sibling
- Soraya Cirilo Carvalho ,
- Beatriz Castanheira Facio ,
- Bruna Felisberto de Souza ,
- Flávia Corrêa Porto de Abreu-D’Agostini ,
- Adriana Moraes Leite , [ … ],
- Monika Wernet
Abstract
ORIGINAL ARTICLEMaternal care in the preterm child’s family context: A comprehensive look towards the sibling
Revista Brasileira de Enfermagem. 2019;72:50-57
DOI 10.1590/0034-7167-2017-0780
- Soraya Cirilo Carvalho ,
- Beatriz Castanheira Facio ,
- Bruna Felisberto de Souza ,
- Flávia Corrêa Porto de Abreu-D’Agostini ,
- Adriana Moraes Leite ,
- Monika Wernet
Views0See moreABSTRACT
Objective:
To analyze maternal care for siblings of preterm babies hospitalized in the neonatal intensive care unit.
Method:
Qualitative research using symbolic interactionism as a theoretical reference and narrative research as a methodological reference. Ten mothers were surveyed through semi-structured interviews.
Results:
Three thematic units emerged from the analysis of data: “social support in the sharing of child care”; “promotion of adaptation to the arrival of a sibling” and “maternal feelings and coping”.
Final considerations:
Care for the premature child’s sibling is developed under mothers’ physical distance from him/her, justified by the need to remain close to the premature child due to risks and fragility related to the condition.
- Soraya Cirilo Carvalho
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REVIEW11-11-2020
Self-reported experience of hospitalized children: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20180740
Abstract
REVIEWSelf-reported experience of hospitalized children: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20180740
DOI 10.1590/0034-7167-2018-0740
Views0See moreABSTRACT
Objective:
To identify available evidence about the self-reported experience of hospitalized children.
Methods:
An integrative review was carried out, and the survey occurred between September and November 2017, in the electronic sources DLTD-USP, CAPES, IBICT, MEDLINE, LILACS and BDENF.
Results:
Ten studies were found, prevailing samples with descriptive design and approach in qualitative and mixed methods research. The literature evidenced the experience of hospitalized children through the report of parents and health professionals; few were self-reported by the child itself. Five themes were identified: Understanding the time of hospital admission, relevance of care received, feeling of pain, importance of the patient companion, information received about hospitalization.
Conclusion:
It was found that experiences in childhood are able to have repercussions throughout life, and it is relevant that nursing is attentive to their clients’ perception in order to have more satisfaction and the negative impact is diminished.
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ORIGINAL ARTICLE03-30-2020
Access to the Unified Health System in the perspective of male homosexuals
- Luís Eduardo Soares dos Santos ,
- Wemerson dos Santos Fontes ,
- Ana Karla Sousa de Oliveira ,
- Luisa Helena de Oliveira Lima ,
- Ana Roberta Vilarouca da Silva , [ … ],
- Ana Larissa Gomes Machado
Abstract
ORIGINAL ARTICLEAccess to the Unified Health System in the perspective of male homosexuals
Revista Brasileira de Enfermagem. 2020;73(2):e20180688
DOI 10.1590/0034-7167-2018-0688
- Luís Eduardo Soares dos Santos ,
- Wemerson dos Santos Fontes ,
- Ana Karla Sousa de Oliveira ,
- Luisa Helena de Oliveira Lima ,
- Ana Roberta Vilarouca da Silva ,
- Ana Larissa Gomes Machado
Views1See moreABSTRACT
Objectives:
To analyze the perception of male homosexuals regarding the access to the Unified Health System.
Methods:
A qualitative study with male homosexuals in a city in the Northeast Brazil. Eight subjects participated, a socioeconomic questionnaire was used for data collection and a focal group was carried out, in which the narratives were recorded and later transcribed. For the analysis of the speeches, the analysis of thematic content was used.
Results:
The analysis revealed five thematic categories that express the limitations on humanization and reception, as well as in the quality of health care offered to subjects, disregarding the psychosocial and lifestyle-related demands.
Final considerations:
It was emphasized that the focus group technique contributed to the approach of the research with the perception of male homosexuals marked by prejudice and discrimination, reflecting the subjects’ dissatisfaction with the care received in the health services.
- Luís Eduardo Soares dos Santos
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ORIGINAL ARTICLE06-08-2020
Nurses’ responsibilities in the aerospace environment
- Shara Bianca De Pin Raduenz ,
- José Luís Guedes dos Santos ,
- Daniele Dalcanal Lazzari ,
- Eliane Regina Pereira do Nascimento ,
- Keyla Cristiane do Nascimento , [ … ],
- André Ricardo Moreira
Abstract
ORIGINAL ARTICLENurses’ responsibilities in the aerospace environment
Revista Brasileira de Enfermagem. 2020;73(4):e20180777
DOI 10.1590/0034-7167-2018-0777
- Shara Bianca De Pin Raduenz ,
- José Luís Guedes dos Santos ,
- Daniele Dalcanal Lazzari ,
- Eliane Regina Pereira do Nascimento ,
- Keyla Cristiane do Nascimento ,
- André Ricardo Moreira
Views0See moreABSTRACT
Objectives:
to characterize the nurses who work in the aerospace environment and to identify their most frequent responsibilities during the pre-flight, flight, and post-flight periods.
Methods:
a quantitative, exploratory-descriptive research, conducted using a survey through Google forms®, from January to April of 2018, with 50 nurses from aerospace services in Brazil. Data were analyzed using descriptive statistics.
Results:
predominance of male participants (64%), mean age of 37 years, with a mean working time in the aerospace environment of six years, in helicopter (54%), and in the southern region (42%). The main pre-flight, flight, and post-flight activities were, respectively: verification/testing of equipment functionality, nursing care for patients, and replacement of supplies and equipment.
Conclusions:
In the aerospace environment, nurses’ work are primarily organizational and victim care actions, during all phases of the flight.
- Shara Bianca De Pin Raduenz
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ORIGINAL ARTICLE05-24-2021
Construction and validation of educational material on promoting breastfeeding in schools
- Roseanne de Sousa Nobre ,
- Artemizia Francisca de Sousa ,
- Ana Roberta Vilarouca da Silva ,
- Ana Larissa Gomes Machado ,
- Viviane Martins da Silva , [ … ],
- Luisa Helena de Oliveira Lima
Abstract
ORIGINAL ARTICLEConstruction and validation of educational material on promoting breastfeeding in schools
Revista Brasileira de Enfermagem. 2021;74:e20200511
DOI 10.1590/0034-7167-2020-0511
- Roseanne de Sousa Nobre ,
- Artemizia Francisca de Sousa ,
- Ana Roberta Vilarouca da Silva ,
- Ana Larissa Gomes Machado ,
- Viviane Martins da Silva ,
- Luisa Helena de Oliveira Lima
Views1See moreABSTRACT
Objective:
to build and validate an educational technology on the promotion of breastfeeding for schoolchildren.
Methods:
a methodological study was developed through a bibliographic survey, situational diagnosis, creation of illustrations, layout, design and texts, validation of the material with the help of expert judges and target audience.
Results:
the content judges enabled the validation of the material with an overall Content Validity Index of 90%, the judges of the design Suitability Assessment of Materials of 90.4% and the target audience with a 95.6% agreement. The readability percentage proved to be excellent, with an overall score of 100%.
Conclusion:
the educational technology proved to be a valid and reliable instrument to promote a breastfeeding culture among schoolchildren.
- Roseanne de Sousa Nobre
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ORIGINAL ARTICLE09-29-2022
Neither angels nor heroes: nurse speeches during the COVID-19 pandemic from a Foucauldian perspective
- Mariana Mendes ,
- Juliana Silveira Bordignon ,
- Robriane Prosdocimi Menegat ,
- Dulcinéia Ghizoni Schneider ,
- Mara Ambrosina de Oliveira Vargas , [ … ],
- Priscila Rodrigues da Cunha
Abstract
ORIGINAL ARTICLENeither angels nor heroes: nurse speeches during the COVID-19 pandemic from a Foucauldian perspective
Revista Brasileira de Enfermagem. 2022;75:e20201329
DOI 10.1590/0034-7167-2020-1329
- Mariana Mendes ,
- Juliana Silveira Bordignon ,
- Robriane Prosdocimi Menegat ,
- Dulcinéia Ghizoni Schneider ,
- Mara Ambrosina de Oliveira Vargas ,
- Evangelia Kotzias Atherino dos Santos ,
- Priscila Rodrigues da Cunha
Views1See moreABSTRACT
Objective:
to analyze the processes of meaning production, based on the speeches of nursing professionals, about how they feel about the titles of “angels and heroes” given by society during the pandemic of COVID-19.
Methods:
a qualitative, documentary research. Data was collected in October and November 2020 and analyzed from the perspective of the Discourse Analysis proposed by Michel Foucault.
Results:
they were organized into two thematic categories: “Angels and heroes? The (not) heroic reality of nursing during the pandemic” and “The search for recognition of the professional work of nursing: between what is said and what is not said”.
Final considerations:
the nurses’ speeches enunciate the search for decent conditions for the execution of care, fair wages, and recognition of the professional work by society.
- Mariana Mendes
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REVIEW09-09-2022
Factors associated with inadequate treatment of syphilis during pregnancy: an integrative review
- Paula Marília Afonso Torres ,
- Amanda Ribeiro de Paula Reis ,
- Andressa Silva Torres dos Santos ,
- Nádia Bruna da Silva Negrinho ,
- Mayra Gonçalves Menegueti , [ … ],
- Elucir Gir
Abstract
REVIEWFactors associated with inadequate treatment of syphilis during pregnancy: an integrative review
Revista Brasileira de Enfermagem. 2022;75(6):e20210965
DOI 10.1590/0034-7167-2021-0965
- Paula Marília Afonso Torres ,
- Amanda Ribeiro de Paula Reis ,
- Andressa Silva Torres dos Santos ,
- Nádia Bruna da Silva Negrinho ,
- Mayra Gonçalves Menegueti ,
- Elucir Gir
Views0See moreABSTRACT
Objectives:
to analyze the evidence available in literature on factors associated with inadequate treatment of syphilis in pregnant women.
Methods:
an integrative review, carried out in the LILACS, CINAHL, Web of Science, Scopus, PubMed and EMBASE databases, with controlled descriptors therapeutic and prenatal syphilis.
Results:
nine publications composed the interpretative analysis, in which low education, income and maternal age, temporary lack of medication and HIV infection were associated with inadequate treatment of syphilis during pregnancy, in addition to delay or absence of prenatal care and receiving the 1st dose of penicillin, lack of tests or treatment less than 30 days before childbirth, and partners’ low compliance with treatment.
Final Considerations:
among the main factors associated with inadequate treatment, clinical and sociodemographic aspects stand out, as well as failures in drug dispensing, prescription and monitoring of treatment of pregnant women and their partners by the health system.
- Paula Marília Afonso Torres
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