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ORIGINAL ARTICLE12-13-2024
Nurses’ experience regarding patient safety in mobile pre-hospital care
- Eduardo Dias Filipe
, - Roberto Chrispim Modesto ,
- Hercules de Oliveira Carmo ,
- Haviley Oliveira Martins ,
- Maristela Santini Martins
Abstract
ORIGINAL ARTICLENurses’ experience regarding patient safety in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77(5):e20230529
DOI 10.1590/0034-7167-2023-0529
- Eduardo Dias Filipe ,
- Roberto Chrispim Modesto ,
- Hercules de Oliveira Carmo ,
- Haviley Oliveira Martins ,
- Maristela Santini Martins
Views0See moreABSTRACT
Objectives:
to understand nurses’ experience regarding patient safety in mobile pre-hospital care.
Method:
a qualitative, exploratory and descriptive study, conducted with nurses active in mobile pre-hospital care services. Semi-structured interviews were conducted, audio-graved and submitted to Bardin’s content analysis.
Results:
from four thematic categories established, nurses reported the care and management skills necessary to work in this service. They demonstrated a commitment to ensuring safe care for patients, staff and spectators. They highlighted the actions taken to prevent and mitigate incidents. However, they based their experiences on practice protocols and individual actions, expressing the need to improve knowledge about patient safety.
Final Considerations:
mobile pre-hospital care nurses’ experience in relation to patient safety was limited, suggesting the need for training on the subject, alignment of work processes and implementation of strategies, aiming to guarantee safe care.
- Eduardo Dias Filipe
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ORIGINAL ARTICLE12-13-2024
Stress in nursing workers caring for people with COVID-19
Revista Brasileira de Enfermagem. 2024;77(5):e20230542
Abstract
ORIGINAL ARTICLEStress in nursing workers caring for people with COVID-19
Revista Brasileira de Enfermagem. 2024;77(5):e20230542
DOI 10.1590/0034-7167-2023-0542
Views1See moreABSTRACT
Objectives:
to analyze stress from the perspective of nursing workers caring for people with COVID-19 in a public hospital in the Recôncavo region of Bahia.
Methods:
this is an exploratory qualitative study, conducted through semi-structured interviews. The data were analyzed using word clouds, similarity trees, and content analysis.
Results:
nursing workers were exposed to stress while attending to patients with COVID-19. The reported stressors in the workplace included: work overload, lack of planning, speed in performing tasks, fatigue, lack of participation in decision-making, lack of support from management, technological changes, excessive responsibility without preparation, interpersonal conflicts, and professional undervaluation.
Conclusions:
exposure to these stressors leads to emotional exhaustion and demotivation, which were intensified during the COVID-19 pandemic.
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ORIGINAL ARTICLE12-13-2024
Knowledge and attitudes of nursing students regarding the sexuality of older adults: a quasi-experimental study
- Ana Carolina Macri Gaspar Vendramini ,
- Rosemeiry Capriata de Souza Azevedo ,
- Priscila Aguiar Mendes ,
- Janderson Diego Pimenta da Silva ,
- Annelita Almeida Oliveira Reiners , [ … ],
- Amanda Cristina de Souza Andrade
Abstract
ORIGINAL ARTICLEKnowledge and attitudes of nursing students regarding the sexuality of older adults: a quasi-experimental study
Revista Brasileira de Enfermagem. 2024;77(5):e20240011
DOI 10.1590/0034-7167-2024-0011
- Ana Carolina Macri Gaspar Vendramini ,
- Rosemeiry Capriata de Souza Azevedo ,
- Priscila Aguiar Mendes ,
- Janderson Diego Pimenta da Silva ,
- Annelita Almeida Oliveira Reiners ,
- Amanda Cristina de Souza Andrade
Views0See moreABSTRACT
Objectives:
to compare the knowledge and attitudes of nursing students regarding sexual behavior and sexually transmitted infections (STIs) in older adults before and after an educational intervention.
Methods:
this quasi-experimental study involved a convenience sample of 45 nursing students from a public university, conducted in three stages: pre-intervention, intervention, and post-intervention. A questionnaire was used to assess sociodemographic characteristics, academic training, and knowledge and attitudes on the topic. The intervention was an educational web conference. Paired t-test and Wilcoxon test were used for data analysis.
Results:
there was a statistically significant difference in the knowledge and attitude scores of nursing students before and after the educational intervention (p < 0.001). A significant increase was observed in the knowledge score (from 9.3 to 12.2) and attitude score (from 108 to 117.2) in the post-intervention phase.
Conclusions:
the knowledge of nursing students regarding the sexuality of older adults increased after the educational intervention, and their attitudes on the subject became more positive.
- Ana Carolina Macri Gaspar Vendramini
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ORIGINAL ARTICLE12-13-2024
Educational booklet on labor and delivery: validity study
- Michelle Tatiane Carvalho Gonçalves ,
- Ana Roberta Vilarouca da Silva ,
- Mara Cristina Ribeiro Furlan ,
- Bruna Moretti Luchesi ,
- Tatiana Carvalho Reis Martins
Abstract
ORIGINAL ARTICLEEducational booklet on labor and delivery: validity study
Revista Brasileira de Enfermagem. 2024;77(5):e20240138
DOI 10.1590/0034-7167-2024-0138
- Michelle Tatiane Carvalho Gonçalves ,
- Ana Roberta Vilarouca da Silva ,
- Mara Cristina Ribeiro Furlan ,
- Bruna Moretti Luchesi ,
- Tatiana Carvalho Reis Martins
Views2See moreABSTRACT
Objectives:
to develop and validate an educational booklet on labor and delivery for pregnant women.
Methods:
this methodological study involved constructing and validating a booklet based on Echer’s framework. We used the Content Validity Index and Cronbach’s alpha for content and face validation, selecting judges according to Fering’s criteria. We then conducted a clinical validation with the target population.
Results:
the booklet, developed based on evidence from an integrative review and validated by judges and the target audience, achieved global Content Validity Index of 0.919 and 0.913, respectively. After clinical validation with 22 pregnant women, it included 28 topics and 48 pages, with illustrations by a graphic designer.
Conclusions:
expert judges and the target audience considered this educational technology valid, deeming it a relevant tool for promoting the health of pregnant women.
- Michelle Tatiane Carvalho Gonçalves
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12-08-2024
Contexto ibero-americano da enfermagem: construindo e compartilhando conhecimento
Revista Brasileira de Enfermagem. 2024;77(1):e770101
Abstract
Contexto ibero-americano da enfermagem: construindo e compartilhando conhecimento
Revista Brasileira de Enfermagem. 2024;77(1):e770101
DOI 10.1590/0034-7167.2024770101pt
Views0Na próxima semana, acontecerão dois grandes eventos científicos em Madri e Granada (Espanha). Serão atividades internacionais, específicas e de forma muito especial, embora não exclusivas do campo ibero-americano, organizadas e desenvolvidas por duas sociedades científicas de enfermagem muito importantes, como a Associação de Enfermagem Comunitária (AEC) e a Associação Latino-Americana de Escolas e Faculdades de […]See more -
ORIGINAL ARTICLE12-08-2024
Initial nipple damages in breastfeeding women: analysis of photographic images and clinical associations
Revista Brasileira de Enfermagem. 2024;77(1):e20220773
Abstract
ORIGINAL ARTICLEInitial nipple damages in breastfeeding women: analysis of photographic images and clinical associations
Revista Brasileira de Enfermagem. 2024;77(1):e20220773
DOI 10.1590/0034-7167-2022-0773
Views0See moreABSTRACT
Objective:
to analyze the initial nipple damage degree by breastfeeding practice and to associate findings with clinical manifestations of breastfeeding women.
Methods:
a retrospective, cross-sectional study with primary data and photographic images database from two randomized clinical trials. Photographic images were analyzed by two independent evaluators using the Nipple Trauma Score. For analysis, the chi-square, Mann-Whitney tests and Kappa coefficient were applied.
Results:
115 breastfeeding women and their respective 186 photographic images were analyzed. The degree of agreement of evaluators using the Nipple Trauma Score was 93.6%. The nipple pain score during breastfeeding was moderate and compromised more than 25% of the nipple surface area.
Conclusions:
assistance to breastfeeding women should prioritize nipple pain intensity instead of the nipple damage size.
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REVIEW12-08-2024
Interventions for Strengthening General Self-Efficacy Beliefs in College Students: An Integrative Review
- Lais Palotta Balderrama Gueroni ,
- Daniele Alcalá Pompeo ,
- Letícia Palota Eid ,
- Marcos Antonio Ferreira Júnior ,
- Carlos Alberto da Cruz Sequeira , [ … ],
- Luciano Garcia Lourenção
Abstract
REVIEWInterventions for Strengthening General Self-Efficacy Beliefs in College Students: An Integrative Review
Revista Brasileira de Enfermagem. 2024;77(1):e20230192
DOI 10.1590/0034-7167-2023-0192
- Lais Palotta Balderrama Gueroni ,
- Daniele Alcalá Pompeo ,
- Letícia Palota Eid ,
- Marcos Antonio Ferreira Júnior ,
- Carlos Alberto da Cruz Sequeira ,
- Luciano Garcia Lourenção
Views0See moreABSTRACT
Objective:
To assess the evidence regarding the effectiveness of interventions aimed at strengthening self-efficacy beliefs in college students.
Methods:
Integrative Review conducted on the Lilacs, PubMed, CinahL, Cochrane Collaboration Databases, Scopus, and PsycInfo databases. The methodological quality of the studies was assessed using tools proposed by the Joanna Briggs Institute, and the results were analyzed descriptively.
Results:
Out of the 10 selected studies, six demonstrated that interventions aimed at strengthening self-efficacy were effective (Levels of Evidence II and III), and four revealed contrary results (Levels of Evidence I and II). Programs aimed at enhancing self-efficacy should include content on positive mental health, psychoeducation strategies, cover a period of eight to twelve weeks, and consider the completion of homework assignments.
Conclusion:
The synthesis of evidence pointed to pathways for building an effective self-efficacy strengthening program to be implemented in universities.
- Lais Palotta Balderrama Gueroni
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REVIEW12-08-2024
Common mental disorders in hematopoietic stem cell transplant patients: a scoping review
- Ana Clara Paiva de Almeida ,
- Valéria Dantas de Azevedo ,
- Tássia Regine de Morais Alves ,
- Viviane Euzébia Pereira Santos ,
- Glauber Weder dos Santos Silva , [ … ],
- Isabelle Campos de Azevedo
Abstract
REVIEWCommon mental disorders in hematopoietic stem cell transplant patients: a scoping review
Revista Brasileira de Enfermagem. 2024;77(1):e20220581
DOI 10.1590/0034-7167-2022-0581
- Ana Clara Paiva de Almeida ,
- Valéria Dantas de Azevedo ,
- Tássia Regine de Morais Alves ,
- Viviane Euzébia Pereira Santos ,
- Glauber Weder dos Santos Silva ,
- Isabelle Campos de Azevedo
Views0See moreABSTRACT
Objective:
to map common recurrent mental disorders in patients undergoing hematopoietic stem cell transplantation.
Methods:
this is a scoping review carried out in January 2022 in electronic databases and repositories of dissertations and thesis. Studies that answered the research question, met the objective of the study and were available in full electronically, in any language, were included.
Results:
the sample consisted of 28 studies, 14 of which were published in the United States of America. The common mental disorders found were depressive, anxiety, post-traumatic stress and mood disorders. Twenty symptoms were mentioned, among the most prevalent are fatigue and sleep disorders/insomnia.
Conclusions:
the difficulty and importance of carrying out the differential diagnosis of these disorders were highlighted, since their symptoms can be confused with other health problems and have a strong potential to interfere with patients’ evolution.
- Ana Clara Paiva de Almeida
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ORIGINAL ARTICLE09-07-2020
Creation and validation of a visual educational technology content for lactation physiology learning
- Polyana de Lima Ribeiro ,
- Daiani Oliveira Cherubim ,
- Stela Maris de Mello Padoin ,
- Cristiane Cardoso de Paula
Abstract
ORIGINAL ARTICLECreation and validation of a visual educational technology content for lactation physiology learning
Revista Brasileira de Enfermagem. 2020;73(6):e20190564
DOI 10.1590/0034-7167-2019-0564
- Polyana de Lima Ribeiro ,
- Daiani Oliveira Cherubim ,
- Stela Maris de Mello Padoin ,
- Cristiane Cardoso de Paula
Views0See moreABSTRACT
Objective:
to create and validate a visual educational technology content for lactation physiology learning.
Method:
a methodological study that contemplated the stages of content creation and validation guided by the conceptual model of Knowledge Translation into action. The creation took place in partnership with the educational technology center of the project’s home institution. The validation was attended by 27 judges with experience in the obstetric, neonatal, pediatric or maternal and child areas and in the theme of breastfeeding.
Results:
an educational technology covered animation and video techniques to locate, respectively, elements of lactation physiology and the population involved. An Overall Content Validity Index of 0.84 was obtained.
Conclusion:
the visual educational technology for lactation physiology learning has been validated in content as a tool to introduce the theme and mediate health education actions that can have a positive impact on breastfeeding.
- Polyana de Lima Ribeiro
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ORIGINAL ARTICLE10-21-2019
Permanent education for good practices in the prevention of pressure injury: almost-experiment
- Ana Laura Mendes Campoi ,
- Rosana Huppes Engel ,
- Thaís Santos Guerra Stacciarini ,
- Aldenora Laísa Paiva de Carvalho Cordeiro ,
- Adriana Feliciana Melo , [ … ],
- Marina Pereira Rezende
Abstract
ORIGINAL ARTICLEPermanent education for good practices in the prevention of pressure injury: almost-experiment
Revista Brasileira de Enfermagem. 2019;72(6):1646-1652
DOI 10.1590/0034-7167-2018-0778
- Ana Laura Mendes Campoi ,
- Rosana Huppes Engel ,
- Thaís Santos Guerra Stacciarini ,
- Aldenora Laísa Paiva de Carvalho Cordeiro ,
- Adriana Feliciana Melo ,
- Marina Pereira Rezende
Views0See moreABSTRACT
Objective:
To verify the effectiveness of the educational intervention through the evaluation of nurses’ knowledge about prevention of pressure injury.
Method:
A quasi-experimental study with a single group, carried out with 95 nurses from a teaching hospital in the interior of Minas Gerais, in August and September 2017. As a teaching strategy, the active methodology and hybrid teaching were used, based on the reference of the Method of the Arch of Charles Maguerez. Data were collected from a validated instrument, called the Pieper Knowledge Test, and analyzed by descriptive statistics and Student’s t-test with significance level of p <0.001.
Results:
The mean number of correct answers obtained by the nurses was 78.8% in the pre-test and 88.8% in the post-test, and the difference was statistically significant (p <0.001).
Conclusion:
The educational intervention developed was effective, since it contributed to the improvement of nurses’ knowledge.
- Ana Laura Mendes Campoi
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ORIGINAL ARTICLE06-01-2020
Primary care mental health: nurses’ activities in the psychosocial care network
- Vanessa Veloso Nunes ,
- Lucíola Galvão Gondim Corrêa Feitosa ,
- Márcia Astrês Fernandes ,
- Camila Aparecida Pinheiro Landim Almeida ,
- Carmen Viana Ramos
Abstract
ORIGINAL ARTICLEPrimary care mental health: nurses’ activities in the psychosocial care network
Revista Brasileira de Enfermagem. 2020;73:e20190104
DOI 10.1590/0034-7167-2019-0104
- Vanessa Veloso Nunes ,
- Lucíola Galvão Gondim Corrêa Feitosa ,
- Márcia Astrês Fernandes ,
- Camila Aparecida Pinheiro Landim Almeida ,
- Carmen Viana Ramos
Views0See moreABSTRACT
Objective:
to describe and analyze the role of expert nurses in mental health in the Family Health Strategy.
Method:
a qualitative study, with 20 Basic Health Units nurses of Teresina, Piauí. The information was collected through semi-structured interviews from March to May 2017 and analyzed using the content analysis method.
Results:
it was found that the conceptions of the mental health disease process were based on the biological model, there was little communication between mental health and basic network, nurses did not feel qualified to work mental health and there were few mental health actions in Primary Care.
Final considerations:
it becomes urgent to implement public policies that articulate mental health and Primary Care, raising awareness and continuing education for nurses.
- Vanessa Veloso Nunes
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ORIGINAL ARTICLE02-25-2022
Factors associated with stress, anxiety and depression in nursing professionals in the hospital context
- Bianca Bacelar de Assis ,
- Cissa Azevedo ,
- Caroline de Castro Moura ,
- Patrick Gonçalves Mendes ,
- Larissa Lucas Rocha , [ … ],
- Tânia Couto Machado Chianca
Abstract
ORIGINAL ARTICLEFactors associated with stress, anxiety and depression in nursing professionals in the hospital context
Revista Brasileira de Enfermagem. 2022;75:e20210263
DOI 10.1590/0034-7167-2021-0263
- Bianca Bacelar de Assis ,
- Cissa Azevedo ,
- Caroline de Castro Moura ,
- Patrick Gonçalves Mendes ,
- Larissa Lucas Rocha ,
- Aline Alves Roncalli ,
- Nayara Ferreira Mota Vieira ,
- Tânia Couto Machado Chianca
Views0See moreABSTRACT
Objective:
to determine the factors associated with stress, anxiety and depression, concomitantly, in nursing professionals who work in the hospital context.
Methods:
a quantitative and cross-sectional study with 353 nursing professionals from a hospital. A sociodemographic questionnaire and the Depression, Anxiety and Stress Scale-21 were used. Data were subjected to descriptive statistical analysis, difference and correlation tests.
Results:
the main factors associated with stress, anxiety and depression, concomitantly, were being female, compromised family and social support, lack of autonomy at work, hostile relationship with colleagues, lack of professional recognition and satisfaction, feeling of being overwhelmed and insecurity.
Conclusions:
demographic, physiological, social and work factors impact the levels of stress, anxiety and depression in nursing professionals. The adoption of coping strategies for modifiable factors should be considered, in order to provide better quality of life for these professionals.
- Bianca Bacelar de Assis
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ORIGINAL ARTICLE11-29-2022
Changes implemented in the work environment of nurses in the COVID-19 pandemic
- José Luís Guedes dos Santos ,
- Fernando Henrique Antunes Menegon ,
- Gustavo Baade de Andrade ,
- Etiane de Oliveira Freitas ,
- Silviamar Camponogara , [ … ],
- Alacoque Lorenzini Erdmann
Abstract
ORIGINAL ARTICLEChanges implemented in the work environment of nurses in the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2022;75:e20201381
DOI 10.1590/0034-7167-2020-1381
- José Luís Guedes dos Santos ,
- Fernando Henrique Antunes Menegon ,
- Gustavo Baade de Andrade ,
- Etiane de Oliveira Freitas ,
- Silviamar Camponogara ,
- Alexandre Pazetto Balsanelli ,
- Alacoque Lorenzini Erdmann
Views0See moreABSTRACT
Objective:
to describe the changes implemented in the work environment of nurses in university hospitals considering the COVID-19 pandemic.
Methods:
this qualitative and descriptive research was developed from an online survey with 75 nurses from three Brazilian university hospitals. Data processing occurred through textual analysis with the aid of software IRAMUTEQ.
Results:
five semantic classes were obtained: Organization of units for exclusive care of patients with COVID-19; Adaptations in the use of personal protective equipment; Physical structure adaptation; Care flow institution; Increased number of beds and training courses. Final considerations: the results show the effort of healthcare and nursing professionals/managers in the development of structural adaptations and reorganizations of care processes, in the hospital context, to respond with quality and efficiency to the demands arising from the COVID-19 pandemic.
- José Luís Guedes dos Santos
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03-03-2021
Concept analysis of Perioperative Thirst for the development of a new nursing diagnosis
- Leonel Alves do Nascimento ,
- Aline Korki Arrabal Garcia ,
- Marilia Ferrari Conchon ,
- Marcos Venícios de Oliveira Lopes ,
- Lígia Fahl Fonseca
Abstract
Concept analysis of Perioperative Thirst for the development of a new nursing diagnosis
Revista Brasileira de Enfermagem. 2021;74(1):e20200065
DOI 10.1590/0034-7167-2020-0065
- Leonel Alves do Nascimento ,
- Aline Korki Arrabal Garcia ,
- Marilia Ferrari Conchon ,
- Marcos Venícios de Oliveira Lopes ,
- Lígia Fahl Fonseca
Views1See moreABSTRACT
Objectives:
to analyze the perioperative thirst concept for the development of a new diagnostic structure according to NANDA International.
Methods:
a concept analysis study based on the framework proposed by Walker and Avant, instrumentalized through an integrative literature review based on SCOPUS, CINAHL, PUBMED, LILACS, and WOS. The elaboration of the diagnostic structure followed NANDA International guidelines.
Results:
41 studies were analyzed revealing that perioperative thirst is prevalent and intense, having visceral and behavioral attributes as the core of the concept. Antecedents indicate that surgical patients are vulnerable to thirst; and consequents 16 signs and symptoms were organized and model cases were developed. A diagnostic structure has been developed for perioperative thirst.
Final Considerations:
concept analysis allowed language standardization that describes thirsty patients, helping the identification, planning of actions and communication of perioperative nursing care.
- Leonel Alves do Nascimento
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ORIGINAL ARTICLE09-06-2022
Evaluating the psychometric properties of the eHealth Literacy Scale in Brazilian adults
- Fábio Luiz Mialhe ,
- Katarinne Lima Moraes ,
- Helena Alves de Carvalho Sampaio ,
- Virgínia Visconde Brasil ,
- Vanessa da Silva Carvalho Vila , [ … ],
- Flávio Rebustini
Abstract
ORIGINAL ARTICLEEvaluating the psychometric properties of the eHealth Literacy Scale in Brazilian adults
Revista Brasileira de Enfermagem. 2022;75(1):e20201320
DOI 10.1590/0034-7167-2020-1320
- Fábio Luiz Mialhe ,
- Katarinne Lima Moraes ,
- Helena Alves de Carvalho Sampaio ,
- Virgínia Visconde Brasil ,
- Vanessa da Silva Carvalho Vila ,
- Gustavo Hermes Soares ,
- Flávio Rebustini
Views0See moreABSTRACT
Objective:
To translate and adapt the eHealth Literacy Scale for the cultural reality of Brazil and to evaluate the psychometric properties of its Brazilian Portuguese version.
Methods:
The instrument was translated and adapted to Brazilian Portuguese and applied to a sample of 502 individuals from 18 to 80 years old who lived in the surrounding areas of six Family Health Units of a city in the countryside of the state of São Paulo, Brazil. The data was evaluated using exploratory and confirmatory factor analysis, item response theory, and instrument reliability measures (Cronbach’s alpha and McDonald’s omega).
Results:
The eHealth Literacy Scale – Brazilian version (eHEALS-Br) presented an excellent internal consistency (α = 0.95 e ω = 0.95), with only one dimension and an explained variation of 81.79%.
Conclusions:
The Brazilian version of the instrument showed excellent psychometric properties to measure the levels of digital health literacy in adults from the country.
- Fábio Luiz Mialhe
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REFLECTION05-11-2022
Nursing Process in the Brazilian context: reflection on its concept and legislation
- Alba Lucia Bottura Leite de Barros ,
- Amália de Fátima Lucena ,
- Sheila Coelho Ramalho Vasconcelos Morais ,
- Marcos Antônio Gomes Brandão ,
- Miriam de Abreu Almeida , [ … ],
- Rosimere Ferreira Santana
Abstract
REFLECTIONNursing Process in the Brazilian context: reflection on its concept and legislation
Revista Brasileira de Enfermagem. 2022;75(6):e20210898
DOI 10.1590/0034-7167-2021-0898
- Alba Lucia Bottura Leite de Barros ,
- Amália de Fátima Lucena ,
- Sheila Coelho Ramalho Vasconcelos Morais ,
- Marcos Antônio Gomes Brandão ,
- Miriam de Abreu Almeida ,
- Marcia Regina Cubas ,
- Tania Couto Machado Chianca ,
- Viviane Martins da Silva ,
- Maria Helena Baena de Moraes Lopes ,
- Rosimere Ferreira Santana
Views0See moreABSTRACT
Objectives:
to reflect on the global understanding of the Nursing Process concept, with emphasis on the Brazilian context.
Methods:
a reflection article, aligned with the vision and expertise of researchers who are members of the Nursing Process Research Network.
Results:
the reflection is presented in two main topics: The evolution of Systematization of Nursing Care X Nursing Process concepts and its consonance with national and international practices, and Brazilian legislation; The Nursing Process concept realignment in Brazilian legislation in line with current care, teaching and research practices. Final Considerations: the reflections were oriented to the Nursing Process’ conceptual, normative and legal issues, including elements of its historical evolution, and, with that, pointed to the need to modify the Brazilian regulation on the Nursing Process.
- Alba Lucia Bottura Leite de Barros
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