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ORIGINAL ARTICLE
Content validity of the Post-Stroke Guidance and Follow-up Booklet
- Bruna Fonseca Vasconcelos
, - Douglas de Araújo Vilhena ,
- Luísa Fonseca Vasconcelos ,
- Paula Mariana Munno Guimarães Corrêa ,
- Magnania Cristiane Pereira da Costa , [ … ],
- Thaís Peixoto Gaiad Machado
08-07-2023
Abstract
ORIGINAL ARTICLEContent validity of the Post-Stroke Guidance and Follow-up Booklet
Revista Brasileira de Enfermagem. 2023;76(3):e20220532
08-07-2023DOI 10.1590/0034-7167-2022-0532
- Bruna Fonseca Vasconcelos ,
- Douglas de Araújo Vilhena ,
- Luísa Fonseca Vasconcelos ,
- Paula Mariana Munno Guimarães Corrêa ,
- Magnania Cristiane Pereira da Costa ,
- Juliana Nunes Santos ,
- Thaís Peixoto Gaiad Machado
Views0See moreABSTRACT
Objectives:
to provide sources of content validity evidence for the Post-Stroke Guidance and Follow-up Booklet.
Methods:
a quantitative-qualitative approach, using two Delphi method and content analysis rounds. The Educational Content Validation Instrument in Health was sent to 53 independent judges. A Content Validity Index above 0.90 was considered.
Results:
of the 14 nurses who participated, 64.3% have experience with stroke care, 35.7% with primary care and 64.3% with educational material production. In content analysis, judges’ suggestions were stratified into four categories: material conformation, objectivity, accuracy and perception. Spelling changes were made to the images, addition of functionality scale, adequacy of technical terms and language. The Content Validity Index in the second round showed a concordance of 0.97.
Conclusions:
the booklet presented satisfactory content validity sources of evidence.
- Bruna Fonseca Vasconcelos
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ORIGINAL ARTICLE
Workload assessment: cross-cultural adaptation, content validity and instrument reliability
- Caroline Lopes Ciofi-Silva ,
- Luciana Cordeiro ,
- Naila Albertina Oliveira ,
- Giulia Marcelino Mainardi ,
- Anna Sara Levin , [ … ],
- Maria Clara Padoveze
08-07-2023
Abstract
ORIGINAL ARTICLEWorkload assessment: cross-cultural adaptation, content validity and instrument reliability
Revista Brasileira de Enfermagem. 2023;76(3):e20220556
08-07-2023DOI 10.1590/0034-7167-2022-0556
- Caroline Lopes Ciofi-Silva ,
- Luciana Cordeiro ,
- Naila Albertina Oliveira ,
- Giulia Marcelino Mainardi ,
- Anna Sara Levin ,
- Rodrigo Maximiano Antunes de Almeida ,
- Juliana Falasco-Fantinatti ,
- Maria Clara Padoveze
Views0See moreABSTRACT
Objectives:
to adapt, validate the content and assess the reliability of the instrument National Aeronautics and Space Administration – Task Load Index, translated into Brazilian Portuguese.
Methods:
a methodological study, divided into five steps: translation; synthesis; back-translation; assessment of the Portuguese version by an expert committee; pre-test and content validity of the final version by health professionals working in inpatient units. The Content Validity Index (CVI) (minimum 0.80) and Cronbach’s alpha (minimum 0.70) were calculated.
Results:
in the first round, in the agreement analysis of the translated version, three items did not reach the minimum CVI value. It was decided to remove the statement. The instrument title and items “performance” and “effort” were changed. There was consensus and approval of the final version in the pre-test step.
Conclusions:
the NASA Task Load Index instrument, adapted to Brazilian Portuguese, presents reliability and content validity evidence.
- Caroline Lopes Ciofi-Silva
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ORIGINAL ARTICLE
Construction and validity of the Interprofessional Communication in Health Scale
- Cláudia Patrícia da Costa Brás ,
- Manuela Maria Conceição Ferreira ,
- Maria do Céu Aguiar Barbieri de Figueiredo
08-07-2023
Abstract
ORIGINAL ARTICLEConstruction and validity of the Interprofessional Communication in Health Scale
Revista Brasileira de Enfermagem. 2023;76(3):e20220483
08-07-2023DOI 10.1590/0034-7167-2022-0483
- Cláudia Patrícia da Costa Brás ,
- Manuela Maria Conceição Ferreira ,
- Maria do Céu Aguiar Barbieri de Figueiredo
Views0See moreABSTRACT
Objectives:
to construct and validate the Interprofessional Communication Scale in Health.
Methods:
a psychometric study was carried out on a sample of 360 nurses from a hospital and university center in central Portugal. Reliability was assessed through internal consistency and construct validity through exploratory and confirmatory factor analysis.
Results:
the Interprofessional Communication in Health Scale, consisting of 27 items, is organized into 3 factors: “Teamwork”, “Conflict management” and “Leadership”, with a total variance of 51.1%. Good internal consistency was obtained, with a Cronbach’s alpha of 0.842, and adequate Goodness of Fit Index model.
Conclusions:
the Interprofessional Communication in Health Scale presents a factorial structure with adequate validity and reliability results, and may constitute a useful self-report instrument in assessing interprofessional communication in health.
- Cláudia Patrícia da Costa Brás
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ORIGINAL ARTICLE
“Educational Material on HIV”: validity of health educational technology for people living with HIV
- Ana Carolina Souza de Lima ,
- Blenda Gonçalves Cabral ,
- Jaqueline Dario Capobiango ,
- Marcos Hirata Soares ,
- Flávia Meneguetti Pieri , [ … ],
- Gilselena Kerbauy
08-07-2023
Abstract
ORIGINAL ARTICLE“Educational Material on HIV”: validity of health educational technology for people living with HIV
Revista Brasileira de Enfermagem. 2023;76(3):e20220549
08-07-2023DOI 10.1590/0034-7167-2022-0549
- Ana Carolina Souza de Lima ,
- Blenda Gonçalves Cabral ,
- Jaqueline Dario Capobiango ,
- Marcos Hirata Soares ,
- Flávia Meneguetti Pieri ,
- Gilselena Kerbauy
Views0ABSTRACT
Objectives:
to validate the educational technology “Educational Material on HIV” (INPI – BR 10 2020 003765 0).
Methods:
a methodological study with 39 expert judges in HIV/AIDS, using a 5-point Likert scale for assessment. Data were tabulated, processed and analyzed through descriptive analysis. Cronbach’s alpha and McDonald’s omega tests were performed to analyze internal consistency, and the Intraclass Correlation Coefficient, for reliability. Agreement was established by a Level Content Validity Index greater than 0.90.
Results:
the assessment instrument showed high internal consistency (Cronbach’s alpha of 0.89; McDonald’s omega of 0.91) with reliable values. Based on the Intraclass Correlation Coefficient, judges’ answers showed acceptable reliability, mean score 0.89 (p<0.001). Agreement among judges was greater than 0.90 in the three assessed dimensions (objectives, presentation and relevance).
Conclusions:
the technology was considered a qualified and adequate tool by the judges regarding its objectives, presentation and relevance.
Keywords:Acquired Immunodeficiency SyndromeEducational TechnologyHealth EducationHIVValidation StudySee more
- Ana Carolina Souza de Lima
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REVIEW
Instruments for assessing foot self-care of people with diabetes: a scoping review
- Amelina de Brito Belchior ,
- Florência Gamileira Nascimento ,
- Mariane Carlos de Sousa ,
- Ana Beatriz Mesquita da Silveira ,
- Sherida Karanini Paz de Oliveira
08-07-2023
Abstract
REVIEWInstruments for assessing foot self-care of people with diabetes: a scoping review
Revista Brasileira de Enfermagem. 2023;76(3):e20220555
08-07-2023DOI 10.1590/0034-7167-2022-0555
- Amelina de Brito Belchior ,
- Florência Gamileira Nascimento ,
- Mariane Carlos de Sousa ,
- Ana Beatriz Mesquita da Silveira ,
- Sherida Karanini Paz de Oliveira
Views0See moreABSTRACT
Objectives:
to map, in the world literature, instruments for assessing foot self-care of people with diabetes.
Methods:
a scoping review in Scopus by Elsevier, MEDLINE via PubMed, LILACS, SciELO databases and gray literature, using the controlled words diabetic foot, self care, questionnaire. Search was carried out in February and March 2021, according to JBI recommendations and PRISMA-ScR extension.
Results:
fifteen studies made up the review, 14 articles and one thesis, published between 2000 and 2020. 16 instruments were identified: five with an emphasis on general self-care and 11 on foot self-care. Inspection, hygiene, washing and drying between the toes, lotion application and use of proper shoes and socks were the main self-care measures presented.
Final Considerations:
foot self-care is assessed by knowledge, social support and frequency with which measures are being put into practice, encouraging professional practice.
- Amelina de Brito Belchior
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ORIGINAL ARTICLE
King’s Parkinson’s Disease Pain Questionnaire: reliability and convergent construct validity
- Ana Carolina Sartori ,
- Fânia Cristina dos Santos ,
- Juliana de Lima Lopes ,
- Vinicius Batista Santos ,
- Meiry Fernanda Pinto Okuno
08-07-2023
Abstract
ORIGINAL ARTICLEKing’s Parkinson’s Disease Pain Questionnaire: reliability and convergent construct validity
Revista Brasileira de Enfermagem. 2023;76(3):e20220379
08-07-2023DOI 10.1590/0034-7167-2022-0379
- Ana Carolina Sartori ,
- Fânia Cristina dos Santos ,
- Juliana de Lima Lopes ,
- Vinicius Batista Santos ,
- Meiry Fernanda Pinto Okuno
Views0See moreABSTRACT
Objectives:
to assess the evidence of reliability and convergent construct validity of the King’s Parkinson’s Disease Pain Questionnaire.
Methods:
psychometric study of 75 older adults with Parkinson’s disease. The instrument was applied by two researchers separately and reapplied by one researcher 15 days later. In terms of reliability, internal consistency was assessed using the Cronbach’s alpha test and stability using the intraclass correlation coefficient. Scores of the King’s Parkinson’s Disease Pain Questionnaire were compared to those of the Geriatric Pain Measure in the assessment of construct validity.
Results:
the mean Cronbach’s alpha obtained between the three assessments was above 0.60, the intraclass correlation between the three assessments was above 0.90, and there was a weak but significant correlation between the two applied scales.
Conclusions:
the instrument showed adequate evidence of convergent construct validity and reliability, and can be used in clinical practice.
- Ana Carolina Sartori
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ORIGINAL ARTICLE
The relationship of general, physical, and psychological violence with depressive symptoms and cognition in elders (cross-sectional study)
- Rafael da Costa Santos ,
- Gleicy Karine Nascimento De Araújo-Monteiro ,
- Matheus Farias Raposo ,
- Angela Maria Henao Castaño ,
- Betânia Maria Pereira dos Santos , [ … ],
- Rafaella Queiroga Souto
08-07-2023
Abstract
ORIGINAL ARTICLEThe relationship of general, physical, and psychological violence with depressive symptoms and cognition in elders (cross-sectional study)
Revista Brasileira de Enfermagem. 2023;76(3):e20220375
08-07-2023DOI 10.1590/0034-7167-2022-0375
- Rafael da Costa Santos ,
- Gleicy Karine Nascimento De Araújo-Monteiro ,
- Matheus Farias Raposo ,
- Angela Maria Henao Castaño ,
- Betânia Maria Pereira dos Santos ,
- Rafaella Queiroga Souto
Views0See moreABSTRACT
Objectives:
to analyze the relationship of general, physical, and psychological violence with depressive symptoms and cognition in the elderly.
Methods:
quantitative, cross-sectional study, carried out with 323 elders from the Brazilian northeast. Data collection used a sociodemographic instrument; the Conflict Tactics Scales Form R; the Geriatric Depression Scale; and the Mini-Mental State Examination. The analysis employed descriptive and inferential statistics.
Results:
as violence increases, so do the depressive symptoms; the opposite was true when comparing violence with cognitive involvement. There is a correlation between physical and psychological violence and depressive symptoms; more depressive elders are from 1.96 to 3.00 times more likely to be the victims of psychological and physical violence, respectively.
Conclusions:
general, physical, and psychological violence is associated with depressive symptoms; those with less cognitive alterations are more vulnerable to abuse. Elders with depressive symptoms are more likely to suffer psychological and physically violence.
- Rafael da Costa Santos
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ORIGINAL ARTICLE
Nursing students’ knowledge and attitude in relation to COVID-19 prevention behavior
- Vhania Dhominica Bani ,
- Pinka Kinanthi Gusti ,
- Marlita Enjel Rawul ,
- Martina Pakpahan ,
- Ester Silitonga
08-07-2023
Abstract
ORIGINAL ARTICLENursing students’ knowledge and attitude in relation to COVID-19 prevention behavior
Revista Brasileira de Enfermagem. 2023;76:e20220588
08-07-2023DOI 10.1590/0034-7167-2022-0588
- Vhania Dhominica Bani ,
- Pinka Kinanthi Gusti ,
- Marlita Enjel Rawul ,
- Martina Pakpahan ,
- Ester Silitonga
Views0See moreABSTRACT
Objectives:
to determine the correlation between nursing students’ level of knowledge and attitudes toward COVID-19 prevention behavior.
Methods:
a cross-sectional study was carried out at the Private University in Indonesia. Accidental sampling was used to select 188 third-year bachelor’s nursing students as respondents. Data collection was conducted through an online questionnaire (Cronbach’s Alpha 0.799-0.959) consisting of 27 questions. The data were analyzed descriptively and inferentially.
Results:
as many as 49.5 % of respondents had high knowledge, 98.4 % had a positive attitude, and 89.9 % had positive behavior in preventing COVID-19 transmission. The Chi-square test revealed that knowledge has no correlation with COVID-19 prevention behavior (p-value 0.864), but attitude did (p-value 0.027).
Conclusions:
nursing students’ attitudes are related to behavior in preventing COVID-19. Nursing students are expected to maintain positive attitudes and behaviors toward COVID-19 prevention as future health workers at the forefront of health services.
- Vhania Dhominica Bani
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ORIGINAL ARTICLE
Managed clinical protocol: impact of implementation on sepsis treatment quality indicators
- Camila Brito Borguezam ,
- Caroline Tolentino Sanches ,
- Silvia Paulino Ribeiro Albaneser ,
- Uiara Rodrigues de Oliveira Moraes ,
- Cintia Magalhães Carvalho Grion , [ … ],
- Gilselena Kerbauy
05-28-2021
Abstract
ORIGINAL ARTICLEManaged clinical protocol: impact of implementation on sepsis treatment quality indicators
Revista Brasileira de Enfermagem. 2021;74(2):e20200282
05-28-2021DOI 10.1590/0034-7167-2020-0282
- Camila Brito Borguezam ,
- Caroline Tolentino Sanches ,
- Silvia Paulino Ribeiro Albaneser ,
- Uiara Rodrigues de Oliveira Moraes ,
- Cintia Magalhães Carvalho Grion ,
- Gilselena Kerbauy
Views1See moreABSTRACT
Objectives:
to assess the impact of the implementation of a managed sepsis protocol on quality indicators of treatment for septic patients in an emergency department of a university hospital.
Methods:
an observational epidemiological study involving septic patients. The study was divided into two phases, pre-intervention and intervention, resulting from the implementation of the managed sepsis protocol. The study variables included sepsis treatment quality indicators. The results were statistically analyzed using the program Epi InfoTM.
Results:
the study sample included 631 patients, 95 from pre-intervention phase and 536 from intervention phases. Implementing the protocol increased patients’ chances of receiving the recommended treatment by 14 times. Implementing the protocol reduced the hospitalization period by 6 days (p <0.001) and decreased mortality (p <0.001).
Conclusions:
this study showed that implementing the managed protocol had an impact on the improvement of sepsis treatment quality indicators.
- Camila Brito Borguezam
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ORIGINAL ARTICLE
Development of an appearance validity instrument for educational technology in health
Revista Brasileira de Enfermagem. 2020;73:e20190559
12-21-2020
Abstract
ORIGINAL ARTICLEDevelopment of an appearance validity instrument for educational technology in health
Revista Brasileira de Enfermagem. 2020;73:e20190559
12-21-2020DOI 10.1590/0034-7167-2019-0559
Views1ABSTRACT
Objectives:
to develop and evaluate the convergence of the instrument for the appearance validity of educational technologies in health.
Methods:
methodological study conducted in two steps. In step 1, the instrument items were developed, with subsequent content validity by nine specialists in the development of educational technologies in health. In step 2, the convergent validity between another instrument and the appearance instrument was performed. Correlation results above r> 0.3 and p <0.05 were considered as plausible convergent validity.
Results:
the ten items of the initial version of the appearance instrument were submitted to content validity that resulted in a final version with 12 items (Content Validity Index = 0.93). The correlation indexes were strong with the objective and appearance domains; moderate with motivation, organization and total; and weak with writing style.
Conclusions:
the appearance instrument demonstrated content validity and convergent validity, in addition to a strong correlation with the other instrument.
Keywords:Educational TechnologyHealth EducationMethodological Research in NursingTechnological DevelopmentValidation StudiesSee more -
REVIEW
Middle range theory for the nursing diagnosis Excess Fluid Volume in pregnant women
- Nathaly Bianka Moraes Fróes ,
- Marcos Venícios de Oliveira Lopes ,
- Cleide Maria Pontes ,
- Gabriele Lima Ferreira ,
- Priscila de Souza Aquino
09-21-2020
Abstract
REVIEWMiddle range theory for the nursing diagnosis Excess Fluid Volume in pregnant women
Revista Brasileira de Enfermagem. 2020;73:e20190334
09-21-2020DOI 10.1590/0034-7167-2019-0334
- Nathaly Bianka Moraes Fróes ,
- Marcos Venícios de Oliveira Lopes ,
- Cleide Maria Pontes ,
- Gabriele Lima Ferreira ,
- Priscila de Souza Aquino
Views1See moreABSTRACT
Objective:
To stablish a middle range theory for the understanding of the causal mechanisms and clinical consequentes of the nursing diagnosis Excess Fluid Volume (00026) among pregnant women.
Method:
The Middle Range Theory was constructed in five stages: defining of construction approach, establishing main concepts, elaborating propositions, developing a pictorial diagram, and establishing the causal relationships and evidence for practice of the Middle Range Theory.
Results:
We identified 14 clinical indicators and 6 causal factors of Excess Fluid Volume. A pictorial diagram was developed and relationships between Excess Fluid Volume elements were established with 6 propositions for them.
Conclusion:
The Middle Range Theory included both physiological and pathological conditions to explain Excess Fluid Volume. This Middle Range Theory might help in the better understanding of interactions between causal factors and clinical indicators of Excess Fluid Volume.
- Nathaly Bianka Moraes Fróes
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ORIGINAL ARTICLE
Nurses’ work process in an emergency hospital service
- Simone Kroll Rabelo ,
- Suzinara Beatriz Soares de Lima ,
- José Luís Guedes dos Santos ,
- Valdecir Zavarese da Costa ,
- Emilene Reisdorfer , [ … ],
- Jocelaine Cardoso Gracioli
07-06-2020
Abstract
ORIGINAL ARTICLENurses’ work process in an emergency hospital service
Revista Brasileira de Enfermagem. 2020;73(5):e20180923
07-06-2020DOI 10.1590/0034-7167-2018-0923
- Simone Kroll Rabelo ,
- Suzinara Beatriz Soares de Lima ,
- José Luís Guedes dos Santos ,
- Valdecir Zavarese da Costa ,
- Emilene Reisdorfer ,
- Tanise Martins dos Santos ,
- Jocelaine Cardoso Gracioli
Views1ABSTRACT
Objectives:
to analyze the nurses’ work process in an Emergency Hospital Service.
Methods:
a qualitative, exploratory and descriptive research conducted with 17 nurses from the emergency service of a high complexity hospital in southern Brazil. Data were collected through interviews, focus group and document analysis. Data analysis followed the thematic content analysis framework.
Results:
four categories emerged: Work environment characteristics; Assistance dimension; Management dimension; Care management.
Final Considerations:
the nurses’ work process in Emergency Hospital Service is characterized by the peculiarities of the setting, with centrality in care and care management aiming at quality care and safety to patients.
Keywords:Emergency NursingEmergency Service, HospitalHealth ManagementNurse's RoleProfessional PracticeSee more - Simone Kroll Rabelo
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ORIGINAL ARTICLE
Quality of life at work in a central sterile processing department
- Gliccia Morguethe Vieira Rego ,
- Isaura Letícia Tavares Palmeira Rolim ,
- Aurean D’Eça Júnior ,
- Ana Hélia de Lima Sardinha ,
- Geysa Santos Góis Lopes , [ … ],
- Nair Portela Silva Coutinho
03-09-2020
Abstract
ORIGINAL ARTICLEQuality of life at work in a central sterile processing department
Revista Brasileira de Enfermagem. 2020;73(2):e20180792
03-09-2020DOI 10.1590/0034-7167-2018-0792
- Gliccia Morguethe Vieira Rego ,
- Isaura Letícia Tavares Palmeira Rolim ,
- Aurean D’Eça Júnior ,
- Ana Hélia de Lima Sardinha ,
- Geysa Santos Góis Lopes ,
- Nair Portela Silva Coutinho
Views1See moreABSTRACT
Objectives:
to evaluate the quality of life of nursing professionals who work in a central sterile processing department.
Methods:
a descriptive, quantitative, exploratory study, conducted with 82 nursing professionals working in the Central Sterile Processing Department of a University Hospital, from September to November 2017. A semi-structured instrument and the questionnaire “Medical Outcomes Study Short-Form 36” were used. Results: most of the participants were female, married, aged 31-40 years; 47.6% with 6-10 years of profession, and 82.9% reported working in CSPD for 1-5 years. The most affected quality of life domains were Pain, Vitality, General Health Status and Social Aspects.
Conclusions:
This study showed a need for rethinking and re-creating the labor dynamics in CSPD to improve the quality of life of these nursing professionals.
- Gliccia Morguethe Vieira Rego
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ORIGINAL ARTICLE
Care complexity in hospitalized elderly according to cognitive performance
Revista Brasileira de Enfermagem. 2019;72:134-139
12-05-2019
Abstract
ORIGINAL ARTICLECare complexity in hospitalized elderly according to cognitive performance
Revista Brasileira de Enfermagem. 2019;72:134-139
12-05-2019DOI 10.1590/0034-7167-2018-0357
Views1See moreABSTRACT
Objective:
to investigate possible differences in care complexity, functional performance and biopsychosocial and health system aspects among hospitalized elderly with or without cognitive decline.
Method:
quantitative, cross-sectional and analytical study in which was used the INTERMED method and cognitive and functional screening scales. We investigated 384 elderly patients admitted to a medical and surgical clinic of a University Hospital located in São Paulo/SP.
Results:
cognitive decline was present in 40.1% of the sample, most of them were longer-lived elderly individuals with less schooling and income, more dependent in activities of daily living and had greater vulnerability in different domains of INTERMED. After adjustments, the elderly with cognitive decline presented greater vulnerability in the psychological domain.
Conclusion:
the relationship between cognitive decline and psychological vulnerability highlights the need to adopt long-term care based on involvement of the family, health team and different services, thereby maximizing the quality of care.
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ORIGINAL ARTICLE
Spatial analysis on tuberculosis and the network of primary health care
- Beatriz do Nascimento Leal ,
- Cristal Ribeiro Mesquita ,
- Laura Maria Vidal Nogueira ,
- Ivaneide Leal Ataide Rodrigues ,
- Lívia Félix de Oliveira , [ … ],
- Rosinelle Janayna Coelho Caldas
09-16-2019
Abstract
ORIGINAL ARTICLESpatial analysis on tuberculosis and the network of primary health care
Revista Brasileira de Enfermagem. 2019;72(5):1197-1202
09-16-2019DOI 10.1590/0034-7167-2017-0897
- Beatriz do Nascimento Leal ,
- Cristal Ribeiro Mesquita ,
- Laura Maria Vidal Nogueira ,
- Ivaneide Leal Ataide Rodrigues ,
- Lívia Félix de Oliveira ,
- Rosinelle Janayna Coelho Caldas
Views1See moreABSTRACT
Objective:
to analyze the spatial distribution of new cases of tuberculosis compared to the location of the Primary Healthcare Units that performed the compulsory notification.
Method:
ecological study conducted in Belém, Pará, with 5,294 new cases of tuberculosis notified to Sistema de Informação de Agravos de Notificação for the period from 2010 to 2014. The cases were georeferenced using the software applications ArcGis 10.2 and TerraView 4.2.2. The techniques of Kernel density and global Moran geostatistics were used.
Results:
the incidence of tuberculosis cases did not vary significantly between the years studied, however there was a variation in incidence between neighborhoods. Health units that exhibited higher number of notifications can suffer great influence of migration from nearby neighborhoods.
Conclusion:
the spatial dynamics of tuberculosis associated with health services allows to know the areas with increased risk of tuberculosis and the density of notifications of health units.
- Beatriz do Nascimento Leal
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