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10-09-2023
Standard Operating Procedure validity on intramuscular vaccine administration in adults: a methodological study
- Elaine Aparecida da Cunha Lima
, - Renata Oliveira Caetano ,
- Marisa Dibbern Lopes Correia ,
- Luana Vieira Toledo ,
- Thais Bitencourt Faria , [ … ],
- Luciene Muniz Braga Daskaleas
Abstract
Standard Operating Procedure validity on intramuscular vaccine administration in adults: a methodological study
Revista Brasileira de Enfermagem. 2023;76(4):e20220692
DOI 10.1590/0034-7167-2022-0692
- Elaine Aparecida da Cunha Lima ,
- Renata Oliveira Caetano ,
- Marisa Dibbern Lopes Correia ,
- Luana Vieira Toledo ,
- Thais Bitencourt Faria ,
- Daniela de Almeida Pereira ,
- Luciene Muniz Braga Daskaleas
Views0See moreABSTRACT
Objective:
to validate a Standard Operating Procedure on the intramuscular vaccine administration technique in adults using high frequency vibration associated with cryotherapy.
Methods:
a literature review on intramuscular vaccination practice using a vibration device associated with cryotherapy. Then, a form was created to validate the instrument, detailing the items that were assessed by judges following recommendations in the literature. Judges’ answers were assessed using the Content Validity Index, with items whose index was greater than or equal to 0.80 being validated.
Results:
twenty-five nurses participated in validity, identifying judges’ opinion regarding item relevance, clarity and accuracy. Judges validated the instrument, according to the values that remained between 0.88 and 1.0.
Conclusions:
the instrument developed and validated is a tool capable of guaranteeing safety and standardizing immunization practice in vaccine rooms.
- Elaine Aparecida da Cunha Lima
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ORIGINAL ARTICLE10-09-2023
Translation and validity of the Multidimensional Individual and Interpersonal Resilience Measure
- Jéssica Diniz Rodrigues Ferreira ,
- Mariana Figueiredo Miranda ,
- Millena Figueiredo Miranda ,
- Marco Aurélio Romano-Silva ,
- Maria Aparecida Camargos Bicalho , [ … ],
- Bernardo de Mattos Viana
Abstract
ORIGINAL ARTICLETranslation and validity of the Multidimensional Individual and Interpersonal Resilience Measure
Revista Brasileira de Enfermagem. 2023;76(4):e20220696
DOI 10.1590/0034-7167-2022-0696
- Jéssica Diniz Rodrigues Ferreira ,
- Mariana Figueiredo Miranda ,
- Millena Figueiredo Miranda ,
- Marco Aurélio Romano-Silva ,
- Maria Aparecida Camargos Bicalho ,
- Bernardo de Mattos Viana
Views0See moreABSTRACT
Objective:
to translate, culturally adapt and validate the Multidimensional Individual and Interpersonal Resilience Measure to Brazilian Portuguese.
Method:
after initial translation, the pre-final version underwent rigorous cultural adaptation procedures. As a result, the final adapted version was submitted to a validity study.
Results:
adaptation procedures provided equivalence between the pre-final and the original versions in semantic, idiomatic, experiential and conceptual terms. A total of 187 older adults were included in the validity study. Exploratory factorial analysis (EFA) generated a model of five factors ((RMSEA = 0.030; TLI = 0.959; X = 151.590 p> 0.05). Final version showed adequate consistency (Cronbach’s α = 0.705) and test-retest reliability (ICC=0.835). No statistically significant correlation was found between resilience and sociodemographic and epidemiological variables assessed in this study.
Conclusion:
EMRII-BR is a valid and reliable instrument for measuring resilience in Brazilian older adults.
- Jéssica Diniz Rodrigues Ferreira
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ORIGINAL ARTICLE10-09-2023
Health care for people with tuberculosis/HIV co-infection from the multidisciplinary team’s perspective
- Eduarda Aguiar da Silva ,
- Paula Hino ,
- Hugo Fernandes ,
- Maria Rita Bertolozi ,
- Aline Aparecida Monroe , [ … ],
- Lucimara Fabiana Fornari
Abstract
ORIGINAL ARTICLEHealth care for people with tuberculosis/HIV co-infection from the multidisciplinary team’s perspective
Revista Brasileira de Enfermagem. 2023;76(4):e20220733
DOI 10.1590/0034-7167-2022-0733
- Eduarda Aguiar da Silva ,
- Paula Hino ,
- Hugo Fernandes ,
- Maria Rita Bertolozi ,
- Aline Aparecida Monroe ,
- Lucimara Fabiana Fornari
Views0See moreABSTRACT
Objective:
to know the multidisciplinary team’s perspective about the health care of people with tuberculosis and human immunodeficiency virus co-infection in relation to treatment.
Methods:
this is a descriptive-exploratory study, with a qualitative approach, carried out in a health care service in São Paulo, from May to June 2019. Semi-structured interviews were conducted with nine professionals from the multidisciplinary team. Data were processed through discourse analysis with the support of webQDA.
Results:
Two empirical categories emerged: Health care interfaces for people with tuberculosis and human immunodeficiency virus co-infection; Barriers and facilitators for health care for people with co-infection.
Final considerations:
the health-disease process in co-infection is mediated by conditions that positively or negatively interfere with treatment compliance. People’s health care goes beyond exclusively clinical assistance and requires the recognition of needs in a broad perspective.
- Eduarda Aguiar da Silva
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ORIGINAL ARTICLE10-09-2023
Independent and combined effects of lifestyle behaviors on adolescent health-related quality of life
Revista Brasileira de Enfermagem. 2023;76(4):e20220780
Abstract
ORIGINAL ARTICLEIndependent and combined effects of lifestyle behaviors on adolescent health-related quality of life
Revista Brasileira de Enfermagem. 2023;76(4):e20220780
DOI 10.1590/0034-7167-2022-0780
Views0See moreABSTRACT
Objective:
To investigate the independent and combined effects of lifestyle behaviors, including physical activity, sedentary behavior, sleep duration and food intake, in the health-related quality of life (HRQoL) of Brazilian adolescents.
Methods:
Cross-sectional school-based study, with the participation of 306 adolescents aged 14 to 18 years. A questionnaire was applied with structured questions to collect lifestyle behaviors data. Perception of the HRQoL was identified using the Kidscreen-27. The study used covariance analysis and linear regression models for statistical analysis.
Results:
Adolescents who reported ≤ 2 hours/day of screen-based sedentary behavior and sleep duration equivalent to 8-10 hours/night presented significantly higher HRQoL. Adolescents who reported joint adherence ≥ 3 healthy lifestyle behaviors demonstrated approximately two [OR=2.12] to three times [OR=3.04] more chance of presenting higher perceptions of HRQoL.
Conclusion:
Although healthy lifestyle behaviors had a positive independent effect on HRQoL, joint adherence to healthy behaviors enhances the cumulative effect.
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ORIGINAL ARTICLE10-09-2023
Spirituality in the uncertainty of illness: the perspective of oncology patients
- Roberto Firpo de Almeida Filho ,
- Maria Cristina Soares Figueiredo Trezza ,
- Isabel Comassetto ,
- Lucas Kayzan Barbosa da Silva ,
- Marcela Porangaba Lopes , [ … ],
- Francyane Adielle de Souza Praxedes
Abstract
ORIGINAL ARTICLESpirituality in the uncertainty of illness: the perspective of oncology patients
Revista Brasileira de Enfermagem. 2023;76(4):e20220712
DOI 10.1590/0034-7167-2022-0712
- Roberto Firpo de Almeida Filho ,
- Maria Cristina Soares Figueiredo Trezza ,
- Isabel Comassetto ,
- Lucas Kayzan Barbosa da Silva ,
- Marcela Porangaba Lopes ,
- Kleytonn Giann Silva de Santana ,
- Francyane Adielle de Souza Praxedes
Views0See moreABSTRACT
Objective:
To analyze spirituality in the process of illness uncertainty in cancer patients.
Methods:
This is a qualitative study, in which Merle Mishel’s Theory of Uncertainty of Disease was used as a theoretical framework; and as a methodological reference, the stages of Bardin’s Content Analysis. As a technique for obtaining information, a semi-structured interview was used.
Results:
Spirituality in the uncertainty of the disease varies from patient to patient and acts in a unique way. They presented readaptation attitudes in their reports. The presence of spirituality in their lives acted as the main force mechanism to deal with the uncertainty of the disease, and this moment was called by Mishel “probabilistic thinking”.
Conclusion:
Patients demonstrated readaptation attitudes in their reports, and spirituality acted as the main mechanism of strength to deal with uncertainty in the disease
- Roberto Firpo de Almeida Filho
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ORIGINAL ARTICLE10-09-2023
Glycemic variability and mortality in oncologic intensive care units
Revista Brasileira de Enfermagem. 2023;76(4):e20220812
Abstract
ORIGINAL ARTICLEGlycemic variability and mortality in oncologic intensive care units
Revista Brasileira de Enfermagem. 2023;76(4):e20220812
DOI 10.1590/0034-7167-2022-0812
Views0See moreABSTRACT
Objective:
This study aimed to investigate the association between glycemic variability and mortality in patients admitted to oncologic intensive care units.
Methods:
A retrospective cohort study was conducted using a convenience sample of 30 medical records of patients over 18 years of age of both sexes. Glycemic variability was measured using the standard deviation and general amplitude. Statistical analysis was performed using the receiver operating characteristic (ROC) curve and the area under the curve (AUC). The significance level (α) was set at 5% with a confidence interval (CI) of 95%.
Results:
The study included 14 male patients (46.67%) with a mean age of 60±15 years. A total of 1503 blood glucose samples were collected. The AUC analysis for the standard deviation did not show a statistically significant result (p=.966; 95% CI=[0.283, 0.726]). In contrast, the general amplitude had a statistically significant association with mortality (p=.049; 95% CI=[0.514, 0.916]).
Conclusions:
This study found that glycemic variability measured by the general amplitude was significantly associated with patient mortality in oncologic intensive care units. These findings suggest that monitoring glycemic variability may be an important factor in the management of critically ill patients in oncologic intensive care units.
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ORIGINAL ARTICLE10-09-2023
Educational intervention in social skills for Primary Care nurses
- Aline Loiola Moura Bianconi ,
- Tatiana da Silva Melo Malaquias ,
- Adriana Valongo Zani ,
- Elen Ferraz Teston ,
- Maira Sayuri Sakai Bortoletto , [ … ],
- Maria do Carmo Fernandez Lourenço Haddad
Abstract
ORIGINAL ARTICLEEducational intervention in social skills for Primary Care nurses
Revista Brasileira de Enfermagem. 2023;76(4):e20220503
DOI 10.1590/0034-7167-2022-0503
- Aline Loiola Moura Bianconi ,
- Tatiana da Silva Melo Malaquias ,
- Adriana Valongo Zani ,
- Elen Ferraz Teston ,
- Maira Sayuri Sakai Bortoletto ,
- Maria do Carmo Fernandez Lourenço Haddad
Views0See moreABSTRACT
Objective:
to assess an educational intervention on social skills for nurses who work in Primary Health Care.
Method:
a qualitative research-intervention study, carried out in the municipalities covered by the 17th Health Regional of Paraná. It was developed in three interrelated stages: exploratory, where meetings were held with the managers to define the groups and logistics for running the course; intermediate, developed in meetings with different groups of nurses, addressing selected topics; assessment, in which the nurses developed a personal plan to improve their social skills.
Results:
participants were 57 nurses who acted as coordinators of Primary Care. They considered the educational intervention in social skills fundamental for positive changes in their professional performance.
Final considerations:
the educational intervention in social skills was assessed as an important strategy to strengthen the development of nurses’ managerial and care skills.
- Aline Loiola Moura Bianconi
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ORIGINAL ARTICLE10-09-2023
Intestinal parasitic infections: telephone health literacy with men in areas of poverty in the syndemic
- Julio Cesar Pegado Bordignon ,
- Antonia de Castro Ribeiro ,
- Érica Tex Paulino ,
- Maria de Fatima Leal Alencar ,
- Marcio Neves Boia , [ … ],
- Antonio Henrique Almeida de Moraes Neto
Abstract
ORIGINAL ARTICLEIntestinal parasitic infections: telephone health literacy with men in areas of poverty in the syndemic
Revista Brasileira de Enfermagem. 2023;76(4):e20220300
DOI 10.1590/0034-7167-2022-0300
- Julio Cesar Pegado Bordignon ,
- Antonia de Castro Ribeiro ,
- Érica Tex Paulino ,
- Maria de Fatima Leal Alencar ,
- Marcio Neves Boia ,
- Antonio Henrique Almeida de Moraes Neto
Views0See moreABSTRACT
Objectives:
to assess Popular Health Education practices on intestinal parasites, carried out by telephone contact with men living in urban communities in Rio de Janeiro, Brazil, during the COVID-19 syndemic.
Method:
a quasi-experimental, quantitative and descriptive study, carried out with men aged 20 to 59 years. Pre-test was applied, and participants were divided into two groups: control and experimental. Popular Education in Health practices were carried out with an experimental group, and post-test was applied for both.
Results:
health education practices were significant in the experimental group, with a reduction in incorrect answers. There was an increase in incorrect answers in the control group’s post-test.
Conclusions:
the Brazilian National Policy for Popular Education in Health contributed to qualify men’s health literacy on intestinal parasites. Practice by telephone contact proved to be a powerful strategy for nursing and public policies to access this group and promote health in Primary Health Care.
- Julio Cesar Pegado Bordignon
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REVIEW09-18-2020
Allocation of resources for health care in COVID-19 pandemic times: integrative review
- Karla Rona da Silva ,
- Fernanda Gonçalves de Souza ,
- Fátima Ferreira Roquete ,
- Shirlei Moreira da Costa Faria ,
- Bruno César Ferreira Peixoto , [ … ],
- Adriane Vieira
Abstract
REVIEWAllocation of resources for health care in COVID-19 pandemic times: integrative review
Revista Brasileira de Enfermagem. 2020;73:e20200244
DOI 10.1590/0034-7167-2020-0244
- Karla Rona da Silva ,
- Fernanda Gonçalves de Souza ,
- Fátima Ferreira Roquete ,
- Shirlei Moreira da Costa Faria ,
- Bruno César Ferreira Peixoto ,
- Adriane Vieira
Views0See moreABSTRACT
Objective:
To analyze information on resource allocation in the context of the COVID-19 pandemic, published in indexed scientific journals, from December 2019 to March 2020.
Methods:
This is an integrative literature review, which took place in March 2020. All databases were investigated and studies were found only in MEDLINE. After applying the established criteria, six articles were selected.
Results:
It was evident that the allocation of resources is carried out as the demands emerge. The fragility in presenting scientific-methodological evidence that can guide decision makers for assertive allocation of available resources is highlighted. The results showed that studies on this subject are incipient and need to be expanded.
Final considerations:
The need for health organizations and area authorities to be better prepared for the proper use of available resources, with allocation based on scientific evidence and maximization of resources is indicated.
- Karla Rona da Silva
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ORIGINAL ARTICLE05-24-2021
Critical thinking in nursing training: evaluation in the area of competence Education in Health
Revista Brasileira de Enfermagem. 2021;74:e20200979
Abstract
ORIGINAL ARTICLECritical thinking in nursing training: evaluation in the area of competence Education in Health
Revista Brasileira de Enfermagem. 2021;74:e20200979
DOI 10.1590/0034-7167-2020-0979
Views0See moreABSTRACT
Objective:
To analyze the constitution of critical thinking in nursing training in the approach by competence and the integrated curriculum, considering the evaluation process by capturing its challenges, and proposing overcoming strategies.
Methods:
Qualitative. In the first phase of data collection, interviews were conducted with twenty-four professors, nine preceptors, and fifteen students to reconstruct the profile of competence, and in the second phase, a workshop to validate the profile identified challenges and proposals. The Collective Subject Discourse was used to analyze the interviews and the holistic competence reference in reconstructing the profile.
Results:
The critical thinking is built based on experiences in the world of work, and evaluation is the conductor of reflections towards emancipation.
Final considerations:
It signals the importance of professor training in the learning evaluation and working with the collective construction of subjects to overcome challenges that happen in the changes of training.
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REFLECTION10-26-2020
Covid-19 pandemic and the motivations for demanding health service in indigenous villages
Revista Brasileira de Enfermagem. 2020;73:e20200312
Abstract
REFLECTIONCovid-19 pandemic and the motivations for demanding health service in indigenous villages
Revista Brasileira de Enfermagem. 2020;73:e20200312
DOI 10.1590/0034-7167-2020-0312
Views0See moreABSTRACT
Objective:
To discuss the fundamental aspects in the establishment of preventive measures to tackle covid-19 among indigenous people in view of the motivations for seeking health care in villages of the Terra Indígena Buriti, Mato Grosso do Sul, Brazil.
Methods:
Theoretical-reflective study based on assumptions of the National Health System and previous ethnographic research that enabled the identification of the motivations to seek health care in Buriti villages.
Results:
Indigenous people seek health centers for health care programs assistance, treatment of cases they cannot resolve and to chat. Such motivations were the basis for discussing the indigenization process in the confrontation of the new coronavirus pandemic in indigenous lands.
Final considerations:
The motivations for seeking health care show the physical and social vulnerability of the Terena ethnicity. The effectiveness of the social isolation measure in the villages depends on the dialogue with indigenous leaders, professional engagement and intersectoral actions.
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ORIGINAL ARTICLE07-10-2020
Formation of protagonist adolescents to prevent bullying in school contexts
- Waldemar Brandão Neto ,
- Catharina Ohany da Silva ,
- Renata Ribeiro Torres do Amorim ,
- Jael Maria de Aquino ,
- Antonio José de Almeida Filho , [ … ],
- Estela Maria Leite Meirelles Monteiro
Abstract
ORIGINAL ARTICLEFormation of protagonist adolescents to prevent bullying in school contexts
Revista Brasileira de Enfermagem. 2020;73:e20190418
DOI 10.1590/0034-7167-2019-0418
- Waldemar Brandão Neto ,
- Catharina Ohany da Silva ,
- Renata Ribeiro Torres do Amorim ,
- Jael Maria de Aquino ,
- Antonio José de Almeida Filho ,
- Betânia da Mata Ribeiro Gomes ,
- Estela Maria Leite Meirelles Monteiro
Views0See moreABSTRACT
Objective:
to develop a participative strategy of health education in the formative process of protagonist adolescents aimed at preventing school bullying.
Method:
qualitative interventive-participatory research, based on the Community-Based Participatory Research and in the Culture Circles of Paulo Freire. The sample was intentional, with the participation of 12 adolescents who were considered leaders. For data production at the moment of educational intervention, observation techniques were employed with note-taking in a field diary, plus photographic and video records.
Results:
the pedagogical intervention model raised the opportunity for the adolescents’ active participation, aiming at the development of skills that create pro-social behaviors, empathetic and assertive relations, which are able to face bullying and transform the school environment.
Final considerations:
the use of participative methodologies, in the youth protagonism perspective, has the potential to support educational practices of school nurses in collaboration and leadership of antibullying programs.
- Waldemar Brandão Neto
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03-26-2021
Professional competency for elder care: perception among professors, nursing students, and nurses
- Rafaela Ferreira ,
- Flávia Maria Derhun ,
- Lígia Carreira ,
- Vanessa Denardi Antoniassi Baldissera ,
- Cremilde Aparecida Trindade Radovanovic , [ … ],
- Pamela Patrícia Mariano
Abstract
Professional competency for elder care: perception among professors, nursing students, and nurses
Revista Brasileira de Enfermagem. 2021;74:e20200446
DOI 10.1590/0034-7167-2020-0446
- Rafaela Ferreira ,
- Flávia Maria Derhun ,
- Lígia Carreira ,
- Vanessa Denardi Antoniassi Baldissera ,
- Cremilde Aparecida Trindade Radovanovic ,
- Pamela Patrícia Mariano
Views0See moreABSTRACT
Objective:
to know the perception of nurses, undergraduate students, and professors about the competencies for professional nurses in elder care.
Methods:
this is a qualitative analytical study developed with six professors, four nurses, and 12 nursing students. Data were collected through semi-structured interviews and analyzed using Fiorin’s Discourse technique, with support from the MAXQDA software.
Results:
the competencies identified included knowledge of theories and general concepts of gerontology, communication, listening, leadership, teamwork, proactivity, respect, and empathy.
Final considerations:
knowing the competencies contributes to understanding the aging process and qualifying nurses for elder care.
- Rafaela Ferreira
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ORIGINAL ARTICLE08-30-2021
Family functionality and burden of family caregivers of users with mental disorders
- Jaciquely José da Costa Andrade ,
- Andrea Cristina Oliveira Silva ,
- Iracema da Silva Frazão ,
- Jaqueline Galdino Albuquerque Perrelli ,
- Thassia Thame de Moura Silva , [ … ],
- Ana Márcia Tenório Souza Cavalcanti
Abstract
ORIGINAL ARTICLEFamily functionality and burden of family caregivers of users with mental disorders
Revista Brasileira de Enfermagem. 2021;74(5):e20201061
DOI 10.1590/0034-7167-2020-1061
- Jaciquely José da Costa Andrade ,
- Andrea Cristina Oliveira Silva ,
- Iracema da Silva Frazão ,
- Jaqueline Galdino Albuquerque Perrelli ,
- Thassia Thame de Moura Silva ,
- Ana Márcia Tenório Souza Cavalcanti
Views0See moreABSTRACT
Objective:
to verify the difference of mean or median in the scores of family functionality and burden of family caregivers of people with mental disorders.
Methods:
cross-sectional study carried out in a Psychosocial Care Center with 61 family caregivers. Instruments were used for sociodemographic characterization, care process, Family Apgar Index and Family Burden Interview Schedule. Mean/median difference tests were adopted.
Results:
women with mental disorders and the presence of children in the home decreased the median of the family Apgar score. Difficulty in the relationship between caregiver/user, nervousness/tension, physical aggression and agitation of patients increased the global average of subjective burden.
Conclusions:
nursing interventions to reduce burden and promote family functionality should prioritize caregivers of women with mental disorders, assist them in managing troublesome behaviors and raising awareness of family nucleus to co-responsibility for caring for sick people, especially in families with children who demand daily care.
- Jaciquely José da Costa Andrade
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REVIEW07-06-2020
Middle-Range Theory for the Nursing Diagnosis of Low Self-Efficacy in Health
Revista Brasileira de Enfermagem. 2020;73(5):e20190370
Abstract
REVIEWMiddle-Range Theory for the Nursing Diagnosis of Low Self-Efficacy in Health
Revista Brasileira de Enfermagem. 2020;73(5):e20190370
DOI 10.1590/0034-7167-2019-0370
Views0See moreABSTRACT
Objectives:
theoretical validation of the concept of low self-efficacy in health as a nursing diagnosis construct.
Methods:
construction of a middle-range theory for validating diagnoses, comprised of five stages: definition of the approach for building the theory; definition of the main concepts; creation of a pictorial diagram; formulation of proposals; establishment of causal relationships and evidence for clinical practice. The main concepts were identified through a literature review and the studies were taken from the LILACS, SCOPUS, CINAHL and PubMed/MEDLINE databases. The final sample was comprised of 92 articles.
Results:
eighteen etiological factors and 16 clinical indicators were identified; characterized as antecedents and manifestations for inferring a diagnosis of low self-efficacy in health.
Conclusions:
the related concepts of the new nursing diagnosis of low self-efficacy in health, to be applied in clinical nursing practice, were identified and defined.
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REFLECTION06-04-2021
Care in pediatric nursing from the perspective of emotions: from Nightingale to the present
- Paula Manuela Jorge Diogo ,
- Bruna Hinnah Borges Martins de Freitas ,
- Ana Inês Lourenço da Costa ,
- Maria Aparecida Munhoz Gaíva
Abstract
REFLECTIONCare in pediatric nursing from the perspective of emotions: from Nightingale to the present
Revista Brasileira de Enfermagem. 2021;74(4):e20200377
DOI 10.1590/0034-7167-2020-0377
- Paula Manuela Jorge Diogo ,
- Bruna Hinnah Borges Martins de Freitas ,
- Ana Inês Lourenço da Costa ,
- Maria Aparecida Munhoz Gaíva
Views0See moreABSTRACT
Objective:
Reflect on the evolution of pediatric nursing care from the perspective of emotions, from the conceptions of Florence Nightingale to the present.
Method:
Reflective study based on theoretical and experiential aspects of emotional care in pediatric nursing.
Results:
From Nightingale, there were many definitions regarding the nursing care in an integrative and humanist logic; and with certain bond to emotional dimension. That time, nursing care was based on the religious conceptions of charity and love of our neighbor and, despite the conceptualization that shapes nursing science today, such conceptions have not ceased to be its attribute, mainly in the care of pediatric nurses.
Final considerations:
In pediatric nursing, nurture care with affection and facilitate emotions management in each interaction nurse-child-family is crucial for caring. This emotional care should evolve into a competence that recognizes the expertise and merit of professional action.
- Paula Manuela Jorge Diogo
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