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ORIGINAL ARTICLE07-29-2024
Contribution of informal caregivers to self-care in individuals with heart failure
- Mailson Marques de Sousa
, - Adriana Meira Tiburtino Nepomuceno ,
- Rayana Pereira Feitosa ,
- Lara de Sá Neves Loureiro ,
- Renan Alves Silva , [ … ],
- Simone Helena dos Santos Oliveira
Abstract
ORIGINAL ARTICLEContribution of informal caregivers to self-care in individuals with heart failure
Revista Brasileira de Enfermagem. 2024;77(3):e20230492
DOI 10.1590/0034-7167-2023-0492
- Mailson Marques de Sousa ,
- Adriana Meira Tiburtino Nepomuceno ,
- Rayana Pereira Feitosa ,
- Lara de Sá Neves Loureiro ,
- Renan Alves Silva ,
- Maria das Graças Melo Fernandes ,
- Simone Helena dos Santos Oliveira
Views0See moreABSTRACT
Objectives:
to evaluate the contribution of informal caregivers to the self-care of individuals with heart failure.
Methods:
a cross-sectional study was conducted with 87 caregivers from March to October 2022 in the city of João Pessoa/PB. The caregivers’ contribution was assessed using the Caregiver Contribution to Self-Care of Heart Failure Index instrument. Scores ≥ 70 points indicate adequate contribution. Data were analyzed using descriptive statistics and Spearman’s correlation.
Results:
the sample consisted of 81.6% female caregivers. Median scores obtained for the self-care contribution scales were: 63.3 for maintenance; 55.5 for management; and 66.6 for confidence. Caregivers never or rarely recommended monitoring body weight, regular physical exercise, extra use of diuretics, and fluid restriction.
Conclusions:
informal caregivers showed inadequate contribution in the areas of maintenance, management, and confidence in self-care of individuals with heart failure.
- Mailson Marques de Sousa
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ORIGINAL ARTICLE07-29-2024
Mental health of parents of children and adolescents who require special health care
- Eliana Roldão dos Santos Nonose ,
- Rosane Meire Munhak da Silva ,
- Eliane Tatsch Neves ,
- Débora Falleiros de Mello ,
- Adriana Zilly , [ … ],
- Regina Aparecida Garcia de Lima
Abstract
ORIGINAL ARTICLEMental health of parents of children and adolescents who require special health care
Revista Brasileira de Enfermagem. 2024;77(3):e20230457
DOI 10.1590/0034-7167-2023-0457
- Eliana Roldão dos Santos Nonose ,
- Rosane Meire Munhak da Silva ,
- Eliane Tatsch Neves ,
- Débora Falleiros de Mello ,
- Adriana Zilly ,
- Aline Cristiane Cavicchioli Okido ,
- Regina Aparecida Garcia de Lima
Views0See moreABSTRACT
Objective:
To identify the manifestations presented by parents of children and adolescents who require special health attention that can impact their mental health.
Methods:
exploratory, qualitative research, based on the concept of vulnerability, with data collection carried out through interviews with 18 parents of children and adolescents with special health care needs, hospitalized in the pediatric ward of a hospital in Paraná, between May/2017 and May/ 2018. Data analyzed by inductive thematic analysis.
Results:
parents experienced situations of vulnerability when providing care at home, with repercussions on their mental health, expressed by manifestations of lack of protection, anxiety and depression.
Final considerations:
It is important that health professionals seek to expand actions to promote care and reduce situations that generate threats, insecurities, concerns and damage to the health of parents, which can impact and further weaken care for children and adolescents who need attention especially health.
- Eliana Roldão dos Santos Nonose
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07-29-2024
Reflections on theoretical framework use in nursing research
- Maria Ribeiro Lacerda ,
- Rudval Souza da Silva ,
- Nadirlene Pereira Gomes ,
- Silvana Regina Rossi Kissula Souza
Abstract
Reflections on theoretical framework use in nursing research
Revista Brasileira de Enfermagem. 2024;77(3):e20230486
DOI 10.1590/0034-7167-2024-0486
- Maria Ribeiro Lacerda ,
- Rudval Souza da Silva ,
- Nadirlene Pereira Gomes ,
- Silvana Regina Rossi Kissula Souza
Views0See moreABSTRACT
Objectives:
to reflect on theoretical framework use in nursing research.
Methods:
a theoretical-reflexive study, based on concepts and constructs pertinent to using nursing theories and other sciences, considering issues of epistemology or philosophy of science.
Results:
we presented what it is and why to do nursing research and what a theoretical framework is and why to use it, in addition to some considerations regarding theoretical framework use in nursing research, essential for constructing disciplinary knowledge, which enables the materialization of researchers’ work and the presentation of propositions resulting from investigations in and for nursing as a discipline and science.
Final Considerations:
based on a reflection based on epistemological conceptions, it is possible to affirm that a theoretical framework is the core of researchers’ thinking, delimiting a problem to be investigated and, based on it, outlining methodological strategies to be followed, supporting nursing action and thinking as discipline and science.
- Maria Ribeiro Lacerda
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REVIEW07-29-2024
Nursing diagnoses for people hospitalized with heart failure: an integrative review
- Ana Paula Dias de Oliveira ,
- Lucas Garcia Lima ,
- Vinicius Batista Santos ,
- Larissa Maiara da Silva Alves Souza ,
- Juliana de Lima Lopes , [ … ],
- Alba Lucia Bottura Leite de Barros
Abstract
REVIEWNursing diagnoses for people hospitalized with heart failure: an integrative review
Revista Brasileira de Enfermagem. 2024;77(3):e20230471
DOI 10.1590/0034-7167-2023-0471
- Ana Paula Dias de Oliveira ,
- Lucas Garcia Lima ,
- Vinicius Batista Santos ,
- Larissa Maiara da Silva Alves Souza ,
- Juliana de Lima Lopes ,
- Alba Lucia Bottura Leite de Barros
Views0See moreABSTRACT
Objectives:
to identify in the literature the main nursing diagnoses according to the NANDA-I diagnostic classification for people hospitalized with heart failure.
Methods:
an integrative literature review, carried out in February 2019 and updated in July 2023, in the MEDLINE via PubMed, LILACS, SciELO and CINAHL databases. Given the use of acronym PEO, studies without a time cut in Portuguese, English and Spanish were included. Descriptive analysis was carried out to present the identified information.
Results:
analysis of 27 articles identified 24 nursing diagnoses, with emphasis on Decreased Cardiac Output, Excessive Fluid Volume, Decreased Activity Tolerance and Fatigue.
Final Considerations:
evidence can contribute to better diagnostic decisions centered on people with heart failure in search of more assertive health results and have the potential to support future studies on a possible syndromic pattern in this population.
- Ana Paula Dias de Oliveira
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ORIGINAL ARTICLE07-29-2024
Disrupted mother-fetus dyad risk in high-risk pregnancies: a Middle-Range Theory
- Ryanne Carolynne Marques Gomes Mendes ,
- Gabrielle Pessôa da Silva ,
- Jaqueline Galdino Albuquerque Perrelli ,
- Cleide Maria Pontes ,
- Lívia Maia Pascoal , [ … ],
- Francisca Márcia Pereira Linhares
Abstract
ORIGINAL ARTICLEDisrupted mother-fetus dyad risk in high-risk pregnancies: a Middle-Range Theory
Revista Brasileira de Enfermagem. 2024;77(3):e20230464
DOI 10.1590/0034-7167-2023-0464
- Ryanne Carolynne Marques Gomes Mendes ,
- Gabrielle Pessôa da Silva ,
- Jaqueline Galdino Albuquerque Perrelli ,
- Cleide Maria Pontes ,
- Lívia Maia Pascoal ,
- Ana Luisa Brandão de Carvalho Lira ,
- Marcos Venícios de Oliveira Lopes ,
- Suzana de Oliveira Mangueira ,
- Francisca Márcia Pereira Linhares
Views0See moreABSTRACT
Objectives:
to develop and evaluate a Middle-Range Theory for the nursing diagnosis “Disrupted Mother-Fetus Dyad Risk” in high-risk pregnancies.
Methods:
this methodological study was conducted in two stages: theory development and evaluation. Dorothea Orem’s General Nursing Model was used as the theoretical-conceptual foundation. Evaluation was conducted using the Delphi method with seven judges, and consensus was achieved when the Content Validity Index of the evaluated items was ≥ 0.80.
Results:
the theory identified 20 elements of the nursing diagnosis “Disrupted Mother-Fetus Dyad Risk” (10 risk factors, 4 at-risk populations, and 6 associated conditions), 14 propositions, and 1 pictogram. After two rounds of evaluation, the theory was considered consistent, with consensus reached for all items, each achieving a Content Validity Index ≥ 0.80.
Conclusions:
the Middle-Range Theory included biopsychosocial factors explaining the nursing phenomenon “Disrupted Mother-Fetus Dyad Risk,” which aids in nurses’ diagnostic reasoning.
- Ryanne Carolynne Marques Gomes Mendes
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ORIGINAL ARTICLE07-29-2024
Family refusal of skin donation for transplantation: trends and associated factors
- Karoline de Oliveira Lins Souto ,
- Rafael Rodrigo da Silva Pimentel ,
- Ágata Nunes Brito ,
- Edvaldo Leal de Moraes ,
- Marcelo José dos Santos
Abstract
ORIGINAL ARTICLEFamily refusal of skin donation for transplantation: trends and associated factors
Revista Brasileira de Enfermagem. 2024;77(3):e20230209
DOI 10.1590/0034-7167-2023-0209
- Karoline de Oliveira Lins Souto ,
- Rafael Rodrigo da Silva Pimentel ,
- Ágata Nunes Brito ,
- Edvaldo Leal de Moraes ,
- Marcelo José dos Santos
Views0See moreABSTRACT
Objectives:
to analyze the trends and factors associated with family refusal of skin donation for transplantation.
Methods:
this cross-sectional study was conducted in the State of São Paulo, with family authorization terms collected from 2001 to 2020. The variables analyzed included year, age, gender, cause of death, and type of institution. Data were analyzed using linear and multiple logistic regression, with the Odds Ratio estimated at p<0.05 for statistical significance.
Results:
1,355 individuals refused skin donation. The trend of refusals decreased between 2001 and 2009 in the age groups of 0-11 years and 12-19 years, but increased in the group aged ≥60 years. This trend continued to decrease in the 0-11 years group from 2010 to 2020, and increased in the 20-40 years group. Males and the age groups of 20-40 years, 41-59 years, and ≥60 years exhibited 27%, 34%, 47%, and 53% lower chances of refusal, respectively.
Conclusions:
there is an urgent need for measures to mitigate the high number of refusals associated with skin donation.
- Karoline de Oliveira Lins Souto
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ORIGINAL ARTICLE07-29-2024
Primary Health Care in transitional care of people with stroke
- Adriana Bitencourt Magagnin ,
- Kenia Lara da Silva ,
- Giane Zupellari dos Santos Melo ,
- Ivonete Teresinha Schulter Buss Heidemann
Abstract
ORIGINAL ARTICLEPrimary Health Care in transitional care of people with stroke
Revista Brasileira de Enfermagem. 2024;77(3):e20230468
DOI 10.1590/0034-7167-2024-0468
- Adriana Bitencourt Magagnin ,
- Kenia Lara da Silva ,
- Giane Zupellari dos Santos Melo ,
- Ivonete Teresinha Schulter Buss Heidemann
Views0See moreABSTRACT
Objectives:
to understand the role of Primary Health Care teams in caring for people with stroke after hospital discharge.
Methods:
single case study, with integrated units of analysis, with a qualitative approach. Data triangulation occurred through interviews with professionals and family caregivers involved in transition of care, in addition to direct observations in rounds and document analysis. For the analyses, the analytical strategies of theoretical propositions and construction of explanations were used, with the help of ATLAS.ti®.
Results:
the importance of counter-referral, the role of community health workers and the multidisciplinary team, health promotion, secondary prevention, home visits as a visceral attribute and nurses as care managers are evident.
Final Considerations:
the high demand on teams and the Social Determinants of Health interfere with adequate continuity of care. Transitional care programs that enable continuity of care are recommended.
- Adriana Bitencourt Magagnin
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ORIGINAL ARTICLE07-29-2024
Completeness of variables in Hospital-Based Cancer Registries for prostatic malignant neoplasm
- Wesley Rocha Grippa ,
- Raphael Manhães Pessanha ,
- Larissa Soares Dell’Antonio ,
- Cristiano Soares da Silva Dell’Antonio ,
- Luciane Bresciani Salaroli , [ … ],
- Luís Carlos Lopes-Júnior
Abstract
ORIGINAL ARTICLECompleteness of variables in Hospital-Based Cancer Registries for prostatic malignant neoplasm
Revista Brasileira de Enfermagem. 2024;77(3):e20230467
DOI 10.1590/0034-7167-2023-0467
- Wesley Rocha Grippa ,
- Raphael Manhães Pessanha ,
- Larissa Soares Dell’Antonio ,
- Cristiano Soares da Silva Dell’Antonio ,
- Luciane Bresciani Salaroli ,
- Luís Carlos Lopes-Júnior
Views0See moreABSTRACT
Objectives:
to analyze the completeness of variables from Hospital-Based Cancer Registries of cases of prostate neoplasm in the Oncology Care Network of a Brazilian state between 2000 and 2020.
Methods:
an ecological time series study, based on secondary data on prostate cancer Hospital-Based Cancer Registries prostate. Data incompleteness was classified as excellent (<5%), good (between 5%-10%), fair (10%-20%), poor (20%-50%) and very poor (>50%), according to the percentage of lack of information.
Results:
there were 13,519 cases of prostate cancer in the Hospital-Based Cancer Registries analyzed. The variables “family history of cancer” (p<0.001), “alcoholism” (p<0.001), “smoking” (p<0.001), “TNM staging” (p<0.001) had a decreasing trend, while “clinical start of treatment” (p<0.001), “origin” (p=0.008) and “occupation” (p<0.001) indicated an increasing trend.
Conclusions:
most Hospital-Based Cancer Registries variables showed excellent completeness, but important variables had high percentages of incompleteness, such as TNM and clinical staging, in addition to alcoholism and smoking.
- Wesley Rocha Grippa
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ORIGINAL ARTICLE04-09-2020
High-risk areas of leprosy in Brazil between 2001-2015
- Rayssa Nogueira Rodrigues ,
- Heloisy Alves de Medeiros Leano ,
- Isabela de Caux Bueno ,
- Kleane Maria da Fonseca Azevedo Araújo ,
- Francisco Carlos Félix Lana
Abstract
ORIGINAL ARTICLEHigh-risk areas of leprosy in Brazil between 2001-2015
Revista Brasileira de Enfermagem. 2020;73(3):e20180583
DOI 10.1590/0034-7167-2018-0583
- Rayssa Nogueira Rodrigues ,
- Heloisy Alves de Medeiros Leano ,
- Isabela de Caux Bueno ,
- Kleane Maria da Fonseca Azevedo Araújo ,
- Francisco Carlos Félix Lana
Views0See moreABSTRACT
Objectives:
to identify high-risk areas of leprosy in Brazil from 2001 to 2015.
Methods:
this is an ecological study of spatial analysis based on Brazilian municipalities. Spatial scan statistics were used to identify spatial clustering and measure the relative risk from the annual detection rate of new cases of leprosy. By criterion based on the Gini index, only secondary clusters were considered.
Results:
spatial scan statistics detected 26 clusters, in which the detection rate was 59.19 cases per 100 thousand inhabitants, while in the remainder of the country it was 11.76. Large part of the cluster area is located in the Legal Amazon. These groups included only 21.34% of the total population, but 60.40% of the new cases of the disease.
Conclusions:
Leprosy remains concentrated in some areas, showing the need for control programs to intensify actions in these municipalities.
- Rayssa Nogueira Rodrigues
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REVIEW04-16-2021
Clinical outcomes of patient navigation performed by nurses in the oncology setting: an integrative review
- Rodrigo Lima Rodrigues ,
- Franciane Schneider ,
- Luciana Puchalski Kalinke ,
- Silvana Silveira Kempfer ,
- Vânia Marli Schubert Backes
Abstract
REVIEWClinical outcomes of patient navigation performed by nurses in the oncology setting: an integrative review
Revista Brasileira de Enfermagem. 2021;74(2):e20190804
DOI 10.1590/0034-7167-2019-0804
- Rodrigo Lima Rodrigues ,
- Franciane Schneider ,
- Luciana Puchalski Kalinke ,
- Silvana Silveira Kempfer ,
- Vânia Marli Schubert Backes
Views0See moreABSTRACT
Objective:
to evidence the clinical outcomes of navigation performed by nurses in cancer patients.
Methods:
this is an integrative literature review with collection in MEDLINE via PUBMED, LILACS, Web of Science, Scopus, and CINAHL databases. The final sample consisted of seven studies. The data were analyzed and presented descriptively. Data related to clinical outcomes were compiled and described in full. The Agency for Healthcare Research and Quality categorization was used to assess the level of evidence.
Results:
the clinical outcomes demonstrated were decreased distress, anxiety and depression, improved control and management of symptoms, improved physical conditioning, improved quality and continuity of care, improved quality of life, reduced time to start treatment.
Final considerations:
there is research that shows better clinical outcomes in cancer patients through navigation by nurses across the continuum of health care.
- Rodrigo Lima Rodrigues
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ORIGINAL ARTICLE12-13-2019
Perceptions and expectations of pregnant women about the type of birth
- Roberta Marielle Arik ,
- Cristina Maria Garcia de Lima Parada ,
- Vera Lúcia Pamplona Tonete ,
- Fernanda Cristina Manzini Sleutjes
Abstract
ORIGINAL ARTICLEPerceptions and expectations of pregnant women about the type of birth
Revista Brasileira de Enfermagem. 2019;72:41-49
DOI 10.1590/0034-7167-2017-0731
- Roberta Marielle Arik ,
- Cristina Maria Garcia de Lima Parada ,
- Vera Lúcia Pamplona Tonete ,
- Fernanda Cristina Manzini Sleutjes
Views0See moreABSTRACT
Objective:
to understand the perceptions and expectations of pregnant women about the type of birth.
Method:
this is a qualitative research, based on the assumptions of the Humanization of Obstetric Care. 15 pregnant women were interviewed twice at the beginning and the end of gestation between October 2015 and May 2016. Data were analyzed according to the method of the Discourse of the Collective Subject.
Results:
the discourses were associated with four themes: Advantages of vaginal birth over cesarean section; Fear and unpredictability of vaginal birth; Importance of the doctor in the definition of the type of birth; and Influence of family and friends in choosing the type of birth.
Final considerations:
according to pregnant women, vaginal birth has more benefit compared to cesarean section. However, during gestation and birth, fear of pain and the unexpected, and medical opinions of friends and family against vaginal birth strongly influence the choice of cesarean section.
- Roberta Marielle Arik
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REVIEW09-30-2020
Telenursing in care, education and management in Latin America and the Caribbean: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20190317
Abstract
REVIEWTelenursing in care, education and management in Latin America and the Caribbean: an integrative review
Revista Brasileira de Enfermagem. 2020;73:e20190317
DOI 10.1590/0034-7167-2019-0317
Views0See moreABSTRACT
Objective:
Analyze the knowledge generated about telenursing related to the roles of nurses (care, education and management) in Latin America and the Caribbean, based on scientific evidence.
Methods:
Integrative review, for the years 2009 to 2019, in scientific databases from Latin America and the Caribbean. Twelve articles were selected.
Results:
Nine studies focused on care and three on education. The information and communication technology used in the studies was telephony directed toward non-communicable diseases. There were concerns about the remote communication process. With respect to education, two focused on educating health teams and one on educating patients.
Conclusion:
It is necessary to conduct studies on telenursing that generate changes in care practices, explore information and communication technology resources and provide communication training focused on this new care model.
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REVIEW08-14-2020
Nursing practice environment in Primary Health Care: a scoping review
Revista Brasileira de Enfermagem. 2020;73(6):e20190479
Abstract
REVIEWNursing practice environment in Primary Health Care: a scoping review
Revista Brasileira de Enfermagem. 2020;73(6):e20190479
DOI 10.1590/0034-7167-2019-0479
Views0INTRODUCTIONKnowledge and scientific evidence about nursing practice environments (NPE) in the context of Primary Health Care (PHC) is scarce.Policy makers, health and professional organizations have proposed to redesign the health system in PHC with the aim of increasing citizens’ accessibility, improving customer outcomes and maximizing efficiency. […]See more
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ORIGINAL ARTICLE08-19-2019
Interruptions and nursing workload during medication administration process
Revista Brasileira de Enfermagem. 2019;72(4):1001-1006
Abstract
ORIGINAL ARTICLEInterruptions and nursing workload during medication administration process
Revista Brasileira de Enfermagem. 2019;72(4):1001-1006
DOI 10.1590/0034-7167-2018-0680
Views0See moreABSTRACT
Objective:
To investigate the sources and causes of interruptions during the medication administration process performed by a nursing team and measure its frequency, duration and impact on the team’s workload.
Métodos:
This is an observational study that timed 121 medication rounds (preparation, administration and documentation) performed by 15 nurses and nine nursing technicians in a Neonatal Intensive Care Unit in the countryside of the state of São Paulo.
Resultados:
63 (52.1%) interruptions were observed. In each round, the number of interruptions that happened ranged from 1-7, for 127 in total; these occurred mainly during the preparation phase, 97 (76.4%). The main interruption sources were: nursing staff – 48 (37.8%) − and self-interruptions – 29 (22.8%). The main causes were: information exchanges – 54 (42.5%) − and parallel conversations – 28 (22%). The increase in the mean time ranged from 53.7 to 64.3% (preparation) and from 18.3 to 19.2% (administration) – p≤0.05.
Conclusão:
Interruptions in the medication process are frequent, interfere in the workload of the nursing team and may reflect on the safety of care.
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ORIGINAL ARTICLE06-29-2020
Personal Protective Equipment in the coronavirus pandemic: training with Rapid Cycle Deliberate Practice
Revista Brasileira de Enfermagem. 2020;73:e20200303
Abstract
ORIGINAL ARTICLEPersonal Protective Equipment in the coronavirus pandemic: training with Rapid Cycle Deliberate Practice
Revista Brasileira de Enfermagem. 2020;73:e20200303
DOI 10.1590/0034-7167-2020-0303
Views0See moreABSTRACT
Objective:
to discuss the application of Rapid Cycle Deliberate Practice for attire and unattire training in the context of COVID-19 and structure a practical guide to the application at this juncture.
Methods:
this methodological study described theoretical and practical aspects of the application of a simulation strategy as a technological training tool. An application guide was constructed from the search for evidence from the main health authority bodies in Brazil.
Results:
maximizing time in Deliberate Practice, feedback with evidence and psychological security are the principles of this strategy. The dynamic involves repetition and feedback. The application guide presents the sequence of actions for attire and unattire.
Final considerations:
coping with this pandemic requires appropriate use of personal protective equipment. The authors suggest the Rapid Cycle Deliberate Practice as a technological educational tool for attire/unattire, since it encourages mastery performance.
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REVIEW06-11-2021
Mental health interventions implemented in the COVID-19 pandemic: what is the evidence?
- Wanderson Carneiro Moreira ,
- Kayo Henrique Jardel Feitosa Sousa ,
- Anderson Reis de Sousa ,
- Thiago da Silva Santana ,
- Regina Célia Gollner Zeitoune , [ … ],
- Maria do Perpétuo Socorro de Sousa Nóbrega
Abstract
REVIEWMental health interventions implemented in the COVID-19 pandemic: what is the evidence?
Revista Brasileira de Enfermagem. 2021;74:e20200635
DOI 10.1590/0034-7167-2020-0635
- Wanderson Carneiro Moreira ,
- Kayo Henrique Jardel Feitosa Sousa ,
- Anderson Reis de Sousa ,
- Thiago da Silva Santana ,
- Regina Célia Gollner Zeitoune ,
- Maria do Perpétuo Socorro de Sousa Nóbrega
Views0See moreABSTRACT
Objective:
to map the evidence on mental health interventions implemented during the COVID-19 pandemic.
Method:
this scoping review was carried out in the MEDLINE/PubMed, SCOPUS, Web of Science, PsycINFO, and Science Direct databases and in the medRxiv, bioRxiv, and PsyArXiv preprints servers using the descriptors “Covid-19”, “coronavirus infection”, “coronavirus”, “2019-nCoV”, “2019 novel coronavirus disease”, “SARS-CoV-2”, “health personnel”, “general public”, and “mental health”.
Results:
eight articles were selected and categorized into mental health interventions for the population, among which mental health interventions were for people diagnosed with suspicion/confirmed COVID-19 and mental health interventions for health professionals.
Conclusion:
telemonitoring, virtual games and strategies focused on social support and muscle relaxation techniques, characterized as non-pharmacological and low-cost, were shown as interventions, which, since they are effective, need to be encouraged and included in mental health care practices.
- Wanderson Carneiro Moreira
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