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ORIGINAL ARTICLE08-30-2024
Meanings attributed to changes experienced by individuals after COVID-19 hospitalization
- Camila Harmuch
, - Jéssica dos Santos Pini ,
- Paula Antunes Bezerra Nacamura ,
- Anny Caroline Ribeiro Devechi ,
- Vinícius Brito de Souza , [ … ],
- Marcelle Paiano
Abstract
ORIGINAL ARTICLEMeanings attributed to changes experienced by individuals after COVID-19 hospitalization
Revista Brasileira de Enfermagem. 2024;77:e20230122
DOI 10.1590/0034-7167-2023-0122
- Camila Harmuch ,
- Jéssica dos Santos Pini ,
- Paula Antunes Bezerra Nacamura ,
- Anny Caroline Ribeiro Devechi ,
- Vinícius Brito de Souza ,
- Juliana Graciela Vestena Zillmer ,
- Maria Aparecida Salci ,
- Marcelle Paiano
Views0See moreABSTRACT
Objectives:
to understand the meanings attributed to the experiences of individuals after hospitalization for COVID-19.
Methods:
qualitative study, with a theoretical framework based on Symbolic Interactionism and a methodological approach grounded in Grounded Theory. Nineteen participants who had moderate and severe forms of COVID-19 after hospitalization were interviewed. Data collection took place between April and November 2021 through online interviews, and the data were analyzed using initial and focused coding in the MAXQDA software.
Results:
the data illustrate new meanings attributed to different aspects of life after hospitalization, including relationships with others, the environment, physical and mental health, finances, identity, and interactions with a new social reality.
Conclusions:
the meanings are intrinsically linked to the value of interpersonal relationships, the perception of their impact, and the consequences after hospitalization. This allows professionals to understand the importance of this information to improve care and prepare for future epidemics.
- Camila Harmuch
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ORIGINAL ARTICLE08-30-2024
Patient safety culture in times of the COVID-19 pandemic: a cross-sectional study in a hospital
- Amanda Lobato Lopes ,
- Rosana Aparecida Pereira ,
- Laura Martins Valdevite Pereira ,
- Felippe Micheli Costa de Castilho ,
- Fernanda Raphael Escobar Gimenes
Abstract
ORIGINAL ARTICLEPatient safety culture in times of the COVID-19 pandemic: a cross-sectional study in a hospital
Revista Brasileira de Enfermagem. 2024;77:e20230187
DOI 10.1590/0034-7167-2023-0187
- Amanda Lobato Lopes ,
- Rosana Aparecida Pereira ,
- Laura Martins Valdevite Pereira ,
- Felippe Micheli Costa de Castilho ,
- Fernanda Raphael Escobar Gimenes
Views0See moreABSTRACT
Objectives:
to assess patient safety culture during the COVID-19 pandemic and identify the dimensions that need to be improved in hospital settings and which sector, open or closed, direct or indirect care, exhibits a higher level of safety culture.
Methods:
a descriptive and cross-sectional study. The validated version for Brazil of the Hospital Survey on Patient Safety Culture instrument was applied to assess patient safety culture. Those dimensions with 75% positive responses were considered strengthened.
Results:
all dimensions presented results lower than 75% of positive responses. Closed sectors showed a stronger safety culture compared to open ones. Indirect care sectors had a low general perception of patient safety when compared to direct care sectors.
Conclusions:
with the pandemic, points of weakness became even more evident, requiring attention and incisive interventions from the institution’s leaders.
- Amanda Lobato Lopes
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REVIEW08-30-2024
Educational actions conducted during the pandemic with primary health care professionals: a scoping review
- Bruna Dias França ,
- Kênia Lara Silva ,
- Lilian Cristina Rezende ,
- Francisco Carlos Felix Lana ,
- Simone de Pinho Barbosa
Abstract
REVIEWEducational actions conducted during the pandemic with primary health care professionals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20230352
DOI 10.1590/0034-7167-2023-0352
- Bruna Dias França ,
- Kênia Lara Silva ,
- Lilian Cristina Rezende ,
- Francisco Carlos Felix Lana ,
- Simone de Pinho Barbosa
Views0See moreABSTRACT
Objectives:
to map the educational actions conducted with primary health care professionals during the COVID-19 pandemic.
Methods:
a scoping review conducted in August 2023, which covered databases such as CINAHL, Medline, LILACS, IBECS, BDENF, and Web of Science. In total, 32 publications were analyzed through content analysis.
Results:
the primary beneficiaries of the educational actions included 69% physicians, 56% nurses, 25% pharmacists, 13% social workers and dentists, 9% psychologists, community health agents, and laboratory professionals, and 6% nursing technicians, nutritionists, and physical educators. The predominant educational interventions were training sessions (mentioned in 19 publications), followed by Continuing Health Education (10 publications) and Continuing Education (three publications).
Final Considerations:
the educational interventions demonstrated positive impacts on professional practice, particularly the Continuing Health Education actions, which were notable for stimulating critical problem-solving among professionals.
- Bruna Dias França
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ORIGINAL ARTICLE08-30-2024
Negative affectivity in university students and its relationship with academic performance and professional outlook after COVID-19
- Bruna de Oliveira Alves ,
- Bárbara Guimarães Lourenço ,
- Bianca Bacelar Assis Araújo ,
- Luana Vieira Toledo ,
- Rafael Lopes Chaves , [ … ],
- Caroline de Castro Moura
Abstract
ORIGINAL ARTICLENegative affectivity in university students and its relationship with academic performance and professional outlook after COVID-19
Revista Brasileira de Enfermagem. 2024;77:e20240040
DOI 10.1590/0034-7167-2024-0040
- Bruna de Oliveira Alves ,
- Bárbara Guimarães Lourenço ,
- Bianca Bacelar Assis Araújo ,
- Luana Vieira Toledo ,
- Rafael Lopes Chaves ,
- Érika de Cássia Lopes Chaves ,
- Tânia Couto Machado Chianca ,
- Caroline de Castro Moura
Views0See moreABSTRACT
Objectives:
to evaluate the prevalence of negative affectivity in university students in the post-COVID-19 pandemic context and its relationship with academic performance and professional outlook.
Methods:
a cross-sectional study was conducted with undergraduate students from a public university in Minas Gerais between September 2022 and September 2023. Data were collected using a sociodemographic and psychosocial characterization questionnaire and the Depression, Anxiety, and Stress Scale 21. The relationships between negative affectivity, academic performance, and professional outlook were verified using the Kruskal-Wallis test, with a significance level of 5%.
Results:
a total of 585 students participated in the study. A high prevalence of depression, anxiety, and stress was found among university students in the post-COVID-19 context, with a notable severity of anxiety. A negative association was detected between the investigated negative affectivity, academic performance, and professional outlook.
Conclusions:
the results indicate an emotional vulnerability in university students, with a relationship between negative affectivity and a decline in academic performance and professional outlook.
- Bruna de Oliveira Alves
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REVIEW08-30-2024
Impact of financial toxicity on adults with cancer during the COVID-19 pandemic: an integrative review
- Luciana de Alcantara Nogueira ,
- Cristiano de Oliveira Ribeiro ,
- Leonel dos Santos Silva ,
- Yasmin Hiorrana dos Santos ,
- Luciana Puchalski Kalinke
Abstract
REVIEWImpact of financial toxicity on adults with cancer during the COVID-19 pandemic: an integrative review
Revista Brasileira de Enfermagem. 2024;77:e20240078
DOI 10.1590/0034-7167-2024-0078
- Luciana de Alcantara Nogueira ,
- Cristiano de Oliveira Ribeiro ,
- Leonel dos Santos Silva ,
- Yasmin Hiorrana dos Santos ,
- Luciana Puchalski Kalinke
Views0See moreABSTRACT
Objectives:
to identify the repercussions of financial toxicity on the lives of adult cancer patients during the COVID-19 pandemic.
Methods:
an integrative review was conducted using the PubMed, Web of Science, Scopus, and Embase databases, as well as the Virtual Health Library portal, in March 2023.
Results:
out of 62 studies found, 13 were included for analysis. The primary repercussions of financial toxicity included difficulties in covering basic expenses such as food, housing, medication, transportation, and internet access; increased anxiety and concerns related to health and financial situations; reduction or absence of income; challenges in obtaining treatment or accessing healthcare services; rising expenses; and telemedicine as a less burdensome alternative.
Conclusions:
the pandemic has exacerbated financial toxicity; therefore, healthcare teams must recognize it as an adverse event of oncological treatment and understand its potential to affect various aspects of patients’ lives.
- Luciana de Alcantara Nogueira
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ORIGINAL ARTICLE08-30-2024
Risk of smoking cessation treatment dropout: a cohort to help (re)think care
- Janaina Pereira da Silva ,
- Adriana Ignácio de Pádua ,
- Ruan Víctor dos Santos Silva ,
- Felipe Lima dos Santos ,
- Poliana Silva de Oliveira , [ … ],
- Cinira Magali Fortuna
Abstract
ORIGINAL ARTICLERisk of smoking cessation treatment dropout: a cohort to help (re)think care
Revista Brasileira de Enfermagem. 2024;77:e20230537
DOI 10.1590/0034-7167-2023-0537
- Janaina Pereira da Silva ,
- Adriana Ignácio de Pádua ,
- Ruan Víctor dos Santos Silva ,
- Felipe Lima dos Santos ,
- Poliana Silva de Oliveira ,
- Priscila Norié Araujo-Betetti ,
- Joris Thievenaz ,
- Cinira Magali Fortuna
Views0See moreABSTRACT
Objectives:
to evaluate the relative risk of smoking cessation treatment dropout during its intensive phase.
Methods:
a retrospective and quantitative cohort study was developed from the electronic medical records of individuals who started smoking cessation treatment between 2015 and 2019 at a specialty clinic in a city in the interior of São Paulo, Brazil. The relative risk of dropping out of treatment was calculated using the Poisson regression model.
Results:
it was observed that out of the 396 (100.0%) individuals who started the treatment, 109 (27.5%) abandoned it before the end of the intensive phase. For each one-year increase in age, the risk of dropping out of smoking cessation treatment decreased by an average of 2%.
Conclusions:
the risk of dropping out of smoking cessation treatment is higher among younger individuals. It is necessary to rethink the care offered to younger adults to promote the continuity of treatment.
- Janaina Pereira da Silva
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ORIGINAL ARTICLE08-26-2024
Influence of the leukoreduction moment of blood components on the clinical outcomes of transfused patients in the emergency department
- Natasha Dejigov Monteiro da Silva ,
- Ana Catharina Herbst ,
- Milena Raquel André ,
- Lilia de Souza Nogueira
Abstract
ORIGINAL ARTICLEInfluence of the leukoreduction moment of blood components on the clinical outcomes of transfused patients in the emergency department
Revista Brasileira de Enfermagem. 2024;77(5):e20230293
DOI 10.1590/0034-7167-2023-0293
- Natasha Dejigov Monteiro da Silva ,
- Ana Catharina Herbst ,
- Milena Raquel André ,
- Lilia de Souza Nogueira
Views0See moreABSTRACT
Objectives:
to investigate the influence of the leukoreduction moment (preor post-storage) of blood components on the clinical outcomes of patients transfused in the emergency department.
Methods:
retrospective cohort study of patients aged 18 years or older who received preor post-storage leukoreduced red blood cell or platelet concentrate in the emergency department and remained in the institution for more than 24 hours. A generalized mixed-effects model was applied in the analyses.
Results:
in a sample of 373 patients (63.27% male, mean age 54.83) and 643 transfusions (69.98% red blood cell), it was identified that the leukoreduction moment influenced the length of hospital stay (p<0.009), but was not dependent on the transfused blood component (p=0.124). The leukoreduction moment had no effect (p>0.050) on transfusion reactions, healthcare-associated infections, or mortality.
Conclusions:
patients who received pre-storage leukoreduced blood components in the emergency department had a shorter length of hospital stay.
- Natasha Dejigov Monteiro da Silva
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ORIGINAL ARTICLE08-26-2024
Driver’s license, head protection devices and severity of motorcyclists’ injuries in traffic accidents
Revista Brasileira de Enfermagem. 2024;77(5):e20230153
Abstract
ORIGINAL ARTICLEDriver’s license, head protection devices and severity of motorcyclists’ injuries in traffic accidents
Revista Brasileira de Enfermagem. 2024;77(5):e20230153
DOI 10.1590/0034-7167-2023-0153
Views0See moreABSTRACT
Objectives:
to describe traffic accidents involving motorcyclists and analyze the association between possession of a motorcycle driver’s license and use of helmets according to the severity of injuries.
Methods:
a cross-sectional study was conducted among all patients hospitalized in the traumatology and orthopedics sector of a public reference hospital in northeastern Brazil.
Results:
170 patients were surveyed, the majority were male (95.9%). Their ages ranged from 18 to 67 years. Most were black or brown (52.3%), had completed elementary school (58.9%) and had monthly income smaller than two minimum wages (56.5%). An association was found between being licensed to drive a motorcycle and wearing a helmet. Among those who suffered moderate injuries, this association was OR=5.66(1.85-17.23) and among those who suffered severe injuries it was OR=13.57(2.82-65.14).
Conclusions:
people who were licensed to drive motorcycles used a helmet as protective equipment more often and, in accidents, suffered fewer injuries.
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REVIEW04-22-2020
Polycyclic aromatic hydrocarbons and development of respiratory and cardiovascular diseases in workers
- Helenize Ferreira Lima Leachi ,
- Maria Helena Palucci Marziale ,
- Júlia Trevisan Martins ,
- Patricia Aroni ,
- Maria José Quina Galdino , [ … ],
- Renata Perfeito Ribeiro
Abstract
REVIEWPolycyclic aromatic hydrocarbons and development of respiratory and cardiovascular diseases in workers
Revista Brasileira de Enfermagem. 2020;73(3):e20180965
DOI 10.1590/0034-7167-2018-0965
- Helenize Ferreira Lima Leachi ,
- Maria Helena Palucci Marziale ,
- Júlia Trevisan Martins ,
- Patricia Aroni ,
- Maria José Quina Galdino ,
- Renata Perfeito Ribeiro
Views0See moreABSTRACT
Objectives:
to identify the scientific evidence on the development of cardiovascular and respiratory diseases due to workplace contamination by polycyclic aromatic hydrocarbons.
Methods:
integrative literature review. The search for primary articles was held in October 2017 in the Medical Literature Analysis and Retrieval System Online (through Pubmed), Web of Science and Latin American and Caribbean Literature in Health Sciences (LILACS).
Results:
the 16 studies analyzed showed that exposure to polycyclic aromatic hydrocarbons was associated with cardiovascular diseases, such as increased blood pressure, heart rate variation, and ischemic heart disease; and respiratory disorders, such as decreased lung function, chronic obstructive pulmonary disease, asthma, wheeze, coughing, pulmonary wheezing, chest tightness, effort dyspnea, and sore throat.
Conclusions:
polycyclic aromatic hydrocarbons cause deleterious effects on the cardiovascular and respiratory systems through mutations and cellular inflammation, being a risk to exposed individuals.
- Helenize Ferreira Lima Leachi
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ORIGINAL ARTICLE08-14-2020
Education to prevent ventilator-associated pneumonia in intensive care unit
- Aline Branco ,
- Emerson Matheus Silva Lourençone ,
- Ariane Baptista Monteiro ,
- Jaqueline Pettitembert Fonseca ,
- Carine Raquel Blatt , [ … ],
- Rita Catalina Aquino Caregnato
Abstract
ORIGINAL ARTICLEEducation to prevent ventilator-associated pneumonia in intensive care unit
Revista Brasileira de Enfermagem. 2020;73(6):e20190477
DOI 10.1590/0034-7167-2019-0477
- Aline Branco ,
- Emerson Matheus Silva Lourençone ,
- Ariane Baptista Monteiro ,
- Jaqueline Pettitembert Fonseca ,
- Carine Raquel Blatt ,
- Rita Catalina Aquino Caregnato
Views0INTRODUCTIONVentilator-Associated Pneumonia (VAP) is one of the complications related to the care of patients hospitalized in the Intensive Care Unit (ICU), which, according to consulted authors, exceeds the mortality rates of other Healthcare Related Infections (HRI). VAP is the second most frequent infection in patients admitted to the ICU, as well as the most prevalent […]See more
- Aline Branco
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ORIGINAL ARTICLE12-13-2019
Mobile health technology for gestational care: evaluation of the GestAção’s app
- Raimunda Magalhães da Silva ,
- Christina César Praça Brasil ,
- Indara Cavalcante Bezerra ,
- Francisca Francisete de Sousa Nunes Queiroz
Abstract
ORIGINAL ARTICLEMobile health technology for gestational care: evaluation of the GestAção’s app
Revista Brasileira de Enfermagem. 2019;72:266-273
DOI 10.1590/0034-7167-2018-0641
- Raimunda Magalhães da Silva ,
- Christina César Praça Brasil ,
- Indara Cavalcante Bezerra ,
- Francisca Francisete de Sousa Nunes Queiroz
Views0See moreABSTRACT
Objective:
to evaluate the GestAção application, based on the experience of pregnant women use.
Method:
an evaluative, applied, methodological, quantitative-qualitative study. This tool was evaluated by 13 pregnant women through questionnaires for sociodemographic profile characterization and Likert scale use to calculate Content Validity Index (CVI); and semi-structured interview, with analysis based on Semiotics.
Results:
the study evidenced a significant level of satisfaction of pregnant women with the application use, considering the objectives (CVI = 0.92), structure and presentation (CVI = 0.86), and relevance (CVI = 0.92).
Final considerations:
the GestAção application obtained an overall CVI of 0.90, evidencing it as a facilitating and supporting technology in the empowerment of pregnant women interested in obtaining knowledge about pregnancy. It has been proved to be a powerful tool to qualify good practices in nursing consultation.
- Raimunda Magalhães da Silva
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08-19-2019
Degree in Nursing: education through problem-based learning
- Maria Zilma dos Santos ,
- Márcia Aparecida Padovan Otani ,
- Silvia Franco da Rocha Tonhom ,
- Maria José Sanches Marin
Abstract
Degree in Nursing: education through problem-based learning
Revista Brasileira de Enfermagem. 2019;72(4):1071-1077
DOI 10.1590/0034-7167-2018-0298
- Maria Zilma dos Santos ,
- Márcia Aparecida Padovan Otani ,
- Silvia Franco da Rocha Tonhom ,
- Maria José Sanches Marin
Views0See moreABSTRACT
Objective:
To describe how undergraduate courses in Nursing are using the problem-based learning (PBL).
Method:
Integrative literature review, from searches in the databases Education Resources Information Center (ERIC), Latin American and Caribbean Health Sciences Literature (Lilacs), and PubMed, from 2010 to 2015. 36 articles were analyzed.
Results:
A teaching method used in all continents, the PBL enables improvement of the critical thinking, autonomy, motivation for learning, active search attitude, ability to work in teams, and problem-solving. Difficulties and challenges relate to the training of students and teachers to understand the principles of the method.
Final considerations:
The benefits of PBL coincide with the needs of nursing training, but its applicability demands constant review in seeking to develop the skills necessary for this training.
- Maria Zilma dos Santos
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REFLECTION10-21-2019
Clinical supervision and preceptorship/tutorship: contributions to the Supervised Curricular Internship in Nursing Education
- Larissa Sapucaia Ferreira Esteves ,
- Isabel Cristina Kowal Olm Cunha ,
- Elena Bohomol ,
- Margarida Reis Santos
Abstract
REFLECTIONClinical supervision and preceptorship/tutorship: contributions to the Supervised Curricular Internship in Nursing Education
Revista Brasileira de Enfermagem. 2019;72(6):1730-1735
DOI 10.1590/0034-7167-2018-0785
- Larissa Sapucaia Ferreira Esteves ,
- Isabel Cristina Kowal Olm Cunha ,
- Elena Bohomol ,
- Margarida Reis Santos
Views0See moreABSTRACT
Objective:
To reflect on the contributions of the clinical supervision and preceptorship/tutorship as means to approach and engage nurses of healthcare services in activities related to the Supervised Curricular Internship, discussing conceptual, theoretical, and practical approaches for higher education in nursing.
Method:
This is a reflection based on the discursive formulation concerning clinical supervision and preceptorship/tutorship.
Results:
Clinical supervision has been widely used by international healthcare institutions to qualify the work processes of nurses, supporting their self-development. Currently, is has been supporting the work of nurses who are preceptors/tutors and monitors students on clinical internships.
Final considerations:
The clinical supervision of nursing students features a robust and effective strategy for the development of interns and for the completion of the teaching-service integration.
- Larissa Sapucaia Ferreira Esteves
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ORIGINAL ARTICLE07-10-2020
Profile of nursing students: quality of life, sleep and eating habits
Revista Brasileira de Enfermagem. 2020;73:e20190365
Abstract
ORIGINAL ARTICLEProfile of nursing students: quality of life, sleep and eating habits
Revista Brasileira de Enfermagem. 2020;73:e20190365
DOI 10.1590/0034-7167-2019-0365
Views0See moreABSTRACT
Objective:
to profile and analyze sleep quality, quality of life and eating habits of nursing students.
Methods:
a cross-sectional, comparative and correlational study with the following variables: sociodemographic characteristics, Pittsburgh sleep quality index, quality of life and eating habits. One hundred ninety-five students participated in the study.
Results:
participants were on average 24 years old. Results showed that females were prevalent (87.1%); 71.0% of the students had poor sleep quality; 98.9% used electronic devices before bedtime. Self-perception of quality of life was indifferent (38.3%), and self-perception of general health, 36.9% expressed satisfaction. Among the participants, 45.13% consumed one portion of fruit and 40.66% two to three portions of vegetables daily.
Conclusion:
the study allowed the profile of these students, sedentary, overweight and poor sleep quality young students who studied and worked.
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ORIGINAL ARTICLE10-23-2020
Building and validating an educational video for elderly individuals about fall risks
- Guilherme Guarino de Moura Sá ,
- Ana Maria Ribeiro dos Santos ,
- Nelson Miguel Galindo Neto ,
- Khelyane Mesquita de Carvalho ,
- Carla Danielle Araújo Feitosa , [ … ],
- Polyana Norberta Mendes
Abstract
ORIGINAL ARTICLEBuilding and validating an educational video for elderly individuals about fall risks
Revista Brasileira de Enfermagem. 2020;73:e20200010
DOI 10.1590/0034-7167-2020-0010
- Guilherme Guarino de Moura Sá ,
- Ana Maria Ribeiro dos Santos ,
- Nelson Miguel Galindo Neto ,
- Khelyane Mesquita de Carvalho ,
- Carla Danielle Araújo Feitosa ,
- Polyana Norberta Mendes
Views0See moreABSTRACT
Objective:
to build and validate educational video for elderly individuals about fall risks.
Methods:
methodological study with video building. validated by 22 judges and assessed by 22 elderly individuals. Content was selected from the Fall Prevention Model and items from the Falls Risk Awareness Questionnaire. Items with an agreement greater than 0.80 were considered valid. verified through Content Validation Index (CVI) and binomial test.
Results:
building the video was guided by the Cognitive Theory of Multimedia Learning. Digital animation and audio narration were used. It lasted ten minutes and five seconds and included biological. socioeconomic. behavioral and environmental risks as well as precautions to avoid them. The CVI of judges had an average of 0.99. and of elderly individuals. an average of 1.0.
Conclusion:
the video was built and validated for content and understanding and can be used to prevent falls in elderly individuals.
- Guilherme Guarino de Moura Sá
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REFLECTION03-05-2021
The nurse’s work in the context of COVID-19 pandemic
- Valéria Gomes Fernandes da Silva ,
- Bruno Neves da Silva ,
- Érika Simone Galvão Pinto ,
- Rejane Maria Paiva de Menezes
Abstract
REFLECTIONThe nurse’s work in the context of COVID-19 pandemic
Revista Brasileira de Enfermagem. 2021;74:e20200594
DOI 10.1590/0034-7167-2020-0594
- Valéria Gomes Fernandes da Silva ,
- Bruno Neves da Silva ,
- Érika Simone Galvão Pinto ,
- Rejane Maria Paiva de Menezes
Views0See moreABSTRACT
Objective:
Reflect on the work experienced by the nurse in coping with the COVID-19 pandemic in a public hospital of the State of Rio Grande do Norte.
Methods:
Reflective essay based in the professional experience in a public reference hospital for the care of patients affected by COVID-19 in the State of Rio Grande do Norte. Results were organized in two empirical categories, which emphasize potentialities and barriers in the nurse’s work in the face of the COVID-19, presented by means of Ishikawa diagram.
Results:
Two categories emerged from the experiences: Nursing leadership in organizing health services to face COVID-19; and the performance of nursing care management in the COVID-19 pandemic.
Final considerations:
It is necessary to value the nurse’s work in all its attributes, as well as strengthen the interdisciplinary work processes, which collaborate to overcome the crisis caused by the pandemic.
- Valéria Gomes Fernandes da Silva
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