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ORIGINAL ARTICLE06-14-2024
Mid-range theory of the nursing diagnosis Overweight
- Ana Carolina Costa Carino
, - Renata Marinho Fernandes ,
- Anna Thays Dias Almeida ,
- Cecília Maria Farias de Queiroz Frazão ,
- Caroline Evelin Nascimento Kluczynik , [ … ],
- Ana Luisa Brandão de Carvalho Lira
Abstract
ORIGINAL ARTICLEMid-range theory of the nursing diagnosis Overweight
Revista Brasileira de Enfermagem. 2024;77(2):e20230372
DOI 10.1590/0034-7167-2023-0372
- Ana Carolina Costa Carino ,
- Renata Marinho Fernandes ,
- Anna Thays Dias Almeida ,
- Cecília Maria Farias de Queiroz Frazão ,
- Caroline Evelin Nascimento Kluczynik ,
- Ana Luisa Brandão de Carvalho Lira
Views0See moreABSTRACT
Objective:
To build a mid-range theory for the nursing diagnosis Overweight in adolescents and young adults.
Methods:
A methodological study in the light of the theoretical frameworks of Roy and of Lopes, Silva and Herdman. A total of 3,925 articles were retrieved and assessed using the State of the Art Through Systematic Review software. The final sample consisted of 28 articles.
Results:
The findings converged to 3 essential attributes, 13 antecedents, and 7 consequences. A mid-range theory was built consisting of an illustrated diagram, 11 propositions, and 12 causal relationships.
Final considerations:
From the creation of the theory, it was possible to better understand the nursing diagnosis Overweight within the context of adolescents and young adults. Understanding nursing phenomena contributes to nursing science’s advancement and strengthening.
- Ana Carolina Costa Carino
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ORIGINAL ARTICLE06-14-2024
The (in)visibility of fibromyalgia through its symptoms and the challenges of its diagnosis and therapy
Revista Brasileira de Enfermagem. 2024;77(2):e20230363
Abstract
ORIGINAL ARTICLEThe (in)visibility of fibromyalgia through its symptoms and the challenges of its diagnosis and therapy
Revista Brasileira de Enfermagem. 2024;77(2):e20230363
DOI 10.1590/0034-7167-2023-0363
Views0See moreABSTRACT
Objective:
To analyze the social representations of fibromyalgia based on its symptoms and their influences on diagnosis and therapy.
Methods:
Qualitative research with the application of the Theory of Social Representations and snowball sampling method. Semi-structured interviews were conducted with 30 adults diagnosed with fibromyalgia in the city of Rio de Janeiro, Brazil, between April 2020 and January 2021. Statistical and lexicographical analysis was performed using Alceste software.
Results:
Pain, as a subjective phenomenon, complicates its legitimacy, diagnosis, and therapy, enhancing suffering. Insufficient information generates judgments, stereotypes, and prejudices.
Final Considerations:
Stigmas, prejudices, the variety and invisibility of symptoms make it difficult to objectify the disease within the Cartesian-biomedical frameworks, generating diagnostic pilgrimage, mistakes, and challenges in treatment. Such representations hinder relationships and the management of the disease. Deconstructing them is a way to better care for those with fibromyalgia. Raising awareness and spreading qualified information are important allies.
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06-14-2024
Duração e qualidade do sono da equipe de enfermagem brasileira que trabalha em turnos
- Rosângela Marion da Silva ,
- Regina Célia Gollner Zeitoune ,
- Flávia Camef Dorneles Lenz ,
- Carolina Renz Pretto ,
- Katerine Moraes dos Santos , [ … ],
- Alexa Pupiara Flores Coelho Centenaro
Abstract
Duração e qualidade do sono da equipe de enfermagem brasileira que trabalha em turnos
Revista Brasileira de Enfermagem. 2024;77(2):e20230167
DOI 10.1590/0034-7167-2023-0167
- Rosângela Marion da Silva ,
- Regina Célia Gollner Zeitoune ,
- Flávia Camef Dorneles Lenz ,
- Carolina Renz Pretto ,
- Katerine Moraes dos Santos ,
- Tânia Solange Bosi de Souza Magnago ,
- Alexa Pupiara Flores Coelho Centenaro
Views1See moreRESUMEN
Objetivo:
analizar la duración y calidad del sueño en profesionales de enfermería que trabajan por turnos.
Método:
investigación analítica, transversal, realizada entre septiembre de 2017 y abril de 2018, en un hospital público del sur de Brasil, con el equipo de enfermería. Se utilizó el cuestionario sociolaboral y de síntomas de salud, la Escala de Somnolencia de Epworth y el Índice de Calidad del Sueño de Pittsburgh. Los datos se presentan como estadística descriptiva e inferencial, análisis bivariado y regresión logística binaria.
Resultados:
participaron 308 profesionales de enfermería, con predominio de sueño prolongado, ausencia de somnolencia y mala calidad del sueño. La duración corta del sueño (<6 h) se asoció con turnos de día y mala calidad del sueño. La calidad del sueño se asoció con la presencia de somnolencia diurna excesiva y con el trabajo diurno.
Conclusión:
los turnos de trabajo, el insomnio y la cefalea fueron los principales factores relacionados con la falta de sueño de los profesionales de enfermería. Los resultados pueden justificar el desarrollo de investigaciones de intervención para la salud de los trabajadores.
- Rosângela Marion da Silva
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ERRATUM06-14-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e05
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e05
DOI 10.1590/0034-7167.20247702e05
Views2In the article “Educational technologies used to promote self-care for people with diabetes mellitus: integrative review”, with DOI number: , published in Revista Brasileira de Enfermagem, 2023;76(Suppl 4):e20230049, in the title:Where it read:[…]See more -
ERRATUM06-14-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e06
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(2):e2024n2e06
DOI 10.1590/0034-7167.20247702e06
Views2In the article “Is there scientific relevance to the plot of films and documentaries about eating disorders?”, with DOI number: , published in Revista Brasileira de Enfermagem, 2024;77(1):e20220547, page 7:Where it read:[…]See more -
ORIGINAL ARTICLE06-14-2024
Functional performance assessment scale for children and adolescents with cancer: cross-cultural study
- Sandra Alves do Carmo ,
- Isabel Cristina dos Santos Oliveira ,
- Soraya Bactuli Cardoso ,
- Jakcilane Rosendo de Gois ,
- Cícero Ivan Alcantara Costa , [ … ],
- Sabrina Ayd Pereira José
Abstract
ORIGINAL ARTICLEFunctional performance assessment scale for children and adolescents with cancer: cross-cultural study
Revista Brasileira de Enfermagem. 2024;77(2):e20230331
DOI 10.1590/0034-7167-2023-0331
- Sandra Alves do Carmo ,
- Isabel Cristina dos Santos Oliveira ,
- Soraya Bactuli Cardoso ,
- Jakcilane Rosendo de Gois ,
- Cícero Ivan Alcantara Costa ,
- Roberta Dantas Breia de Noronha ,
- Tania Vignuda de Souza ,
- Sabrina Ayd Pereira José
Views0See moreABSTRACT
Objectives:
to describe the methodological process of cross-cultural adaptation of the PlayPerformance Scale for Children to Brazilian Portuguese.
Methods:
methodological study of translation and cross-cultural adaptation in six stages: translation, synthesis of translations, back-translation, evaluation by a committee of judges, evaluation by expert nurses, and pretest. The agreement and representativeness of the items were assessed using the content validity index. A minimum value of 80% agreement was considered.
Results:
all stages of the translation and cross-cultural adaptation process were satisfactory. In the evaluation performed by the committee of judges, all items obtained agreement above 80%. Fifteen pediatric nurses conducted the content validation, suggesting necessary modifications for understanding and application. Thirty children and adolescents with cancer were assessed with the scale for the pre-test.
Conclusions:
the scale was cross-culturally adapted to Brazilian Portuguese. The need for psychometric testing in a consistent sample is emphasized.
- Sandra Alves do Carmo
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ORIGINAL ARTICLE06-14-2024
Translation and Cross-Cultural Adaptation of the LYMPH-ICF Instrument for Lymphedema into Portuguese/Brazil
- Ana Paula Oliveira Santos ,
- Samantha Karlla Lopes de Almeida Rizzi ,
- Gil Facina ,
- Afonso Celso Pinto Nazário ,
- Simone Elias
Abstract
ORIGINAL ARTICLETranslation and Cross-Cultural Adaptation of the LYMPH-ICF Instrument for Lymphedema into Portuguese/Brazil
Revista Brasileira de Enfermagem. 2024;77(2):e20230137
DOI 10.1590/0034-7167-2023-0137
- Ana Paula Oliveira Santos ,
- Samantha Karlla Lopes de Almeida Rizzi ,
- Gil Facina ,
- Afonso Celso Pinto Nazário ,
- Simone Elias
Views0See moreABSTRACT
Objective:
The aim of this study is to cross-culturally adapt the Lymphoedema Functioning, Disability and Health Questionnaire Lymphoedema (LYMPH-ICF) instrument into Brazilian Portuguese and conduct a pilot application (n = 10), without psychometric pretensions.
Method:
Methodological research was conducted, following the steps of translation, synthesis, back-translation, and evaluation by the expert committee. Two translators, two back-translators, and twelve professionals participated in the expert committee. A pretest was carried out with 10 patients with secondary lymphedema due to breast cancer. The degree of agreement was determined by the content validity coefficient.
Results:
It was necessary to modify 8 out of the 29 questions comprising the questionnaire, which exhibited idiomatic disagreement. However, despite these changes, there were no indications of impairments, as content reliability was achieved through a validity coefficient of 0.90.
Final Considerations:
The instrument was successfully translated and cross-culturally adapted for Brazil with a high level of agreement.
- Ana Paula Oliveira Santos
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REVIEW06-14-2024
Lean and/or Six Sigma for process optimization in the perioperative period: an integrative review
- Lucas Gardim ,
- Fernanda Rodrigues dos Santos ,
- Bruna Moreno Dias ,
- Lívia Barrionuevo El Hetti Fuentes ,
- Renata Cristina de Campos Pereira Silveira , [ … ],
- Andrea Bernardes
Abstract
REVIEWLean and/or Six Sigma for process optimization in the perioperative period: an integrative review
Revista Brasileira de Enfermagem. 2024;77(2):e20230431
DOI 10.1590/0034-7167-2023-0431
- Lucas Gardim ,
- Fernanda Rodrigues dos Santos ,
- Bruna Moreno Dias ,
- Lívia Barrionuevo El Hetti Fuentes ,
- Renata Cristina de Campos Pereira Silveira ,
- Andrea Bernardes
Views0See moreABSTRACT
Objective:
To analyze the evidence on the influence of Lean and/or Six Sigma for process optimization in the perioperative period.
Methods:
Integrative review carried out in the MEDLINE (PubMed), Web of Science, EMBASE, CINAHL, Scopus and LILACS databases on the use of Lean and/or Six Sigma to optimize perioperative processes. The studies included were analyzed in three thematic categories: flow of surgical patients, work process and length of stay.
Results:
The final sample consisted of ten studies, which covered all operative periods. Lean and/or Six Sigma make a significant contribution to optimizing perioperative processes.
Final considerations:
Lean and/or Six Sigma optimize perioperative processes to maximize the achievement of system stability indicators, making it possible to identify potential problems in order to recognize them and propose solutions that can enable the institution of patient-centered care.
- Lucas Gardim
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ORIGINAL ARTICLE02-10-2020
Stress and health risk behaviors among university students
- Ellaine Santana de Oliveira ,
- Antonia Fabiana Rodrigues da Silva ,
- Kadija Cristina Barbosa da Silva ,
- Tatiana Victória Carneiro Moura ,
- Açucena Leal de Araújo , [ … ],
- Ana Roberta Vilarouca da Silva
Abstract
ORIGINAL ARTICLEStress and health risk behaviors among university students
Revista Brasileira de Enfermagem. 2020;73(1):e20180035
DOI 10.1590/0034-7167-2018-0035
- Ellaine Santana de Oliveira ,
- Antonia Fabiana Rodrigues da Silva ,
- Kadija Cristina Barbosa da Silva ,
- Tatiana Victória Carneiro Moura ,
- Açucena Leal de Araújo ,
- Ana Roberta Vilarouca da Silva
Views0See moreABSTRACT
Objective:
To analyze the level of stress and its relationship with health risk behaviors among university students.
Method:
Cross-sectional analytical study carried out at a higher education institution in Picos-PI. A total of 377 students were evaluated for socio-demographic and academic variables, stress profile, sleep quality, alcohol use, smoking habits and level of physical activity. The Statistical Package for the Social Sciences (SPSS), version 20.0 was used for data processing and analysis.
Results:
Sleep quality was poor for 65.3% of the subjects, and sleep disturbances were found in 17.0%. Stress was observed in 68.7% of the sample. Stress was associated with the following variables: gender, time in the institution, poor sleep quality.
Conclusion:
Most of the students evaluated present some level of stress associated with poor sleep quality, which is a risk to the quality of life of these individuals.
- Ellaine Santana de Oliveira
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09-16-2019
Construct validation: coping with HIV/AIDS in Primary Health Care
- Révia Ribeiro Castro ,
- Sylvia Silva de Oliveira ,
- Illiana Rose Benvinda de Oliveira Pereira ,
- Wenysson Noleto dos Santos ,
- Sâmara Fontes Fernandes , [ … ],
- Richardson Augusto Rosendo da Silva
Abstract
Construct validation: coping with HIV/AIDS in Primary Health Care
Revista Brasileira de Enfermagem. 2019;72(5):1173-1181
DOI 10.1590/0034-7167-2018-0734
- Révia Ribeiro Castro ,
- Sylvia Silva de Oliveira ,
- Illiana Rose Benvinda de Oliveira Pereira ,
- Wenysson Noleto dos Santos ,
- Sâmara Fontes Fernandes ,
- Richardson Augusto Rosendo da Silva
Views0See moreABSTRACT
Objective:
To validate the construct and measure the trustworthiness of a questionnaire aimed at assessing HIV/AIDS coping actions developed by health professionals in Primary Health Care.
Method:
A methodological study carried out with 397 primary health care professionals in two municipalities in the Northeast region of Brazil. The construct validity was developed by the exploratory and confirmatory factor analysis, and the reliability analyzed by the reliability and reproducibility.
Results:
The validation determined six factors retention that composed the six domains of the questionnaire. Internal consistency was 0.91 and quality of the confirmatory analysis adjustment was 0.998 for Goodness of Fit Index. The domains presented Kappa values between 0.833 and 0.997.
Conclusions:
The final questionnaire was composed of 18 items and presented feasibility of application, and potential to evaluate actions for HIV/AIDS control in Primary Health Care.
- Révia Ribeiro Castro
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ORIGINAL ARTICLE11-12-2022
Low-laser light therapy in venous ulcer healing: a randomized clinical trial
Revista Brasileira de Enfermagem. 2022;75(3):e20210396
Abstract
ORIGINAL ARTICLELow-laser light therapy in venous ulcer healing: a randomized clinical trial
Revista Brasileira de Enfermagem. 2022;75(3):e20210396
DOI 10.1590/0034-7167-2021-0396
Views0See moreABSTRACT
Objectives:
to compare the effect of adjuvant low-laser light therapy versus conventional treatment alone on venous ulcer healing.
Methods:
this is a randomized clinical trial with 40 patients randomized equally to a control group (topical and compressive treatment) and intervention group (adjuvant low-laser light therapy). Outcomes of interest were Wound Healing: Secondary Intention and Tissue Integrity: Skin & Mucous Membranes, as described in the Classification of Nursing Outcomes/NOC.
Results:
groups with similar sociodemographic and clinical characteristics. Eighty-two ulcers were assessed, with an average duration of 1 to 5 years, in 1,066 nursing consultations, with a statistically significant difference in the time and number of healed ulcers (intervention group). There was a significant improvement in the nursing outcomes under study and in eight clinical indicators.
Conclusions:
low-laser light therapy improves and reduces tissue regeneration time, contributing to advances in wound treatment.
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05-21-2021
Evolution of nursing teaching in the use of education technology: a scoping review
- Mayara Lima Barbosa ,
- Lhana Lorena de Melo Atanasio ,
- Suzane Gomes de Medeiros ,
- Cecília Olívia Paraguai de Oliveira Saraiva ,
- Viviane Euzébia Pereira Santos
Abstract
Evolution of nursing teaching in the use of education technology: a scoping review
Revista Brasileira de Enfermagem. 2021;74:e20200422
DOI 10.1590/0034-7167-2020-0422
- Mayara Lima Barbosa ,
- Lhana Lorena de Melo Atanasio ,
- Suzane Gomes de Medeiros ,
- Cecília Olívia Paraguai de Oliveira Saraiva ,
- Viviane Euzébia Pereira Santos
Views1See moreABSTRACT
Objective:
To identify and map the technological tools of information and communication to support the teaching learning process in Nursing teaching courses.
Methods:
This is a scoping review whose search was carried out in seven databases and in grey literature. After an initial analysis of the selection, 88 texts were read integrally, and 29 made up the final sample.
Results:
Virtual learning environment and object, simulation, hypermedia, and software or cellphone applications were the tools the nursing professors used the most. Studies highlight that the application of technology was important in the teaching-learning process, since it encouraged teaching based on safe care, motivating and developing abilities/competences, supported on significant, effective, flexible, and autonomous learning.
Conclusion:
The contribution of the technology for nursing formation stands out, but it should be highlighted that its employment must be critical, reflective, based on pedagogical theories and developed by trained professors.
- Mayara Lima Barbosa
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ORIGINAL ARTICLE09-30-2020
Organizational culture, authentic leadership and quality improvement in Canadian healthcare facilities
- Andrea Bernardes ,
- Carmen Silvia Gabriel ,
- Greta G. Cummings ,
- Ariane Cristina Barboza Zanetti ,
- Alexandre Bevilacqua Leoneti , [ … ],
- Vanessa Gomes Maziero
Abstract
ORIGINAL ARTICLEOrganizational culture, authentic leadership and quality improvement in Canadian healthcare facilities
Revista Brasileira de Enfermagem. 2020;73:e20190732
DOI 10.1590/0034-7167-2019-0732
- Andrea Bernardes ,
- Carmen Silvia Gabriel ,
- Greta G. Cummings ,
- Ariane Cristina Barboza Zanetti ,
- Alexandre Bevilacqua Leoneti ,
- Graziela Caldana ,
- Vanessa Gomes Maziero
Views0See moreABSTRACT
Objective:
To investigate relationships among flexible and hierarchical organizational cultures, quality improvement domains, and authentic leadership competencies in Canadian healthcare facilities.
Method:
Observational cross-sectional study conducted in Alberta, Canada. Nurse managers (n=226) completed a survey including validated measures of organizational culture, quality improvement and authentic leadership. Data were analyzed using descriptive statistics, Spearman’s correlation coefficient and Chi-squared test (p<0.05).
Results:
Quality improvement through accreditation is related to organizational culture and authentic leadership. We saw a propensity for participants who reported working in a more flexible culture also reported greater quality improvement implementation and authentic leadership practices.
Conclusion:
This study assessed and reported the relationships between flexible organizational cultures, quality improvement through the accreditation process, and authentic leadership practices of healthcare managers. Flexible organizational cultures influence the adoption of authentic leadership, participatory management model and also improves quality.
- Andrea Bernardes
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ORIGINAL ARTICLE09-16-2019
Temporal trend of leprosy in a region of high endemicity in the Brazilian Northeast
- Thayza Miranda Pereira ,
- Lucilane Maria Sales da Silva ,
- Maria Socorro de Araújo Dias ,
- Lorena Dias Monteiro ,
- Maria Rocineide Ferreira da Silva , [ … ],
- Olga Maria de Alencar
Abstract
ORIGINAL ARTICLETemporal trend of leprosy in a region of high endemicity in the Brazilian Northeast
Revista Brasileira de Enfermagem. 2019;72(5):1356-1362
DOI 10.1590/0034-7167-2018-0682
- Thayza Miranda Pereira ,
- Lucilane Maria Sales da Silva ,
- Maria Socorro de Araújo Dias ,
- Lorena Dias Monteiro ,
- Maria Rocineide Ferreira da Silva ,
- Olga Maria de Alencar
Views0See moreABSTRACT
Objective:
to analyze the temporal trend and epidemiological patterns of leprosy indicators in Sobral, a municipality countryside of the state of Ceará, from 2001 to 2016.
Method:
a time series study based on data from the Department of Informatics of the Unified Health System. The time trend analysis was performed using the join point regression model.
Results:
There were 2,220 new cases of leprosy in Sobral from 2001 to 2016. Of these, 158 (7.2%) in children younger than 15 years of age, the proportion of new male cases was 52.8% (1,162), cases with grade 2 were 7.0% (156), and proportion of cases diagnosed by contact examination 5.7% (126).
Final considerations:
leprosy remains hyperendemic in adults and children, demonstrating the character of neglected disease. Analysis of the temporal trend allowed to verify that the instability in the detection coefficients, reflect operational problems in the organization of the services
- Thayza Miranda Pereira
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ORIGINAL ARTICLE03-07-2022
Adaptation and validation of the Advanced Practice Nursing Competency Assessment Instrument
- Flávia Carvalho Pena Dias ,
- Tamara Cristina Baitelo ,
- Beatriz Rosana Gonçalves de Oliveira Toso ,
- Pedro Sastre-Fullana ,
- Ana Railka de Souza Oliveira-Kumakura , [ … ],
- Renata Cristina Gasparino
Abstract
ORIGINAL ARTICLEAdaptation and validation of the Advanced Practice Nursing Competency Assessment Instrument
Revista Brasileira de Enfermagem. 2022;75(5):e20210582
DOI 10.1590/0034-7167-2021-0582
- Flávia Carvalho Pena Dias ,
- Tamara Cristina Baitelo ,
- Beatriz Rosana Gonçalves de Oliveira Toso ,
- Pedro Sastre-Fullana ,
- Ana Railka de Souza Oliveira-Kumakura ,
- Renata Cristina Gasparino
Views0See moreABSTRACT
Objective:
To adapt and validate the content of the Advanced Practice Nursing Competency Assessment Instrument (APNCAI) to Brazilian culture.
Methods:
This is a methodological study that followed the stages of translation, synthesis, back translation, evaluation by a committee of five specialists, pre-test with 31 nurses, and evaluation by the author of the original instrument. The Content Validity Index (minimum 0.90) and the modified Kappa (minimum 0.74) were calculated to evaluate the content.
Result:
In the first round of content evaluation, 18 items had to be altered because they did not reach the minimum values established. Three items have not reached a consensus in the second round and had to be sent to the author of the original version. In the pre-test, 13 items were returned to the specialists because they suffered content changes.
Conclusion:
The Advanced Practice Nursing Competency Assessment Instrument (APNCAI) – Brazilian version was cross-culturally adapted, and its content was validated.
- Flávia Carvalho Pena Dias
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ORIGINAL ARTICLE08-19-2019
Factors related to impaired comfort in chronic kidney disease patients on hemodialysis
- Geórgia Alcântara Alencar Melo ,
- Letícia Lima Aguiar ,
- Renan Alves Silva ,
- Glauberto da Silva Quirino ,
- Ana Karina Bezerra Pinheiro , [ … ],
- Joselany Áfio Caetano
Abstract
ORIGINAL ARTICLEFactors related to impaired comfort in chronic kidney disease patients on hemodialysis
Revista Brasileira de Enfermagem. 2019;72(4):889-895
DOI 10.1590/0034-7167-2018-0120
- Geórgia Alcântara Alencar Melo ,
- Letícia Lima Aguiar ,
- Renan Alves Silva ,
- Glauberto da Silva Quirino ,
- Ana Karina Bezerra Pinheiro ,
- Joselany Áfio Caetano
Views0See moreABSTRACT
Objective:
to analyze the factors related to the impaired comfort of chronic kidney diseases (CKD) patients on hemodialysis.
Method:
this is a cross-sectional study with 80 patients undergoing hemodialysis in a renal replacement therapy unit through interviews using two instruments, one for clinical and sociodemographic characteristics and the General Comfort Questionnaire, during the hemodialysis session. Mann-Whitney tests and the logistic regression model were used for data analysis.
Results:
the study found that being younger (p=0.045); being married (p=0.05); and absence of impaired physical mobility (p=0.007) were contributing factors for greater comfort in CKD patients on hemodialysis. Thus, when establishing the odds ratio, it was possible to observe that being 55 years of age or older, being single and having impaired physical mobility represents a 45.7% chance of developing this diagnosis.
Conclusions:
sociodemographic and clinical variables contribute to the study outcome, demanding attention during the planning of nursing interventions.
- Geórgia Alcântara Alencar Melo
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