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ORIGINAL ARTICLE05-13-2024
Generalized Resistance Deficits in inmates with hypertension: missing resources that limit health
- Marta Cossetin Costa
, - Maria de Fátima Mantovani ,
- Fernanda Moura D’Almeida Miranda ,
- Ivonete Teresinha Schülter Buss Heidemann ,
- Aida Maris Peres
Abstract
ORIGINAL ARTICLEGeneralized Resistance Deficits in inmates with hypertension: missing resources that limit health
Revista Brasileira de Enfermagem. 2024;77(2):e20230246
DOI 10.1590/0034-7167-2023-0246
- Marta Cossetin Costa ,
- Maria de Fátima Mantovani ,
- Fernanda Moura D’Almeida Miranda ,
- Ivonete Teresinha Schülter Buss Heidemann ,
- Aida Maris Peres
Views0See moreABSTRACT
Objective:
to understand the Generalized Resistance Deficits of people deprived of liberty with hypertension in a Brazilian prison unit.
Method:
qualitative research, anchored in Salutogenesis, carried out with 38 people with hypertension from a Brazilian prison unit, from February to July 2022, with a semi-structured interview with open-ended questions, whose analysis was thematic, explaining the limitations to health in prison.
Results:
13 Generalized Resistance Deficits were reported, mostly related to the prison environment and, to a lesser extent, to the social group and the individual, respectively. Living in prison for people with hypertension implies living with a high number of Generalized Resistance Deficits, accentuating the movement towards the disease pole.
Final considerations:
knowing Generalized Resistance Deficits allows directing health promotion to support the use of available Generalized Resistance Resources and contributes to the expansion of intersectoral policies.
- Marta Cossetin Costa
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REVIEW05-13-2024
Lean methodology: contributions to improving work processes in health and nursing
- Fernanda Novaes Moreno Brancalion ,
- Lara Gonçalves de Souza ,
- Simone Berger ,
- Antônio Fernandes Costa Lima
Abstract
REVIEWLean methodology: contributions to improving work processes in health and nursing
Revista Brasileira de Enfermagem. 2024;77(2):e20230322
DOI 10.1590/0034-7167-2023-0322
- Fernanda Novaes Moreno Brancalion ,
- Lara Gonçalves de Souza ,
- Simone Berger ,
- Antônio Fernandes Costa Lima
Views0See moreABSTRACT
Objective:
to investigate the contributions of applying the Lean methodology to improve work processes in health and nursing and its impact on associated financial aspects.
Method:
an integrative review, carried out in six databases, whose sample of ten (100.0%) studies was analyzed and summarized descriptively.
Results:
the outcomes obtained were stratified into: benefits/barriers to Lean Healthcare implementation; economic aspects involving Lean Healthcare implementation; and process improvements through Lean Healthcare implementation. The majority of studies (60.0%) were carried out in university hospitals, contexts that need to continually improve the quality of services provided, generally with scarce and limited resources, which support the viability of maintaining the teaching, research and extension tripod.
Conclusion:
three (30.0%) studies highlighted the financial aspects associated with Lean methodology application. The others only mentioned the possibility of financial gains through improving processes and reducing waste.
- Fernanda Novaes Moreno Brancalion
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REVIEW05-13-2024
Stunting predictors among children aged 0-24 months in Southeast Asia: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20220625
Abstract
REVIEWStunting predictors among children aged 0-24 months in Southeast Asia: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20220625
DOI 10.1590/0034-7167-2022-0625
Views0See moreABSTRACT
Objective:
To identify predictors of stunting among children 0-24 months in Southeast Asia.
Methods:
This scoping review focused on articles with observational study design in English published from 2012 to 2023 from five international databases. The primary keyword used were: “stunting” OR “growth disorder” AND “newborn” AND “predict” AND “Southeast Asia”.
Results:
Of the 27 articles selected for the final analysis there are thirteen predictors of stunting in seven Southeast Asia countries. The thirteen predictors include the child, mother, home, inadequate complementary feeding, inadequate breastfeeding, inadequate care, poor quality foods, food and water safety, infection, political economy, health and healthcare, water, sanitation, and environment, and social culture factor.
Conclusion:
All these predictors can lead to stunting in Southeast Asia. To prevent it, health service providers and other related sectors need to carry out health promotion and health prevention according to the predictors found.
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05-13-2024
A influência da internet nas escolhas sobre a saúde e o bem-estar dos idosos
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
Abstract
A influência da internet nas escolhas sobre a saúde e o bem-estar dos idosos
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
DOI 10.1590/0034-7167-2023-0321
Views0See moreRESUMEN
Objetivos:
describir el perfil de los ancianos que acceden a internet para buscar información de salud e identificar los factores que pueden influir en las decisiones de los ancianos sobre su salud a partir de la información recopilada en línea.
Métodos:
391 ancianos respondieron a un cuestionario online sobre hábitos y satisfacción con la información de salud recogida en internet. El procesamiento de datos implicó regresión logística.
Resultados:
la educación superior reduce en un 44% la probabilidad de que un anciano siga las recomendaciones de salud en los sitios web. Sin embargo, las actividades sociales y la salud autopercibida aumentan la posibilidad de seguir las recomendaciones en un 83% y un 71%, respectivamente. La creencia de que internet promueve hábitos saludables aumenta 29,2 veces la probabilidad de que un anciano siga un consejo.
Consideraciones Finales:
conocer el perfil de los ancianos que utilizan internet puede ayudar a los profesionales a formular políticas públicas y construir buenas plataformas de información sobre salud y bienestar.
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ORIGINAL ARTICLE05-13-2024
The influence of the internet on choices about older adults’ health and well-being
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
Abstract
ORIGINAL ARTICLEThe influence of the internet on choices about older adults’ health and well-being
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
DOI 10.1590/0034-7167-2023-0321
Views0See moreABSTRACT
Objectives:
to describe the profile of older adults who access the internet to search for health information and identify the factors that can influence older adults’ decisions about their health based on information collected online.
Methods:
391 older adults answered an online questionnaire regarding habits and satisfaction with information about health collected on the internet. Data processing involved Logistic Regression.
Results:
higher education reduces by 44% the likelihood of an older adult following the health recommendations on internet sites. However, social activities and self-perceived health increase the possibility of following the recommendations by 83% and 71%, respectively. The belief that the internet promotes healthy habits increases by 29.2 times the probability of an older adult following the advice.
Final Considerations:
knowing the profile of older adults who use the Internet can help professionals formulate public policies and build good information platforms on health and well-being.
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REVIEW05-13-2024
Technologies used in the treatment of burn victims in intensive care: a scope review
- Kyohana Matos de Freitas Clementino ,
- Gabriela Duarte Bezerra ,
- Gleice Adriana Araujo Gonçalves ,
- Maria Corina Amaral Viana ,
- Luis Rafael Leite Sampaio , [ … ],
- Woneska Rodrigues Pinheiro
Abstract
REVIEWTechnologies used in the treatment of burn victims in intensive care: a scope review
Revista Brasileira de Enfermagem. 2024;77(1):e20220738
DOI 10.1590/0034-7167-2022-0738
- Kyohana Matos de Freitas Clementino ,
- Gabriela Duarte Bezerra ,
- Gleice Adriana Araujo Gonçalves ,
- Maria Corina Amaral Viana ,
- Luis Rafael Leite Sampaio ,
- Woneska Rodrigues Pinheiro
Views0See moreABSTRACT
Objectives:
to analyze the technologies used by the nursing team in the treatment of skin lesions caused by burns in patients under intensive care.
Methods:
this is a scope review conducted on the LILACS, Medline, PubMed, and CINAHL databases without temporal or language restrictions.
Results:
the highlighted technologies included the use of specialized dressings, biological agents such as probiotics and cyanobacteria, as well as negative pressure therapies and enzymes such as papain and collagenase. Some technologies, such as nanocrystalline silver, demonstrated efficacy in infection control.
Final Considerations:
the study identified essential technologies in burn care, emphasizing the need for further research on “soft” technologies. The findings support the promotion of evidence-based nursing care for burn patients in intensive care and enhance knowledge about effective treatments.
- Kyohana Matos de Freitas Clementino
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ORIGINAL ARTICLE05-03-2024
What is the burden of multimorbidity and the factors associated with its occurrence in elderly Brazilians?
- Danielle Samara Tavares de Oliveira-Figueiredo ,
- Matteus Pio Gianotti Pereira Cruz Silva ,
- Paula Yhasmym de Oliveira Feitosa ,
- Bruna Cardoso Leite ,
- Fabiana Lucena Rocha , [ … ],
- Luciana Dantas Farias de Andrade
Abstract
ORIGINAL ARTICLEWhat is the burden of multimorbidity and the factors associated with its occurrence in elderly Brazilians?
Revista Brasileira de Enfermagem. 2024;77(1):e20220809
DOI 10.1590/0034-7167-2022-0809
- Danielle Samara Tavares de Oliveira-Figueiredo ,
- Matteus Pio Gianotti Pereira Cruz Silva ,
- Paula Yhasmym de Oliveira Feitosa ,
- Bruna Cardoso Leite ,
- Fabiana Lucena Rocha ,
- Luciana Dantas Farias de Andrade
Views0See moreABSTRACT
Objective:
To estimate the prevalence of multimorbidity in elderly people and its association with sociodemographic characteristics, lifestyle, and anthropometry.
Methods:
This was a cross-sectional study using data from the National Health Survey, 2019. A total of 22,728 elderly individuals from all 27 Brazilian states were randomly selected. Poisson regression models with robust variance were employed, and a significance level of 5% was adopted.
Results:
The prevalence of multimorbidity was 51.6% (95% CI: 50.4-52.7), with the highest estimates observed in the South and Southeast. Multimorbidity was associated with being female (aPR = 1.33; 95% CI: 1.27-1.39), being 80 years old or older (aPR = 1.12; 95% CI: 1.05-1.19), having low education (aPR = 1.16; 95% CI: 1.07-1.25), past cigarette use (aPR = 1.16; 95% CI: 1.11-1.21), insufficient physical activity (aPR = 1.13; 95% CI: 1.06-1.21), and screen use for 3 hours or more per day (aPR = 1.13; 95% CI: 1.08-1.18).
Conclusion:
Multimorbidity affects more than half of the elderly population in Brazil and is associated with social, demographic, and behavioral factors.
- Danielle Samara Tavares de Oliveira-Figueiredo
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ORIGINAL ARTICLE05-03-2024
Cancer patient satisfaction regarding the quality of information received: psychometric validity of EORTC QLQ-INFO25
Revista Brasileira de Enfermagem. 2024;77(1):e20230358
Abstract
ORIGINAL ARTICLECancer patient satisfaction regarding the quality of information received: psychometric validity of EORTC QLQ-INFO25
Revista Brasileira de Enfermagem. 2024;77(1):e20230358
DOI 10.1590/0034-7167-2023-0358
Views0See moreABSTRACT
Objectives:
to psychometrically validate the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire EORTC QLQ-INFO25 instrument and identify the domains that influence patients’ perception of the information received.
Methods:
a cross-sectional methodology with cancer patients in a Brazilian philanthropic hospital institution. Sociodemographic and clinical instruments, EORTC QLQ-C30, EORTC QLQ-INFO25 and Supportive Care Needs Survey – Short Form 34 were used. Analysis occurred using Cronbach’s alpha coefficients, intraclass correlation, test-retest and exploratory factor analysis.
Results:
128 respondents participated. Cronbach’s alpha coefficient was 0.85. The test-retest obtained p-value=0.21. In the factor analysis, one item was excluded. Satisfaction with the information received was 74%, with three areas with averages below 70%. In open-ended questions, there was a greater desire for information.
Conclusions:
validity evidence was obtained with instrument reliability, consistency and stability. Respondents expressed satisfaction with the information received.
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ORIGINAL ARTICLE05-24-2021
PEDCARE: validation of a mobile application on diabetic foot self-care
- Antonio Dean Barbosa Marques ,
- Thereza Maria Magalhães Moreira ,
- Rhanna Emanuela Fontenele Lima de Carvalho ,
- Edna Maria Camelo Chaves ,
- Shérida Karanini Paz de Oliveira , [ … ],
- Jarbas Aryel Nunes da Silveira
Abstract
ORIGINAL ARTICLEPEDCARE: validation of a mobile application on diabetic foot self-care
Revista Brasileira de Enfermagem. 2021;74:e20200856
DOI 10.1590/0034-7167-2020-0856
- Antonio Dean Barbosa Marques ,
- Thereza Maria Magalhães Moreira ,
- Rhanna Emanuela Fontenele Lima de Carvalho ,
- Edna Maria Camelo Chaves ,
- Shérida Karanini Paz de Oliveira ,
- Gilvan Ferreira Felipe ,
- Jarbas Aryel Nunes da Silveira
Views0See moreABSTRACT
Objective:
to describe the process of validating a multimedia application on a mobile platform to promote foot care for people with diabetes.
Method:
a technological production and methodological type study. Content and appearance were validated by 39 judges (29 nursing judges and ten information and communication technology judges and 15 people from the target audience).
Results:
nursing judges made it possible to validate the material with a total Content Validity Index of 0.95, a non-significant binomial test for most items and Cronbach’s alpha of 0.92, information and communication technology judges with Suitability Assessment of Materials of 99.2% and the target audience with an agreement index of 98%.
Conclusion:
the application proved to be valid and reliable for use in clinical practice as an educational technology to promote foot care for people with diabetes.
- Antonio Dean Barbosa Marques
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ORIGINAL ARTICLE06-27-2019
Package of menthol measures for thirst relief: a randomized clinical study
- Viviane Moreira Serato ,
- Lígia Fahl Fonseca ,
- Marcela Maria Birolim ,
- Edilaine Giovanini Rossetto ,
- Lílian Denise Mai , [ … ],
- Aline Korki Arrabal Garcia
Abstract
ORIGINAL ARTICLEPackage of menthol measures for thirst relief: a randomized clinical study
Revista Brasileira de Enfermagem. 2019;72(3):600-608
DOI 10.1590/0034-7167-2018-0057
- Viviane Moreira Serato ,
- Lígia Fahl Fonseca ,
- Marcela Maria Birolim ,
- Edilaine Giovanini Rossetto ,
- Lílian Denise Mai ,
- Aline Korki Arrabal Garcia
Views0See moreABSTRACT
Objective:
To evaluate the effectiveness of the menthol package (lip hydration and ice popsicles) compared to a package of non-menthol measures (lip hydration and ice popsicles) as a way to relieve thirst in patients in the Anesthetic Recovery Room.
Method:
Randomized and parallel trial study, with 120 patients randomized patients in an experimental group – menthol measurements (n=59) and control group – measures without menthol (n = 61).
Results:
There was a significant (p<0.05) decrease in intensity, hydration, dryness and taste in the oral cavity between the three moments of assessment/intervention in the two groups. The difference was significant in the experimental group for thirst intensity at the second assessment/intervention point (p<0.05) after a single administration of the menthol package.
Conclusion:
There was a reduction in thirst intensity in both groups. Patients who received menthol packages showed a significant decrease in intensity after a single evaluation/intervention time. NCT: 02869139.
- Viviane Moreira Serato
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ORIGINAL ARTICLE06-27-2019
Caring for the carer: quality of life and burden of female caregivers
- Michelly Guedes de Oliveira Araújo ,
- Michelinne Oliveira Machado Dutra ,
- Carla Carolina Silva Leite Freitas ,
- Tatiane Gomes Guedes ,
- Francisco Stélio de Souza , [ … ],
- Rosilene Santos Baptista
Abstract
ORIGINAL ARTICLECaring for the carer: quality of life and burden of female caregivers
Revista Brasileira de Enfermagem. 2019;72(3):728-736
DOI 10.1590/0034-7167-2018-0334
- Michelly Guedes de Oliveira Araújo ,
- Michelinne Oliveira Machado Dutra ,
- Carla Carolina Silva Leite Freitas ,
- Tatiane Gomes Guedes ,
- Francisco Stélio de Souza ,
- Rosilene Santos Baptista
Views0See moreABSTRACT
Objective:
To assess the quality of life and the burden of female caregivers.
Method:
Descriptive, cross-sectional, quantitative study carried out with 224 informal caregivers from March to July 2016. Three instruments were used: a characterization form for the caregiver, the WHOQOL-Bref questionnaire and the Zarit Burden Interview. The following tests were used: Cronbach’s Alpha, Kolmogorov-Smirnov, Kruskal-Wallis, Spearman and Mann-Whitney.
Results:
The mean age of caregivers was 51.8 years with a standard deviation of 13.7. They were predominantly married, had a low income and low level of education, were first-degree relatives, had been providing care for one to five years and presented some pathology. The associations of quality of life that presented statistical significance were: income, marital status, number of people living with the caregiver and time of care.
Conclusion:
The burden was negatively correlated with QOL, that is, the greater the burden, the more impaired will be the life of these caregivers.
- Michelly Guedes de Oliveira Araújo
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REVIEW03-24-2021
Development of clinical competence in nursing in simulation: the perspective of Bloom’s taxonomy
- Juliana da Silva Garcia Nascimento ,
- Tainá Vilhar Siqueira ,
- Jordana Luiza Gouvêa de Oliveira ,
- Mateus Goulart Alves ,
- Daniela da Silva Garcia Regino , [ … ],
- Maria Celia Barcellos Dalri
Abstract
REVIEWDevelopment of clinical competence in nursing in simulation: the perspective of Bloom’s taxonomy
Revista Brasileira de Enfermagem. 2021;74(1):e20200135
DOI 10.1590/0034-7167-2020-0135
- Juliana da Silva Garcia Nascimento ,
- Tainá Vilhar Siqueira ,
- Jordana Luiza Gouvêa de Oliveira ,
- Mateus Goulart Alves ,
- Daniela da Silva Garcia Regino ,
- Maria Celia Barcellos Dalri
Views0See moreABSTRACT
Objectives:
to investigate the scientific evidence on the use of Bloom’s taxonomy for developing competence in nursing professionals and students in clinical simulation.
Methods:
integrative review of the National Library of Medicine (NLM), National Institutes of Health (NIH), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Latin American and Caribbean Literature in Health Sciences (LILACS), Web of Science and SCOPUS databases, using the Rayyan application.
Results:
a total of 871 studies were identified; four composed the sample. The development of clinical competence occurred through the coordination of knowledge, skills, and attitudes. To develop the cognitive domain, the objectives of knowledge and comprehension of the Bloom’s taxonomy were mobilized. The psychomotor domain required development of the skills demanded by the proposed clinical care. The affective domain was developed through will and motivation to learn.
Conclusions:
it is possible to develop clinical competence in nursing by adopting Bloom’s taxonomy in each phase of clinical simulation.
- Juliana da Silva Garcia Nascimento
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ORIGINAL ARTICLE12-04-2020
Pressure injury related to the use of personal protective equipment in COVID-19 pandemic
- Manuela de Mendonça Figueirêdo Coelho ,
- Viviane Mamede Vasconcelos Cavalcante ,
- Juliano Teixeira Moraes ,
- Luciana Catunda Gomes de Menezes ,
- Sarah Vieira Figueirêdo , [ … ],
- Solange Gurgel Alexandre
Abstract
ORIGINAL ARTICLEPressure injury related to the use of personal protective equipment in COVID-19 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200670
DOI 10.1590/0034-7167-2020-0670
- Manuela de Mendonça Figueirêdo Coelho ,
- Viviane Mamede Vasconcelos Cavalcante ,
- Juliano Teixeira Moraes ,
- Luciana Catunda Gomes de Menezes ,
- Sarah Vieira Figueirêdo ,
- Mírian Ferreira Coelho Castelo Branco ,
- Solange Gurgel Alexandre
Views0See moreABSTRACT
Objective:
To describe the prevalence and factors associated with pressure injuries related to the use of personal protective equipment during the COVID-19 pandemic.
Methods:
Cross-sectional study conducted using an instrument made available in social networks with 1,106 health professionals. The data were analyzed using descriptive statistics and compared, considering pvalue < 0.05.
Results:
There was a prevalence of 69.4% for pressure injuries related to the use of personal protective equipment, with an average of 2.4 injuries per professional. The significant factors were: under 35 years of age, working and wearing personal protective equipment for more than six hours a day, in hospital units, and without the use of inputs for protection.
Conclusion:
Pressure injuries related to the use of medical devices showed a high prevalence in this population. The recognition of the damage in these professionals makes it possible to advance in prevention strategies.
- Manuela de Mendonça Figueirêdo Coelho
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03-27-2020
Coronavirus 2020
Revista Brasileira de Enfermagem. 2020;73(2):e2020n2
Abstract
Coronavirus 2020
Revista Brasileira de Enfermagem. 2020;73(2):e2020n2
DOI 10.1590/0034-7167-2020730201
Views0Emerging and reemerging infectious diseases are constant challenges for public health worldwide. Recent cases of pneumonia of unknown cause in Wuhan, China, have led to the discovery of a new type of Coronavirus (2019-nCoV), which are enveloped RNA viruses, commonly found in humans, other mammals and birds, capable of causing respiratory, enteric, hepatic, and neurological […]See more -
ORIGINAL ARTICLE12-13-2019
Accessibility of children with special health needs to the health care network
- Eliane Tatsch Neves ,
- Aline Cristiane Cavicchioli Okido ,
- Fernanda Luisa Buboltz ,
- Raíssa Passos dos Santos ,
- Regina Aparecida Garcia de Lima
Abstract
ORIGINAL ARTICLEAccessibility of children with special health needs to the health care network
Revista Brasileira de Enfermagem. 2019;72:65-71
DOI 10.1590/0034-7167-2017-0899
- Eliane Tatsch Neves ,
- Aline Cristiane Cavicchioli Okido ,
- Fernanda Luisa Buboltz ,
- Raíssa Passos dos Santos ,
- Regina Aparecida Garcia de Lima
Views0See moreABSTRACT
Objective:
To know how children with special health needs access the health care network.
Method:
This is a qualitative research of descriptive-exploratory type, developed using semi-structured interviews mediated by the Talking Map design. Participants were 19 family caregivers of these children in two Brazilian municipalities. Data were submitted to inductive thematic analysis.
Results:
Difficulties were mentioned from the diagnosis moment to the specialized follow-up, something represented by the itinerary of the c hild and his/her family in the search for the definition of the medical diagnosis and the access to a specialized professional; a gap between the children’s needs and the care offered was observed in primary health care.
Conclusion:
The access of children with special health needs is filled with obstacles such as slowness in the process of defining the child’s diagnosis and referral to a specialist. Primary health care services were replaced by care in emergency care units.
- Eliane Tatsch Neves
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ORIGINAL ARTICLE07-13-2020
Incontinence-associated dermatitis in elderly patients: prevalence and risk factors
- Mariana Ferreira ,
- Luciana Abbade ,
- Silvia Cristina Mangini Bocchi ,
- Hélio Amante Miot ,
- Paulo Villas Boas , [ … ],
- Heloísa Quatrini Carvalho Passos Guimaraes
Abstract
ORIGINAL ARTICLEIncontinence-associated dermatitis in elderly patients: prevalence and risk factors
Revista Brasileira de Enfermagem. 2020;73:e20180475
DOI 10.1590/0034-7167-2018-0475
- Mariana Ferreira ,
- Luciana Abbade ,
- Silvia Cristina Mangini Bocchi ,
- Hélio Amante Miot ,
- Paulo Villas Boas ,
- Heloísa Quatrini Carvalho Passos Guimaraes
Views0See moreABSTRACT
Objective:
To determine the prevalence and risk factors for incontinence-associated dermatitis in the elderly.
Method:
Cross-sectional exploratory study carried out in public hospitals. The dermatitis prevalence and associations were obtained by calculating the ratio. The effect dimension was estimated by the odds ratio with a 95% confidence interval and statistical significance p <0.05.
Results:
138 elderly people were included, with an average age of 77.2 years old (± 9.3); 69 (50%) had combined fecal and urinary incontinence. The dermatitis prevalence was 36.2% (50); 28% (14) had pressure injuries; 14% (7), candidiasis. Risk factors were: longer hospital stay (Odds Ratio = 5.8 [2.6-12.9]), obesity (Odds Ratio = 3.6 [1.2-10.4]), high level of dependence (Odds Ratio = 2.4 [1,1-5,0]) and high risk for pressure injury (Odds Ratio = 6.1 [1,4-26,9]).
Conclusion:
The study found a high prevalence of dermatitis associated with incontinence. The early recognition of risk factors favors effective preventive actions.
- Mariana Ferreira
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