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ORIGINAL ARTICLE12-16-2024
Editorial discourses in the history of Acta Paulista de Enfermagem (1988-2017)
Revista Brasileira de Enfermagem. 2024;77(6):e20230362
Abstract
ORIGINAL ARTICLEEditorial discourses in the history of Acta Paulista de Enfermagem (1988-2017)
Revista Brasileira de Enfermagem. 2024;77(6):e20230362
DOI 10.1590/0034-7167-2023-0362
Views0See moreABSTRACT
Objectives:
to analyze the editorial discourses of Acta Paulista de Enfermagem from 1988 to 2017.
Methods:
qualitative, historical, oral research, with interviews with the journal’s editors. Statements were categorized and presented in three decades, discussed from Foucault’s archaeological perspective.
Results:
seven statements presented three discourses. In the first decade, the discourse of knowledge registration and circulation presented statements of graduate studies and professional recognition. In the second decade, knowledge internationalization was added, with statements of business and editorial panopticism, selection criteria, indexing and digitalization. Finally, the discourse of shifting scientific assessment centrality was added with statements of preprint, open science, exclusive digitalization and mediatization of science.
Final Considerations:
the journal needed to adapt to form its official discourse, which made it possible, over the years, to change its initial peripheral position to a central one within scientific communication, supporting its panoptic role.
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REVIEW12-16-2024
Strategies for expanding vaccination coverage in children in Brazil: systematic literature review
- Janaina Fonseca Almeida Souza
, - Thales Philipe Rodrigues da Silva ,
- Camila Kümmel Duarte ,
- Anna Luiza de Fatima Pinho Lins Gryschek ,
- Elysângela Dittz Duarte , [ … ],
- Fernanda Penido Matozinhos
Abstract
REVIEWStrategies for expanding vaccination coverage in children in Brazil: systematic literature review
Revista Brasileira de Enfermagem. 2024;77(6):e20230343
DOI 10.1590/0034-7167-2023-0343
- Janaina Fonseca Almeida Souza ,
- Thales Philipe Rodrigues da Silva ,
- Camila Kümmel Duarte ,
- Anna Luiza de Fatima Pinho Lins Gryschek ,
- Elysângela Dittz Duarte ,
- Fernanda Penido Matozinhos
Views1See moreABSTRACT
Objectives:
to identify the strategies found in the literature for increasing vaccination coverage among children in Brazil. It is justified mainly by the current scenario of falling vaccination coverage.
Methods:
systematic literature review. The search was carried out in the Pubmed (MEDLINE), Embase and Scopus databases, following the PRISMA guidelines.
Results:
initially, 4,824 results were returned. In the end, 6 studies were included for narrative synthesis using the SWiM methodology. Of these, 50% dealt with studies related to the Bolsa Família Program (PBF). The others explored strategies for approaching parents directly, Rapid Vaccination Monitoring (MRV) and the Community Health Agents Program (PACS). The PBF did not guarantee compliance with the conditionality of keeping vaccinations up to date. The MRV and PACS are effective strategies, especially because they allow active search for absentees.
Conclusions:
we conclude that more publications are needed on strategies to increase vaccination coverage among children in Brazil.
- Janaina Fonseca Almeida Souza
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ORIGINAL ARTICLE12-16-2024
Educational technology to empower patients as participants in their care
- Rodrigo da Silva Ramos ,
- Mateus Ferreira de Aguiar ,
- Eurinete Catarina Guimarães da Silva ,
- Cleberson Morais Caetano ,
- Rizioléia Marina Pinheiro Pina , [ … ],
- Hadelândia Milon de Oliveira
Abstract
ORIGINAL ARTICLEEducational technology to empower patients as participants in their care
Revista Brasileira de Enfermagem. 2024;77(6):e20230359
DOI 10.1590/0034-7167-2023-0359
- Rodrigo da Silva Ramos ,
- Mateus Ferreira de Aguiar ,
- Eurinete Catarina Guimarães da Silva ,
- Cleberson Morais Caetano ,
- Rizioléia Marina Pinheiro Pina ,
- Joice Claret Neves ,
- Hadelândia Milon de Oliveira
Views0See moreABSTRACT
Objectives:
to build and validate an educational technology to empower patients as participants in their own care.
Methods:
methodological study to develop an educational technology based on the elaboration, validation, and evaluation that were carried out in five stages at a teaching hospital in Amazonas. The study was carried out from 2019 to 2022, with the participation of 19 judges specialized in patient safety and 72 patients admitted to the hospital’s medical and surgical clinics, the study setting.
Results:
the agreement between the judges obtained an overall index of 0.85, being considered validated. The overall analysis of the booklet obtained an assessment of the level of agreement above 85%.
Final Considerations:
the educational technology presented here was validated and suitable for promoting patient/professional rapprochement and consolidating health care in a way that increases the patient’s ability to contribute to their treatment and prevent the occurrence of adverse events.
- Rodrigo da Silva Ramos
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ORIGINAL ARTICLE12-13-2024
Educational booklet on labor and delivery: validity study
- Michelle Tatiane Carvalho Gonçalves ,
- Ana Roberta Vilarouca da Silva ,
- Mara Cristina Ribeiro Furlan ,
- Bruna Moretti Luchesi ,
- Tatiana Carvalho Reis Martins
Abstract
ORIGINAL ARTICLEEducational booklet on labor and delivery: validity study
Revista Brasileira de Enfermagem. 2024;77(5):e20240138
DOI 10.1590/0034-7167-2024-0138
- Michelle Tatiane Carvalho Gonçalves ,
- Ana Roberta Vilarouca da Silva ,
- Mara Cristina Ribeiro Furlan ,
- Bruna Moretti Luchesi ,
- Tatiana Carvalho Reis Martins
Views2See moreABSTRACT
Objectives:
to develop and validate an educational booklet on labor and delivery for pregnant women.
Methods:
this methodological study involved constructing and validating a booklet based on Echer’s framework. We used the Content Validity Index and Cronbach’s alpha for content and face validation, selecting judges according to Fering’s criteria. We then conducted a clinical validation with the target population.
Results:
the booklet, developed based on evidence from an integrative review and validated by judges and the target audience, achieved global Content Validity Index of 0.919 and 0.913, respectively. After clinical validation with 22 pregnant women, it included 28 topics and 48 pages, with illustrations by a graphic designer.
Conclusions:
expert judges and the target audience considered this educational technology valid, deeming it a relevant tool for promoting the health of pregnant women.
- Michelle Tatiane Carvalho Gonçalves
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ORIGINAL ARTICLE12-13-2024
Interobserver agreement in Reception and Risk Stratification in Obstetrics implementation
- Manuela Beatriz Velho ,
- Luciana Santos Pimentel ,
- Fernanda Amâncio Soares da Silva ,
- Alberto Trapani Junior ,
- Thayná Ventura , [ … ],
- Roxana Knobel
Abstract
ORIGINAL ARTICLEInterobserver agreement in Reception and Risk Stratification in Obstetrics implementation
Revista Brasileira de Enfermagem. 2024;77(5):e20230361
DOI 10.1590/0034-7167-2023-0361
- Manuela Beatriz Velho ,
- Luciana Santos Pimentel ,
- Fernanda Amâncio Soares da Silva ,
- Alberto Trapani Junior ,
- Thayná Ventura ,
- Adaiana Fátima Almeida ,
- Roberta Costa ,
- Roxana Knobel
Views0See moreABSTRACT
Objectives:
to analyze interobserver agreement in the Reception and Risk Stratification in Obstetrics protocol implementation.
Methods:
a cross-sectional study carried out during Reception and Risk Stratification in Obstetrics implementation, conducted in a tertiary hospital in southern Brazil with 891 participants in January 2020. Descriptive and interobserver agreement analysis was carried out using the Kappa coefficient in the risk stratification assigned by the triage nurse and reviewed by the researcher.
Results:
around half of the calls (55.6%) were stratified as not very urgent (green), followed by urgent (yellow) (31.8%), very urgent (orange) (9.3%), not urgent (blue) (3.4%) and no emerging stratification (red). Agreement analysis of revised stratification found Kappa values of 0.20 (blue), 0.54 (green), 0.77 (yellow) and 0.80 (orange).
Conclusions:
most appointments were non-urgent. The agreement analysis between the revised and assigned risk stratification revealed greater interobserver agreement as the priority level increased.
- Manuela Beatriz Velho
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12-13-2024
Training of Brazilian indigenous nurses: between human rights, valuing diversity and inclusion
- Nádile Juliane Costa de Castro ,
- Ezequiel Sakew Wai Wai ,
- Fernanda Teixeira Paes ,
- Nyvia Cristina dos Santos Lima
Abstract
Training of Brazilian indigenous nurses: between human rights, valuing diversity and inclusion
Revista Brasileira de Enfermagem. 2024;77(5):e20230430
DOI 10.1590/0034-7167-2023-0430
- Nádile Juliane Costa de Castro ,
- Ezequiel Sakew Wai Wai ,
- Fernanda Teixeira Paes ,
- Nyvia Cristina dos Santos Lima
Views0See moreABSTRACT
Objectives:
to analyze the possibilities and potential of training indigenous nurses, given the Brazilian Health System (SUS), understanding the relationships between education and health.
Methods:
theoretical-reflective study, based on scientific literature, aligned with the experience, critical thinking of its authors and the Sustainable Development Goals in Brazil.
Results:
this text articulates three axes: Potential for including indigenous students in nursing training; Paths to achieving equity through inclusion and retention policies for indigenous students at different levels; and Implications of this for the SUS and global health.
Final Considerations:
indigenous students, beneficiaries of affirmative actions, face challenges of inclusion and retention in public universities that directly impact their academic training. Added to this are the difficulties identified in basic education, professor training and implementation of permanence policies, with consequences for services and training at other levels.
- Nádile Juliane Costa de Castro
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ORIGINAL ARTICLE12-13-2024
Stress in nursing workers caring for people with COVID-19
Revista Brasileira de Enfermagem. 2024;77(5):e20230542
Abstract
ORIGINAL ARTICLEStress in nursing workers caring for people with COVID-19
Revista Brasileira de Enfermagem. 2024;77(5):e20230542
DOI 10.1590/0034-7167-2023-0542
Views1See moreABSTRACT
Objectives:
to analyze stress from the perspective of nursing workers caring for people with COVID-19 in a public hospital in the Recôncavo region of Bahia.
Methods:
this is an exploratory qualitative study, conducted through semi-structured interviews. The data were analyzed using word clouds, similarity trees, and content analysis.
Results:
nursing workers were exposed to stress while attending to patients with COVID-19. The reported stressors in the workplace included: work overload, lack of planning, speed in performing tasks, fatigue, lack of participation in decision-making, lack of support from management, technological changes, excessive responsibility without preparation, interpersonal conflicts, and professional undervaluation.
Conclusions:
exposure to these stressors leads to emotional exhaustion and demotivation, which were intensified during the COVID-19 pandemic.
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ORIGINAL ARTICLE12-13-2024
Adaptation and implementation of a Nursing care protocol for children in the Amazon Region
- Aline Lara de Carvalho ,
- Ezequiel Kleber Carpes Menezes ,
- Deisi Cristine Forlin Benedet ,
- Juliane Dias Aldrighi ,
- Hérica de Lara Cardoso , [ … ],
- Marilene Loewen Wall
Abstract
ORIGINAL ARTICLEAdaptation and implementation of a Nursing care protocol for children in the Amazon Region
Revista Brasileira de Enfermagem. 2024;77(5):e20230245
DOI 10.1590/0034-7167-2023-0245
- Aline Lara de Carvalho ,
- Ezequiel Kleber Carpes Menezes ,
- Deisi Cristine Forlin Benedet ,
- Juliane Dias Aldrighi ,
- Hérica de Lara Cardoso ,
- Marcus Vinicius da Rocha Santos da Silva ,
- Tatiane Herreira Trigueiro ,
- Marilene Loewen Wall
Views0See moreABSTRACT
Objectives:
to describe the process of implementing an adapted protocol for pediatric nursing care in a health unit located in a municipality in the Amazon Region.
Methods:
methodological research conducted in a basic health unit with four family health teams in the state of Rondônia, involving seven nursing professionals. Data collection occurred between October 2020 and April 2022, following the research phases: situational diagnosis, exploratory phase, protocol definition, implementation, and evaluation.
Results:
the outcome was the adaptation and implementation of a nursing care protocol for children.
Final Considerations:
the adaptation and implementation process can be an effective approach to improving care, strengthening nursing as a profession with a solid foundation in scientific and clinical evidence. This facilitates early problem identification and appropriate guidance, leading to better health outcomes for children.
- Aline Lara de Carvalho
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REFLECTION02-22-2021
Convergent care research and its qualification as scientific research
Revista Brasileira de Enfermagem. 2021;74(1):e20190657
Abstract
REFLECTIONConvergent care research and its qualification as scientific research
Revista Brasileira de Enfermagem. 2021;74(1):e20190657
DOI 10.1590/0034-7167-2019-0657
Views0See moreABSTRACT
Objectives:
to highlight the main attributes of Convergent Care Research that ratify it as a method of scientific research. Methods: it is a theoretical-reflective study on Convergent Care Research’s theoretical-methodological assumptions. Development: Convergent Care Research is compatible with the Social Constructionism paradigm. Convergent Care Research projects have two approaches: practical and conceptual. The Convergent Care Research process corpus contains five phases: conception; instrumentation; scrutiny; analysis and theorizing. Final Considerations: Convergent Care Research rigor encompasses the relationship between research and care practice, and this corresponds to the convergence of these two dimensions. Due to its theoretical foundation and criteria of methodological rigor, Convergent Care Research is aligned with scientific research methods.
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ORIGINAL ARTICLE10-21-2019
Consumption of alcohol and drugs and school absenteeism among high school students of public schools
Revista Brasileira de Enfermagem. 2019;72(6):1692-1698
Abstract
ORIGINAL ARTICLEConsumption of alcohol and drugs and school absenteeism among high school students of public schools
Revista Brasileira de Enfermagem. 2019;72(6):1692-1698
DOI 10.1590/0034-7167-2018-0828
Views0See moreABSTRACT
Objective:
To evaluate the relation between the consumption of alcohol and other drugs and school absenteeism in high school students of public schools in the 30 days prior to data collection.
Method:
Cross-sectional study of quantitative character conducted from May to September 2017, with 282 high school students of public schools of Mossoró-RN. We used a closed questionnaire with questions about drug consumption as our instrument of analysis. We performed hierarchical binary logistic regression by using the SPSS 20.0.
Results:
In bivariate analysis, the relation between absenteeism and drug consumption patterns proved to be significant to those who engage in heavy episodic drinking of alcohol and in the use of tobacco, inhalants and marijuana. The adjusted regression model only included the variables tobacco and heavy episodic drinking of alcohol.
Conclusion:
The hierarchical binary logistic regression analysis corroborated with absenteeism outcomes, explaining it in 12.3% of cases.
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ORIGINAL ARTICLE10-21-2019
Caregiver burden and stress in psychiatric hospital admission
- Tássia Ghissoni Pedroso ,
- Angélica da Silva Araújo ,
- Maria Tereza Signorini Santos ,
- Sueli Aparecida Frari Galera ,
- Lucilene Cardoso
Abstract
ORIGINAL ARTICLECaregiver burden and stress in psychiatric hospital admission
Revista Brasileira de Enfermagem. 2019;72(6):1699-1706
DOI 10.1590/0034-7167-2018-0832
- Tássia Ghissoni Pedroso ,
- Angélica da Silva Araújo ,
- Maria Tereza Signorini Santos ,
- Sueli Aparecida Frari Galera ,
- Lucilene Cardoso
Views0See moreABSTRACT
Objective:
to evaluate the relation between sociodemographics factors, stress and burden of care of family caregivers of patients at a psychiatric hospital admission.
Method:
quantitative study, with a cross-sectional correlation design. A total of 112 family caregivers participated, older than 18, in a Brazilian psychiatric hospital. A sociodemographic questionnaire was used to collect data, the Zarit Burden Interview and LIPP Adult Stress Symptom Inventory.
Results:
burden of care in family caregivers at a psychiatric hospital admission was significantly associated with stress (p=0.000). The psychological symptoms of stress predicted severe burden. Most caregivers presented a moderate or severe burden, with 52.7% in the resistance phase of stress; 66.1% presented psychological symptoms.
Conclusion:
results show the alarming situation of caregivers of patients from a psychiatric hospital, evidencing their own vulnerability to illness. Indeed, the during admission in a psychiatric hospital, not only patients need care, but also their caregivers.
- Tássia Ghissoni Pedroso
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ORIGINAL ARTICLE10-26-2020
Suspected COVID-19 flu-like syndrome in men who have sex with men and have been involved in casual sex
- Herica Emilia Félix de Carvalho ,
- Guilherme Schneider ,
- Anderson Reis de Sousa ,
- Emerson Lucas Silva Camargo ,
- Rômulo Veloso Nunes , [ … ],
- Álvaro Francisco Lopes de Sousa
Abstract
ORIGINAL ARTICLESuspected COVID-19 flu-like syndrome in men who have sex with men and have been involved in casual sex
Revista Brasileira de Enfermagem. 2020;73:e20200913
DOI 10.1590/0034-7167-2020-0913
- Herica Emilia Félix de Carvalho ,
- Guilherme Schneider ,
- Anderson Reis de Sousa ,
- Emerson Lucas Silva Camargo ,
- Rômulo Veloso Nunes ,
- Matheus Arantes Possani ,
- Dulce Aparecida Barbosa ,
- Isabel Amélia Costa Mendes ,
- Álvaro Francisco Lopes de Sousa
Views0See moreABSTRACT
Objective:
To evaluate the presence of flu-like syndrome suggestive of COVID-19 in men who have sex with men (MSM) and engaged in casual sex during a period of social isolation.
Method:
National epidemiological survey, applied in April and May 2020, by adaptation of Respondent Drive Sampling.
Results:
1,337 MSM participated in the survey, of which 514 (38.4%) had fever associated with another sign or symptom of flu-like syndrome. Social, demographic characteristics, sexual practices and activities during the period of social isolation were statistically associated with the presence of flu-like syndrome. There was a statistical difference (p < 0.001) in the average of partners between those who had signs and symptoms of flu-like syndrome (3.5) and those who did not (1.7).
Conclusion:
Evidence of signs and symptoms indicative of flu-like syndrome suggestive of COVID 19 in Brazilian MSM who were involved in casual sex during the period of social isolation.
- Herica Emilia Félix de Carvalho
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ORIGINAL ARTICLE10-21-2019
Functional independence of elderly patients who fell: a follow-up study
Revista Brasileira de Enfermagem. 2019;72(6):1715-1722
Abstract
ORIGINAL ARTICLEFunctional independence of elderly patients who fell: a follow-up study
Revista Brasileira de Enfermagem. 2019;72(6):1715-1722
DOI 10.1590/0034-7167-2018-0845
Views0See moreABSTRACT
Objective:
to evaluate, in emergency hospital service and at home, the functional independence of elderly people who fell.
Method:
longitudinal study with 151 elderly. Functional Independence Measure (FIM) was used. Statistical tests were performed with univariate and bivariate analysis.
Results:
mean of total FIM value in the hospital was 70.4; and at home 84.3 (p <0.001). Independence was lower in the motor domain, in “self-care”, “mobility” and “locomotion” dimensions, in the two evaluations (p <0.001). Dependence reduced from 97.3% elderly in the hospital to 82.8% at home (p <0.001). There was a negative correlation between total FIM and age, number of medications, number of diseases and hospitalization time in both evaluations. Femoral and hip fractures were associated with lower total FIM values (p <0.001).
Conclusion:
the elderly had less independence in the hospital compared to at home, with greater impairment in the motor domain and “self-care”, “mobility” and “locomotion” dimensions, in the two moments evaluated.
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ORIGINAL ARTICLE07-31-2020
Explanatory models of families of children with type 1 diabetes mellitus
- Isa Ribeiro de Oliveira Dantas ,
- Rhyquelle Rhibna Neris ,
- Márcia Maria Fontão Zago ,
- Manoel Antônio dos Santos ,
- Lucila Castanheira Nascimento
Abstract
ORIGINAL ARTICLEExplanatory models of families of children with type 1 diabetes mellitus
Revista Brasileira de Enfermagem. 2020;73:e20180975
DOI 10.1590/0034-7167-2018-0975
- Isa Ribeiro de Oliveira Dantas ,
- Rhyquelle Rhibna Neris ,
- Márcia Maria Fontão Zago ,
- Manoel Antônio dos Santos ,
- Lucila Castanheira Nascimento
Views0See moreABSTRACT
Objectives:
to analyze how children with type 1 diabetes mellitus and their families explain the pathology, based on their understanding of the factors related to the discovery of diabetes, the etiology, treatment, and prognosis of the disease.
Methods:
qualitative methodological approach, based on medical anthropology and the narrative method. In-depth interviews were conducted with 12 families of children with type 1 diabetes mellitus attending follow-up consultations at a specialized center. The statements were subjected to inductive thematic analysis.
Results:
the explanatory models identified describe the families search for the clarification of the signs and symptoms that the child had. Faced with the disease, families reorganized themselves to meet new health care needs of children, such as adequate nutrition, physical exercise, and blood glucose monitoring.
Final Considerations:
knowing the explanatory models allows the understanding of how families give meaning to the child’s illness, favoring daily nursing care and an effective control of the disease.
- Isa Ribeiro de Oliveira Dantas
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ORIGINAL ARTICLE12-08-2023
Polypharmacy, potentially inappropriate medications and associated factors among older adults with hypertension in primary care
- Carine Teles Sangaleti ,
- Maicon Henrique Lentsck ,
- Dannyele Cristina da Silva ,
- Andrielli Machado ,
- Maria Regiane Trincaus , [ … ],
- Fernanda Marciano Consolim Colombo
Abstract
ORIGINAL ARTICLEPolypharmacy, potentially inappropriate medications and associated factors among older adults with hypertension in primary care
Revista Brasileira de Enfermagem. 2023;76:e20220785
DOI 10.1590/0034-7167-2022-0785
- Carine Teles Sangaleti ,
- Maicon Henrique Lentsck ,
- Dannyele Cristina da Silva ,
- Andrielli Machado ,
- Maria Regiane Trincaus ,
- Maria Cristina Umpierrez Vieira ,
- Bruno Bordin Pelazza ,
- Fernanda Marciano Consolim Colombo
Views0See moreABSTRACT
Objective:
to identify the prevalence and associations of polypharmacy and potentially inappropriate medication use among older adults with hypertension treated in primary care.
Methods:
a cross-sectional study carried out with older adults with hypertension treated at a Family Health Strategy unit. Data collection included analysis of medical records, interviews and multidimensional assessment of older adults. Socio-demographic information and clinical variables were collected. Statistical analysis was performed by multiple logistic regression.
Results:
polypharmacy prevalence was 38.09%, and potentially inappropriate medication (PIM), 28.57%. There was a significant association between polypharmacy and PIM use, altered sleep and ethnicity. PIM use was associated with polypharmacy, worse family functioning, and absence of a caregiver. Cognitive decline reduces the prevalence of these medications.
Conclusions:
polypharmacy and PIM use among older adults with hypertension represent a problem in this population, especially among the most vulnerable.
- Carine Teles Sangaleti
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ORIGINAL ARTICLE10-01-2022
Continuity of care for children with special healthcare needs during the COVID-19 pandemic
- José Pinheiro Batista Medeiros ,
- Eliane Tatsch Neves ,
- Mardênia Gomes Vasconcelos Pitombeira ,
- Sarah Vieira Figueiredo ,
- Daniella Barbosa Campos , [ … ],
- Ilvana Lima Verde Gomes
Abstract
ORIGINAL ARTICLEContinuity of care for children with special healthcare needs during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2022;75(2):e20210150
DOI 10.1590/0034-7167-2021-0150
- José Pinheiro Batista Medeiros ,
- Eliane Tatsch Neves ,
- Mardênia Gomes Vasconcelos Pitombeira ,
- Sarah Vieira Figueiredo ,
- Daniella Barbosa Campos ,
- Ilvana Lima Verde Gomes
Views0See moreABSTRACT
Objective:
To describe the continuity of care for children with special healthcare needs during the COVID-19 pandemic through the perception of their caregivers in the Northeast of Brazil.
Methods:
Qualitative descriptive-exploratory research carried out between June and September 2020, in a municipality in the Northeast of Brazil. Eleven caregivers participated through semi-structured interviews conducted at home. The data were submitted to thematic content analysis.
Results:
The social isolation period and the suspension of health services affected the continuity of care, configuring the category “Implications of the COVID-19 pandemic for the continuity of care”. Caregivers expressed fear of children contracting the coronavirus, characterizing the category “Fears and uncertainties of the COVID-19 pandemic in view of the vulnerability of children with special healthcare needs”.
Final considerations:
Caregivers’ reports revealed problems in the continuity of care for the studied cohort. Therefore, health care practices must be rethought in times of pandemic.
- José Pinheiro Batista Medeiros
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