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ORIGINAL ARTICLE07-19-2024
Validation of an instrument for patient classification to support obstetric nursing care
Revista Brasileira de Enfermagem. 2024;77(2):e20230401
Abstract
ORIGINAL ARTICLEValidation of an instrument for patient classification to support obstetric nursing care
Revista Brasileira de Enfermagem. 2024;77(2):e20230401
DOI 10.1590/0034-7167-2023-0401
Views0See moreABSTRACT
Objectives:
to develop and validate an instrument for the classification of pregnant and postpartum women according to the demand for nursing care.
Methods:
a methodological study conducted in three stages: 1) construction of the instrument based on literature review; 2) content validation using the Delphi technique with 12 experts; and 3) Evaluation of the convergent construct validity through the correlation between the scores of the constructed instrument and the Fugulin instrument.
Results:
an instrument with ten indicators of specific care for pregnant and postpartum women was developed. A content validity index higher than 0.9 was obtained, requiring only one round of the Delphi technique. The Spearman coefficient was 0.64 between the instruments, indicating a strong correlation.
Conclusions:
the classification instrument specifically constructed for pregnant and postpartum women showed evidence of content validity and convergent construct validity with a widely used instrument in the national territory.
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ORIGINAL ARTICLE07-19-2024
Validation of an instrument for assessing leprosy care in children and adolescents
- Gutembergue Santos de Sousa
, - Isael Marcos Silva Mendonça ,
- Lia Hanna Martins Morita ,
- Denise da Costa Boamorte Cortela ,
- Pãmela Rodrigues de Souza Silva , [ … ],
- Silvana Margarida Benevides Ferreira
Abstract
ORIGINAL ARTICLEValidation of an instrument for assessing leprosy care in children and adolescents
Revista Brasileira de Enfermagem. 2024;77(2):e20230344
DOI 10.1590/0034-7167-2023-0344
- Gutembergue Santos de Sousa ,
- Isael Marcos Silva Mendonça ,
- Lia Hanna Martins Morita ,
- Denise da Costa Boamorte Cortela ,
- Pãmela Rodrigues de Souza Silva ,
- Silvana Margarida Benevides Ferreira
Views1See moreABSTRACT
Objectives:
to validate the content of an instrument for assessing leprosy care in individuals under 15 years old in the context of Primary Health Care.
Methods:
methodological study of content validation, based on the evaluation of essential and derived attributes in primary care, in the professional version. For data analysis, the Content Validation Index (CVI ≥ 0.8) and Cronbach’s Alpha were calculated.
Results:
a higher percentage of judges among nurses (61.5%) was observed; with a doctorate (46.2%), and engaged in teaching and research (77%). The overall Content Validation Index of the instrument was 0.98. In the analysis of Cronbach’s Alpha of the instrument, the assigned value was 0.717.
Conclusions:
the instrument represents an advancement in the measurement of health evaluation policies and can significantly contribute to improving the quality of care provided to children and adolescents with leprosy.
- Gutembergue Santos de Sousa
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ORIGINAL ARTICLE07-19-2024
Validation of the Brazilian Version of the Modified Scale for Delineating Advanced Practice Nursing Roles
Revista Brasileira de Enfermagem. 2024;77(2):e20230211
Abstract
ORIGINAL ARTICLEValidation of the Brazilian Version of the Modified Scale for Delineating Advanced Practice Nursing Roles
Revista Brasileira de Enfermagem. 2024;77(2):e20230211
DOI 10.1590/0034-7167-2023-0211
Views0See moreABSTRACT
Objectives:
to validate the Brazilian version of the Modified Scale for Delineating Advanced Practice Nursing Roles.
Methods:
this was a methodological study for the clinical validation of an instrument, conducted with 207 nurses working in primary care. Exploratory and confirmatory factor analysis, Cronbach’s alpha test, and z-test for proportion comparison were used.
Results:
the internal reliability of the scale was 0.944, with alpha greater than 0.80 in most domains, except for Education (0.786). In the exploratory factor analysis, considering the criterion of eigenvalue greater than one, eight factors were identified, explaining 79.38% of the variance. In the comparison of proportions, the adequate responses (≥ 2) in the domain of Comprehensive Direct Care, in both analyzed groups, were statistically equal. This domain had the highest score of adequate responses, followed by Education and Systems Support. Insufficient scoring was observed in the domains of Publication and Professional Leadership.
Conclusions:
the instrument demonstrated stability and reliability to be used in the evaluation of advanced nursing practice.
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REVIEW07-15-2024
Factors associated with Burnout Syndrome in police officers: a scoping review
- Beatriz Maria dos Santos Santiago Ribeiro ,
- Fabio Scorsolini-Comin ,
- Maria Lucia do Carmo Cruz Robazzi ,
- Sérgio Valverde Marques dos Santos ,
- Fábio de Souza Terra , [ … ],
- Rita de Cassia de Marchi Barcellos Dalri
Abstract
REVIEWFactors associated with Burnout Syndrome in police officers: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20230444
DOI 10.1590/0034-7167-2023-0444
- Beatriz Maria dos Santos Santiago Ribeiro ,
- Fabio Scorsolini-Comin ,
- Maria Lucia do Carmo Cruz Robazzi ,
- Sérgio Valverde Marques dos Santos ,
- Fábio de Souza Terra ,
- Rita de Cassia de Marchi Barcellos Dalri
Views0See moreABSTRACT
Objectives:
to synthesize research on factors associated with Burnout Syndrome (BS) in police officers.
Methods:
a scoping review was conducted without temporal or language restrictions. Data were exported to EndNote to remove duplicates and then imported into the Rayyan app for organization, article selection, and data extraction.
Results:
a total of 4559 publications were identified, with 50 studies included in the review. Research conducted in Brazil and the United States predominated. Certain occupational factors were found to be more closely linked to police officers compared to other professions, including law enforcement, frequency of interaction with suspects and criminals, rank, dissatisfaction with the organization, and civilian confrontations.
Conclusions:
certain aspects of the police profession contribute to BS, even in countries with better working conditions in public security. It is recommended to prioritize health promotion initiatives for these professionals.
- Beatriz Maria dos Santos Santiago Ribeiro
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07-15-2024
Invisibilidade do trabalho da enfermagem: tecnologia como via de combate
Revista Brasileira de Enfermagem. 2024;77:e77suppl0301
Abstract
Invisibilidade do trabalho da enfermagem: tecnologia como via de combate
Revista Brasileira de Enfermagem. 2024;77:e77suppl0301
DOI 10.1590/0034-7167.202477suppl0301pt
Views0Na concepção comum, o trabalho é comumente associado a uma atividade remunerada em uma sociedade mercantil e de direito, refletindo a visão moderna que o limita ao tempo trocado por salário. Essa perspectiva, influenciada pelos princípios da Revolução Industrial, estabelece uma dicotomia entre o trabalho e o tempo fora dele, segmentando a vida em esferas […]See more -
ORIGINAL ARTICLE07-15-2024
Root cause analysis of safety incidents in antineoplastic use in children
- Elizangela Domiciano Garcia Barreto ,
- Valcieny Souza Sandes ,
- Gustavo Cattelan Nobre ,
- Monica Martins ,
- Sima Esther Ferman , [ … ],
- Elisangela Costa Lima
Abstract
ORIGINAL ARTICLERoot cause analysis of safety incidents in antineoplastic use in children
Revista Brasileira de Enfermagem. 2024;77:e20230139
DOI 10.1590/0034-7167-2021-0139
- Elizangela Domiciano Garcia Barreto ,
- Valcieny Souza Sandes ,
- Gustavo Cattelan Nobre ,
- Monica Martins ,
- Sima Esther Ferman ,
- Elisangela Costa Lima
Views1See moreABSTRACT
Objectives:
to identify and analyze the factors that contribute to safety incident occurrence in the processes of prescribing, preparing and dispensing antineoplastic medications in pediatric oncology patients.
Methods:
a quality improvement study focused on oncopediatric pharmaceutical care processes that identified and analyzed incidents between 2019-2020. A multidisciplinary group performed root cause analysis (RCA), identifying main contributing factors.
Results:
in 2019, seven incidents were recorded, 57% of which were prescription-related. In 2020, through active search, 34 incidents were identified, 65% relating to prescription, 29% to preparation and 6% to dispensing. The main contributing factors were interruptions, lack of electronic alert, work overload, training and staff shortages.
Conclusions:
the results showed that adequate recording and application of RCA to identified incidents can provide improvements in the quality of pediatric oncology care, mapping contributing factors and enabling managers to develop an effective action plan to mitigate risks associated with the process.
- Elizangela Domiciano Garcia Barreto
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07-15-2024
Invisibility of nursing work: technology as a means of combat
Revista Brasileira de Enfermagem. 2024;77:e77suppl0301
Abstract
Invisibility of nursing work: technology as a means of combat
Revista Brasileira de Enfermagem. 2024;77:e77suppl0301
DOI 10.1590/0034-7167.202477suppl0301
Views0In the common conception, work is commonly associated with a paid activity in a commercial and legal society, reflecting the modern view that limits it to time exchanged for wage. This perspective, influenced by Industrial Revolution principles, establishes a dichotomy between work and time outside of work, segmenting life into professional and private spheres. However, […]See more -
REVIEW07-15-2024
Risk for imbalanced blood pressure pattern among incarcerated women: Middle-Range Theory
- Gabrielle Pessôa da Silva ,
- Camila Takáo Lopes ,
- Marcos Venícios de Oliveira Lopes ,
- Ryanne Carolynne Marques Gomes Mendes ,
- Jaqueline Galdino Albuquerque Perrelli , [ … ],
- Francisca Márcia Pereira Linhares
Abstract
REVIEWRisk for imbalanced blood pressure pattern among incarcerated women: Middle-Range Theory
Revista Brasileira de Enfermagem. 2024;77:e20230288
DOI 10.1590/0034-7167-2023-0288
- Gabrielle Pessôa da Silva ,
- Camila Takáo Lopes ,
- Marcos Venícios de Oliveira Lopes ,
- Ryanne Carolynne Marques Gomes Mendes ,
- Jaqueline Galdino Albuquerque Perrelli ,
- Lívia Maia Pascoal ,
- Suzana de Oliveira Mangueira ,
- Francisca Márcia Pereira Linhares
Views0See moreABSTRACT
Objectives:
to develop a Middle-Range Theory for the Risk for imbalanced blood pressure pattern among incarcerated women.
Methods:
theoretical development study to obtain the theoretical-causal validity of the Nursing Diagnosis Risk for unstable blood pressure. The Middle-Range Theory was developed according to six stages: establishment of the approach to developing the theory; definition of the conceptual models to be later analyzed; definition of the main conceptions; a pictorial diagram; propositions; causal relationships and evidence for practice.
Results:
two attributes and 20 antecedents related to imbalanced blood pressure were identified, a pictorial diagram was developed, and nine theoretical propositions were presented.
Conclusions:
the theory developed here favors the diagnostic reasoning of nurses and contributes to planning actions to promote the cardiovascular health of incarcerated women. A new proposition for the diagnosis of Risk for unstable blood pressure was also structured with a new title, definition, and etiological factors.
- Gabrielle Pessôa da Silva
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REVIEW07-14-2021
Complications, clinical manifestations of congenital syphilis, and aspects related to its prevention: an integrative review
- Ana Fátima Braga Rocha ,
- Maria Alix Leite Araújo ,
- Valéria Lima de Barros ,
- Camila Félix Américo ,
- Geraldo Bezerra da Silva Júnior
Abstract
REVIEWComplications, clinical manifestations of congenital syphilis, and aspects related to its prevention: an integrative review
Revista Brasileira de Enfermagem. 2021;74(4):e20190318
DOI 10.1590/0034-7167-2019-0318
- Ana Fátima Braga Rocha ,
- Maria Alix Leite Araújo ,
- Valéria Lima de Barros ,
- Camila Félix Américo ,
- Geraldo Bezerra da Silva Júnior
Views0See moreABSTRACT
Objectives:
to identify the scientific evidence about the clinical complications and manifestations of congenital syphilis and aspects related to its prevention.
Methods:
integrative review after a search in the databases LILACS and MEDLINE, carried out in March 2018, using the descriptors “syphilis, congenital”, “complications”, and “signs and symptoms”, leading to the selection of 27 researches.
Results:
the publications found were published from 1966 to 2017, and most of them were from Latin America and Africa. Negative outcomes, laboratory changes, and the clinical manifestations in congenital syphilis, whether early or delayed, were, respectively: low weight at birth, anemia, hepatosplenomegaly, and dental alterations. The lack of treatment of the pregnant women in the prenatal was the most common occasion in which the opportunity to prevent the complications of congenital syphilis was lost.
Conclusions:
the scientific evidences analyzed showed serious complications of congenital syphilis that could be avoided if early opportunities of diagnosing and treating the pregnant women are not lost during the prenatal.
- Ana Fátima Braga Rocha
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ORIGINAL ARTICLE07-15-2020
Cultural adaptation of Infant Feeding Intentions Scale (IFI) for pregnant women in Brazil
- Fernanda Garcia Bezerra Góes ,
- Beatriz Cabral Ledo ,
- Andressa Silva Torres dos Santos ,
- Fernanda Maria Vieira Pereira-Ávila ,
- Aline Cerqueira Santos Santana da Silva , [ … ],
- Marialda Moreira Christoffel
Abstract
ORIGINAL ARTICLECultural adaptation of Infant Feeding Intentions Scale (IFI) for pregnant women in Brazil
Revista Brasileira de Enfermagem. 2020;73:e20190103
DOI 10.1590/0034-7167-2019-0103
- Fernanda Garcia Bezerra Góes ,
- Beatriz Cabral Ledo ,
- Andressa Silva Torres dos Santos ,
- Fernanda Maria Vieira Pereira-Ávila ,
- Aline Cerqueira Santos Santana da Silva ,
- Marialda Moreira Christoffel
Views0See moreABSTRACT
Objectives:
to translate and culturally adapt the Infant Feeding Intentions Scale for pregnant women in Brazil.
Methods:
methodological study that included stages of translation, synthesis, face and content validation, back translation and semantic assessment. In the face and content and semantic validation stages, we used the Content Validity Index for individual items and for the overall scale for clarity and representativeness.
Results:
nine (100.0%) experts participated in face and content validation, and the average index obtained was 85.0% for representativeness. In the semantic assessment, performed with 31 (100.0%) pregnant women, the tool was considered clear, obtaining an average index of 91.0%.
Conclusions:
the Brazilian version of the scale was considered representative and clear. After assessing psychometric properties, the scale is expected to be valid and reliable to assess maternal intention to breastfeed exclusively until the infant’s six months of life in different Brazilian settings.
- Fernanda Garcia Bezerra Góes
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ORIGINAL ARTICLE03-24-2021
Development, validation and application of clinical simulation scenarios for assessment of stomatherapy specialists
- Angélica Olivetto de Almeida ,
- Sônia Regina Pérez Evangelista Dantas ,
- Maria Angela Boccara de Paula ,
- Juliany Lino Gomes Silva ,
- Ednalda Maria Franck , [ … ],
- Ana Railka de Souza Oliveira-Kumakura
Abstract
ORIGINAL ARTICLEDevelopment, validation and application of clinical simulation scenarios for assessment of stomatherapy specialists
Revista Brasileira de Enfermagem. 2021;74(1):e20200360
DOI 10.1590/0034-7167-2020-0360
- Angélica Olivetto de Almeida ,
- Sônia Regina Pérez Evangelista Dantas ,
- Maria Angela Boccara de Paula ,
- Juliany Lino Gomes Silva ,
- Ednalda Maria Franck ,
- Ana Railka de Souza Oliveira-Kumakura
Views0See moreABSTRACT
Objectives:
to build and validate three clinical simulation scenarios and report the application with candidates for the specialist’s degree in stomatherapy.
Methods:
methodological study, building three scenarios and evaluation checklists; content validation with judges, using content validity index and Modified Kappa Coefficient; pre-test and application.
Results:
scenarios built based on nursing care for: 1. insufficiency and venous ulcer; 2. demarcation of intestinal stomia; and 3. Clean intermittent catheterization. In the content validation of the 24 items appreciated, 83%, 80%, and 92% were validated without change. In the pre-test, the objectives and checklists were adjusted. In the application, to standardize the evaluation, actors and evaluators were trained previously, and each candidate passed the three stations.
Conclusions:
scenarios built and with validated content, based on evidence and covering the three areas of stomatherapy. The pre-test allowed for adjustments in the scenarios, and the candidates achieved the expected objectives.
- Angélica Olivetto de Almeida
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ORIGINAL ARTICLE12-07-2020
Management of home care by family caregivers to elderly after hospital discharge
- Rosangela Aparecida Elerati Silva ,
- Camila do Nascimento Silva ,
- Patrícia Pinto Braga ,
- Denise Barbosa de Castro Friedrich ,
- Ricardo Bezerra Cavalcante , [ … ],
- Edna Aparecida Barbosa de Castro
Abstract
ORIGINAL ARTICLEManagement of home care by family caregivers to elderly after hospital discharge
Revista Brasileira de Enfermagem. 2020;73:e20200474
DOI 10.1590/0034-7167-2020-0474
- Rosangela Aparecida Elerati Silva ,
- Camila do Nascimento Silva ,
- Patrícia Pinto Braga ,
- Denise Barbosa de Castro Friedrich ,
- Ricardo Bezerra Cavalcante ,
- Edna Aparecida Barbosa de Castro
Views1See moreABSTRACT
Objective:
To understand the management of home care by family caregivers of dependent elderly people after hospital discharge.
Methods:
Qualitative research guided by hermeneutics-dialectic, anchored in the theory of communicative action. Data collection took place using a semi-structured interview with 11 participants.
Results:
Two categories were constructed: Management of the many types of care by the caregiver and the relationship between family caregiver and health care network. Care and management actions carried out routinely cause major changes in the family caregiver’s life. He/she does not recognize planning, home care periodicity or support in required procedures.
Final Considerations:
The management of home care for dependent elderly people after hospital discharge is complex, involving physical and emotional overloads, as well as difficulties in getting support from health services. The planning shared between the health team and the family since the discharge is required, and the better visibility of the role of primary care when the patient is assisted by a home care service.
- Rosangela Aparecida Elerati Silva
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07-09-2021
Sexuality is associated with the quality of life of the elderly!
- Edison Vitório de Souza Júnior ,
- Benedito Fernandes da Silva Filho ,
- Vinicius Santos Barros ,
- Átila Rodrigues Souza ,
- Jéssica Ribeiro de Jesus Cordeiro , [ … ],
- Namie Okino Sawada
Abstract
Sexuality is associated with the quality of life of the elderly!
Revista Brasileira de Enfermagem. 2021;74:e20201272
DOI 10.1590/0034-7167-2020-1272
- Edison Vitório de Souza Júnior ,
- Benedito Fernandes da Silva Filho ,
- Vinicius Santos Barros ,
- Átila Rodrigues Souza ,
- Jéssica Ribeiro de Jesus Cordeiro ,
- Lais Reis Siqueira ,
- Namie Okino Sawada
Views0See moreABSTRACT
Objective:
to analyze the association between sexuality and quality of life of Brazilian elderly residents in the community.
Methods:
a cross-sectional study conducted with 477 Brazilian elderly. The data were collected between August and October 2020. We used the EVASI and WHOQOL-OLD (World Health Organization Quality of Life). Data analysis was performed with Mann-Whitney, Spearman and Kruskal-Wallis correlation tests, with Bonferroni post-hoc application when necessary, considering a 95% confidence interval.
Results:
there was a statistical association between all dimensions of sexuality and the general quality of life of the elderly (p<0.05).
Conclusion:
the stimulation of sexuality can be configured as an innovative and holistic strategy focused on the promotion of health and active aging, since this study found the association between sexuality and the general quality of life of elderly people.
- Edison Vitório de Souza Júnior
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ORIGINAL ARTICLE06-01-2020
Stress and cortisol levels among members of the nursing team
- Vanessa Augusto Bardaquim ,
- Sérgio Valverde Marques dos Santos ,
- Ernandes Gonçalves Dias ,
- Rita de Cássia de Marchi Barcellos Dalri ,
- Aida Maria de Oliveira Cruz Mendes , [ … ],
- Maria Lúcia do Carmo Cruz Robazzi
Abstract
ORIGINAL ARTICLEStress and cortisol levels among members of the nursing team
Revista Brasileira de Enfermagem. 2020;73:e20180953
DOI 10.1590/0034-7167-2018-0953
- Vanessa Augusto Bardaquim ,
- Sérgio Valverde Marques dos Santos ,
- Ernandes Gonçalves Dias ,
- Rita de Cássia de Marchi Barcellos Dalri ,
- Aida Maria de Oliveira Cruz Mendes ,
- Maria Cecília Gallani ,
- Maria Lúcia do Carmo Cruz Robazzi
Views0See moreABSTRACT
Objective:
To analyze the characteristics of hospital nursing professionals with the presence of stress, and to associate this with capillary cortisol.
Method:
A cross-sectional, exploratory and correlational study, conducted in a hospital in São Paulo, Brazil. A total of 164 nursing professionals participated; the Perceived Stress Scale was administered, and hair samples were obtained for laboratory analysis. Data were entered into a Microsoft Excel spreadsheet (2010), and then into Microsoft Office and the R software, version 3.2.2.
Results:
High levels of capillary cortisol in 47% of participants suggest the presence of stress, but no statistical significance between cortisol and stress levels were found.
Conclusions:
Stress and capillary cortisol levels were indicative of stress among nursing professionals; however, no association between them was found, although the values found were above those recommended.
- Vanessa Augusto Bardaquim
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REVIEW06-18-2021
Impact of social protection programs on adults diagnosed with Tuberculosis: systematic review
- Francisca Bruna Arruda Aragão ,
- Ricardo Alexandre Arcêncio ,
- Miguel Fuentealba-Torres ,
- Tânia Silva Gomes Carneiro ,
- Ludmilla Leidianne Limíro Souza , [ … ],
- Regina Célia Fiorati
Abstract
REVIEWImpact of social protection programs on adults diagnosed with Tuberculosis: systematic review
Revista Brasileira de Enfermagem. 2021;74(3):e20190906
DOI 10.1590/0034-7167-2019-0906
- Francisca Bruna Arruda Aragão ,
- Ricardo Alexandre Arcêncio ,
- Miguel Fuentealba-Torres ,
- Tânia Silva Gomes Carneiro ,
- Ludmilla Leidianne Limíro Souza ,
- Yan Mathias Alves ,
- Regina Célia Fiorati
Views0See moreABSTRACT
Objectives:
to analyze the impact of social protection programs on adults diagnosed with Tuberculosis.
Methods:
systematic review conducted by PRISMA, with registration PROSPERO CRD42019130884. The studies were identified in the VHL, PubMed, Scielo, CINAHL and Scopus databases, using the descriptors “Social Protection” and “Tuberculosis”, in combination with keywords combined with Boolean operators AND and OR. Observational and interventional studies published until October 23, 2019, in Portuguese, English and Spanish, were included.
Results:
social protection programs improve the treatment of tuberculosis, cure rates, adherence to treatment, the provision of services for the control of TB and reduce poverty.
Conclusions:
social protection programs have a positive impact on the treatment and control of people diagnosed with Tuberculosis.
- Francisca Bruna Arruda Aragão
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ORIGINAL ARTICLE12-05-2019
Functional health literacy in hypertensive elders at primary health care
- Victor Roberto Santos Costa ,
- Polyana D’arc Rezende Costa ,
- Eduardo Yoshio Nakano ,
- Daniel Apolinário ,
- Alfredo Nicodemos Cruz Santana
Abstract
ORIGINAL ARTICLEFunctional health literacy in hypertensive elders at primary health care
Revista Brasileira de Enfermagem. 2019;72:266-273
DOI 10.1590/0034-7167-2018-0897
- Victor Roberto Santos Costa ,
- Polyana D’arc Rezende Costa ,
- Eduardo Yoshio Nakano ,
- Daniel Apolinário ,
- Alfredo Nicodemos Cruz Santana
Views0See moreABSTRACT
Objective:
to assess the relationship between inadequate functional health literacy and inadequate blood pressure control in older people with hypertension in Primary Health Care.
Method:
a cross-sectional study with sample calculated at 392. SAHLPA-18 tool was used for functional health literacy; blood pressure was measured; sociodemographic and clinical data were collected. Hierarchical logistic regression was used.
Results:
(high) inadequate blood pressure and (low) functional inadequate health literacy were present in 41.6% and 54.6% of the people, respectively. Factors associated with inadequate blood pressure were: inadequate functional health literacy, black-brown skin color, overweight-obesity, hypertension diagnosis time, non-adherence to exercise/diet, drug treatment. Schooling had no association with inadequate blood pressure
Conclusion:
hypertensive elderly people with inadequate health literacy were more likely to have inadequate blood pressure. Thus, health professionals need to value functional health literacy as a possible component to control blood pressure.
- Victor Roberto Santos Costa
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