-
ORIGINAL ARTICLE11-28-2023
Nursing protocol in chronic kidney disease prevention in older adults in primary care
- Fernanda Ferreira Krepker
, - Cristina Arreguy-Sena ,
- Luciene Muniz Braga ,
- Paula Krempser ,
- Jéssica de Castro Santos , [ … ],
- Herica Silva Dutra
Abstract
ORIGINAL ARTICLENursing protocol in chronic kidney disease prevention in older adults in primary care
Revista Brasileira de Enfermagem. 2023;76(1):e20220052
DOI 10.1590/0034-7167-2022-0052
- Fernanda Ferreira Krepker ,
- Cristina Arreguy-Sena ,
- Luciene Muniz Braga ,
- Paula Krempser ,
- Jéssica de Castro Santos ,
- Herica Silva Dutra
Views0See moreASBTRACT
Objectives:
to develop a protocol for Nursing Process operationalization in approaching older adults with vulnerability to chronic kidney disease in Primary Health Care, based on Neuman’s stressors.
Methods:
a methodological study, carried out in two stages: 1) synthesis of evidence using an inductive strategy (mixed method study) and 2) protocol development to support the nursing process operationalization with older adults enrolled in a Basic Health Unit, using a deductive strategy (Neuman’s stressor concepts, NANDA, NIC, and NOC taxonomies, Risner’s line of reasoning, and cross-mapping), described according to A Step-by-Step Guide to Developing Protocols.
Results:
102 older adults participated, and 17 diagnoses, 34 interventions and 26 nursing outcomes were identified.
Conclusions:
the protocol developed is a technology that makes it possible to operationalize the Nursing Process, based on Neuman’s stressors and on taxonomy, conceptual and care frameworks, guiding care and nursing records.
- Fernanda Ferreira Krepker
-
ORIGINAL ARTICLE11-28-2023
The Chronic Care Model and its implications for Specialized Outpatient Care
- Francielle Renata Danielli Martins Marques ,
- Grazieli Adrieli Rodrigues Pires ,
- José Luís Guedes Dos Santos ,
- Vanessa Denardi Antoniassi Baldissera ,
- Maria Aparecida Salci
Abstract
ORIGINAL ARTICLEThe Chronic Care Model and its implications for Specialized Outpatient Care
Revista Brasileira de Enfermagem. 2023;76(1):e20210315
DOI 10.1590/0034-7167-2021-0315
- Francielle Renata Danielli Martins Marques ,
- Grazieli Adrieli Rodrigues Pires ,
- José Luís Guedes Dos Santos ,
- Vanessa Denardi Antoniassi Baldissera ,
- Maria Aparecida Salci
Views0See moreABSTRACT
Objective:
to assess the Chronic Care Model implementation in Specialized Outpatient Care and its repercussions for health care.
Methods:
qualitative evaluative research, conducted by the Chronic Care Model. We used observation techniques, document analysis and interviews with 21 health professionals from specialized care. Analysis was conducted by triangulation, with the aid of MAXQDA software for initial and focused coding. All ethical aspects were respected.
Results:
professionals recognized that the model reorganized service care and administrative practices, presenting positive repercussions for the health of people assisted. The absence of continuing education for service professionals compromised the complete model implementation.
Final considerations:
the implementation, even if partial, of the model brings contributions to service improvement. The weaknesses that are still present are compatible with professionals’ difficulty in distancing themselves from the biomedical model.
- Francielle Renata Danielli Martins Marques
-
ORIGINAL ARTICLE11-28-2023
Effects of the COVID-19 pandemic on nurses’ psychological well being in an emergency room
Revista Brasileira de Enfermagem. 2023;76:e20220171
Abstract
ORIGINAL ARTICLEEffects of the COVID-19 pandemic on nurses’ psychological well being in an emergency room
Revista Brasileira de Enfermagem. 2023;76:e20220171
DOI 10.1590/0034-7167-2022-0171
Views0See moreABSTRACT
Objectives:
to assess the level of anxiety of nurses in an emergency room in view of the new Coronavirus and describe the relationship between the degrees of anxiety and their sociodemographic variables.
Methods:
quantitative descriptive-correlational study with a sample of 60 nurses. A questionnaire was used as a data collection instrument based on the Hamilton Anxiety Assessment Scale.
Results:
the nurses’ average anxiety is mild. A statistically significant relationship was found between anxiety and the variables “sex” and “children”, with women having higher levels of anxiety than men, and nurses who do not have children showing mild, moderate, or severe anxiety.
Conclusions:
COVID-19 triggers anxiety in nurses, sometimes at pathological levels. Being female and not having children increase the anxiety experienced. Sex can be considered the determining factor for the level of anxiety experienced.
-
ORIGINAL ARTICLE11-28-2023
Construction and validation of an algorithm for disinfection of ambulances transporting patients with contagious infectious diseases
Revista Brasileira de Enfermagem. 2023;76:e20220081
Abstract
ORIGINAL ARTICLEConstruction and validation of an algorithm for disinfection of ambulances transporting patients with contagious infectious diseases
Revista Brasileira de Enfermagem. 2023;76:e20220081
DOI 10.1590/0034-7167-2022-0081
Views0See moreABSTRACT
Objectives:
to develop and validate an algorithm to guide professionals in cleaning and disinfecting ambulances after transferring patients with contagious infectious diseases.
Methods:
the study was conducted between September and November 2021. The developed algorithm was validated by 104 judges, including nurses, physical therapists, and physicians who care for patients with contagious infectious diseases. It used the Delphi technique and content validity index.
Results:
in the first evaluation, the judges considered the algorithm “unsuitable” and “fully suitable”. The algorithm reviewed according to the judges’ suggestions was rated between “suitable” and “fully suitable” in the second evaluation. The overall content validity index was 0.960 and 0.998 in the first and second evaluations.
Conclusions:
the algorithm to guide the cleaning and disinfection of ambulances after transferring patients with contagious infectious diseases was developed and validated by specialists in the field, with consensus among the judges in the second evaluation.
-
ORIGINAL ARTICLE11-28-2023
Geospatialization of tuberculosis and income transfer programs among Indigenous peoples in an endemic territory
- Ingrid Bentes Lima ,
- Laura Maria Vidal Nogueira ,
- Lidiane de Nazaré Mota Trindade ,
- Ivaneide Leal Ataide Rodrigues ,
- Suzana Rosa André , [ … ],
- Ana Inês Sousa
Abstract
ORIGINAL ARTICLEGeospatialization of tuberculosis and income transfer programs among Indigenous peoples in an endemic territory
Revista Brasileira de Enfermagem. 2023;76:e20220216
DOI 10.1590/0034-7167-2022-0216
- Ingrid Bentes Lima ,
- Laura Maria Vidal Nogueira ,
- Lidiane de Nazaré Mota Trindade ,
- Ivaneide Leal Ataide Rodrigues ,
- Suzana Rosa André ,
- Ana Inês Sousa
Views1See moreABSTRACT
Objective:
To analyze the spatial pattern of tuberculosis in Indigenous peoples from the State of Pará and its correlation with income transfer.
Methods:
Ecological study, with 340 cases reported in Indigenous peoples in the State of Pará, Brazil, in the period 2016-2020. The study performed a descriptive analysis and calculation of incidence rates with smoothing by the local empirical Bayesian method. The Global Moran index assessed the autocorrelation of the rates with income transfer data, p<0,05.
Results:
The Marajó and metropolitan mesoregions of Belém had the highest tuberculosis rates, and a reduced number of people benefited from income transfer (high-low correlation). The study identified high rates, and a significant number of people benefited from financial aid (high correlation high), I=0.399, p=0.027 in the Southwest.
Conclusions:
The spatial autocorrelation between tuberculosis and access to income transfer programs constitutes a relevant subsidy for the formulation of social protection policies and may impact the disease control actions in Indigenous territories, valuing the epidemiological heterogeneity identified in the mesoregions.
- Ingrid Bentes Lima
-
ORIGINAL ARTICLE11-28-2023
Remote consultation with people with eating disorders during the COVID-19 pandemic
- Camila Biscacio Falco ,
- Maria Angélica de Almeida Peres ,
- Jose Carlos Appolinario ,
- Livia Lopes Menescal ,
- Izabella de Góes Anderson Maciel Tavares
Abstract
ORIGINAL ARTICLERemote consultation with people with eating disorders during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2023;76:e20220197
DOI 10.1590/0034-7167-2022-0197
- Camila Biscacio Falco ,
- Maria Angélica de Almeida Peres ,
- Jose Carlos Appolinario ,
- Livia Lopes Menescal ,
- Izabella de Góes Anderson Maciel Tavares
Views0See moreABSTRACT
Objectives:
to analyze subjective experiences related to adaptation to remote care by users with eating disorders during the COVID-19 pandemic.
Methods:
a descriptive study with a qualitative approach conducted with users of an eating disorders outpatient clinic. A semi-structured remote interview was applied using the Google Meet application. The data were submitted to lexical analysis using ALCESTE software and discussed in the light of scientific evidence.
Results:
the remote appointment is a positive strategy but not a substitute for the face-to-face modality. The research cited financial savings, closer contact with professionals, and flexibility of service schedules as advantages. It pointed out the difficulty in clinical evaluation concerning weight, vital signs, and poor mastery of technology as limitations.
Final Considerations:
the study induces discussion about the systematization of remote care, which, during the COVID-19 pandemic, were responsible for providing a greater sense of support to people with eating disorders.
- Camila Biscacio Falco
-
11-28-2023
Efeitos da pandemia de COVID-19 no bem-estar psicológico dos enfermeiros de um serviço de urgência
Revista Brasileira de Enfermagem. 2023;76:e20220171
Abstract
Efeitos da pandemia de COVID-19 no bem-estar psicológico dos enfermeiros de um serviço de urgência
Revista Brasileira de Enfermagem. 2023;76:e20220171
DOI 10.1590/0034-7167-2022-0171
Views0See moreRESUMEN
Objetivos:
evaluar nivel de ansiedad de enfermeros de un servicio de urgencia frente al nuevo coronavirus y describir la relación entre niveles de ansiedad y variables sociodemográficas.
Métodos:
estudio cuantitativo descriptivo-correlacional con una muestra de 60 enfermeros. Recorrido a la aplicación de una encuesta como instrumento de recolecta de datos basándose en la Escala de Evaluación de Ansiedad de Hamilton.
Resultados:
el escore mediano de ansiedad de los enfermeros es leve. Verificado que hay una relación estadísticamente significante entre la ansiedad y la variable “sexo” e “hijos”, con mujeres presentando niveles de ansiedad superiores a los hombres y los enfermeros sin hijos presentando niveles de ansiedad leve, moderada o severa.
Conclusiones:
la COVID-19 desencadena ansiedad en los enfermeros, por veces a niveles patológicos; y ser del sexo femenino y no tener hijos la aumenta. Es posible afirmar que el sexo fue el factor determinante para el nivel de ansiedad experimentado.
-
ORIGINAL ARTICLE11-27-2023
Mental suffering in family daily life: a temporal journey according to Merleau-Ponty
- Patricia Anjos Lima de Carvalho ,
- Vanessa Thamyris Carvalho dos Santos ,
- Marlene Gomes Terra ,
- Márcia Aparecida Ferreira de Oliveira ,
- Ricardo Henrique Soares , [ … ],
- Edite Lago da Silva Sena
Abstract
ORIGINAL ARTICLEMental suffering in family daily life: a temporal journey according to Merleau-Ponty
Revista Brasileira de Enfermagem. 2023;76(5):e20230258
DOI 10.1590/0034-7167-2023-0258
- Patricia Anjos Lima de Carvalho ,
- Vanessa Thamyris Carvalho dos Santos ,
- Marlene Gomes Terra ,
- Márcia Aparecida Ferreira de Oliveira ,
- Ricardo Henrique Soares ,
- Edite Lago da Silva Sena
Views1See moreABSTRACT
Objectives:
to describe the family’s experience in relation to daily life with a family member experiencing mental suffering.
Methods:
a qualitative, descriptive, phenomenological study grounded in Merleau-Ponty’s ontology of experience was conducted in ten households in a city in the state of Bahia, Brazil, where 24 participants of the Intersubjectivity Wheels reside. The descriptions produced were subjected to the Ambiguity Analytics technique.
Results:
the descriptions were categorized into: absence as a creative power of the sense of “being” and “not being a family”; and exclusion and acceptance as expressions of mental suffering in the family context.
Final Considerations:
the experience of mental suffering in the family’s daily life is marked by ambiguous feelings, such as joy and sadness, disappointment and satisfaction, lack of love and love. However, experiencing these feelings can mobilize the desire to “become” a family, increase the sense of autonomy and independence, and drive the formation of new family configurations.
- Patricia Anjos Lima de Carvalho
-
ORIGINAL ARTICLE03-30-2020
Team-Based Learning: a randomized clinical trial in undergraduate nursing
- Sabrina Ramires Sakamoto ,
- Magda Cristina Queiroz Dell’Acqua ,
- Luciana Patrícia Fernandes Abbade ,
- Silvia Maria Caldeira ,
- Suzimar de Fátima Benato Fusco , [ … ],
- Marla Andréia Garcia de Avila
Abstract
ORIGINAL ARTICLETeam-Based Learning: a randomized clinical trial in undergraduate nursing
Revista Brasileira de Enfermagem. 2020;73(2):e20180621
DOI 10.1590/0034-7167-2018-0621
- Sabrina Ramires Sakamoto ,
- Magda Cristina Queiroz Dell’Acqua ,
- Luciana Patrícia Fernandes Abbade ,
- Silvia Maria Caldeira ,
- Suzimar de Fátima Benato Fusco ,
- Marla Andréia Garcia de Avila
Views0See moreABSTRACT
Objectives:
To compare the knowledge on surgical safety through the team-based learning methodology and lecture classes for undergraduate Nursing students, and evaluate the learning satisfaction with team-based learning.
Methods:
Randomized, controlled, parallel, two-arm, unblinded clinical trial developed in the Faculty of Medicine of a public university in Botucatu, Brazil. The groups included 14 students for team-based learning and 11 students for lecture classes.
Results:
Students’ apprehension of knowledge in the team-based learning group was significantly higher compared to the control group (p<0.002) by considering the pre-test results. After 30 days, there was no significant difference between groups. The experience with the methodology was considered positive among students.
Conclusions:
Team-based learning is an important pedagogic tool available and has proven effective in education and learning with students playing the role of protagonists.
- Sabrina Ramires Sakamoto
-
04-14-2021
Factors associated with anxiety in multiprofessional health care residents during the COVID-19 pandemic
- Eder Samuel Oliveira Dantas ,
- João de Deus de Araújo Filho ,
- Glauber Weder dos Santos Silva ,
- Maria Yohana Matias Silveira ,
- Marianny Nayara Paiva Dantas , [ … ],
- Karina Cardoso Meira
Abstract
Factors associated with anxiety in multiprofessional health care residents during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2021;74:e20200961
DOI 10.1590/0034-7167-2020-0961
- Eder Samuel Oliveira Dantas ,
- João de Deus de Araújo Filho ,
- Glauber Weder dos Santos Silva ,
- Maria Yohana Matias Silveira ,
- Marianny Nayara Paiva Dantas ,
- Karina Cardoso Meira
Views0See moreABSTRACT
Objective:
To estimate the prevalence and factors associated with anxiety among multiprofessional health residents during the COVID-19 pandemic.
Methods:
Cross-sectional study, conducted in July 2020 with multiprofessional health residents (n = 67) from a university hospital. We used the Beck Anxiety Inventory to assess anxiety. Analyzing data through the chi-square test, likelihood ratio, and multiple analysis using Poisson regression with robust variance.
Results:
The proportion of moderate/severe anxiety was 31.3%, which showed significant association with working in sectors involving COVID-19 and directly with suspected/confirmed cases of COVID-19. During the multiple analysis, we found prevalence of anxiety in participants who needed psychological support after entering their residence and those who used psychotropic meds.
Conclusion:
The results seem to indicate that residents had their mental health impaired during the pandemic, but the maintenance of the variables in the model also suggests that they sought help to control anxiety.
- Eder Samuel Oliveira Dantas
-
REVIEW12-13-2019
The use of children’s stories in nursing care for the child: an integrative review
Revista Brasileira de Enfermagem. 2019;72:333-342
Abstract
REVIEWThe use of children’s stories in nursing care for the child: an integrative review
Revista Brasileira de Enfermagem. 2019;72:333-342
DOI 10.1590/0034-7167-2018-0456
Views0See moreABSTRACT
Objective:
To identify how children’s stories can be used in child care.
Method:
Integrative literature review, conducted in databases between 2000 and 2018, in three languages. Full research articles were included that agreed with the following question: “How can children’s stories be used in child care?”.
Results:
From the analysis of 16 selected articles, three categories emerged: The use of stories in the hospital; Specialized nursing intervention; and Stories in the educational dimension.
Final considerations:
Evidence shows benefits to children, families, institutions and nursing. The use of children’s stories as a care intervention can occur in different situations and settings, values; boosts bonds, reduces anxiety in children and families, encourages children’s participation in care, and promotes health education. It is a low-cost and still incipient strategy in nursing.
-
REVIEW12-13-2019
Interfaces of vulnerability dimensions in violence against children
- Paula Hino ,
- Renata Ferreira Takahashi ,
- Lúcia Yasuko Izumi Nichiata ,
- Maíra Rosa Apostólico ,
- Monica Taminato , [ … ],
- Hugo Fernandes
Abstract
REVIEWInterfaces of vulnerability dimensions in violence against children
Revista Brasileira de Enfermagem. 2019;72:343-347
DOI 10.1590/0034-7167-2018-0463
- Paula Hino ,
- Renata Ferreira Takahashi ,
- Lúcia Yasuko Izumi Nichiata ,
- Maíra Rosa Apostólico ,
- Monica Taminato ,
- Hugo Fernandes
Views0See moreABSTRACT
Objective:
present and discuss the potential use of the concept of vulnerability for the development of practices to address violence against children.
Method:
this is a theoretical study that presents the characteristics of the phenomenon of violence against children, to which the concept of vulnerability is applied.
Results:
proposal of a framework for the analysis of violence against children in the perspective of vulnerability, creating individual and collective dimensions. Violence against children, when analyzed in the perspective of this concept, broadens the understanding of this phenomenon, as it exposes aspects and conditions from outside the family that are co-responsible for the occurrence of this phenomenon.
Conclusion:
developing studies to identify the vulnerability of children to violence is essential for the development of practices to address this issue.
- Paula Hino
-
ORIGINAL ARTICLE02-10-2020
Nursing practices in a psychological care center
- Elitiele Ortiz dos Santos ,
- Adriane Domingues Eslabão ,
- Luciane Prado Kantorski ,
- Leandro Barbosa de Pinho
Abstract
ORIGINAL ARTICLENursing practices in a psychological care center
Revista Brasileira de Enfermagem. 2020;73(1):e20180175
DOI 10.1590/0034-7167-2018-0175
- Elitiele Ortiz dos Santos ,
- Adriane Domingues Eslabão ,
- Luciane Prado Kantorski ,
- Leandro Barbosa de Pinho
Views0See moreABSTRACT
Objective:
To analyze the practices developed by nursing professionals in a Psychosocial Care Center (CAPS).
Method:
A qualitative and evaluative research based on the Fourth Generation Assessment and conducted in a CAPS II of Santa Catarina State in 2014. For data collection, semi-structured interviews, field observation, and data recycling group were used with workers. Constant Comparative Method was used for data analysis.
Results:
Practices aimed at the subject and their clinical, social, prevention, treatment and articulation with the health network were identified. Medication care is a specificity of nursing that aims to promote autonomy and social reintegration. There is a need for greater articulation between the nursing and pharmacy staff, as well as creating spaces for users to talk about medication.
Conclusion:
Nursing practices are focused on biopsychosocial care, aiming to deconstruct care models focused on the disease and symptoms.
- Elitiele Ortiz dos Santos
-
REFLECTION02-05-2021
Empathic listening: welcoming strategy for nursing Professional in coping with with the coronavirus pandemic
- Lucia Tobase ,
- Sandra Helena Cardoso ,
- Renata Tavares Franco Rodrigues ,
- Heloisa Helena Ciqueto Peres
Abstract
REFLECTIONEmpathic listening: welcoming strategy for nursing Professional in coping with with the coronavirus pandemic
Revista Brasileira de Enfermagem. 2021;74:e20200721
DOI 10.1590/0034-7167-2020-0721
- Lucia Tobase ,
- Sandra Helena Cardoso ,
- Renata Tavares Franco Rodrigues ,
- Heloisa Helena Ciqueto Peres
Views0See moreABSTRACT
Objective:
to reflect on empathic listening use as a welcoming strategy for nursing professionals to cope with the challenges during the pandemic caused by the new coronavirus.
Methods:
this is a reflection study based on updated data surveys and theoretical-conceptual aspects of Non-Violent Communication and empathic listening.
Results:
in the performance during the COVID-19 pandemic, nursing professionals are exposed to violence of different natures related to occupational stress, work overload, anguishes and silenced suffering, with implications for the workers’ health, who can be benefited and strengthened with empathetic listening.
Final considerations:
the health crisis has highlighted the weaknesses of the health system. Nursing acts as the largest contingent of the health workforce in coping with the pandemic. Empathetic listening is a powerful strategy in caring for and strengthening nursing professionals.
- Lucia Tobase
-
ORIGINAL ARTICLE02-25-2022
Factors associated with stress, anxiety and depression in nursing professionals in the hospital context
- Bianca Bacelar de Assis ,
- Cissa Azevedo ,
- Caroline de Castro Moura ,
- Patrick Gonçalves Mendes ,
- Larissa Lucas Rocha , [ … ],
- Tânia Couto Machado Chianca
Abstract
ORIGINAL ARTICLEFactors associated with stress, anxiety and depression in nursing professionals in the hospital context
Revista Brasileira de Enfermagem. 2022;75:e20210263
DOI 10.1590/0034-7167-2021-0263
- Bianca Bacelar de Assis ,
- Cissa Azevedo ,
- Caroline de Castro Moura ,
- Patrick Gonçalves Mendes ,
- Larissa Lucas Rocha ,
- Aline Alves Roncalli ,
- Nayara Ferreira Mota Vieira ,
- Tânia Couto Machado Chianca
Views0See moreABSTRACT
Objective:
to determine the factors associated with stress, anxiety and depression, concomitantly, in nursing professionals who work in the hospital context.
Methods:
a quantitative and cross-sectional study with 353 nursing professionals from a hospital. A sociodemographic questionnaire and the Depression, Anxiety and Stress Scale-21 were used. Data were subjected to descriptive statistical analysis, difference and correlation tests.
Results:
the main factors associated with stress, anxiety and depression, concomitantly, were being female, compromised family and social support, lack of autonomy at work, hostile relationship with colleagues, lack of professional recognition and satisfaction, feeling of being overwhelmed and insecurity.
Conclusions:
demographic, physiological, social and work factors impact the levels of stress, anxiety and depression in nursing professionals. The adoption of coping strategies for modifiable factors should be considered, in order to provide better quality of life for these professionals.
- Bianca Bacelar de Assis
-
08-10-2020
Repercussions of intestinal ostomy on male sexuality: an integrative review
- Isabella Felix de Araújo Meira ,
- Fernanda Rios da Silva ,
- Anderson Reis de Sousa ,
- Evanilda Souza de Santana Carvalho ,
- Darci de Oliveira Santa Rosa , [ … ],
- Álvaro Pereira
Abstract
Repercussions of intestinal ostomy on male sexuality: an integrative review
Revista Brasileira de Enfermagem. 2020;73(6):e20190245
DOI 10.1590/0034-7167-2019-0245
- Isabella Felix de Araújo Meira ,
- Fernanda Rios da Silva ,
- Anderson Reis de Sousa ,
- Evanilda Souza de Santana Carvalho ,
- Darci de Oliveira Santa Rosa ,
- Álvaro Pereira
Views2INTRODUCTIONThe intestinal ostomy, also known as stoma and ostomy, consists of an artificial opening, produced surgically, whose purpose is to divert the flow of effluents to the external environment. Such a condition can impact the lives of affected individuals due to transformations that affect human multi-dimensionality, including negative repercussions involving sexuality(–).In the United States of […]See more
- Isabella Felix de Araújo Meira
Search
Search in:
Nuvem de Tags
Adolescente (85) Atenção Primária à Saúde (239) COVID-19 (91) Criança (91) Cuidados de Enfermagem (269) Educação em Enfermagem (151) Educação em Saúde (139) Enfermagem (930) Enfermagem Pediátrica (86) Estudantes de Enfermagem (77) Estudos de Validação (131) Família (87) Idoso (208) Promoção da Saúde (99) Qualidade de Vida (104) Saúde do Trabalhador (86) Saúde Mental (145) Saúde Pública (82) Segurança do Paciente (150) Tecnologia Educacional (100)