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ORIGINAL ARTICLE11-15-2022
Social determinants of health that permeate the mental suffering of children on the french-brazilian border
- Nádia Cristine Coelho Eugenio Pedrosa
, - Carolina Almeida de Oliveira ,
- Maria Izabel Tentes Côrtes ,
- Renan Alves Silva ,
- Marina Nolli Bittencourt , [ … ],
- Jordânia Vieira Silva
Abstract
ORIGINAL ARTICLESocial determinants of health that permeate the mental suffering of children on the french-brazilian border
Revista Brasileira de Enfermagem. 2022;75:e20200295
DOI 10.1590/0034-7167-2020-0295
- Nádia Cristine Coelho Eugenio Pedrosa ,
- Carolina Almeida de Oliveira ,
- Maria Izabel Tentes Côrtes ,
- Renan Alves Silva ,
- Marina Nolli Bittencourt ,
- Jordânia Vieira Silva
Views0See moreABSTRACT
Objectives:
to understand the determinants involved in the mental suffering of schoolchildren on the French-Brazilian border.
Methods:
a qualitative study was conducted with children from 6 to 12 years of age from four State schools in the municipality of Oiapoque, located on the French-Brazilian border. The data were obtained through interviews, analyzed by the IRAMUTEQ software, and interpreted in the light of the Dahlgren and Whitehead’s social determinants of health model.
Results:
data indicate that the mental suffering experienced by children, especially characterized by anxious symptoms, such as concern of becoming fat and worries, were permeated by social situations that children went through daily, such as family abandonment, domestic violence, and bullying.
Final Considerations:
social determinants can be predictors of mental suffering in children, especially in environments of extreme vulnerability, such as the border, in a context of financial difficulties, domestic violence, and absence of parenting.
- Nádia Cristine Coelho Eugenio Pedrosa
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ORIGINAL ARTICLE11-15-2022
Reasons assigned to suicide attempts: adolescents’ perceptions
- Émilen Vieira Simões ,
- Adriane Maria Netto de Oliveira ,
- Leandro Barbosa de Pinho ,
- Luciano Garcia Lourenção ,
- Stella Minasi de Oliveira , [ … ],
- Francisca Lucélia Ribeiro de Farias
Abstract
ORIGINAL ARTICLEReasons assigned to suicide attempts: adolescents’ perceptions
Revista Brasileira de Enfermagem. 2022;75:e20210163
DOI 10.1590/0034-7167-2021-0163
- Émilen Vieira Simões ,
- Adriane Maria Netto de Oliveira ,
- Leandro Barbosa de Pinho ,
- Luciano Garcia Lourenção ,
- Stella Minasi de Oliveira ,
- Francisca Lucélia Ribeiro de Farias
Views0See moreABSTRACT
Objective:
identify the reasons for attempting suicide from the perspective of adolescents.
Methods:
qualitative study conducted with ten adolescents who attempted suicide and were attending a Centro de Atenção Psicossocial Infanto-Juvenil located in a city in the south of Brazil. Semi-structured interviews were held in July 2020 using WhatsApp. Data were analyzed according to Minayo’s Content Thematic Analysis.
Results:
the adolescents’ reports listed the reasons that triggered suicide attempts, such as changes in the adolescents’ life cycle and violence, which led them to attempt suicide to solve problems.
Final considerations:
Data analysis revealed the reasons that triggered suicide attempts from the adolescents’ perspective and difficulties to cope with problems, probably explained by their lack of experience in dealing with frustrations and disappointments.
- Émilen Vieira Simões
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ORIGINAL ARTICLE11-12-2022
Factors associated with sexual practices and positions performed by pregnant women: a cross-sectional study
- Emanuelly Vieira Pereira ,
- Jameson Moreira Belém ,
- Maria Juscinaide Henrique Alves ,
- Jaqueline Alves Silva Torquato ,
- Paulo Renato Alves Firmino , [ … ],
- Glauberto da Silva Quirino
Abstract
ORIGINAL ARTICLEFactors associated with sexual practices and positions performed by pregnant women: a cross-sectional study
Revista Brasileira de Enfermagem. 2022;75(3):e20210162
DOI 10.1590/0034-7167-2021-0162
- Emanuelly Vieira Pereira ,
- Jameson Moreira Belém ,
- Maria Juscinaide Henrique Alves ,
- Jaqueline Alves Silva Torquato ,
- Paulo Renato Alves Firmino ,
- Ana Virgínia de Melo Fialho ,
- Glauberto da Silva Quirino
Views0See moreABSTRACT
Objectives:
to identify factors associated with the sexual practices and positions performed by pregnant women.
Methods:
a cross-sectional, quantitative study conducted with 354 pregnant women, in the interior of Ceará, Brazil, in 2016. For data collection, a form and a Pregnancy Sexuality Questionnaire were used.
Results:
there was a reduction in the sexual initiative of the woman, sexual disposition of the couple, sexual practices and most of the sexual positions, while the maintenance of preliminary sexual activities and initiative to perform them was verified. Sexual practices and positions decreased (p<0.0001): preliminary sexual activities, sexual disposition, lubrication, orgasm, pain or discomfort, sexual positions, sexual practices, and sexual satisfaction. Sexual practices and positions increased (p<0.0001) as a function of: education, number of deliveries, sexual life, desire and arousal, and sexual disposition of the pregnant woman, frequency of orgasm and of sexual practices (p<0.0001).
Conclusions:
sexual practices and positions of pregnant women were affected by domains of sexual function, sexual, reproductive, physical, and psychological aspects.
- Emanuelly Vieira Pereira
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11-12-2022
Relação entre atividade física e mudança na capacidade funcional numa coorte de idosos em São Paulo, Brasil
Revista Brasileira de Enfermagem. 2022;75(3):e20200837
Abstract
Relação entre atividade física e mudança na capacidade funcional numa coorte de idosos em São Paulo, Brasil
Revista Brasileira de Enfermagem. 2022;75(3):e20200837
DOI 10.1590/0034-7167-2020-0837
Views0See moreRESUMEN
Objetivos:
evaluar la relación entre ejercicio físico de ocio y cambio de capacidad funcional entre ancianos.
Métodos:
analizamos datos de una cohorte de ancianos en búsqueda de determinantes de la capacidad funcional en el seguimiento. Datos de la línea de base fueron recolectados entre 2007 y 2008 – acompañamiento mediano de 3,5 años. Fue construido un modelo de regresión linear multivariado completo para evaluar la capacidad funcional al fin del seguimiento, controlando por la capacidad funcional en la línea de base, características sociodemográficas, de salud y conductas y cantidad de ejercicio físico en el período.
Resultados:
el modelo final mostró capacidad funcional independientemente correlacionada con la edad (p<0,001), masa corporal (p=0,013) y número de actividades cotidianas comprometidas en la línea de base (p<0,001). Capacidad funcional mejoró con el aumento del ejercicio físico, pero perdió significación estadística después de ajustes (p=0,384).
Conclusiones:
capacidad funcional disminuyó con el aumento de la edad, el aumento de la perdida de la capacidad funcional en la línea de base y el aumento de la masa corporal. Aunque no significativamente relacionado, el ejercicio físico en el ocio aparece como un importante factor cambiable.
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ORIGINAL ARTICLE11-12-2022
Relationship between physical activity and functional capacity change in aged cohort in São Paulo, Brazil
Revista Brasileira de Enfermagem. 2022;75(3):e20200837
Abstract
ORIGINAL ARTICLERelationship between physical activity and functional capacity change in aged cohort in São Paulo, Brazil
Revista Brasileira de Enfermagem. 2022;75(3):e20200837
DOI 10.1590/0034-7167-2020-0837
Views0See moreABSTRACT
Objectives:
to evaluate the relationship between leisure-time physical activity and functional capacity change among aged people.
Methods:
we analyzed data of an aged cohort looking for determinants of functional capacity at follow-up. Baseline data were collected between 2007 and 2008 – average follow-up of 3,5 years. A full multivariate linear regression model was built to evaluate functional capacity at the end of the follow-up, controlling for functional capacity at baseline, sociodemographic, health and behavioral characteristics and amount of leisure-time physical activity in the period.
Results:
final model showed functional capacity independently correlated with age (p<0.001), body mass (p=0.013) and the number of activities of daily living compromised at baseline (p<0.001). Functional capacity improved with increased physical activity but loss statistical significance after adjustments (p=0.384).
Conclusions:
functional capacity decreases with increased age, increased loss of functional capacity at baseline and increased body mass. Albeit a non-significant association, leisure-time physical activity appears as an important modifiable factor.
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ORIGINAL ARTICLE11-12-2022
Low-laser light therapy in venous ulcer healing: a randomized clinical trial
Revista Brasileira de Enfermagem. 2022;75(3):e20210396
Abstract
ORIGINAL ARTICLELow-laser light therapy in venous ulcer healing: a randomized clinical trial
Revista Brasileira de Enfermagem. 2022;75(3):e20210396
DOI 10.1590/0034-7167-2021-0396
Views0See moreABSTRACT
Objectives:
to compare the effect of adjuvant low-laser light therapy versus conventional treatment alone on venous ulcer healing.
Methods:
this is a randomized clinical trial with 40 patients randomized equally to a control group (topical and compressive treatment) and intervention group (adjuvant low-laser light therapy). Outcomes of interest were Wound Healing: Secondary Intention and Tissue Integrity: Skin & Mucous Membranes, as described in the Classification of Nursing Outcomes/NOC.
Results:
groups with similar sociodemographic and clinical characteristics. Eighty-two ulcers were assessed, with an average duration of 1 to 5 years, in 1,066 nursing consultations, with a statistically significant difference in the time and number of healed ulcers (intervention group). There was a significant improvement in the nursing outcomes under study and in eight clinical indicators.
Conclusions:
low-laser light therapy improves and reduces tissue regeneration time, contributing to advances in wound treatment.
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ORIGINAL ARTICLE11-12-2022
Construction and validation of an instrument for assessing the functionality of individuals with schistosomiasis
- Andréa Costa de Oliveira ,
- Shirley Verônica Melo Almeida Lima ,
- Álvaro Francisco Lopes-Sousa ,
- Jader Pereira de Farias Neto ,
- Karina Conceição Gomes Machado de Araújo
Abstract
ORIGINAL ARTICLEConstruction and validation of an instrument for assessing the functionality of individuals with schistosomiasis
Revista Brasileira de Enfermagem. 2022;75(3):e20210306
DOI 10.1590/0034-7167-2021-0306
- Andréa Costa de Oliveira ,
- Shirley Verônica Melo Almeida Lima ,
- Álvaro Francisco Lopes-Sousa ,
- Jader Pereira de Farias Neto ,
- Karina Conceição Gomes Machado de Araújo
Views0See moreABSTRACT
Objectives:
to construct and validate an instrument for assessing the functionality of individuals with schistosomiasis.
Methods:
methodological study, developed in three stages: 1) construction of the instrument and its association with categories of the International Classification of Functionality, which the study used to elaborate the questions; 2) validation of content, performed by judges experts in the subject; 3) application of the instrument by the test-retest technique in the population with schistosomiasis in 14 days. The study used the correlation coefficient kappa to calculate the degree of agreement between the judges kappa.
Results:
in its final version, the instrument consists of 27 items, 9 of which are from the Body functions component, 6 from Body structures, 4 from Activity and participation, and 8 from Environmental factors.
Conclusions:
the constructed instrument has a biopsychosocial approach, considering four components of the ICF, besides presenting good validity and interobserver reliability.
- Andréa Costa de Oliveira
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11-11-2022
Análisis de la situación de las matronas y necesidad de medir sus cargas de trabajo
- Lorena Gómez García ,
- Ana Myriam Seva Llor ,
- María Fuensanta Hellín Gil ,
- María Dolores Roldán Valcárcel ,
- Pablo Paredes Cerezo , [ … ],
- Francisco Javier Navarro Guerrero
Abstract
Análisis de la situación de las matronas y necesidad de medir sus cargas de trabajo
Revista Brasileira de Enfermagem. 2022;75:e20210920
DOI 10.1590/0034-7167-2021-0920esp
- Lorena Gómez García ,
- Ana Myriam Seva Llor ,
- María Fuensanta Hellín Gil ,
- María Dolores Roldán Valcárcel ,
- Pablo Paredes Cerezo ,
- Esperanza de la Iglesia Cano ,
- Guadalupe Ruiz Merino ,
- Francisco Javier Navarro Guerrero
Views0See moreRESUMEN
Objetivo:
Analizar la situación laboral de las matronas y detectar sus necesidades de medición de cargas de trabajo.
Métodos:
Estudio de metodología mixta (cuantitativo y cualitativo), observacional, descriptivo y transversal. Se realizaron dos fases: La primera fase metodológica, consistió en la realización de entrevistas individuales semiestructuradas. Y en la segunda fase metodológica, se analizaron las intervenciones de enfermería (NIC) que las matronas efectúan en paritorio durante su jornada asistencial.
Resultados:
El 90,3% de las matronas presentan sobrecarga en el trabajo, pues para el 80,6% el ratio matrona- gestante no se encuentra bien establecido; pues tiempo medio de ejecución de una intervención de enfermería (NIC), es de 20 minutos. Por ello, el 100% de la muestra considera de máxima utilidad el desarrollo de herramientas de medición de cargas de trabajo.
Conclusiones:
Se ratifica la necesidad de generar un instrumento que considere la diversidad de intervenciones de enfermería (NIC) que desarrollan dentro del paritorio.
- Lorena Gómez García
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08-19-2019
Degree in Nursing: education through problem-based learning
- Maria Zilma dos Santos ,
- Márcia Aparecida Padovan Otani ,
- Silvia Franco da Rocha Tonhom ,
- Maria José Sanches Marin
Abstract
Degree in Nursing: education through problem-based learning
Revista Brasileira de Enfermagem. 2019;72(4):1071-1077
DOI 10.1590/0034-7167-2018-0298
- Maria Zilma dos Santos ,
- Márcia Aparecida Padovan Otani ,
- Silvia Franco da Rocha Tonhom ,
- Maria José Sanches Marin
Views0See moreABSTRACT
Objective:
To describe how undergraduate courses in Nursing are using the problem-based learning (PBL).
Method:
Integrative literature review, from searches in the databases Education Resources Information Center (ERIC), Latin American and Caribbean Health Sciences Literature (Lilacs), and PubMed, from 2010 to 2015. 36 articles were analyzed.
Results:
A teaching method used in all continents, the PBL enables improvement of the critical thinking, autonomy, motivation for learning, active search attitude, ability to work in teams, and problem-solving. Difficulties and challenges relate to the training of students and teachers to understand the principles of the method.
Final considerations:
The benefits of PBL coincide with the needs of nursing training, but its applicability demands constant review in seeking to develop the skills necessary for this training.
- Maria Zilma dos Santos
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ORIGINAL ARTICLE10-23-2020
Building and validating an educational video for elderly individuals about fall risks
- Guilherme Guarino de Moura Sá ,
- Ana Maria Ribeiro dos Santos ,
- Nelson Miguel Galindo Neto ,
- Khelyane Mesquita de Carvalho ,
- Carla Danielle Araújo Feitosa , [ … ],
- Polyana Norberta Mendes
Abstract
ORIGINAL ARTICLEBuilding and validating an educational video for elderly individuals about fall risks
Revista Brasileira de Enfermagem. 2020;73:e20200010
DOI 10.1590/0034-7167-2020-0010
- Guilherme Guarino de Moura Sá ,
- Ana Maria Ribeiro dos Santos ,
- Nelson Miguel Galindo Neto ,
- Khelyane Mesquita de Carvalho ,
- Carla Danielle Araújo Feitosa ,
- Polyana Norberta Mendes
Views0See moreABSTRACT
Objective:
to build and validate educational video for elderly individuals about fall risks.
Methods:
methodological study with video building. validated by 22 judges and assessed by 22 elderly individuals. Content was selected from the Fall Prevention Model and items from the Falls Risk Awareness Questionnaire. Items with an agreement greater than 0.80 were considered valid. verified through Content Validation Index (CVI) and binomial test.
Results:
building the video was guided by the Cognitive Theory of Multimedia Learning. Digital animation and audio narration were used. It lasted ten minutes and five seconds and included biological. socioeconomic. behavioral and environmental risks as well as precautions to avoid them. The CVI of judges had an average of 0.99. and of elderly individuals. an average of 1.0.
Conclusion:
the video was built and validated for content and understanding and can be used to prevent falls in elderly individuals.
- Guilherme Guarino de Moura Sá
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ORIGINAL ARTICLE06-01-2020
Construction and validation of an educational technology for mother-child bond in the neonatal intensive care unit
- Aliniana da Silva Santos ,
- Lidiane do Nascimento Rodrigues ,
- Késia Cartaxo Andrade ,
- Maria Solange Nogueira dos Santos ,
- Maria Corina Amaral Viana , [ … ],
- Edna Maria Camelo Chaves
Abstract
ORIGINAL ARTICLEConstruction and validation of an educational technology for mother-child bond in the neonatal intensive care unit
Revista Brasileira de Enfermagem. 2020;73(4):e20190083
DOI 10.1590/0034-7167-2019-0083
- Aliniana da Silva Santos ,
- Lidiane do Nascimento Rodrigues ,
- Késia Cartaxo Andrade ,
- Maria Solange Nogueira dos Santos ,
- Maria Corina Amaral Viana ,
- Edna Maria Camelo Chaves
Views0See moreABSTRACT
Objectives:
to describe the process of construction and validation of an educational booklet to promote bonding between mothers and newborns in a Neonatal Intensive Care Unit.
Methods:
methodological study developed through data collection in the literature and with the target audience; construction of the booklet; qualification of the material through validation by judges (health and communication experts/designer) and assessment by the target audience (mothers of at-risk newborns). Data were analyzed descriptively.
Results:
booklet content was validated, obtaining an overall Content Validity Index of 0.92. Appearance was rated “Superior” with 80% percentage. Mothers performed an assessment with 100% agreement between the items.
Conclusions:
the booklet was validated in all domains assessed and can be used by mothers with children hospitalized in the Neonatal Unit.
- Aliniana da Silva Santos
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ORIGINAL ARTICLE07-10-2020
Profile of nursing students: quality of life, sleep and eating habits
Revista Brasileira de Enfermagem. 2020;73:e20190365
Abstract
ORIGINAL ARTICLEProfile of nursing students: quality of life, sleep and eating habits
Revista Brasileira de Enfermagem. 2020;73:e20190365
DOI 10.1590/0034-7167-2019-0365
Views0See moreABSTRACT
Objective:
to profile and analyze sleep quality, quality of life and eating habits of nursing students.
Methods:
a cross-sectional, comparative and correlational study with the following variables: sociodemographic characteristics, Pittsburgh sleep quality index, quality of life and eating habits. One hundred ninety-five students participated in the study.
Results:
participants were on average 24 years old. Results showed that females were prevalent (87.1%); 71.0% of the students had poor sleep quality; 98.9% used electronic devices before bedtime. Self-perception of quality of life was indifferent (38.3%), and self-perception of general health, 36.9% expressed satisfaction. Among the participants, 45.13% consumed one portion of fruit and 40.66% two to three portions of vegetables daily.
Conclusion:
the study allowed the profile of these students, sedentary, overweight and poor sleep quality young students who studied and worked.
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ORIGINAL ARTICLE08-19-2019
Mobile application for the teaching of the International Classification for Nursing Practice
- Nikaelly Pinheiro Mota ,
- Claudenisa Mara de Araújo Vieira ,
- Maria Naiane Rolim Nascimento ,
- Adriana Moraes Bezerra ,
- Glauberto da Silva Quirino , [ … ],
- Nuno Damácio de Carvalho Félix
Abstract
ORIGINAL ARTICLEMobile application for the teaching of the International Classification for Nursing Practice
Revista Brasileira de Enfermagem. 2019;72(4):1020-1027
DOI 10.1590/0034-7167-2018-0751
- Nikaelly Pinheiro Mota ,
- Claudenisa Mara de Araújo Vieira ,
- Maria Naiane Rolim Nascimento ,
- Adriana Moraes Bezerra ,
- Glauberto da Silva Quirino ,
- Nuno Damácio de Carvalho Félix
Views0See moreABSTRACT
Objective:
Developing a mobile application for the teaching of the International Classification for Nursing Practice.
Methods:
Methodological applied research for technological production, performed in three phases of the contextualized instructional design model: analysis, design and development.
Results:
The application has an initial screen, which provides information about the team and its purpose. Then, four moblets are listed, including presentation, user’s guide consisting of five modules, educational games and five clinical cases. The references on which the application was based are also presented.
Final considerations:
It was possible to develop an application with the potential to promote the knowledge of nursing students and professionals about this classification system.
- Nikaelly Pinheiro Mota
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REFLECTION06-29-2020
Children’s (in)visibility in social vulnerability and the impact of the novel coronavirus (COVID-19)
- Marialda Moreira Christoffel ,
- Ana Leticia Monteiro Gomes ,
- Tania Vignuda de Souza ,
- Lia Leão Ciuffo
Abstract
REFLECTIONChildren’s (in)visibility in social vulnerability and the impact of the novel coronavirus (COVID-19)
Revista Brasileira de Enfermagem. 2020;73:e20200302
DOI 10.1590/0034-7167-2020-0302
- Marialda Moreira Christoffel ,
- Ana Leticia Monteiro Gomes ,
- Tania Vignuda de Souza ,
- Lia Leão Ciuffo
Views0See moreABSTRACT
Objective:
To examine the impact of the infection by the novel coronavirus on Brazilian children in situation of social vulnerability based on the Millennium Sustainable Development Goals.
Method:
Reflective study based on discursive formulation in three aspects: principles of the objectives and goals for the millennium sustainable development; impact of the pandemic on the health of children and their families living in social vulnerability; and the role of pediatric nursing in the care provided – limits and challenges.
Results:
In January 2020, the news of COVID 19 is released as a pandemic. In Brazil, children and families are still without access to basic rights, thereby increasing their risks of social vulnerability because of the quarantine. The nursing field has an important role in monitoring children and their families, offering guidance in search for solutions and preventing contamination.
Conclusion:
There are still challenges to be overcome by the children and their families in situations of vulnerability against COVID-19.
- Marialda Moreira Christoffel
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REFLECTION03-05-2021
The nurse’s work in the context of COVID-19 pandemic
- Valéria Gomes Fernandes da Silva ,
- Bruno Neves da Silva ,
- Érika Simone Galvão Pinto ,
- Rejane Maria Paiva de Menezes
Abstract
REFLECTIONThe nurse’s work in the context of COVID-19 pandemic
Revista Brasileira de Enfermagem. 2021;74:e20200594
DOI 10.1590/0034-7167-2020-0594
- Valéria Gomes Fernandes da Silva ,
- Bruno Neves da Silva ,
- Érika Simone Galvão Pinto ,
- Rejane Maria Paiva de Menezes
Views0See moreABSTRACT
Objective:
Reflect on the work experienced by the nurse in coping with the COVID-19 pandemic in a public hospital of the State of Rio Grande do Norte.
Methods:
Reflective essay based in the professional experience in a public reference hospital for the care of patients affected by COVID-19 in the State of Rio Grande do Norte. Results were organized in two empirical categories, which emphasize potentialities and barriers in the nurse’s work in the face of the COVID-19, presented by means of Ishikawa diagram.
Results:
Two categories emerged from the experiences: Nursing leadership in organizing health services to face COVID-19; and the performance of nursing care management in the COVID-19 pandemic.
Final considerations:
It is necessary to value the nurse’s work in all its attributes, as well as strengthen the interdisciplinary work processes, which collaborate to overcome the crisis caused by the pandemic.
- Valéria Gomes Fernandes da Silva
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ORIGINAL ARTICLE03-30-2020
Clinical simulation in teaching Pediatric Nursing: students’ perception
- Mayara Gombrade Teles ,
- Ana Márcia Chiaradia Mendes-Castillo ,
- Ana Railka de Souza Oliveira-Kumakura ,
- Juliany Lino Gomes Silva
Abstract
ORIGINAL ARTICLEClinical simulation in teaching Pediatric Nursing: students’ perception
Revista Brasileira de Enfermagem. 2020;73(2):e20180720
DOI 10.1590/0034-7167-2018-0720
- Mayara Gombrade Teles ,
- Ana Márcia Chiaradia Mendes-Castillo ,
- Ana Railka de Souza Oliveira-Kumakura ,
- Juliany Lino Gomes Silva
Views0See moreABSTRACT
Objectives:
to comprehend the perception of undergraduate nursing students about learning to care for the child and family through clinical simulation.
Methods:
this is a qualitative research conducted with ten nursing students through semi-structured interviews. Data were analyzed through content analysis.
Results:
data were organized into two categories: “learning a new way to learn,” in which students describe their experiences during the simulation, and “learning a new way to care,” in which they reflect on learning through simulation.
Final considerations:
we believe that clinical simulation practice in teaching should be encouraged because of the benefits it can offer to the students, faculty, patients and their families. However, we recommend further studies to validate scenarios of child and family healthcare.
- Mayara Gombrade Teles
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