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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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ORIGINAL ARTICLE07-13-2020
Mental health of nursing in coping with COVID-19 at a regional university hospital
- Eduardo Bassani Dal’Bosco ,
- Lara Simone Messias Floriano ,
- Suellen Vienscoski Skupien ,
- Guilherme Arcaro ,
- Alessandra Rodrigues Martins , [ … ],
- Aline Cristina Correa Anselmo
Abstract
ORIGINAL ARTICLEMental health of nursing in coping with COVID-19 at a regional university hospital
Revista Brasileira de Enfermagem. 2020;73:e20200434
DOI 10.1590/0034-7167-2020-0434
- Eduardo Bassani Dal’Bosco ,
- Lara Simone Messias Floriano ,
- Suellen Vienscoski Skupien ,
- Guilherme Arcaro ,
- Alessandra Rodrigues Martins ,
- Aline Cristina Correa Anselmo
Views0See moreABSTRACT
Objective:
to identify prevalence and factors associated with anxiety and depression in nursing professionals who work to cope with COVID-19 at a university hospital.
Methods:
a cross-sectional observational study using a sociodemographic questionnaire and Hospital Anxiety and Depression Scale, with 88 nursing professionals. Data were analyzed using absolute and relative frequency and Statistical Package for the Social Sciences.
Results:
there was prevalence of anxiety (48.9%) and depression (25%). The majority of the sample consisted of women over 40 years old, married or in a common-law marriage, white, with higher education or graduate degree, with an income above 3,000.00 reais, public servants, working 40 hours a week and working in the hospital from 1 to 5 years.
Conclusion:
we must consider the impact on mental health nursing caused by COVID-19 and intervene with coping strategies to minimize the suffering of professionals.
- Eduardo Bassani Dal’Bosco
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REFLECTION04-22-2020
Thematic content analysis using ATLAS.ti software: Potentialities for researchs in health
Revista Brasileira de Enfermagem. 2020;73(3):e20190250
Abstract
REFLECTIONThematic content analysis using ATLAS.ti software: Potentialities for researchs in health
Revista Brasileira de Enfermagem. 2020;73(3):e20190250
DOI 10.1590/0034-7167-2019-0250
Views0See moreABSTRACT
Objective:
to describe the most important tools of ATLAS.ti Software and to associate them with the procedures of Thematic Content Analysis.
Method:
It is a theoretical reflection of the Content Analysis phases of Laurence Bardin, associating them with software tools Atlas.ti and showing its usefulness for data analysis in qualitative research.
Results:
historical contextualization and the available resources of Atlas.ti software with presentation of health research involving the phases of thematic content analysis.
Final considerations:
The Atlas.ti software assists in the accomplishment of the thematic content analysis being this promising association in health research.
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REFLECTION10-26-2020
Nursing education: challenges and perspectives in times of the COVID-19 pandemic
- Ana Luisa Brandão de Carvalho Lira ,
- Edlamar Kátia Adamy ,
- Elizabeth Teixeira ,
- Francisca Valda da Silva
Abstract
REFLECTIONNursing education: challenges and perspectives in times of the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200683
DOI 10.1590/0034-7167-2020-0683
- Ana Luisa Brandão de Carvalho Lira ,
- Edlamar Kátia Adamy ,
- Elizabeth Teixeira ,
- Francisca Valda da Silva
Views0See moreABSTRACT
Objective:
To discuss the challenges and perspectives of nursing education in times of the COVID-19 pandemic.
Methods:
Reflection study, with theoretical approach based on national and international publications, allied to the experience of researchers in the area of nursing education.
Results:
Four sections are identified: Nursing education: current affairs and perspectives; Education and technologies in time of pandemic: acceleration, alteration and paralysis; Difference between emergency, intentional and remote teaching; the return to the “new normality”: new structuring axes and legal norms.
Final considerations:
The conclusion is that longstanding challenges have emerged with the pandemic, and the processes of acceleration, change and paralysis have marked education in these times. Moreover, epidemiological, technological and psychological aspects should be more valued in the return to activities.
- Ana Luisa Brandão de Carvalho Lira
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ORIGINAL ARTICLE11-13-2020
Social determinants of health and COVID-19 infection in Brazil: an analysis of the pandemic
- Alexandre Medeiros de Figueiredo ,
- Daniela Cristina Moreira Marculino de Figueiredo ,
- Luciano Bezerra Gomes ,
- Adriano Massuda ,
- Eugenia Gil-García , [ … ],
- Antonio Daponte
Abstract
ORIGINAL ARTICLESocial determinants of health and COVID-19 infection in Brazil: an analysis of the pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200673
DOI 10.1590/0034-7167-2020-0673
- Alexandre Medeiros de Figueiredo ,
- Daniela Cristina Moreira Marculino de Figueiredo ,
- Luciano Bezerra Gomes ,
- Adriano Massuda ,
- Eugenia Gil-García ,
- Rodrigo Pinheiro de Toledo Vianna ,
- Antonio Daponte
Views0See moreABSTRACT
Objective:
To analyze the influence of socioeconomic, demographic, epidemiological factors, and the health system structure in the evolution of the COVID-19 pandemic in Brazil.
Methods:
Ecological study with variables extracted from databases, having the incidence and mortality by COVID-19 until August 23, 2020, in Brazilian states, as response variables. The magnitude of the associations was estimated using Spearman’s correlation coefficient and multiple regression analysis.
Results:
In the Brazilian states, 59.8% of variation in the incidence of COVID-19 was justified by income inequality, significant home densification, and higher mortality. In the case of mortality, those same variables explained 57.9% of the country’s variations in federal units.
Conclusion:
Our results indicate that socioeconomic factors influenced the evolution and impact of COVID-19 in Brazil. Thus, we suggest comprehensive actions to ensure economic conditions and strengthening of health networks for populations with socioeconomic vulnerability.
- Alexandre Medeiros de Figueiredo
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ORIGINAL ARTICLE08-10-2020
Braden Scale in pressure ulcer risk assessment
Revista Brasileira de Enfermagem. 2020;73(6):e20190413
Abstract
ORIGINAL ARTICLEBraden Scale in pressure ulcer risk assessment
Revista Brasileira de Enfermagem. 2020;73(6):e20190413
DOI 10.1590/0034-7167-2019-0413
Views0See moreABSTRACT
Objective:
To analyze the applicability of the Braden Scale to individuals admitted to an Intensive Care Unit (ICU) with the nursing diagnosis Impaired Physical Mobility, in its prediction potential to develop pressure ulcer (PU).
Methods:
A cross-sectional, quantitative study that evaluated all patients hospitalized in an ICU between November 2016 and February 2017, with the Braden Scale.
Results:
The prevalence of PU was 35.8% (24/67), in male individuals 58.3% (14/24), diagnosed with ischemic CVA 51.9% (12/27), and with hemorrhagic CVA 7.4% (2/27). Among patients classified at severe risk of developing pressure ulcer, 83.3% (20/53) developed it, and 76.7% (33/53) did not develop it.
Conclusion:
The performance of the Braden Scale showed a balance between sensitivity and specificity, confirming it as a better predictive risk assessment instrument in this group of patients.
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ORIGINAL ARTICLE02-27-2020
Prevalence of symptoms and quality of life of cancer patients
- Marina de Góes Salvetti ,
- Caroline Silva Pereira Machado ,
- Suzana Cristina Teixeira Donato ,
- Adriana Marques da Silva
Abstract
ORIGINAL ARTICLEPrevalence of symptoms and quality of life of cancer patients
Revista Brasileira de Enfermagem. 2020;73(2):e20180287
DOI 10.1590/0034-7167-2018-0287
- Marina de Góes Salvetti ,
- Caroline Silva Pereira Machado ,
- Suzana Cristina Teixeira Donato ,
- Adriana Marques da Silva
Views0See moreABSTRACT
Objectives:
to analyze the prevalence of symptoms and their relationship with the quality of life of cancer patients.
Methods:
this is a cross-sectional study with 107 patients evaluated using a sociodemographic instrument, the hospital anxiety and depression scale (HADS) and the quality of life scale (EORTC-QLQ-C30). Pearson’s correlation test was used to evaluate the relationship between symptoms and quality of life.
Results:
prevalence of female patients (56.1%), 55 years as the mean age and 10 years of schooling. Fatigue (76.6%), insomnia (47.7%), pain (42.1%), loss of appetite (37.4%), anxiety (31.8%) and depression (21.5%) were identified. Anxiety and depression symptoms presented a negative correlation with quality of life and positive correlation with physical symptoms.
Conclusions:
fatigue, insomnia, pain and loss of appetite were the most common and most intense symptoms. Anxiety and depression symptoms presented a negative correlation with quality of life and positive correlation with physical symptoms.
- Marina de Góes Salvetti
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ORIGINAL ARTICLE06-27-2019
Validation of a booklet on self-care with the diabetic foot
- Yara Lanne Santiago Galdino ,
- Thereza Maria Magalhães Moreira ,
- Antonio Dean Barbosa Marques ,
- Francisca Alexandra Araújo da Silva
Abstract
ORIGINAL ARTICLEValidation of a booklet on self-care with the diabetic foot
Revista Brasileira de Enfermagem. 2019;72(3):780-787
DOI 10.1590/0034-7167-2017-0900
- Yara Lanne Santiago Galdino ,
- Thereza Maria Magalhães Moreira ,
- Antonio Dean Barbosa Marques ,
- Francisca Alexandra Araújo da Silva
Views0See moreABSTRACT
Objective:
to describe the validation of the booklet on self-care with the feet of people with diabetes.
Method:
methodological study, focusing on the validation of a printed booklet. The content and appearance of the booklet was validated by 23 judges divided into three groups: 11 content and appearance, seven technicians and five of the area of design and marketing. The appearance was validated by 30 people with type 2 Diabetes Mellitus.
Results:
the judges in the nursing area allowed the validation of material with a Content Validity Index (CVI) of 0.99, judges in the area of design and marketing with Suitability Assessment of Materials (SAM) of 99.2% and the target audience with concordance index of 99.4%.
Conclusion:
the educational booklet proved to be valid and reliable educational material to be used in order to promote compliance with self-care with the feet of people with Diabetes Mellitus.
- Yara Lanne Santiago Galdino
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REVIEW03-24-2021
Strategies of active learning methodologies in nursing education: an integrative literature review
- Joyce Fernanda Soares Albino Ghezzi ,
- Elza de Fátima Ribeiro Higa ,
- Monike Alves Lemes ,
- Maria José Sanches Marin
Abstract
REVIEWStrategies of active learning methodologies in nursing education: an integrative literature review
Revista Brasileira de Enfermagem. 2021;74(1):e20200130
DOI 10.1590/0034-7167-2020-0130
- Joyce Fernanda Soares Albino Ghezzi ,
- Elza de Fátima Ribeiro Higa ,
- Monike Alves Lemes ,
- Maria José Sanches Marin
Views0See moreABSTRACT
Objectives:
to analyze the scientific evidence on the strategies of active learning methodologies used in the training of nurses, as well as their contributions and obstacles in training.
Methods:
integrative literature review conducted with 33 selected articles in the Medical Literature Analysis and Retrieval System Online, Latin American and Caribbean Literature in Health Sciences, Nursing Database, Scopus, Web of Science and Education Resources Information Center databases.
Results:
among the strategies, simulation, problem-based learning and flipped classroom were highlighted. The active search, the integration of theory and practice and group work were examples of contributions to the training of nurses. However, the lack of preparation of the actors and the lack of structural support contribute to the dissatisfaction of the students.
Final Considerations:
the active learning methodology places the student at the heart of the learning process, favors critical thinking and the ability to make decisions.
- Joyce Fernanda Soares Albino Ghezzi
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