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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
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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
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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.
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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.
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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
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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
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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.
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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
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EXPERIENCE REPORT04-09-2020
Implementation of an Artificial Intelligence Algorithm for sepsis detection
- Luciana Schleder Gonçalves ,
- Maria Luiza de Medeiros Amaro ,
- Andressa de Lima Miranda Romero ,
- Fernanda Karoline Schamne ,
- Jacson Luiz Fressatto , [ … ],
- Carolina Wrobel Bezerra
Abstract
EXPERIENCE REPORTImplementation of an Artificial Intelligence Algorithm for sepsis detection
Revista Brasileira de Enfermagem. 2020;73(3):e20180421
DOI 10.1590/0034-7167-2018-0421
- Luciana Schleder Gonçalves ,
- Maria Luiza de Medeiros Amaro ,
- Andressa de Lima Miranda Romero ,
- Fernanda Karoline Schamne ,
- Jacson Luiz Fressatto ,
- Carolina Wrobel Bezerra
Views0See moreABSTRACT
Objectives:
to present the nurses’ experience with technological tools to support the early identification of sepsis.
Methods:
experience report before and after the implementation of artificial intelligence algorithms in the clinical practice of a philanthropic hospital, in the first half of 2018.
Results:
describe the motivation for the creation and use of the algorithm; the role of the nurse in the development and implementation of this technology and its effects on the nursing work process.
Final Considerations:
technological innovations need to contribute to the improvement of professional practices in health. Thus, nurses must recognize their role in all stages of this process, in order to guarantee safe, effective and patient-centered care. In the case presented, the participation of the nurses in the technology incorporation process enables a rapid decision-making in the early identification of sepsis.
- Luciana Schleder Gonçalves
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ORIGINAL ARTICLE06-27-2019
Caring for the carer: quality of life and burden of female caregivers
- Michelly Guedes de Oliveira Araújo ,
- Michelinne Oliveira Machado Dutra ,
- Carla Carolina Silva Leite Freitas ,
- Tatiane Gomes Guedes ,
- Francisco Stélio de Souza , [ … ],
- Rosilene Santos Baptista
Abstract
ORIGINAL ARTICLECaring for the carer: quality of life and burden of female caregivers
Revista Brasileira de Enfermagem. 2019;72(3):728-736
DOI 10.1590/0034-7167-2018-0334
- Michelly Guedes de Oliveira Araújo ,
- Michelinne Oliveira Machado Dutra ,
- Carla Carolina Silva Leite Freitas ,
- Tatiane Gomes Guedes ,
- Francisco Stélio de Souza ,
- Rosilene Santos Baptista
Views0See moreABSTRACT
Objective:
To assess the quality of life and the burden of female caregivers.
Method:
Descriptive, cross-sectional, quantitative study carried out with 224 informal caregivers from March to July 2016. Three instruments were used: a characterization form for the caregiver, the WHOQOL-Bref questionnaire and the Zarit Burden Interview. The following tests were used: Cronbach’s Alpha, Kolmogorov-Smirnov, Kruskal-Wallis, Spearman and Mann-Whitney.
Results:
The mean age of caregivers was 51.8 years with a standard deviation of 13.7. They were predominantly married, had a low income and low level of education, were first-degree relatives, had been providing care for one to five years and presented some pathology. The associations of quality of life that presented statistical significance were: income, marital status, number of people living with the caregiver and time of care.
Conclusion:
The burden was negatively correlated with QOL, that is, the greater the burden, the more impaired will be the life of these caregivers.
- Michelly Guedes de Oliveira Araújo
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REVIEW03-24-2021
Development of clinical competence in nursing in simulation: the perspective of Bloom’s taxonomy
- Juliana da Silva Garcia Nascimento ,
- Tainá Vilhar Siqueira ,
- Jordana Luiza Gouvêa de Oliveira ,
- Mateus Goulart Alves ,
- Daniela da Silva Garcia Regino , [ … ],
- Maria Celia Barcellos Dalri
Abstract
REVIEWDevelopment of clinical competence in nursing in simulation: the perspective of Bloom’s taxonomy
Revista Brasileira de Enfermagem. 2021;74(1):e20200135
DOI 10.1590/0034-7167-2020-0135
- Juliana da Silva Garcia Nascimento ,
- Tainá Vilhar Siqueira ,
- Jordana Luiza Gouvêa de Oliveira ,
- Mateus Goulart Alves ,
- Daniela da Silva Garcia Regino ,
- Maria Celia Barcellos Dalri
Views0See moreABSTRACT
Objectives:
to investigate the scientific evidence on the use of Bloom’s taxonomy for developing competence in nursing professionals and students in clinical simulation.
Methods:
integrative review of the National Library of Medicine (NLM), National Institutes of Health (NIH), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Latin American and Caribbean Literature in Health Sciences (LILACS), Web of Science and SCOPUS databases, using the Rayyan application.
Results:
a total of 871 studies were identified; four composed the sample. The development of clinical competence occurred through the coordination of knowledge, skills, and attitudes. To develop the cognitive domain, the objectives of knowledge and comprehension of the Bloom’s taxonomy were mobilized. The psychomotor domain required development of the skills demanded by the proposed clinical care. The affective domain was developed through will and motivation to learn.
Conclusions:
it is possible to develop clinical competence in nursing by adopting Bloom’s taxonomy in each phase of clinical simulation.
- Juliana da Silva Garcia Nascimento
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ORIGINAL ARTICLE06-27-2019
Package of menthol measures for thirst relief: a randomized clinical study
- Viviane Moreira Serato ,
- Lígia Fahl Fonseca ,
- Marcela Maria Birolim ,
- Edilaine Giovanini Rossetto ,
- Lílian Denise Mai , [ … ],
- Aline Korki Arrabal Garcia
Abstract
ORIGINAL ARTICLEPackage of menthol measures for thirst relief: a randomized clinical study
Revista Brasileira de Enfermagem. 2019;72(3):600-608
DOI 10.1590/0034-7167-2018-0057
- Viviane Moreira Serato ,
- Lígia Fahl Fonseca ,
- Marcela Maria Birolim ,
- Edilaine Giovanini Rossetto ,
- Lílian Denise Mai ,
- Aline Korki Arrabal Garcia
Views0See moreABSTRACT
Objective:
To evaluate the effectiveness of the menthol package (lip hydration and ice popsicles) compared to a package of non-menthol measures (lip hydration and ice popsicles) as a way to relieve thirst in patients in the Anesthetic Recovery Room.
Method:
Randomized and parallel trial study, with 120 patients randomized patients in an experimental group – menthol measurements (n=59) and control group – measures without menthol (n = 61).
Results:
There was a significant (p<0.05) decrease in intensity, hydration, dryness and taste in the oral cavity between the three moments of assessment/intervention in the two groups. The difference was significant in the experimental group for thirst intensity at the second assessment/intervention point (p<0.05) after a single administration of the menthol package.
Conclusion:
There was a reduction in thirst intensity in both groups. Patients who received menthol packages showed a significant decrease in intensity after a single evaluation/intervention time. NCT: 02869139.
- Viviane Moreira Serato
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03-27-2020
Coronavirus 2020
Revista Brasileira de Enfermagem. 2020;73(2):e2020n2
Abstract
Coronavirus 2020
Revista Brasileira de Enfermagem. 2020;73(2):e2020n2
DOI 10.1590/0034-7167-2020730201
Views0Emerging and reemerging infectious diseases are constant challenges for public health worldwide. Recent cases of pneumonia of unknown cause in Wuhan, China, have led to the discovery of a new type of Coronavirus (2019-nCoV), which are enveloped RNA viruses, commonly found in humans, other mammals and birds, capable of causing respiratory, enteric, hepatic, and neurological […]See more -
ORIGINAL ARTICLE12-04-2020
Pressure injury related to the use of personal protective equipment in COVID-19 pandemic
- Manuela de Mendonça Figueirêdo Coelho ,
- Viviane Mamede Vasconcelos Cavalcante ,
- Juliano Teixeira Moraes ,
- Luciana Catunda Gomes de Menezes ,
- Sarah Vieira Figueirêdo , [ … ],
- Solange Gurgel Alexandre
Abstract
ORIGINAL ARTICLEPressure injury related to the use of personal protective equipment in COVID-19 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200670
DOI 10.1590/0034-7167-2020-0670
- Manuela de Mendonça Figueirêdo Coelho ,
- Viviane Mamede Vasconcelos Cavalcante ,
- Juliano Teixeira Moraes ,
- Luciana Catunda Gomes de Menezes ,
- Sarah Vieira Figueirêdo ,
- Mírian Ferreira Coelho Castelo Branco ,
- Solange Gurgel Alexandre
Views0See moreABSTRACT
Objective:
To describe the prevalence and factors associated with pressure injuries related to the use of personal protective equipment during the COVID-19 pandemic.
Methods:
Cross-sectional study conducted using an instrument made available in social networks with 1,106 health professionals. The data were analyzed using descriptive statistics and compared, considering pvalue < 0.05.
Results:
There was a prevalence of 69.4% for pressure injuries related to the use of personal protective equipment, with an average of 2.4 injuries per professional. The significant factors were: under 35 years of age, working and wearing personal protective equipment for more than six hours a day, in hospital units, and without the use of inputs for protection.
Conclusion:
Pressure injuries related to the use of medical devices showed a high prevalence in this population. The recognition of the damage in these professionals makes it possible to advance in prevention strategies.
- Manuela de Mendonça Figueirêdo Coelho
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ORIGINAL ARTICLE12-13-2019
Accessibility of children with special health needs to the health care network
- Eliane Tatsch Neves ,
- Aline Cristiane Cavicchioli Okido ,
- Fernanda Luisa Buboltz ,
- Raíssa Passos dos Santos ,
- Regina Aparecida Garcia de Lima
Abstract
ORIGINAL ARTICLEAccessibility of children with special health needs to the health care network
Revista Brasileira de Enfermagem. 2019;72:65-71
DOI 10.1590/0034-7167-2017-0899
- Eliane Tatsch Neves ,
- Aline Cristiane Cavicchioli Okido ,
- Fernanda Luisa Buboltz ,
- Raíssa Passos dos Santos ,
- Regina Aparecida Garcia de Lima
Views0See moreABSTRACT
Objective:
To know how children with special health needs access the health care network.
Method:
This is a qualitative research of descriptive-exploratory type, developed using semi-structured interviews mediated by the Talking Map design. Participants were 19 family caregivers of these children in two Brazilian municipalities. Data were submitted to inductive thematic analysis.
Results:
Difficulties were mentioned from the diagnosis moment to the specialized follow-up, something represented by the itinerary of the c hild and his/her family in the search for the definition of the medical diagnosis and the access to a specialized professional; a gap between the children’s needs and the care offered was observed in primary health care.
Conclusion:
The access of children with special health needs is filled with obstacles such as slowness in the process of defining the child’s diagnosis and referral to a specialist. Primary health care services were replaced by care in emergency care units.
- Eliane Tatsch Neves
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REVIEW12-05-2019
Vulnerability of the elderly: a conceptual analysis
- Keylla Talitha Fernandes Barbosa ,
- Fabiana Maria Rodrigues Lopes de Oliveira ,
- Maria das Graças Melo Fernandes
Abstract
REVIEWVulnerability of the elderly: a conceptual analysis
Revista Brasileira de Enfermagem. 2019;72:337-344
DOI 10.1590/0034-7167-2018-0728
- Keylla Talitha Fernandes Barbosa ,
- Fabiana Maria Rodrigues Lopes de Oliveira ,
- Maria das Graças Melo Fernandes
Views0See moreABSTRACT
Objective:
To analyze the concept of vulnerability of the elderly.
Method:
A concept analysis, according to the method proposed by Walker and Avant, operationalized through integrative review through search in scientific data portals using the
Descriptors:
Health vulnerability, aged, health services for the aged, health of the elderly, vulnerable populations and geriatric health services. To compose the literary corpus, 36 studies were selected.
Results:
Concept antecedents, as well as its attributes, were identified in individual, social and programmatic characteristics, which make up the characteristics of “vulnerability of the elderly”, besides consequences of the phenomenon. These characteristics were analyzed with emphasis on aspects that contribute to the process of vulnerability of the elderly.
Conclusion:
The study demonstrated the multidimensionality of the phenomena studied, highlighting the peculiarities of vulnerability during aging. However, there is a need for further studies on the construct.
- Keylla Talitha Fernandes Barbosa
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