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ORIGINAL ARTICLE
Nursing care management strategies to address the COVID-19 pandemic
- Gabriela Marcellino de Melo Lanzoni
, - Leonardo Pereira de Sousa ,
- Viviane Pecini da Cunha ,
- Ana Lúcia Schaefer Ferreira de Mello ,
- Alexandre Pazetto Balsanelli , [ … ],
- José Luís Guedes dos Santos
01-10-2024
Abstract
ORIGINAL ARTICLENursing care management strategies to address the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77:e20230254
01-10-2024DOI 10.1590/0034-7167-20230254
- Gabriela Marcellino de Melo Lanzoni ,
- Leonardo Pereira de Sousa ,
- Viviane Pecini da Cunha ,
- Ana Lúcia Schaefer Ferreira de Mello ,
- Alexandre Pazetto Balsanelli ,
- José Luís Guedes dos Santos
Views0See moreABSTRACT
Objective:
To characterize nursing care management strategies for addressing the COVID-19 pandemic.
Method:
A descriptive, qualitative study conducted with 22 nurse professionals at a University Hospital in Southern Brazil. Data collection through interviews in June and August 2021, analyzed according to Bardin’s Content Analysis and the theoretical framework of complex thinking.
Results:
The identified strategies were organized into four categories: Reorganization of health services; People management and emergency admission; Multiprofessional articulation; and Bedside nursing care.
Final Considerations:
Professional performance revealed a complex interplay between leadership and care management practices, even in the face of working condition restrictions, and were understood as crucial in the pandemic scenario.
- Gabriela Marcellino de Melo Lanzoni
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ORIGINAL ARTICLE
Self-harm in the two years of greatest restrictions during the covid-19 pandemic: a cross-sectional study
- Odilon Vieira Santos ,
- Letícia Aparecida Machado Lisboa da Silva ,
- Meiry Fernanda Pinto Okuno ,
- Paula Hino ,
- José Ramón Martínez-Riera , [ … ],
- Hugo Fernandes
01-10-2024
Abstract
ORIGINAL ARTICLESelf-harm in the two years of greatest restrictions during the covid-19 pandemic: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77:e20240289
01-10-2024DOI 10.1590/0034-7167-2024-0289
- Odilon Vieira Santos ,
- Letícia Aparecida Machado Lisboa da Silva ,
- Meiry Fernanda Pinto Okuno ,
- Paula Hino ,
- José Ramón Martínez-Riera ,
- Hugo Fernandes
Views0See moreABSTRACT
Objective:
to analyze occurrence of self-harm, sociodemographic profile of victims and referrals in the first 24 months of the COVID-19 pandemic in São Paulo.
Method:
cross-sectional study carried out by the Notifiable Diseases Information System with data on self-harm in São Paulo. The period outlined was March 2020 to February 2022. R (4.0.2) software and chi-square test were used.
Results:
there were 15,946 incidents. Victims were young, white, single, heterosexual women. There was high incidence of people with previous mental disorders more than once and without clear motivation. The method used was poisoning/intoxication. There was a considerable number of referrals to the health network, although not totalitarian.
Conclusion:
the years of greater insecurity in relation to the pandemic have given rise to self-harm cases with peculiar characteristics. Agile health policies must be applied in atypical conditions, such as pandemics, especially for adolescents/young people with previous mental disorders.
- Odilon Vieira Santos
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REVIEW
Prevalence and exposure variables of latent infection by mycobacterium tuberculosis in healthcare workers
- Raphael Sampaio dos Santos ,
- Katerine Moraes dos Santos ,
- Angela Maria Mendes Abreu ,
- Cristiane Cardoso de Paula ,
- Regina Célia Gollner Zeitoune
01-10-2024
Abstract
REVIEWPrevalence and exposure variables of latent infection by mycobacterium tuberculosis in healthcare workers
Revista Brasileira de Enfermagem. 2024;77:e20240052
01-10-2024DOI 10.1590/0034-7167-2024-0052
- Raphael Sampaio dos Santos ,
- Katerine Moraes dos Santos ,
- Angela Maria Mendes Abreu ,
- Cristiane Cardoso de Paula ,
- Regina Célia Gollner Zeitoune
Views0See moreABSTRACT
Objectives:
To identify in the scientific literature the prevalence, diagnostic methods, and exposure variables of latent infection by Mycobacterium tuberculosis in healthcare workers.
Methods:
An integrative review of the scientific literature based on the following review question: What are the available scientific evidence in the literature that address the prevalence of latent infection by Mycobacterium tuberculosis in healthcare workers and its association with possible risk factors among these workers?
Results:
Being a physician or nurse, being older, and being male were generally associated with higher prevalences. The study also showed that interferon-gamma release assays were more commonly used as a diagnostic method compared to skin tests.
Conclusions:
More studies are needed regarding the epidemiology of latent infection by Mycobacterium tuberculosis in the context of healthcare workers, aiming for higher impact actions that contribute to the reduction of tuberculosis worldwide.
- Raphael Sampaio dos Santos
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ORIGINAL ARTICLE
Social Representations of pregnancy among trans men
- Danilo Martins Roque Pereira ,
- Ednaldo Cavalcante de Araújo ,
- Sheyla Costa de Oliveira ,
- Anderson Reis de Sousa ,
- Mariana Mercês Mesquita Espíndola , [ … ],
- Joecio Cordeiro Cardoso
01-10-2024
Abstract
ORIGINAL ARTICLESocial Representations of pregnancy among trans men
Revista Brasileira de Enfermagem. 2024;77:e20240094
01-10-2024DOI 10.1590/0034-7167-2024-0094
- Danilo Martins Roque Pereira ,
- Ednaldo Cavalcante de Araújo ,
- Sheyla Costa de Oliveira ,
- Anderson Reis de Sousa ,
- Mariana Mercês Mesquita Espíndola ,
- Milka Gabrielle de Lira Nóbrega West ,
- Marclineide Nóbrega de Andrade Ramalho ,
- Joecio Cordeiro Cardoso
Views0See moreABSTRACT
Objective:
to understand the meanings and experiences of pregnancy among trans men in light of the Theory of Social Representations.
Methods:
this is a qualitative, descriptive and exploratory study, carried out with trans men selected for convenience and availability. Data production took place from September to October 2021, via the Google Meet® platform, based on interviews with a semi-structured script. Interview lexicographic textual analysis was performed using the Reinert method and instrumented by IRAMUTEQ version 7.0.
Results:
social representations of pregnancy involved a wide field of meanings, in which efforts were articulated to accept opportune and solitary pregnancy, fear of the parturition process and influence of physical and emotional changes.
Final considerations:
the study reinforces the importance of advanced nursing practice in assisting the pregnancy-puerperal cycle, based on the perspective of comprehensive care, equity in access to services and respect for differences.
- Danilo Martins Roque Pereira
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REVIEW
Health of quilombola children as a challenge for the Sustainable Development Goals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20240106
01-10-2024
Abstract
REVIEWHealth of quilombola children as a challenge for the Sustainable Development Goals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20240106
01-10-2024DOI 10.1590/0034-7167-2024-0106
Views0See moreABSTRACT
Objective:
to map the literature on quilombola children’s health and its relationship with the Sustainable Development Goals.
Method:
a scoping review, which followed the JBI protocol and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Searches were conducted in the LILACS, BDENF, Web of Science, Scopus, MEDLINE databases and Google Scholar platform. The research protocol was registered in the Open Science Framework.
Results:
eighteen articles out of 2,055 studies were selected as relevant for this study. The articles were grouped into four axes: Access to healthcare services; Nutritional aspects of quilombola children; Health problems of quilombola children; and Care for quilombola children. The relationship between these articles and SDGs 1, 3, 4, 6 and 10 was observed.
Final considerations:
the study provided an extremely important mapping of the theme of quilombola children’s health and themes related to the Sustainable Development Goals.
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EXPERIENCE REPORT
Sustainability in Higher Education: Experience report on achieving Sustainable Development Goals
- Laura Mafalda Carvalho Lopes ,
- Rosalina Matias-Correia ,
- Rosa Carla Gomes da Silva ,
- Natália de Jesus Barbosa Machado ,
- Ana Paula dos Santos Jesus Marques França
01-10-2024
Abstract
EXPERIENCE REPORTSustainability in Higher Education: Experience report on achieving Sustainable Development Goals
Revista Brasileira de Enfermagem. 2024;77:e20240118
01-10-2024DOI 10.1590/0034-7167-2024-0118
- Laura Mafalda Carvalho Lopes ,
- Rosalina Matias-Correia ,
- Rosa Carla Gomes da Silva ,
- Natália de Jesus Barbosa Machado ,
- Ana Paula dos Santos Jesus Marques França
Views0See moreABSTRACT
Objective:
Describe the activities aimed at achieving the Sustainable Development Goals (SDGs), implemented by a polytechnic higher education institution, in the northern region of Portugal.
Methods:
This is an experience report from a Higher Education Institution, which characterizes the contribution to the SDGs, within the scope of teaching, research, campus and leadership.
Results:
In total, 1247 activities were mapped, with a preponderance in the “people” dimension (685 activities), with SDG 3 being the most prominent. Scientific articles contribute significantly to the SDGs, with a notable discrepancy between automatic (Scopus) and manual classifications, indicating a tendency to underestimate the impact of nursing studies.
Conclusion:
The results demonstrate the significant contribution of this institution to the SDGs, with a special focus on health and education. This contribution reflects the mission of the institution, which involves training competent and socially conscious health professionals, but simultaneously the need for greater awareness and training of the teaching staff.
- Laura Mafalda Carvalho Lopes
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ORIGINAL ARTICLE
Nursing students and the internet: a reflection of digital ethics
- Ana Carolina Barboza Brandão ,
- Ingrid Bemfica Ramos ,
- Anna Carolina Caetano Griesang de Oliveira ,
- Sabrina da Costa Machado Duarte ,
- Joyce Martins Arimatea Branco Tavares , [ … ],
- Priscilla Valladares Broca
01-10-2024
Abstract
ORIGINAL ARTICLENursing students and the internet: a reflection of digital ethics
Revista Brasileira de Enfermagem. 2024;77:e20230459
01-10-2024DOI 10.1590/0034-7167-2023-0459
- Ana Carolina Barboza Brandão ,
- Ingrid Bemfica Ramos ,
- Anna Carolina Caetano Griesang de Oliveira ,
- Sabrina da Costa Machado Duarte ,
- Joyce Martins Arimatea Branco Tavares ,
- Priscilla Valladares Broca
Views0See moreABSTRACT
Objectives:
to identify how first-year nursing students use cyberspace and propose an orientation guide with criteria guiding the use of cyberspace.
Methods:
qualitative and descriptive research, carried out with 24 nursing students from a federal public institution in Rio de Janeiro. Data collection was carried out through semi-structured interviews. Data analysis occurred using IRAMUTEQ®. The research was approved by the institution’s Research Ethics Committee.
Results:
students use cyberspace to communicate, study, find “cool things”, share photos and memories. Furthermore, they are concerned about hate speech, intolerance and fake news. The good and bad sides and the types of technologies most used were also portrayed.
Final considerations:
the moral and ethical values of physical coexistence, together with awareness of individual responsibility, are the pillars for using cyberspace. The guide comes as an awareness tool.
- Ana Carolina Barboza Brandão
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LETTER TO THE EDITOR
Adherence to COVID-19 vaccination during the pandemic and fake news: Correspondence
Revista Brasileira de Enfermagem. 2024;77:e202477Suppl101c
01-10-2024
Abstract
LETTER TO THE EDITORAdherence to COVID-19 vaccination during the pandemic and fake news: Correspondence
Revista Brasileira de Enfermagem. 2024;77:e202477Suppl101c
01-10-2024
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ORIGINAL ARTICLE
Psychosocial risks related to the nurse in the psychiatric hospital and management strategies
- Maria Carolina Santos Scozzafave ,
- Laura Andrian Leal ,
- Mirelle Inácio Soares ,
- Silvia Helena Henriques
08-19-2019
Abstract
ORIGINAL ARTICLEPsychosocial risks related to the nurse in the psychiatric hospital and management strategies
Revista Brasileira de Enfermagem. 2019;72(4):834-840
08-19-2019DOI 10.1590/0034-7167-2017-0311
- Maria Carolina Santos Scozzafave ,
- Laura Andrian Leal ,
- Mirelle Inácio Soares ,
- Silvia Helena Henriques
Views0See moreABSTRACT
Objective:
To characterize the presence of psychosocial risks related to the work of the nurse in a psychiatric hospital and the strategies for managing these risks.
Methods:
Qualitative, in which 25 nurses from a psychiatric hospital participated using semi-structured interviews from November 2014 to January 2015. Data analysis was performed using the thematic method.
Results:
The results showed psychosocial risks related to the work of psychiatric nurses, such as: insufficient academic training; lack of preparation and maintenance of equipment; poor relationship with colleagues; shortage of human resources and lack of capacity building; conflict between the demands of the home and work, as well as strategies for managing psychosocial risks such as family, cinema, music, reading, among others.
Final considerations:
This study should provoke the reflection of managers and future nurses regarding the working conditions in a psychiatric hospital and possible psychosocial risks to which they are exposed.
- Maria Carolina Santos Scozzafave
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ORIGINAL ARTICLE
Structural and procedural conditions in National Immunization Program Information System establishment
- Brener Santos Silva ,
- Kátia Cristina de Souza ,
- Ronimara Gonçalves de Souza ,
- Samuel Barroso Rodrigues ,
- Valéria Conceição de Oliveira , [ … ],
- Eliete Albano de Azevedo Guimarães
06-01-2020
Abstract
ORIGINAL ARTICLEStructural and procedural conditions in National Immunization Program Information System establishment
Revista Brasileira de Enfermagem. 2020;73(4):e20180939
06-01-2020DOI 10.1590/0034-7167-2018-0939
- Brener Santos Silva ,
- Kátia Cristina de Souza ,
- Ronimara Gonçalves de Souza ,
- Samuel Barroso Rodrigues ,
- Valéria Conceição de Oliveira ,
- Eliete Albano de Azevedo Guimarães
Views0ABSTRACT
Objectives:
to analyze structural and process conditions in National Immunization Program Information System establishment.
Methods:
a cross-sectional study conducted in 307 vaccination rooms in the state of Minas Gerais in 2017. For data collection, a multidimensional questionnaire was used. Descriptive data analysis was performed.
Results:
vaccination rooms have basic inputs necessary for System establishment. The greatest problems relate to professional practice. Low enrollment of population, failures in the active search for absentees, vaccine scheduling and absence of reports to monitor vaccination coverage were identified. Training was considered insufficient and ineffective.
Conclusions:
Immunization Information System is an essential technological innovation for the management of immunization actions. However, the production of timely records and the use of information are still challenges. Investments in training are required to ensure System’s management and operationalization activities.
Keywords:Evaluation StudiesHealth Information SystemsImmunization ProgramsInformation TechnologyNursingSee more - Brener Santos Silva
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Trends in fertility rates, proportion of antenatal consultations and caesarean sections among Brazilian adolescents
- Milena Laryssa Costa Bicalho ,
- Fernanda Gontijo Araújo ,
- Gisele Nepomuceno de Andrade ,
- Eunice Francisca Martins ,
- Mariana Santos Felisbino-Mendes
06-28-2021
Abstract
Trends in fertility rates, proportion of antenatal consultations and caesarean sections among Brazilian adolescents
Revista Brasileira de Enfermagem. 2021;74:e20200884
06-28-2021DOI 10.1590/0034-7167-2020-0884
- Milena Laryssa Costa Bicalho ,
- Fernanda Gontijo Araújo ,
- Gisele Nepomuceno de Andrade ,
- Eunice Francisca Martins ,
- Mariana Santos Felisbino-Mendes
Views0ABSTRACT
Objective:
To analyze the temporal trends in the fertility rate, proportion of antenatal consultations and caesarean sections in Brazilian adolescents aged 15 to 19, between 2000 and 2015. Methods: The fertility rate, proportion of prenatal consultations and proportion of routes of birth were calculated using data from DATASUS. The trend analysis was performed using the Prais-Winsten regression model and the annual percentage change.
Results:
There was a trend of reduction of 3.5% per year in the fertility rate among adolescents (p<0.05), in addition to an increasing trend of 6% per year in the proportion of more than six antenatal consultations (p <0.0001) and an increasing trend of 6.8% per year in the proportion of caesarean sections (p<0.0001).
Conclusion:
Despite the decreasing trend in fertility rates among Brazilian adolescents, they remain high. Also noteworthy is the growing trend for caesarean sections, even with improved access to antenatal care.
Keywords:Birth RateCaesarean SectionDescriptors:Pregnancy in adolescencePrenatal CareTime Serie StudiesSee more
- Milena Laryssa Costa Bicalho
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ORIGINAL ARTICLE
Nursing protocol in vascular trauma prevention: peripheral catheterization bundle in urgency
- Paula Krempser ,
- Cristina Arreguy-Sena ,
- Pedro Miguel dos Santos Dinis Parreira ,
- Anabela de Sousa Salgueiro-Oliveira
10-21-2019
Abstract
ORIGINAL ARTICLENursing protocol in vascular trauma prevention: peripheral catheterization bundle in urgency
Revista Brasileira de Enfermagem. 2019;72(6):1512-1518
10-21-2019DOI 10.1590/0034-7167-2018-0457
- Paula Krempser ,
- Cristina Arreguy-Sena ,
- Pedro Miguel dos Santos Dinis Parreira ,
- Anabela de Sousa Salgueiro-Oliveira
Views0See moreABSTRACT
Objective:
to create, apply and analyze in clinical practice the effectiveness of a bundle to prevent peripheral vascular trauma to approach the peripheral venous puncture process.
Method:
action research with 435 adult participants in an emergency service from 2011 to 2013. Creation of the bundle for prevention of vascular trauma based on scientific evidence, ease of operation, observation and measurement with implantation through an educational intervention of the team of nursing. Effectiveness analyzed by descriptive and inferential statistics using chi-square. Consecutive sample with 95% confidence interval.
Results:
Five stages of the bundle were related to the catheter fixation, permanence and removal process. The incidence of vascular traumas due to vein punctures reduced by 46.41% after implantation of the bundle to prevent vascular trauma associated with emergency peripheral catheterization.
Conclusion:
The bundle in clinical practice reduced vascular traumas by venipuncture.
- Paula Krempser
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ORIGINAL ARTICLE
Autonomy in the reproductive health of quilombolas women and associated factors
- Elionara Teixeira Boa Sorte Fernandes ,
- Sílvia Lúcia Ferreira ,
- Cláudia Suely Barreto Ferreira ,
- Eliene Almeida Santos
09-21-2020
Abstract
ORIGINAL ARTICLEAutonomy in the reproductive health of quilombolas women and associated factors
Revista Brasileira de Enfermagem. 2020;73:e20190786
09-21-2020DOI 10.1590/0034-7167-2019-0786
- Elionara Teixeira Boa Sorte Fernandes ,
- Sílvia Lúcia Ferreira ,
- Cláudia Suely Barreto Ferreira ,
- Eliene Almeida Santos
Views0ABSTRACT
Objective:
Identify the level of reproductive autonomy of quilombola women and associate it with sociodemographic characteristics and aspects of sexual and reproductive health.
Methods:
Cross-sectional census study carried out in quilombola communities in a municipality in Bahia. Data was collected through questionnaires from the National Health Survey and the Reproductive Autonomy Scale, applied to quilombola women who agreed to participate. Descriptive statistics procedures were used and associations were made between reproductive autonomy scores and sociodemographic and reproductive characteristics.
Results:
The average total score for reproductive autonomy was 2.06. An association was found between the “decision-making” score and marital status. The score for “total reproductive autonomy” was associated with the use of contraceptive method.
Conclusion:
The reality of the study participants converges with the literature regarding the interference of sociodemographic and reproductive factors in the reproductive autonomy of black women.
Keywords:African Continental Ancestry GroupPersonal AutonomyReproductive HealthSocioeconomic FactorsWomenSee more - Elionara Teixeira Boa Sorte Fernandes
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ORIGINAL ARTICLE
Playful educational intervention with schoolchildren on intestinal parasitosis
- Gabriela Rodrigues Bragagnollo ,
- Tâmyssa Simões dos Santos ,
- Renata Elizabete Pagotti da Fonseca ,
- Marcelo Acrani ,
- Maria Zita Pires Castelo Branco , [ … ],
- Beatriz Rossetti Ferreira
09-16-2019
Abstract
ORIGINAL ARTICLEPlayful educational intervention with schoolchildren on intestinal parasitosis
Revista Brasileira de Enfermagem. 2019;72(5):1203-1210
09-16-2019DOI 10.1590/0034-7167-2017-0551
- Gabriela Rodrigues Bragagnollo ,
- Tâmyssa Simões dos Santos ,
- Renata Elizabete Pagotti da Fonseca ,
- Marcelo Acrani ,
- Maria Zita Pires Castelo Branco ,
- Beatriz Rossetti Ferreira
Views0See moreABSTRACT
Objective:
To analyze the playful educational interventions in the knowledge of schoolchildren about intestinal parasitosis.
Method:
This is a quasi-experimental, non-randomized study, based on pre- and post-intervention, conducted in a public elementary school in a peripheric neighborhood in the city of Ribeirão Preto (SP). The study population consisted of 101 students enrolled in the 5th and 6th grade. For comparison, we used the generalized version of the McNemar chi-squared test.
Results:
Of the 101 schoolchildren who participated in the study, 48 (47.5%) were female and 53 (52.5%) were male, aged from 9 to 14 years. Students’ knowledge on intestinal parasitic infections has increased significantly after the playful educational intervention.
Conclusion:
Playful educational interventions are an excellent didactical resource in the teaching-learning process of schoolchildren.
- Gabriela Rodrigues Bragagnollo
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ORIGINAL ARTICLE
Group Brief Intervention: effectiveness in motivation to change alcohol intake
Revista Brasileira de Enfermagem. 2020;73(1):e20180138
02-10-2020
Abstract
ORIGINAL ARTICLEGroup Brief Intervention: effectiveness in motivation to change alcohol intake
Revista Brasileira de Enfermagem. 2020;73(1):e20180138
02-10-2020DOI 10.1590/0034-7167-2018-0138
Views0See moreABSTRACT
Objective:
To verify the effectiveness of the group brief intervention (GBI), performed by nurses in motivational stages to change the pattern of alcohol intake.
Method:
Randomized controlled trial with 3-month follow-up. The ruler of readiness for change was applied in 180 individuals with risk or harmful alcohol intake pattern in basic health unit. Only the experimental group (EG) was submitted to the intervention. Both groups (experimental and control [CG]) participated in the follow-up.
Results:
EG had a mean score before GBI=6.55 (SD=3.41) points (preparation). After GBI=8.00 (SD=2.88) points (action) and in the follow-up 7.92 (SD=3.06) points (action). CG presented a mean score before GBI=5.42 (SD=3.26) points (preparation); after GBI=6.67 (SD=3.05) points (preparation) and in the follow up had a mean score of 4.80 (SD=2.86) points (contemplation). There was a statistically significant difference between the two groups at the motivational stages (p≤ 0,03).
Conclusion:
It was evidenced that GBI was effective in increasing the motivation to change harmful alcohol intake.
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EXPERIENCE REPORT
Pedagogical mediations for non-formal nursing teaching during the COVID-19 pandemic
- Juliana Amaral Prata ,
- Alex Simões de Mello ,
- Frances Valéria Costa e Silva ,
- Magda Guimarães de Araujo Faria
11-13-2020
Abstract
EXPERIENCE REPORTPedagogical mediations for non-formal nursing teaching during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2020;73:e20200499
11-13-2020DOI 10.1590/0034-7167-2020-0499
- Juliana Amaral Prata ,
- Alex Simões de Mello ,
- Frances Valéria Costa e Silva ,
- Magda Guimarães de Araujo Faria
Views0See moreABSTRACT
Objective:
to report the experience of developing pedagogical mediations in a Virtual Learning Environment implemented in a nursing faculty during the COVID-19 pandemic.
Methods:
an experience report on the construction of a distance course aimed at graduates and residents of a nursing faculty at a public university located in the city of Rio de Janeiro.
Results:
the course’s conception, operationalization and implementation were the result of a collective work that culminated in a non-formal, virtual and problematic teaching process, which reached a participation rate of 82% of enrolled students.
Final considerations:
even in times of social isolation, the course promoted collaborative learning of knowledge about COVID-19 and strengthened the relationship between professors and students. The possibility of carrying out distance activities based on solid methodological proposals that contradict the content logic often observed in distance learning is emphasized.
- Juliana Amaral Prata
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