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EDITORIAL
Ibero-American nursing context: constructing and sharing knowledge
Revista Brasileira de Enfermagem. 2024;77(1):e770101
12-08-2024
Abstract
EDITORIALIbero-American nursing context: constructing and sharing knowledge
Revista Brasileira de Enfermagem. 2024;77(1):e770101
12-08-2024DOI 10.1590/0034-7167.2024770101
Views0Next week, two major scientific events will take place in Madrid and Granada (Spain). These will be international, specific activities in a very special way, although not exclusive to the Ibero-American field, organized and developed by two very important scientific nursing societies, such as Community Nursing Association (AEC) and Latin American Association of Schools and […]See more
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EDITORIAL
Contexto ibero-americano da enfermagem: construindo e compartilhando conhecimento
Revista Brasileira de Enfermagem. 2024;77(1):e770101
12-08-2024
Abstract
EDITORIALContexto ibero-americano da enfermagem: construindo e compartilhando conhecimento
Revista Brasileira de Enfermagem. 2024;77(1):e770101
12-08-2024DOI 10.1590/0034-7167.2024770101pt
Views0Na próxima semana, acontecerão dois grandes eventos científicos em Madri e Granada (Espanha). Serão atividades internacionais, específicas e de forma muito especial, embora não exclusivas do campo ibero-americano, organizadas e desenvolvidas por duas sociedades científicas de enfermagem muito importantes, como a Associação de Enfermagem Comunitária (AEC) e a Associação Latino-Americana de Escolas e Faculdades de […]See more -
ORIGINAL ARTICLE
Sleep quality of vulnerable elderly people: associated factors
- Ariene Angelini dos Santos-Orlandi
, - Ana Carolina Ottaviani ,
- Elén dos Santos Alves ,
- Tábatta Renata Pereira de Brito ,
- Keika Inouye
11-29-2024
Abstract
ORIGINAL ARTICLESleep quality of vulnerable elderly people: associated factors
Revista Brasileira de Enfermagem. 2024;77:e20230283
11-29-2024DOI 10.1590/0034-7167-2023-0283
- Ariene Angelini dos Santos-Orlandi ,
- Ana Carolina Ottaviani ,
- Elén dos Santos Alves ,
- Tábatta Renata Pereira de Brito ,
- Keika Inouye
Views0See moreABSTRACT
Objective:
To identify factors associated with poor sleep quality in elderly dependent individuals in social vulnerability.
Method:
Cross-sectional study with 59 elderly dependent individuals assisted by Family Health Units in São Carlos/SP. The following tools were used: Katz Index, Lawton and Brody Scale, Pittsburgh Sleep Quality Index, Addenbrooke’s Cognitive Examination Revised, Fried’s Frailty Phenotype, Geriatric Depression Scale (15 items), Perceived Stress Scale, Family APGAR, Social Support Scale from the Medical Outcomes Study, and World Health Organization Quality of Life, abbreviated and “old” versions.
Results:
The majority of participants were women (52.5%), aged 60-74 years (71.1%), and had poor sleep quality (76.2%). Stress (OR=1.12; 95%CI=1.02-1.22) and polypharmacy (OR=7.39; 95%CI=1.22-44.73) increased the chances of poor sleep quality, while physical activity decreased these chances (OR=0.15; 95%CI=0.02-0.79).
Conclusion:
Stress and polypharmacy are associated with poor sleep quality in elderly dependent individuals.
- Ariene Angelini dos Santos-Orlandi
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REVIEW
Assessment of knowledge in oncology about care for transgender people: a scoping review
- Fernanda Fachetti Xavier de Almeida ,
- Cremilson de Paula Silva ,
- Ricardo Souza Evangelista Sant’Ana ,
- Ruan Nilton Rodrigues Melo
11-29-2024
Abstract
REVIEWAssessment of knowledge in oncology about care for transgender people: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20230532
11-29-2024DOI 10.1590/0034-7167-2023-0532
- Fernanda Fachetti Xavier de Almeida ,
- Cremilson de Paula Silva ,
- Ricardo Souza Evangelista Sant’Ana ,
- Ruan Nilton Rodrigues Melo
Views0ABSTRACT
Objective:
to identify evidence available in the literature on instruments and methodologies used to assess healthcare professionals’ knowledge about cancer care for the transgender population.
Methods:
a scoping review was conducted in seven databases, including studies that answered the question: what is the healthcare professionals’ level of knowledge about cancer care for the transgender population?
Results:
forty-one articles were selected that dealt specifically with healthcare professionals’knowledge in relation to care for the LGBTQIAPN+ population, especially the transgender population. Eighteen studies assessed patients’ perceptions of professionals’knowledge, whereas other studies used their own assessment tools, considering the global context of LGBTQIAPN+ health.
Conclusions:
there is no tested and validated instrument that assesses the knowledge about the transgender population’s oncological health, highlighting the need to construct and validate an instrument focused on this population’s needs.
Keywords:Health Services for Transgender PeopleNeoplasmsOncologyProfessional TrainingTransgender PeopleSee more
- Fernanda Fachetti Xavier de Almeida
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ORIGINAL ARTICLE
Interpersonal violence in the state of Espírito Santo: analysis of mandatory notifications between 2011 and 2018
- Franciéle Marabotti Costa Leite ,
- Luíza Eduarda Portes Ribeiro ,
- Tiffani Matos Oliveira ,
- Evellym Souza Correa ,
- Márcia Regina de Oliveira Pedroso , [ … ],
- Dherik Fraga Santos
11-22-2024
Abstract
ORIGINAL ARTICLEInterpersonal violence in the state of Espírito Santo: analysis of mandatory notifications between 2011 and 2018
Revista Brasileira de Enfermagem. 2024;77(5):e20230081
11-22-2024DOI 10.1590/0034-7167-2023-0081
- Franciéle Marabotti Costa Leite ,
- Luíza Eduarda Portes Ribeiro ,
- Tiffani Matos Oliveira ,
- Evellym Souza Correa ,
- Márcia Regina de Oliveira Pedroso ,
- Dherik Fraga Santos
Views0See moreABSTRACT
Objective:
To identify the frequency of notifications of interpersonal violence in Espírito Santo from 2011 to 2018, and the factors associated with this issue.
Methods:
This is a cross-sectional study in which all cases of interpersonal violence from the Information System for Notifiable Diseases in the state of Espírito Santo during the period from 2011 to 2018 were analyzed. Absolute and relative frequencies and 95% confidence intervals were calculated, as well as Poisson regression.
Results:
During the analyzed period, 27,277 cases were reported in Espírito Santo (P: 75%; 95% CI: 74.5-75.4), being more prevalent among females, children, and the elderly, individuals of black/mixed race, people without disabilities, and residents of urban areas. Regarding the perpetrator, there was a higher prevalence of individuals aged 25 years and older, males, with a current or former intimate partner relationship with the victim, and suspected alcohol use at the time of the aggression. In terms of the characteristics of the aggression, there was a higher prevalence of repeat violence, involving a single aggressor, and occurring in the residence.
Conclusions:
The notification of interpersonal violence in Espírito Santo showed a high prevalence and was associated with characteristics of the victim, aggressor, and event. This scenario reinforces the need for interventions such as professional qualification, expansion of intersectoral actions, and reformulation of public policies.
- Franciéle Marabotti Costa Leite
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ORIGINAL ARTICLE
Prevalence of prescription and effectiveness of analgesia for treating vaginal delivery pain
- Juan Ignacio Calcagno ,
- Sarah Iribarren ,
- Cristiane Flora Villarreal ,
- Patricia Santos de Oliveira ,
- Amado Nizarala de Ávila
11-22-2024
Abstract
ORIGINAL ARTICLEPrevalence of prescription and effectiveness of analgesia for treating vaginal delivery pain
Revista Brasileira de Enfermagem. 2024;77(5):e20230327
11-22-2024DOI 10.1590/0034-7167-2023-0327
- Juan Ignacio Calcagno ,
- Sarah Iribarren ,
- Cristiane Flora Villarreal ,
- Patricia Santos de Oliveira ,
- Amado Nizarala de Ávila
Views0See moreABSTRACT
Objectives:
to assess pain management during labor.
Methods:
a cross-sectional study was carried out by reviewing medical records and conducting postpartum interviews. Prevalence and effectiveness of analgesia were assessed.
Results:
the prevalence of non-pharmacological analgesia was 61.86% of 215 women in labor in Obstetric Center and 82.51% of 62 in midwife-led unit. Prevalence of severe pain, on the Visual Analogue Scale, before and after non-pharmacological analgesia, was from 92.16% to 64.04% (p=0.00) in Obstetric Center and from 85.96% to 52.63% (p=0.01) in midwife-led unit. Prevalence of pharmacological analgesia in Obstetric Centers was 15.81%, with no variation in severe pain (p=0.57). Patients’ request for analgesia was associated with education (p=0.00) and pain intensity (p=0.02).
Conclusions:
non-pharmacological analgesia improved pain intensity. Prevalence of pharmacological analgesic prescription was lower than that identified in developed countries. Pain management needs to consider the preferences and needs of women in labor.
- Juan Ignacio Calcagno
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ORIGINAL ARTICLE
Knowledge sharing: nurse managers’ practices
- Ana Lúcia Arcanjo Oliveira Cordeiro ,
- Rosana Maria de Oliveira Silva ,
- Josicélia Dumêt Fernandes ,
- Gilberto Tadeu Reis da Silva
11-22-2024
Abstract
ORIGINAL ARTICLEKnowledge sharing: nurse managers’ practices
Revista Brasileira de Enfermagem. 2024;77(5):e20230287
11-22-2024DOI 10.1590/0034-7167-2023-0287
- Ana Lúcia Arcanjo Oliveira Cordeiro ,
- Rosana Maria de Oliveira Silva ,
- Josicélia Dumêt Fernandes ,
- Gilberto Tadeu Reis da Silva
Views0ABSTRACT
Objective:
To analyze how management practices for sharing knowledge are developed in public hospitals in the context of nursing.
Methods:
Qualitative research, carried out with 15 nurse managers from six public hospitals, from July to September 2022. Data were collected through semi-structured interviews and analyzed according to content analysis and in a model for sharing knowledge at work.
Results:
Knowledge sharing in nursing occurs through intraand extra-organizational training (training, courses and events), use of digital communication tools (media and social networks) and individual and collective contact between professionals during the service (experiences, exchange of experiences and assessment feedback).
Final considerations:
Sharing knowledge is relevant to nursing work. To improve it, it must be understood that effective sharing occurs from person to person, in their daily practices, and must be conducted as a strategically planned process by nurse managers.
Keywords:Health Information ManagementHealth Services AdministrationKnowledge ManagementNursing Service, HospitalNursing Staff, HospitalSee more - Ana Lúcia Arcanjo Oliveira Cordeiro
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ORIGINAL ARTICLE
Transitions experienced by people living with limitations resulting from leprosy: a research-care study
Revista Brasileira de Enfermagem. 2024;77(5):e20230229
11-22-2024
Abstract
ORIGINAL ARTICLETransitions experienced by people living with limitations resulting from leprosy: a research-care study
Revista Brasileira de Enfermagem. 2024;77(5):e20230229
11-22-2024DOI 10.1590/0034-7167-2023-0229
Views0See moreABSTRACT
Objective:
to understand the transitional processes that affect the adaptation of people who live with limitations resulting from leprosy.
Methods:
This is a qualitative study based on the precepts of Transition Theory, mediated by care-research, with 24 people with limitations resulting from leprosy in an ex-hospital colony in Piauí. Semi-structured interviews were carried out. The interviews were analyzed using Iramuteq software.
Results:
the researched-caregivers experienced the four types of transitions, including feelings of fear, worry, loneliness, hopelessness, guilt and a tendency to hide the diagnosis. Breakdowns and resignation were revealed, with spirituality, adaptation to the new life situation and acceptance as facilitating conditions for coping with the transitional process, with a consequent improvement in quality of life.
Final considerations:
the transitional processes had a positive significance, since they contributed to adaptation and the achievement of quality of life.
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ORIGINAL ARTICLE
Consumption of alcohol and drugs and school absenteeism among high school students of public schools
Revista Brasileira de Enfermagem. 2019;72(6):1692-1698
10-21-2019
Abstract
ORIGINAL ARTICLEConsumption of alcohol and drugs and school absenteeism among high school students of public schools
Revista Brasileira de Enfermagem. 2019;72(6):1692-1698
10-21-2019DOI 10.1590/0034-7167-2018-0828
Views0ABSTRACT
Objective:
To evaluate the relation between the consumption of alcohol and other drugs and school absenteeism in high school students of public schools in the 30 days prior to data collection.
Method:
Cross-sectional study of quantitative character conducted from May to September 2017, with 282 high school students of public schools of Mossoró-RN. We used a closed questionnaire with questions about drug consumption as our instrument of analysis. We performed hierarchical binary logistic regression by using the SPSS 20.0.
Results:
In bivariate analysis, the relation between absenteeism and drug consumption patterns proved to be significant to those who engage in heavy episodic drinking of alcohol and in the use of tobacco, inhalants and marijuana. The adjusted regression model only included the variables tobacco and heavy episodic drinking of alcohol.
Conclusion:
The hierarchical binary logistic regression analysis corroborated with absenteeism outcomes, explaining it in 12.3% of cases.
Keywords:AbsenteeismAdolescentsConsumption of Alcohol by MinorsDisorders Related to Substance UseStudentsSee more -
ORIGINAL ARTICLE
Knowledge, attitudes and practices related to sexually transmitted infections of men in prison
- Josias Alves de Oliveira ,
- Anderson Reis de Sousa ,
- Lílian Conceição Guimarães de Almeida ,
- Isabella Félix Meira Araújo ,
- Ailton da Silva Santos , [ … ],
- Álvaro Pereira
01-14-2022
Abstract
ORIGINAL ARTICLEKnowledge, attitudes and practices related to sexually transmitted infections of men in prison
Revista Brasileira de Enfermagem. 2022;75:e20201273
01-14-2022DOI 10.1590/0034-7167-2020-1273
- Josias Alves de Oliveira ,
- Anderson Reis de Sousa ,
- Lílian Conceição Guimarães de Almeida ,
- Isabella Félix Meira Araújo ,
- Ailton da Silva Santos ,
- Tania Christiane Ferreira Bispo ,
- Álvaro Pereira
Views0See moreABSTRACT
Objectives:
to analyze the knowledge, attitudes, and practices related to sexually transmitted infections of men in prison.
Methods:
qualitative study, based on the methodology Knowledge, Attitude and Practice, conducted with 30 men in prison. The study applied individual interviews submitted to the analyze of the discourse.
Results:
the incipient knowledge of men was associated with: self-illness and the others’, diagnosis, and perception of risk behavior, pervaded by distrust or lack of understanding of the rapid test for detection. The attitudes involved culpability of partnerships, non-adherence to prevention inputs, and resistance to look for health services. The practices are linked to health care after the identification of the disease, use of penile condoms, and attention to the partnership.
Conclusions:
the reduced knowledge about Sexually Transmitted Infections makes attitudes stereotyped, stigmatized, compromised by the level of education. The level of health care and the limits of deprivation of liberty weaken the practices.
- Josias Alves de Oliveira
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Leprosy educational practices with adolescents: an integrative literature review
- Bruna Hinnah Borges Martins de Freitas ,
- Fabiane Blanco e Silva ,
- Jéssica Maria Ferreira de Jesus ,
- Maria Angélica Brum Alencastro
09-16-2019
Abstract
Leprosy educational practices with adolescents: an integrative literature review
Revista Brasileira de Enfermagem. 2019;72(5):1397-1404
09-16-2019DOI 10.1590/0034-7167-2017-0458
- Bruna Hinnah Borges Martins de Freitas ,
- Fabiane Blanco e Silva ,
- Jéssica Maria Ferreira de Jesus ,
- Maria Angélica Brum Alencastro
Views0See moreABSTRACT
Objectives:
to identify scientific evidence in the literature regarding educational actions on leprosy developed with adolescents.
Method:
an integrative review of the literature, with the following research question: what are the leprosy educational practices currently being developed with adolescents? The search was performed in the following databases: MEDLINE, Scopus, LILACS, CINAHL, BVS Hanseníase and other sources, using “adolescent”; “leprosy”; “health education”; “public health”, and “public health practice” as keywords. Results: the sample was comprised of nine studies. Leprosy educational practices with adolescents verifiably promote change in knowledge when they are based on constructivist methodologies. The nurse is recognized as a professional with potential for developing these educational practices. Final considerations: actions for leprosy education with adolescents do lead to changes in knowledge, but new research is needed to evaluate their effectiveness in further improving this knowledge as well as changing behaviors and practices.
- Bruna Hinnah Borges Martins de Freitas
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ORIGINAL ARTICLE
Work overload and risk behaviors in motorcyclists
- Washington José dos Santos ,
- Vanessa Maria da Silva Cêlho ,
- Gustavo Barreto Santos ,
- Albanita Gomes da Costa de Ceballos
10-21-2019
Abstract
ORIGINAL ARTICLEWork overload and risk behaviors in motorcyclists
Revista Brasileira de Enfermagem. 2019;72(6):1479-1484
10-21-2019DOI 10.1590/0034-7167-2018-0279
- Washington José dos Santos ,
- Vanessa Maria da Silva Cêlho ,
- Gustavo Barreto Santos ,
- Albanita Gomes da Costa de Ceballos
Views0See moreABSTRACT
Objective:
to analyze the association between work overload and risk behaviors adopted by motorcyclists.
Method:
a cross-sectional study of injured motorcycle drivers hospitalized at the Hospital da Restauração Governador Paulo Guerra in the city of Recife, PE, from May to September 2016. A questionnaire was applied containing sociodemographic variables related to work overload and risk behaviors adoption. Odds Ratio (OR) and 95% Confidence Interval were used to analyze the association between the variables.
Results:
there was a predominance of males (97.6%), mean age 31.44 years (SD = 9.50). There was an association of sleep/fatigue at the accident time with difficulties carrying out work tasks (OR = 3.7), feeling tired during work (OR = 4.6) and feeling under pressure to carry out work tasks (OR = 3.5).
Conclusion:
work overload was associated with risk behaviors adoption. It is believed that this fact can have an impact on the occurrence and severity of accidents.
- Washington José dos Santos
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ORIGINAL ARTICLE
Educational technology for fatigue management related to antineoplastic chemotherapy
- Marcela Maria de Melo Perdigão ,
- Andrea Bezerra Rodrigues ,
- Tayanne de Lima Magalhães ,
- Fernanda Macedo Cartaxo Freitas ,
- Lia Guedes Bravo , [ … ],
- Patrícia Peres de Oliveira
10-21-2019
Abstract
ORIGINAL ARTICLEEducational technology for fatigue management related to antineoplastic chemotherapy
Revista Brasileira de Enfermagem. 2019;72(6):1519-1525
10-21-2019DOI 10.1590/0034-7167-2018-0505
- Marcela Maria de Melo Perdigão ,
- Andrea Bezerra Rodrigues ,
- Tayanne de Lima Magalhães ,
- Fernanda Macedo Cartaxo Freitas ,
- Lia Guedes Bravo ,
- Patrícia Peres de Oliveira
Views0See moreABSTRACT
Objective:
To construct and validate an educational technology (ET) on fatigue and non-pharmacological strategies for the management of this symptom in people with cancer undergoing outpatient antineoplastic chemotherapy.
Method:
This is a methodological study composed of three stages: 1) elaboration of the ET using the theoretical-methodological model of Doak, Doak and Root; 2) validation of content and appearance by seven nurses via the content validity index (CVI); and 3) a pilot test with 10 patients.
Results:
The ET “Knowing and coping with fatigue” contemplates the definition of fatigue, its causes and the interventions of physical exercise practice, sleep hygiene, energy conservation and behavioral intervention. The overall CVI obtained with the judges was 0.95.
Conclusion:
The ET presented content and appearance validity for health education regarding fatigue related to antineoplastic chemotherapy in outpatient cancer patients.
- Marcela Maria de Melo Perdigão
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ORIGINAL ARTICLE
Functional independence of elderly patients who fell: a follow-up study
Revista Brasileira de Enfermagem. 2019;72(6):1715-1722
10-21-2019
Abstract
ORIGINAL ARTICLEFunctional independence of elderly patients who fell: a follow-up study
Revista Brasileira de Enfermagem. 2019;72(6):1715-1722
10-21-2019DOI 10.1590/0034-7167-2018-0845
Views0See moreABSTRACT
Objective:
to evaluate, in emergency hospital service and at home, the functional independence of elderly people who fell.
Method:
longitudinal study with 151 elderly. Functional Independence Measure (FIM) was used. Statistical tests were performed with univariate and bivariate analysis.
Results:
mean of total FIM value in the hospital was 70.4; and at home 84.3 (p <0.001). Independence was lower in the motor domain, in “self-care”, “mobility” and “locomotion” dimensions, in the two evaluations (p <0.001). Dependence reduced from 97.3% elderly in the hospital to 82.8% at home (p <0.001). There was a negative correlation between total FIM and age, number of medications, number of diseases and hospitalization time in both evaluations. Femoral and hip fractures were associated with lower total FIM values (p <0.001).
Conclusion:
the elderly had less independence in the hospital compared to at home, with greater impairment in the motor domain and “self-care”, “mobility” and “locomotion” dimensions, in the two moments evaluated.
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ORIGINAL ARTICLE
Content validation of an educational booklet for asthma control and management in children
- Kamila Ferreira Lima ,
- Ana Lúcia Araújo Gomes ,
- Emanuella Silva Joventino Melo ,
- Flávia Ximenes Vasconcelos ,
- Janaina Landim de Sousa , [ … ],
- Lorena Pinheiro Barbosa
05-24-2021
Abstract
ORIGINAL ARTICLEContent validation of an educational booklet for asthma control and management in children
Revista Brasileira de Enfermagem. 2021;74:e20200353
05-24-2021DOI 10.1590/0034-7167-2020-0353
- Kamila Ferreira Lima ,
- Ana Lúcia Araújo Gomes ,
- Emanuella Silva Joventino Melo ,
- Flávia Ximenes Vasconcelos ,
- Janaina Landim de Sousa ,
- Mariana Cavalcante Martins ,
- Lorena Pinheiro Barbosa
Views0See moreABSTRACT
Objective:
to validate the content and appearance of the educational booklet “You can control your child’s asthma – let’s learn together?” with parents and caregivers of children with asthma.
Methods:
this is a methodological study, carried out with 34 mothers and caregivers of children, from two to 10 years old, diagnosed with asthma. The educational booklet validation was performed using Content Validity Index (CVI) and assessment of comprehension, attractiveness, self-efficacy, persuasion, and cultural acceptance domains.
Results:
the booklet was considered clear (99.8%) and relevant (100%), with a global CVI of 0.99. Domain assessment proved to be an easy-to-understand tool, culturally appropriate, attractive, with persuasive power and promoting self-efficacy.
Conclusion:
the booklet is valid and adequate for promoting the self-efficacy of parents and caregivers in childhood asthma control and management, potentially scalable to other realities of outpatient care.
- Kamila Ferreira Lima
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ORIGINAL ARTICLE
Care coordination and longitudinality in primary health care in the Brazilian Amazon
- Amanda Lia Rebelo Rabelo ,
- Rúbia Aparecida Lacerda ,
- Esron Soares Carvalho Rocha ,
- Juliana Gagno ,
- Marcia Cristina Rodrigues Fausto , [ … ],
- Maria Jacirema Ferreira Gonçalves
04-22-2020
Abstract
ORIGINAL ARTICLECare coordination and longitudinality in primary health care in the Brazilian Amazon
Revista Brasileira de Enfermagem. 2020;73(3):e20180841
04-22-2020DOI 10.1590/0034-7167-2018-0841
- Amanda Lia Rebelo Rabelo ,
- Rúbia Aparecida Lacerda ,
- Esron Soares Carvalho Rocha ,
- Juliana Gagno ,
- Marcia Cristina Rodrigues Fausto ,
- Maria Jacirema Ferreira Gonçalves
Views0ABSTRACT
Objectives:
to evaluate the attributes of primary health care, care coordination and longitudinality, from the perception of the professional and patients in the state of Amazonas, Brazil.
Methods:
quantitative evaluative study, in which was used an external evaluation instrument with 469 professionals and 1,888 patients from 367 primary health care facilities that adhered to the Program for Improving Access and Quality of primary health care (Portuguese acronym: PMAQ) standardized by the Ministry of Health. Data were grouped by multivariate cluster analysis in order to find a classification of primary health care from the perspective of professionals and patients.
Results:
the attributes of coordination and longitudinality are still expressed in a weak and undeveloped way in the Brazilian Amazon scenario.
Conclusions:
it is necessary to recognize the organizational barriers and what could promote conditions for the performance of health care teams in the perspective of a continuous, integral and coordinated care.
Keywords:Continuity of Patient CareHealth EvaluationHealth PolicyIntegrality in HealthPrimary Health CareSee more
- Amanda Lia Rebelo Rabelo
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