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ORIGINAL ARTICLE12-16-2023
Tangency and multiple factors of violence against lecturer: nuances of the experience in pedagogical practices in health education
- Angela Gilda Alves
, - Flaviane Cristina Rocha César ,
- Maria Alves Barbosa ,
- Lizete Malagoni de Almeida Cavalcante Oliveira ,
- Dolors Rodríguez-Martín , [ … ],
- Sara Oliveira Souza
Abstract
ORIGINAL ARTICLETangency and multiple factors of violence against lecturer: nuances of the experience in pedagogical practices in health education
Revista Brasileira de Enfermagem. 2023;76(1):e20210865
DOI 10.1590/0034-7167-2021-0865
- Angela Gilda Alves ,
- Flaviane Cristina Rocha César ,
- Maria Alves Barbosa ,
- Lizete Malagoni de Almeida Cavalcante Oliveira ,
- Dolors Rodríguez-Martín ,
- Edinamar Aparecida Santos da Silva ,
- Johnatan Martins Sousa ,
- Sara Oliveira Souza
Views0See moreABSTRACT
Objective:
to identify factors that lead the teacher to experience violence in their pedagogical practice in health education.
Method:
research with a qualitative approach, based on the Grounded Theory, conducted with 11 professors of the nursing course of a public university in the central region of Brazil in 2020 and 2021. Online semi-structured interviews were analyzed partially in the light of the Constructivist Grounded Theory.
Results:
factors that lead lecturer to experience violence are characterized by institutional culture, gender, professor’s perception of violence, and the triggers that drive students to commit violence. Social status and inequalities lead to positions of domination and, consequently, create a fertile ground for violence.
Final Considerations:
analyzing violence under Bourdieu’s theory, it is clear that student violence towards lecturer and the reports contained in this study deserve pedagogical reflection. However, it is necessary to include these discussions as a background in teaching environments.
- Angela Gilda Alves
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REVIEW12-16-2023
Educational interventions in child development and health literacy assumptions: an integrative review
- Rayara Medeiros Duarte Luz ,
- Dayana Cecília de Brito Marinho ,
- Ana Paula Esmeraldo Lima ,
- Maria Wanderleya Lavor Coriolano-Marinus
Abstract
REVIEWEducational interventions in child development and health literacy assumptions: an integrative review
Revista Brasileira de Enfermagem. 2023;76(1):e20220116
DOI 10.1590/0034-7167-2022-0116
- Rayara Medeiros Duarte Luz ,
- Dayana Cecília de Brito Marinho ,
- Ana Paula Esmeraldo Lima ,
- Maria Wanderleya Lavor Coriolano-Marinus
Views0See moreABSTRACT
Objectives:
to analyze scientific evidence in the literature that addresses educational interventions conducted by health professionals on early childhood development in a community context and to identify which health literacy assumptions are present during the implementation of interventions.
Method:
an integrative review in PubMed, CINAHL and Web of Science databases. Of 300 studies found, we selected 11 for the sample.
Results:
health professionals are trained to implement interventions with parents/caregivers to promote child development in community settings. Parents are encouraged to develop an environment that is encouraging and conducive to the development of their children. The main dimensions of health literacy found were access and apply.
Conclusion:
it confirms the importance of training health professionals, with skills and communicative skills to guide parents/caregivers to encourage the development of their children in their family environment with playful and interactive activities.
- Rayara Medeiros Duarte Luz
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ORIGINAL ARTICLE12-16-2023
Cardiac anxiety in the perioperative period of patients undergoing cardiac surgical procedures: an observational study
- Bruna Sonego Kazitani ,
- Letícia Mansano Martins ,
- Vitor Melz da Silva ,
- Paolla Algarte Fernandes ,
- Suellen Rodrigues de Oliveira Maier , [ … ],
- Carina Aparecida Marosti Dessotte
Abstract
ORIGINAL ARTICLECardiac anxiety in the perioperative period of patients undergoing cardiac surgical procedures: an observational study
Revista Brasileira de Enfermagem. 2023;76(1):e20220250
DOI 10.1590/0034-7167-2022-0250
- Bruna Sonego Kazitani ,
- Letícia Mansano Martins ,
- Vitor Melz da Silva ,
- Paolla Algarte Fernandes ,
- Suellen Rodrigues de Oliveira Maier ,
- Carina Aparecida Marosti Dessotte
Views0See moreABSTRACT
Objective:
to compare cardiac anxiety symptoms in patients undergoing coronary artery bypass graft and valve surgery repair in the preoperative period, on the day of hospital discharge and on the first return visit after hospital discharge.
Methods:
an observational study, carried out in inpatient units and in outpatient clinic of a university hospital. Data were collected through interviews. Cardiac anxiety symptoms were assessed using the Cardiac Anxiety Questionnaire.
Results:
we observed the effect of time on cardiac anxiety symptoms of patients undergoing coronary artery bypass graft in the total score and in the “Avoidance” domain at discharge and at the first return visit. In patients undergoing valve repair surgery, the effect of time on symptoms was observed only in the first return visit, when compared with the preoperative period.
Conclusion:
the findings revealed increased cardiac anxiety symptoms in the postoperative period, discharge and first return, when compared to the preoperative period.
- Bruna Sonego Kazitani
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ORIGINAL ARTICLE12-16-2023
School Nursing Guide for student health promotion: construction and validity
- Emanoel Avelar Muniz ,
- Maria Veraci Oliveira Queiroz ,
- Patrícia Neyva da Costa Pinheiro ,
- Maria Rocineide Ferreira da Silva ,
- Thereza Maria Magalhães Moreira , [ … ],
- Valter Cordeiro Barbosa Filho
Abstract
ORIGINAL ARTICLESchool Nursing Guide for student health promotion: construction and validity
Revista Brasileira de Enfermagem. 2023;76(1):e20220260
DOI 10.1590/0034-7167-2022-0260
- Emanoel Avelar Muniz ,
- Maria Veraci Oliveira Queiroz ,
- Patrícia Neyva da Costa Pinheiro ,
- Maria Rocineide Ferreira da Silva ,
- Thereza Maria Magalhães Moreira ,
- Eliany Nazaré Oliveira ,
- Isabelline Freitas Dantas Paiva de Almeida ,
- Valter Cordeiro Barbosa Filho
Views0See moreABSTRACT
Objectives:
to describe the process of construction and validity of a School Nursing Guide for student health promotion.
Methods:
a methodological study, carried out from February to December 2021, composed of Convergent Care Research based on Pender’s Health Promotion Model. Based on the literature and dialogue with 11 nurses in the seven online focus groups, actions were constructed. Subsequently, 24 judges assessed content and appearance.
Results:
the guide proposes strategies for developing school nursing practices focusing on health promotion. The Appearance Validity Index ranged from 0.63 to 1.0, and the total was 0.84. The Content Validity Index ranged from 0.95 to 1.0, and the total was 0.997.
Conclusions:
the guide incorporated the needs of young people recognized by professionals, and the assessment phase confirms its validity, and can be used in the context of practice with young people.
- Emanoel Avelar Muniz
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12-16-2023
Fatores psicossociais correlacionados com a intenção comportamental das pessoas com diabetes mellitus tipo 2 (DM2) para uso de insulina
- Bernadete de Lourdes André Gouveia ,
- Mailson Marques de Sousa ,
- Taciana da Costa Farias Almeida ,
- Wallison Pereira dos Santos ,
- Danilo Donizetti Trevizan , [ … ],
- Simone Helena dos Santos Oliveira
Abstract
Fatores psicossociais correlacionados com a intenção comportamental das pessoas com diabetes mellitus tipo 2 (DM2) para uso de insulina
Revista Brasileira de Enfermagem. 2023;76(1):e20210617
DOI 10.1590/0034-7167-2021-0617
- Bernadete de Lourdes André Gouveia ,
- Mailson Marques de Sousa ,
- Taciana da Costa Farias Almeida ,
- Wallison Pereira dos Santos ,
- Danilo Donizetti Trevizan ,
- Maria Júlia Guimarães Oliveira Soares ,
- Simone Helena dos Santos Oliveira
Views0See moreRESUMEN
Objetivos:
analizar los factores psicosociales correlacionados con la intención conductal de personas con diabetes mellitus tipo 2 (DM2) para uso de insulina.
Métodos:
estudio transversal. Instrumento validado basado en la Teoría de Conducta Planeada fue utilizada para identificar las medidas directas (actitud, norma subjetiva y control percibido), medidas indirectas (creencias conductuales, normativas y de control) e intención conductal para uso de insulina. Análisis descriptivo y correlación de Spearman fueron realizados para el análisis de datos.
Resultados:
un total de 211 individuos participaron del estudio, con una mediana positiva de intención conductal. Actitud, creencias normativas y conductuales fueron los predictores que presentaron una correlación significante (r=0,16, r=-0,15 y r=0,25, respectivamente; p<0,05) con la intención.
Conclusiones:
hay una intención conductal positiva en el uso de insulina por personas con DM2. Actitud, creencias Normativas y creencias conductuales tienen una correlación de baja magnitud con la intención de personas con DM2 de usar insulina.
- Bernadete de Lourdes André Gouveia
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ORIGINAL ARTICLE12-08-2023
Polypharmacy, potentially inappropriate medications and associated factors among older adults with hypertension in primary care
- Carine Teles Sangaleti ,
- Maicon Henrique Lentsck ,
- Dannyele Cristina da Silva ,
- Andrielli Machado ,
- Maria Regiane Trincaus , [ … ],
- Fernanda Marciano Consolim Colombo
Abstract
ORIGINAL ARTICLEPolypharmacy, potentially inappropriate medications and associated factors among older adults with hypertension in primary care
Revista Brasileira de Enfermagem. 2023;76:e20220785
DOI 10.1590/0034-7167-2022-0785
- Carine Teles Sangaleti ,
- Maicon Henrique Lentsck ,
- Dannyele Cristina da Silva ,
- Andrielli Machado ,
- Maria Regiane Trincaus ,
- Maria Cristina Umpierrez Vieira ,
- Bruno Bordin Pelazza ,
- Fernanda Marciano Consolim Colombo
Views0See moreABSTRACT
Objective:
to identify the prevalence and associations of polypharmacy and potentially inappropriate medication use among older adults with hypertension treated in primary care.
Methods:
a cross-sectional study carried out with older adults with hypertension treated at a Family Health Strategy unit. Data collection included analysis of medical records, interviews and multidimensional assessment of older adults. Socio-demographic information and clinical variables were collected. Statistical analysis was performed by multiple logistic regression.
Results:
polypharmacy prevalence was 38.09%, and potentially inappropriate medication (PIM), 28.57%. There was a significant association between polypharmacy and PIM use, altered sleep and ethnicity. PIM use was associated with polypharmacy, worse family functioning, and absence of a caregiver. Cognitive decline reduces the prevalence of these medications.
Conclusions:
polypharmacy and PIM use among older adults with hypertension represent a problem in this population, especially among the most vulnerable.
- Carine Teles Sangaleti
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ORIGINAL ARTICLE12-08-2023
Care for older adults with disabilities in Long Term Care Facility
- Isadora Queiroz Correa Garchet Furtado ,
- Isabela Silva Cancio Velloso ,
- Carolina Salles Galdino ,
- Alexandre de Pádua Carrieri
Abstract
ORIGINAL ARTICLECare for older adults with disabilities in Long Term Care Facility
Revista Brasileira de Enfermagem. 2023;76:e20220767
DOI 10.1590/0034-7167-2022-0767
- Isadora Queiroz Correa Garchet Furtado ,
- Isabela Silva Cancio Velloso ,
- Carolina Salles Galdino ,
- Alexandre de Pádua Carrieri
Views0See moreABSTRACT
Objective:
to analyze the constitution of care offered to older adults with disabilities, from Long Term Care Facility professionals’ perspective.
Methods:
this is a discourse analysis based on the post-structuralist framework. Participants in this study are professionals involved in the care for older adults, totaling 14 respondents, 13 women and one man.
Results:
from professionals’ perspective, there is a fine line between caring for older adults with disabilities and maintaining their autonomy. Care in which autonomy is restricted predisposes older adults to a process of dependency.
Final considerations:
caring for older adults with disabilities constitutes the challenge between caring and maintaining independence. Thus, older adult-centered care should be taken as a premise so that their individualities are respected.
- Isadora Queiroz Correa Garchet Furtado
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ORIGINAL ARTICLE12-08-2023
Fear of COVID-19 when experiencing pregnancy or childbirth in the pandemic: what are the associated factors?
- Ana Júlia de Paula ,
- Paulo César Condeles ,
- Jéssica Aparecida da Silva ,
- Luciano Marques dos Santos ,
- Luciana Mara Monti Fonseca , [ … ],
- Monika Wernet
Abstract
ORIGINAL ARTICLEFear of COVID-19 when experiencing pregnancy or childbirth in the pandemic: what are the associated factors?
Revista Brasileira de Enfermagem. 2023;76:e20220755
DOI 10.1590/0034-7167-2022-0755
- Ana Júlia de Paula ,
- Paulo César Condeles ,
- Jéssica Aparecida da Silva ,
- Luciano Marques dos Santos ,
- Luciana Mara Monti Fonseca ,
- Mariana Torreglosa Ruiz ,
- Monika Wernet
Views0See moreABSTRACT
Objective:
to identify factors associated with fear of COVID-19 among women who experienced pregnancy or childbirth during the pandemic.
Methods:
a cross-sectional study, nested within a prospective cohort, using an online survey, from August 2021 to February 2022, based on descriptive data analysis.
Results:
of the 431 participants, 52.8% were postpartum women and 20.1% were pregnant women. With regard to fear of COVID-19, a mean score of 20.46 was obtained (moderate fear). The highest fear scores were present in women whose newborns were admitted to hospital in neonatal critical units (p=0.032), and the lowest among those covered by supplementary health (insurance) (p=0.016).
Conclusion:
among pregnant and postpartum women, high fear of COVID-19 translated into the possibility of having newborns admitted to hospital in a critical unit. The importance of supporting actions to support pregnant/postpartum women’s mental health in relation to COVID-19 or other threats that may influence the neonatal outcome stands out.
- Ana Júlia de Paula
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ORIGINAL ARTICLE12-07-2020
Sarcopenia screening in elderly in primary health care: nurse knowledge and practices
- Rutielle Ferreira Silva ,
- Maria do Livramento Fortes Figueiredo ,
- Juan José Tirado Darder ,
- Ana Maria Ribeiro dos Santos ,
- Maria Antonieta Rubio Tyrrell
Abstract
ORIGINAL ARTICLESarcopenia screening in elderly in primary health care: nurse knowledge and practices
Revista Brasileira de Enfermagem. 2020;73:e20200421
DOI 10.1590/0034-7167-2020-0421
- Rutielle Ferreira Silva ,
- Maria do Livramento Fortes Figueiredo ,
- Juan José Tirado Darder ,
- Ana Maria Ribeiro dos Santos ,
- Maria Antonieta Rubio Tyrrell
Views0See moreABSTRACT
Objective:
Describe the knowledge and practices of the Primary Health Care nurse on sarcopenia screening in the elderly.
Methods:
Qualitative study conducted with 24 Primary Health Care nurses. The data was collected through semi-structured interviews, recorded and later transcribed. The speeches were grouped in thematic categories, later analyzed, supported by Paulo Freire’s reference.
Results:
The findings showed that the primary care nurses’ knowledge of sarcopenia screening in the elderly was incipient and fragile. This reality is reflected in a gap in practice, although some instruments already require the registration of characteristics indicative of sarcopenia, such as the evaluation of the calf circumference.
Final Considerations:
The need to train nurses to perform sarcopenia screening and to implement a promotional and preventive care plan, which will result in improving the quality of life of the elderly assisted in Primary Care, was highlighted.
- Rutielle Ferreira Silva
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ORIGINAL ARTICLE02-17-2020
Social network of children with cronic disease: knowledge and practice of nursing
Revista Brasileira de Enfermagem. 2020;73(2):e20180371
Abstract
ORIGINAL ARTICLESocial network of children with cronic disease: knowledge and practice of nursing
Revista Brasileira de Enfermagem. 2020;73(2):e20180371
DOI 10.1590/0034-7167-2018-0371
Views0See moreABSTRACT
Objectives:
To identify the knowledge and practice of primary care nurses about the social network approach for families of children with chronic diseases.
Methods:
Qualitative research, conducted by means of interviews with 23 family health nurses, from one municipality in Paraíba and one in Rio de Janeiro, from June to July of 2017. The data were interpreted using thematic analysis.
Results:
Social network meant institutional support offered by services outside the unit, and socioeconomic problems involved the family context. In practice, nurses find it difficult to provide comprehensive care and establish ties with families. When referring to other professionals, a weakness in the counter-referral to the family health unit is found.
Final considerations:
Some gaps were found regarding the knowledge and practice of nurses regarding the social network approach, which requires professional training to strengthen social relationships and the necessary support for families of children with chronic diseases.
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ORIGINAL ARTICLE10-21-2019
Inclusion of mental health in primary health care: care strategy in the territory
Revista Brasileira de Enfermagem. 2019;72(6):1677-1682
Abstract
ORIGINAL ARTICLEInclusion of mental health in primary health care: care strategy in the territory
Revista Brasileira de Enfermagem. 2019;72(6):1677-1682
DOI 10.1590/0034-7167-2018-0806
Views0See moreABSTRACT
Objective:
To analyze the strategies, challenges and possibilities of the articulation between mental health and primary health care from the perspective of health managers.
Method:
Exploratory, qualitative research carried out with 28 managers of mental health and primary care. The data were collected through semi-structured interviews between July and November 2013 and submitted to thematic content analysis.
Results:
The inclusion of mental health actions in primary care made it possible, in the view of managers, to increase users’ access to the care they need. This care strategy allows the extension of care practices in the territory, with matrix support as the main tool for the implementation of this care strategy.
Final considerations:
The articulation between primary care and mental health is a powerful device for psychosocial care, but it demands a new conformation of the Psychosocial Care Centers (Caps) and primary care services.
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06-11-2021
Prevention of facial injuries caused by personal protective equipment during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2021;74:e20201219
Abstract
Prevention of facial injuries caused by personal protective equipment during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2021;74:e20201219
DOI 10.1590/0034-7167-2020-1219
Views0See moreABSTRACT
Objective:
Develop and validate a leaflet to guide health professionals in preventive measures related to injuries caused by the use of personal protective equipment during the COVID-19 pandemic.
Methods:
For the construction of the brochure, an integrative review was carried out in the main databases. The evaluation of the leaflet was made by 59 health professionals (nurses, physiotherapists, and doctors), using the Delphi technique.
Results:
In the first evaluation cycle, the items in the brochure were considered by the judges to be “inadequate” to “adequate”; the Content Validity Index was 0.80-1.0. After the adjustments suggested by the judges were implemented, the leaflet was sent back to the second evaluation cycle, in which all items were considered “adequate”, resulting in a Content Validity Index of 1.0.
Conclusion:
The developed brochure has content validity and can assist health professionals in preventing injuries caused by the use of personal protective equipment the developed brochure has content validity and can assist health professionals in preventing injuries caused by the use of personal protective equipment.
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ORIGINAL ARTICLE07-08-2020
Self-efficacy in elderly with type 2 Diabetes Mellitus
- Mariana Campos de Sousa ,
- Bruna Stephanie Sousa Malaquias ,
- Suzel Regina Ribeiro Chavaglia ,
- Rosali Isabel Barduchi Ohl ,
- Fabiana Fernandes Silva de Paula , [ … ],
- Álvaro da Silva Santos
Abstract
ORIGINAL ARTICLESelf-efficacy in elderly with type 2 Diabetes Mellitus
Revista Brasileira de Enfermagem. 2020;73:e20180980
DOI 10.1590/0034-7167-2018-0980
- Mariana Campos de Sousa ,
- Bruna Stephanie Sousa Malaquias ,
- Suzel Regina Ribeiro Chavaglia ,
- Rosali Isabel Barduchi Ohl ,
- Fabiana Fernandes Silva de Paula ,
- Karina Santos da Silva ,
- Álvaro da Silva Santos
Views0See moreABSTRACT
Objective:
to analyze the self-efficacy of elderly with type 2 diabetes mellitus and the relationship with sociodemographic, clinical, knowledge, and attitude variables.
Method:
a cross-sectional quantitative study conducted with 256 elderly people enrolled in Family Health Strategies. Data were obtained through interviews. Descriptive statistical analysis and multiple linear regression model were performed (p <0.05).
Results:
female, 69.95-year mean age, white skin color, 4-7 years of schooling, living with a partner, retirees, low individual monthly income, 6 to 15 years of illness, Catholics, living with children (with or without spouse). The elderly’s low knowledge and negative attitude prevailed. Self-efficacy was associated with attitude and knowledge in the domains “General and Specific Diet”, “Physical Exercise” and “Blood Glucose”.
Conclusion:
self-efficacy investigations in type 2 Diabetes Mellitus management in the elderly are important and encourage treatment adherence.
- Mariana Campos de Sousa
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ORIGINAL ARTICLE09-16-2019
Knowledge of nursing student on the prevention of sexually transmitted infections
Revista Brasileira de Enfermagem. 2019;72(5):1145-1152
Abstract
ORIGINAL ARTICLEKnowledge of nursing student on the prevention of sexually transmitted infections
Revista Brasileira de Enfermagem. 2019;72(5):1145-1152
DOI 10.1590/0034-7167-2017-0801
Views0See moreABSTRACT
Objective:
To identify the knowledge and self-care actions taken by nursing undergraduate students of a Federal University of the South of Brazil, against Sexually Transmitted Infections.
Method:
Exploratory qualitative study, conducted 40 interviews with undergraduate students at the beginning and end of the course. The analysis was thematic, resulting in three categories.
Results:
Knowledge about the subject is a decisive factor for self-care, and the more knowledge, the greater the prevention. The dissemination of knowledge of students at the end of the course not only influences self-care but also health promotion in the social sphere.
Final considerations:
Knowledge is important in self-care and caring for others. The dissemination of knowledge becomes evident according to the complexity of the course. Stable relationships may interfere with the use or disuse of condoms in sexual relationships, a misnomer present in today’s society.
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REFLECTION09-29-2022
Health care of deaf persons during coronavirus pandemics
Revista Brasileira de Enfermagem. 2022;75:e20201036
Abstract
REFLECTIONHealth care of deaf persons during coronavirus pandemics
Revista Brasileira de Enfermagem. 2022;75:e20201036
DOI 10.1590/0034-7167-2020-1036
Views0See moreABSTRACT
Objective:
To reflect about the barriers experienced by the deaf population during the COVID-19 pandemic, the proposals to overcome communication barriers in health care and the role of public policies in effecting the social inclusion of deaf people.
Methods:
Reflection based on studies on health care for deaf people, the COVID-19 pandemic and public accessibility policies.
Results:
The global crisis of COVID-19 has deepened pre-existing inequalities in the world, in addition to highlighting the vulnerability of people with disabilities, including deaf. Government, institutional and social initiatives to mitigate difficulties in communicating to deaf people have been made, but they are still insufficient to guarantee protection for them in this pandemic and full inclusion in health care.
Final considerations:
Social inclusion, supported by law, and the linguistic accessibility of deaf people still need to generate broad and concrete actions so that deaf people can enjoy their rights as citizens.
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EXPERIENCE REPORT08-19-2019
PLISSIT model: sexual counseling for breast cancer survivors
- Natália Gondim de Almeida ,
- Débora Fernandes Britto ,
- Juliana Vieira Figueiredo ,
- Thereza Maria Magalhães Moreira ,
- Rhanna Emanuela Fontenele Lima de Carvalho , [ … ],
- Ana Virgínia de Melo Fialho
Abstract
EXPERIENCE REPORTPLISSIT model: sexual counseling for breast cancer survivors
Revista Brasileira de Enfermagem. 2019;72(4):1109-1113
DOI 10.1590/0034-7167-2018-0525
- Natália Gondim de Almeida ,
- Débora Fernandes Britto ,
- Juliana Vieira Figueiredo ,
- Thereza Maria Magalhães Moreira ,
- Rhanna Emanuela Fontenele Lima de Carvalho ,
- Ana Virgínia de Melo Fialho
Views0See moreABSTRACT
Objective:
Reporting the experience of use of the PLISSIT model as tool for the nursing care of breast cancer survivors with sexual dysfunction.
Method:
case study developed from January to August 2017, in the outpatient mastology clinic and sexuality service of a maternity in Fortaleza, Ceará, Brazil, with 15 breast cancer survivors.
Results:
sexual counseling sessions were conducted using the PLISSIT model to address sexual issues, highlighting the particularities of women who experience survival after the treatment of breast cancer.
Final considerations:
the model used in the practice of nursing care is customary and allows identifying issues experienced by women, as it has easy availability and practicality for use by nursing professionals, helping to address sexual matters with greater tranquility.
- Natália Gondim de Almeida
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