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ORIGINAL ARTICLE08-26-2024
Factors associated with COVID-19 death in pregnant women hospitalized in Intensive Care Units
- Milena Ricioli Ribeiro
, - Marcela de Andrade Pereira Silva ,
- Leticia Furlan de Lima Prates ,
- Rosana Rosseto de Oliveira ,
- Maria Dalva de Barros Carvalho , [ … ],
- Sandra Marisa Pelloso
Abstract
ORIGINAL ARTICLEFactors associated with COVID-19 death in pregnant women hospitalized in Intensive Care Units
Revista Brasileira de Enfermagem. 2024;77(5):e20230172
DOI 10.1590/0034-7167-2023-0172
- Milena Ricioli Ribeiro ,
- Marcela de Andrade Pereira Silva ,
- Leticia Furlan de Lima Prates ,
- Rosana Rosseto de Oliveira ,
- Maria Dalva de Barros Carvalho ,
- Sandra Marisa Pelloso
Views0See moreABSTRACT
Objectives:
to evaluate the factors associated with COVID-19 death in pregnant women hospitalized in Intensive Care Units in Brazil.
Methods:
this ecological study was conducted using secondary data from Brazilian pregnant women with COVID-19 hospitalized in Intensive Care Units between March 2020 and March 2022. Univariate analysis and logistic regression were employed.
Results:
out of 3,547 pregnant women with COVID-19 hospitalized in Intensive Care Units, 811 died (22.8%). It was found that lack of COVID-19 vaccination (OR: 2.73; 95% CI: 1.83; 4.04), dyspnea (OR: 1.73; 95% CI: 1.17; 2.56), obesity (OR: 1.51; 95% CI: 1.05; 2.17), chronic cardiovascular disease (OR: 1.65; 95% CI: 1.14; 2.38), and non-white race/color (OR: 1.29; 95% CI: 1.00; 1.66) were independently and significantly associated with death.
Conclusions:
it is concluded that vaccination status, presence of comorbidities, and clinical and ethnic-racial characteristics are associated with COVID-19 death in pregnant women hospitalized in Intensive Care Units in Brazil.
- Milena Ricioli Ribeiro
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ORIGINAL ARTICLE08-26-2024
Influence of the leukoreduction moment of blood components on the clinical outcomes of transfused patients in the emergency department
- Natasha Dejigov Monteiro da Silva ,
- Ana Catharina Herbst ,
- Milena Raquel André ,
- Lilia de Souza Nogueira
Abstract
ORIGINAL ARTICLEInfluence of the leukoreduction moment of blood components on the clinical outcomes of transfused patients in the emergency department
Revista Brasileira de Enfermagem. 2024;77(5):e20230293
DOI 10.1590/0034-7167-2023-0293
- Natasha Dejigov Monteiro da Silva ,
- Ana Catharina Herbst ,
- Milena Raquel André ,
- Lilia de Souza Nogueira
Views0See moreABSTRACT
Objectives:
to investigate the influence of the leukoreduction moment (preor post-storage) of blood components on the clinical outcomes of patients transfused in the emergency department.
Methods:
retrospective cohort study of patients aged 18 years or older who received preor post-storage leukoreduced red blood cell or platelet concentrate in the emergency department and remained in the institution for more than 24 hours. A generalized mixed-effects model was applied in the analyses.
Results:
in a sample of 373 patients (63.27% male, mean age 54.83) and 643 transfusions (69.98% red blood cell), it was identified that the leukoreduction moment influenced the length of hospital stay (p<0.009), but was not dependent on the transfused blood component (p=0.124). The leukoreduction moment had no effect (p>0.050) on transfusion reactions, healthcare-associated infections, or mortality.
Conclusions:
patients who received pre-storage leukoreduced blood components in the emergency department had a shorter length of hospital stay.
- Natasha Dejigov Monteiro da Silva
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ORIGINAL ARTICLE08-26-2024
Leadership styles and personal values of professors at a school of nursing
- Chennyfer Dobbins Abi Rached ,
- Bianca Batista de Siqueira ,
- Bruna Franco Massa ,
- Caroline da Silva Fonseca Paulo ,
- Sofia de Souza Cruz
Abstract
ORIGINAL ARTICLELeadership styles and personal values of professors at a school of nursing
Revista Brasileira de Enfermagem. 2024;77(5):e20230333
DOI 10.1590/0034-7167-2023-0333
- Chennyfer Dobbins Abi Rached ,
- Bianca Batista de Siqueira ,
- Bruna Franco Massa ,
- Caroline da Silva Fonseca Paulo ,
- Sofia de Souza Cruz
Views0See moreABSTRACT
Objectives:
to identify professors’ leadership styles and personal values.
Methods:
a quantitative, descriptive-exploratory study. Population was made up of professors in doctoral category 1 at a public university in the state of São Paulo. Data collection took place from June to August 2021. Sociodemographic characterization was extracted, and the Leadership Team Values Assessment was applied. Data were analyzed using measures of central tendency.
Results:
population included 13 professors. The level that represents authentic leadership was the most prevalent. The commitment, positive attitude and trust values stood out. The level portrayed by visionary leadership was the least identified.
Conclusions:
professors’ personal values provide a theoretical basis for guiding and analyzing professors’ leadership styles. Leadership in the educational context must be recognized and studied to promote a more comprehensive and effective approach to developing and improving educational leaders.
- Chennyfer Dobbins Abi Rached
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EDITORIAL08-19-2024
Sexual abuse, abortion and public health in Brazil: when moral judgment accentuates inequities
- Ricardo de Mattos Russo Rafael ,
- Livia Angeli-Silva ,
- Ivone Evangelista Cabral ,
- Roberta Georgia Sousa dos Santos
Abstract
EDITORIALSexual abuse, abortion and public health in Brazil: when moral judgment accentuates inequities
Revista Brasileira de Enfermagem. 2024;77:e77suppl0401
DOI 10.1590/0034-7167.202477suppl0401
- Ricardo de Mattos Russo Rafael ,
- Livia Angeli-Silva ,
- Ivone Evangelista Cabral ,
- Roberta Georgia Sousa dos Santos
Views0Here is an academic-political editorial that aims to call on the scientific field to reflect on the dangers of decisions regarding the right to abortion under moral rules, since there is no evidence that such a perspective translates into practices of care, protection of childhood and gender equity – elements that are so urgent and […]See more - Ricardo de Mattos Russo Rafael
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ORIGINAL ARTICLE08-19-2024
Bioethical issues in the family health strategy: Considerations for nursing care management
- Ieda Carla Almeida dos Santos de Souza Pastana ,
- Gabriela Arantes Wagner ,
- Geisa Colebrusco de Souza Gonçalves ,
- Mariana Cabral Schveitzer
Abstract
ORIGINAL ARTICLEBioethical issues in the family health strategy: Considerations for nursing care management
Revista Brasileira de Enfermagem. 2024;77:e20220818
DOI 10.1590/0034-7167-2022-0818
- Ieda Carla Almeida dos Santos de Souza Pastana ,
- Gabriela Arantes Wagner ,
- Geisa Colebrusco de Souza Gonçalves ,
- Mariana Cabral Schveitzer
Views0See moreABSTRACT
Objective:
To understand the bioethical issues involved in the care management of nurses working in the Family Health Strategy.
Method:
A qualitative study was conducted through five focus groups with 36 nurses selected in the sample. Thematic content analysis was performed based on the bioethical framework, and the synthesis was presented in a conceptual map.
Results:
Bioethical issues were identified in the nursing care practice, related to both specific bioethical themes and the peculiarities of the work. Additionally, challenges and facilitators that interfere with addressing these issues were identified.
Final considerations:
Understanding the bioethical issues involved in the care management of nurses was possible with the theoretical support of different bioethical perspectives. The identified issues relate to persistent and current themes in the field of bioethics. However, some aspects intrinsic to daily practice are still imperceptible to professionals, contributing to the difficulty of discussing bioethics in this care model.
- Ieda Carla Almeida dos Santos de Souza Pastana
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ORIGINAL ARTICLE08-19-2024
The use of individual tracking programs in public health: a bioethics dilemma
- Ricardo Jardim Neiva ,
- João Felício Rodrigues Neto ,
- Ana Paula Oliveira Nascimento Alves ,
- Patrícia de Sousa Fernandes Queiroz ,
- Leila das Graças Siqueira , [ … ],
- Renê Ferreira da Silva-Júnior
Abstract
ORIGINAL ARTICLEThe use of individual tracking programs in public health: a bioethics dilemma
Revista Brasileira de Enfermagem. 2024;77:e20230041
DOI 10.1590/0034-7167-2023-0041
- Ricardo Jardim Neiva ,
- João Felício Rodrigues Neto ,
- Ana Paula Oliveira Nascimento Alves ,
- Patrícia de Sousa Fernandes Queiroz ,
- Leila das Graças Siqueira ,
- Clara Cynthia Melo e Lima ,
- Francisca Souza Santos Dias ,
- Renê Ferreira da Silva-Júnior
Views0See moreABSTRACT
Objective:
to understand the bioethical perspectives on mobile tracking device use.
Methods:
theoretical study based on action research, carried out with eight graduate students from a public university. A focus group was used, with a thematic content analysis methodology with a codebook structure, approved by the Research Ethics Committee.
Results:
from the analysis, there was a concern about using devices after the pandemic ended. Using or not the device, rights inherent to humans, legislation and effectiveness of methods deepen interpretations, moving participants from a personalistic conception of the topic to a vision focused on professional implications about the methods.
Final considerations:
the debate on the impact of using technological devices on health, especially those that imply restriction of rights that refer to individuals’ private life, involves a discussion of a professional nature, in addition to requirement for clear rules on the topic.
- Ricardo Jardim Neiva
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08-19-2024
Abuso sexual, aborto y salud pública en Brasil: cuando el juicio moral acentúa las inequidades
- Ricardo de Mattos Russo Rafael ,
- Livia Angeli-Silva ,
- Ivone Evangelista Cabral ,
- Roberta Georgia Sousa dos Santos
Abstract
Abuso sexual, aborto y salud pública en Brasil: cuando el juicio moral acentúa las inequidades
Revista Brasileira de Enfermagem. 2024;77:e77suppl0401
DOI 10.1590/0034-7167.202477suppl0401es
- Ricardo de Mattos Russo Rafael ,
- Livia Angeli-Silva ,
- Ivone Evangelista Cabral ,
- Roberta Georgia Sousa dos Santos
Views0He aquí un editorial académico-político que pretende convocar al campo científico a reflexionar sobre los peligros de decisiones sobre el derecho al aborto bajo reglas morales, ya que no hay evidencia de que tal perspectiva se traduzca en prácticas de cuidado, protección infantil y equidad de género, elementos tan urgentes y necesarios para la enfermería. […]See more - Ricardo de Mattos Russo Rafael
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08-19-2024
Abuso sexual, aborto e saúde pública no brasil: quando o julgamento moral acentua as iniquidades
- Ricardo de Mattos Russo Rafael ,
- Livia Angeli-Silva ,
- Ivone Evangelista Cabral ,
- Roberta Georgia Sousa dos Santos
Abstract
Abuso sexual, aborto e saúde pública no brasil: quando o julgamento moral acentua as iniquidades
Revista Brasileira de Enfermagem. 2024;77:e77suppl0401
DOI 10.1590/0034-7167.202477suppl0401pt
- Ricardo de Mattos Russo Rafael ,
- Livia Angeli-Silva ,
- Ivone Evangelista Cabral ,
- Roberta Georgia Sousa dos Santos
Views0Eis aqui um editorial acadêmico-político que tem como objetivo convocar o campo científico a refletir sobre os perigos das decisões relativas ao direito ao aborto sob réguas morais, uma vez que não há evidências de que tal perspectiva se traduza em práticas de cuidado, proteção à infância e equidade de gênero – elementos tão urgentes […]See more - Ricardo de Mattos Russo Rafael
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08-19-2019
Humor intervention in the nurse-patient interaction
- Luis Manuel Mota Sousa ,
- Cristina Maria Alves Marques-Vieira ,
- Ana Vanessa Antunes ,
- Maria de Fátima Graça Frade ,
- Sandy Pedro Silva Severino , [ … ],
- Olga Sousa Valentim
Abstract
Humor intervention in the nurse-patient interaction
Revista Brasileira de Enfermagem. 2019;72(4):1078-1085
DOI 10.1590/0034-7167-2018-0609
- Luis Manuel Mota Sousa ,
- Cristina Maria Alves Marques-Vieira ,
- Ana Vanessa Antunes ,
- Maria de Fátima Graça Frade ,
- Sandy Pedro Silva Severino ,
- Olga Sousa Valentim
Views0ABSTRACT
Objective:
To describe the factors influencing the use of humor in nursing care, its applicability and benefits.
Method:
A scoping review was performed using the Arksey and O’Mally methodology. A search for articles published between 2008 and 2018 was performed using the platforms EBSCO Host, Virtual Health Library and Google Scholar.
Results:
From the initial 465 articles found, 17 were included for final revision. Data allowed to retrieve information on humor definition; its applicability as a nursing intervention; humor as a tool to improve nurse-patient communication and relationship; influence factors; type of humor interventions; humor benefits in health care context and; limitations and precautions of humor intervention.
Conclusion:
The use of humor promotes both communication and human interaction; it promotes well-being; helps deal/cope with difficult and unpleasant situations, reduces tension, discomfort and stress; and strengthens the immune system. This intervention should be used with caution.
Keywords:CommunicationNurse-Patient RelationsNursingPatient Outcome AssessmentWit and Humor as SubjectSee more
- Luis Manuel Mota Sousa
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ORIGINAL ARTICLE10-21-2019
Workloads and burnout of nursing workers
- Deciane Pintanela de Carvalho ,
- Laurelize Pereira Rocha ,
- Eliana Cardia de Pinho ,
- Jamila Geri Tomaschewski-Barlem ,
- Edison Luiz Devos Barlem , [ … ],
- Leonardo Salomão Goulart
Abstract
ORIGINAL ARTICLEWorkloads and burnout of nursing workers
Revista Brasileira de Enfermagem. 2019;72(6):1435-1441
DOI 10.1590/0034-7167-2017-0659
- Deciane Pintanela de Carvalho ,
- Laurelize Pereira Rocha ,
- Eliana Cardia de Pinho ,
- Jamila Geri Tomaschewski-Barlem ,
- Edison Luiz Devos Barlem ,
- Leonardo Salomão Goulart
Views0See moreABSTRACT
Objective:
to identify workloads in nursing work and its association with nursing worker burnout.
Method:
a cross-sectional study, including 211 nursing workers from a university hospital, between July and August 2016. For the analysis, the descriptive statistics, Chi-Square Test, Fisher’s Exact Test and Mann Whitney U-Test were used.
Results:
the most evidenced loads were biological. A significant association was found between workloads and workers’ occupation, as well as a significant association between workloads and worker burnout. Burnout caused upper limb pain, neck and lumbar pain, lower limb pain, muscle spasm, lower limb edema, mental fatigue, headache, nervousness, and forgetfulness.
Conclusion:
workloads identification is a subsidy for the promotion of interventions that minimize the burnout generated to the health of the nursing worker.
- Deciane Pintanela de Carvalho
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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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ORIGINAL ARTICLE07-13-2020
Incontinence-associated dermatitis in elderly patients: prevalence and risk factors
- Mariana Ferreira ,
- Luciana Abbade ,
- Silvia Cristina Mangini Bocchi ,
- Hélio Amante Miot ,
- Paulo Villas Boas , [ … ],
- Heloísa Quatrini Carvalho Passos Guimaraes
Abstract
ORIGINAL ARTICLEIncontinence-associated dermatitis in elderly patients: prevalence and risk factors
Revista Brasileira de Enfermagem. 2020;73:e20180475
DOI 10.1590/0034-7167-2018-0475
- Mariana Ferreira ,
- Luciana Abbade ,
- Silvia Cristina Mangini Bocchi ,
- Hélio Amante Miot ,
- Paulo Villas Boas ,
- Heloísa Quatrini Carvalho Passos Guimaraes
Views0See moreABSTRACT
Objective:
To determine the prevalence and risk factors for incontinence-associated dermatitis in the elderly.
Method:
Cross-sectional exploratory study carried out in public hospitals. The dermatitis prevalence and associations were obtained by calculating the ratio. The effect dimension was estimated by the odds ratio with a 95% confidence interval and statistical significance p <0.05.
Results:
138 elderly people were included, with an average age of 77.2 years old (± 9.3); 69 (50%) had combined fecal and urinary incontinence. The dermatitis prevalence was 36.2% (50); 28% (14) had pressure injuries; 14% (7), candidiasis. Risk factors were: longer hospital stay (Odds Ratio = 5.8 [2.6-12.9]), obesity (Odds Ratio = 3.6 [1.2-10.4]), high level of dependence (Odds Ratio = 2.4 [1,1-5,0]) and high risk for pressure injury (Odds Ratio = 6.1 [1,4-26,9]).
Conclusion:
The study found a high prevalence of dermatitis associated with incontinence. The early recognition of risk factors favors effective preventive actions.
- Mariana Ferreira
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08-19-2019
Clinical simulation in nursing education in intensive therapy: an integrative review
Revista Brasileira de Enfermagem. 2019;72(4):1061-1070
Abstract
Clinical simulation in nursing education in intensive therapy: an integrative review
Revista Brasileira de Enfermagem. 2019;72(4):1061-1070
DOI 10.1590/0034-7167-2018-0217
Views0See moreABSTRACT
Objective:
to analyze the publications on clinical simulation practices for education in Nursing in Intensive Care.
Method:
an integrative review carried out through LILACS, PubMed, Cochrane Library, CINAHL and SciELO databases, of articles published from 2008 to 2017.
Results:
29 articles were selected, of which 76% discuss the use of simulation in continuing education of nursing professionals, while the others describe their use for student education. There is a higher prevalence of studies with a level of evidence 6 (17), with 28 international publications. There was an increase in scientific production, with 16 articles published in the last three years.
Conclusion:
variables after simulation use, such as confidence, communication skills, efficiency in the identification of clinical worsening of patients, development of technical skills, teamwork and clinical decision-making, presented a significant improvement, demonstrating that this tool is effective in qualifying care for critical patients.
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01-20-2021
Burnout Syndrome and Associated Factors in Intensive Care Unit Nurses
- Núbia Samara Caribé de Aragão ,
- Gabriella Bené Barbosa ,
- Cleide Lucilla Carneiro Santos ,
- Deise dos Santos Silva Nascimento ,
- Laís Barbosa Souza Vilas Bôas , [ … ],
- Carlito Lopes Nascimento Sobrinho
Abstract
Burnout Syndrome and Associated Factors in Intensive Care Unit Nurses
Revista Brasileira de Enfermagem. 2021;74:e20190535
DOI 10.1590/0034-7167-2019-0535
- Núbia Samara Caribé de Aragão ,
- Gabriella Bené Barbosa ,
- Cleide Lucilla Carneiro Santos ,
- Deise dos Santos Silva Nascimento ,
- Laís Barbosa Souza Vilas Bôas ,
- Davi Félix Martins Júnior ,
- Carlito Lopes Nascimento Sobrinho
Views0See moreABSTRACT
Objective:
to estimate prevalence and factors associated with Burnout Syndrome in intensive care nurses in a city in the state of Bahia.
Methods:
a cross-sectional, population-based study carried out with 65 intensive care nurses through a self-administered questionnaire, from July to November 2016, containing sociodemographic data, lifestyle, work characteristics. To define burnout syndrome, the Maslach Burnout Inventory was used.
Results:
Burnout Syndrome prevalence was 53.6%, an association was observed with age, tobacco consumption, alcohol use, weekly night shift hours, employment relationship, having an intensive care specialist title, number of patients on duty, monthly income and considering active or high-strain job.
Conclusion:
the results of this study can contribute to expanding the discussion on stressful working conditions in Intensive Care Units.
- Núbia Samara Caribé de Aragão
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ORIGINAL ARTICLE12-05-2019
Elderly caregivers of the elderly: frailty, loneliness and depressive symptoms
- Ariene Angelini dos Santos-Orlandi ,
- Allan Gustavo Brigola ,
- Ana Carolina Ottaviani ,
- Bruna Moretti Luchesi ,
- Érica Nestor Souza , [ … ],
- Sofia Cristina Iost Pavarini
Abstract
ORIGINAL ARTICLEElderly caregivers of the elderly: frailty, loneliness and depressive symptoms
Revista Brasileira de Enfermagem. 2019;72:88-96
DOI 10.1590/0034-7167-2018-0137
- Ariene Angelini dos Santos-Orlandi ,
- Allan Gustavo Brigola ,
- Ana Carolina Ottaviani ,
- Bruna Moretti Luchesi ,
- Érica Nestor Souza ,
- Fernanda Gomez de Moura ,
- Juliana de Fátima Zacarin ,
- Mariélli Terassi ,
- Nathalia Alves de Oliveira ,
- Sofia Cristina Iost Pavarini
Views0See moreABSTRACT
Objective:
to investigate the association between frailty, loneliness and depressive symptoms of elderly caregivers.
Method:
a cross – sectional study carried out with 341 elderly caregivers enrolled in Family Health Units of a city in the countryside of São Paulo State. The interviews were domiciliary and included questionnaire for characterization of the caregiver, Fried’s frailty phenotype, family APGAR (family functionality), Geriatric Depression Scale (depressive symptoms) and item 3 of the Herth Hope Scale (loneliness). Logistic regression was used to analyze the association between depressive symptoms and solitude (independent variables), and frailty and pre-frailty (dependent variables).
Results:
there was an association between frailty, loneliness and depressive symptoms. Elderly caregivers had increased odds of 158% presenting pre-frailty, and 360% of frailty. Elderly caregivers with depressive symptoms had an increased chance of 242% of presenting fragility.
Conclusion:
elderly and lonely caregivers with depressive symptoms are more likely to be frail and pre-frail.
- Ariene Angelini dos Santos-Orlandi
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ORIGINAL ARTICLE06-08-2020
Usability of a mobile application on diabetic foot self-care
- Antonio Dean Barbosa Marques ,
- Thereza Maria Magalhães Moreira ,
- Thaís Vaz Jorge ,
- Sara Maria Soares Rabelo ,
- Rhanna Emanuela Fontenele Lima de Carvalho , [ … ],
- Gilvan Ferreira Felipe
Abstract
ORIGINAL ARTICLEUsability of a mobile application on diabetic foot self-care
Revista Brasileira de Enfermagem. 2020;73(4):e20180862
DOI 10.1590/0034-7167-2018-0862
- Antonio Dean Barbosa Marques ,
- Thereza Maria Magalhães Moreira ,
- Thaís Vaz Jorge ,
- Sara Maria Soares Rabelo ,
- Rhanna Emanuela Fontenele Lima de Carvalho ,
- Gilvan Ferreira Felipe
Views0See moreABSTRACT
Objectives:
to assess the usability of an app prototype for diabetic foot self-care by an end user.
Methods:
a descriptive study that uses heuristic assessment of a hybrid app usability. Fifteen users of an outpatient diabetes care service in a capital of Northeastern Brazil participated in the study during April 2018. The usability measurement tool called Smartphone Usability questionnaiRE was applied.
Results:
the lowest score was 77 and the highest was 112, with an average usability of 96.1 points. Usability was framed in the last two levels, 70 and 8o. Users now strongly agree (level 70) and fully (level 80) with the assessed items, which represents good usability of the apps prototype.
Conclusions:
the final product developed focuses on user needs and requirements, which can ensure usability based on effectiveness, efficiency and satisfaction triad.
- Antonio Dean Barbosa Marques
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