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ORIGINAL ARTICLE05-13-2024
Generalized Resistance Deficits in inmates with hypertension: missing resources that limit health
- Marta Cossetin Costa
, - Maria de Fátima Mantovani ,
- Fernanda Moura D’Almeida Miranda ,
- Ivonete Teresinha Schülter Buss Heidemann ,
- Aida Maris Peres
Abstract
ORIGINAL ARTICLEGeneralized Resistance Deficits in inmates with hypertension: missing resources that limit health
Revista Brasileira de Enfermagem. 2024;77(2):e20230246
DOI 10.1590/0034-7167-2023-0246
- Marta Cossetin Costa ,
- Maria de Fátima Mantovani ,
- Fernanda Moura D’Almeida Miranda ,
- Ivonete Teresinha Schülter Buss Heidemann ,
- Aida Maris Peres
Views0See moreABSTRACT
Objective:
to understand the Generalized Resistance Deficits of people deprived of liberty with hypertension in a Brazilian prison unit.
Method:
qualitative research, anchored in Salutogenesis, carried out with 38 people with hypertension from a Brazilian prison unit, from February to July 2022, with a semi-structured interview with open-ended questions, whose analysis was thematic, explaining the limitations to health in prison.
Results:
13 Generalized Resistance Deficits were reported, mostly related to the prison environment and, to a lesser extent, to the social group and the individual, respectively. Living in prison for people with hypertension implies living with a high number of Generalized Resistance Deficits, accentuating the movement towards the disease pole.
Final considerations:
knowing Generalized Resistance Deficits allows directing health promotion to support the use of available Generalized Resistance Resources and contributes to the expansion of intersectoral policies.
- Marta Cossetin Costa
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REVIEW05-13-2024
Lean methodology: contributions to improving work processes in health and nursing
- Fernanda Novaes Moreno Brancalion ,
- Lara Gonçalves de Souza ,
- Simone Berger ,
- Antônio Fernandes Costa Lima
Abstract
REVIEWLean methodology: contributions to improving work processes in health and nursing
Revista Brasileira de Enfermagem. 2024;77(2):e20230322
DOI 10.1590/0034-7167-2023-0322
- Fernanda Novaes Moreno Brancalion ,
- Lara Gonçalves de Souza ,
- Simone Berger ,
- Antônio Fernandes Costa Lima
Views0See moreABSTRACT
Objective:
to investigate the contributions of applying the Lean methodology to improve work processes in health and nursing and its impact on associated financial aspects.
Method:
an integrative review, carried out in six databases, whose sample of ten (100.0%) studies was analyzed and summarized descriptively.
Results:
the outcomes obtained were stratified into: benefits/barriers to Lean Healthcare implementation; economic aspects involving Lean Healthcare implementation; and process improvements through Lean Healthcare implementation. The majority of studies (60.0%) were carried out in university hospitals, contexts that need to continually improve the quality of services provided, generally with scarce and limited resources, which support the viability of maintaining the teaching, research and extension tripod.
Conclusion:
three (30.0%) studies highlighted the financial aspects associated with Lean methodology application. The others only mentioned the possibility of financial gains through improving processes and reducing waste.
- Fernanda Novaes Moreno Brancalion
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REVIEW05-13-2024
Stunting predictors among children aged 0-24 months in Southeast Asia: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20220625
Abstract
REVIEWStunting predictors among children aged 0-24 months in Southeast Asia: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20220625
DOI 10.1590/0034-7167-2022-0625
Views0See moreABSTRACT
Objective:
To identify predictors of stunting among children 0-24 months in Southeast Asia.
Methods:
This scoping review focused on articles with observational study design in English published from 2012 to 2023 from five international databases. The primary keyword used were: “stunting” OR “growth disorder” AND “newborn” AND “predict” AND “Southeast Asia”.
Results:
Of the 27 articles selected for the final analysis there are thirteen predictors of stunting in seven Southeast Asia countries. The thirteen predictors include the child, mother, home, inadequate complementary feeding, inadequate breastfeeding, inadequate care, poor quality foods, food and water safety, infection, political economy, health and healthcare, water, sanitation, and environment, and social culture factor.
Conclusion:
All these predictors can lead to stunting in Southeast Asia. To prevent it, health service providers and other related sectors need to carry out health promotion and health prevention according to the predictors found.
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05-13-2024
A influência da internet nas escolhas sobre a saúde e o bem-estar dos idosos
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
Abstract
A influência da internet nas escolhas sobre a saúde e o bem-estar dos idosos
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
DOI 10.1590/0034-7167-2023-0321
Views0See moreRESUMEN
Objetivos:
describir el perfil de los ancianos que acceden a internet para buscar información de salud e identificar los factores que pueden influir en las decisiones de los ancianos sobre su salud a partir de la información recopilada en línea.
Métodos:
391 ancianos respondieron a un cuestionario online sobre hábitos y satisfacción con la información de salud recogida en internet. El procesamiento de datos implicó regresión logística.
Resultados:
la educación superior reduce en un 44% la probabilidad de que un anciano siga las recomendaciones de salud en los sitios web. Sin embargo, las actividades sociales y la salud autopercibida aumentan la posibilidad de seguir las recomendaciones en un 83% y un 71%, respectivamente. La creencia de que internet promueve hábitos saludables aumenta 29,2 veces la probabilidad de que un anciano siga un consejo.
Consideraciones Finales:
conocer el perfil de los ancianos que utilizan internet puede ayudar a los profesionales a formular políticas públicas y construir buenas plataformas de información sobre salud y bienestar.
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ORIGINAL ARTICLE05-13-2024
The influence of the internet on choices about older adults’ health and well-being
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
Abstract
ORIGINAL ARTICLEThe influence of the internet on choices about older adults’ health and well-being
Revista Brasileira de Enfermagem. 2024;77(1):e20230321
DOI 10.1590/0034-7167-2023-0321
Views0See moreABSTRACT
Objectives:
to describe the profile of older adults who access the internet to search for health information and identify the factors that can influence older adults’ decisions about their health based on information collected online.
Methods:
391 older adults answered an online questionnaire regarding habits and satisfaction with information about health collected on the internet. Data processing involved Logistic Regression.
Results:
higher education reduces by 44% the likelihood of an older adult following the health recommendations on internet sites. However, social activities and self-perceived health increase the possibility of following the recommendations by 83% and 71%, respectively. The belief that the internet promotes healthy habits increases by 29.2 times the probability of an older adult following the advice.
Final Considerations:
knowing the profile of older adults who use the Internet can help professionals formulate public policies and build good information platforms on health and well-being.
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REVIEW05-13-2024
Technologies used in the treatment of burn victims in intensive care: a scope review
- Kyohana Matos de Freitas Clementino ,
- Gabriela Duarte Bezerra ,
- Gleice Adriana Araujo Gonçalves ,
- Maria Corina Amaral Viana ,
- Luis Rafael Leite Sampaio , [ … ],
- Woneska Rodrigues Pinheiro
Abstract
REVIEWTechnologies used in the treatment of burn victims in intensive care: a scope review
Revista Brasileira de Enfermagem. 2024;77(1):e20220738
DOI 10.1590/0034-7167-2022-0738
- Kyohana Matos de Freitas Clementino ,
- Gabriela Duarte Bezerra ,
- Gleice Adriana Araujo Gonçalves ,
- Maria Corina Amaral Viana ,
- Luis Rafael Leite Sampaio ,
- Woneska Rodrigues Pinheiro
Views0See moreABSTRACT
Objectives:
to analyze the technologies used by the nursing team in the treatment of skin lesions caused by burns in patients under intensive care.
Methods:
this is a scope review conducted on the LILACS, Medline, PubMed, and CINAHL databases without temporal or language restrictions.
Results:
the highlighted technologies included the use of specialized dressings, biological agents such as probiotics and cyanobacteria, as well as negative pressure therapies and enzymes such as papain and collagenase. Some technologies, such as nanocrystalline silver, demonstrated efficacy in infection control.
Final Considerations:
the study identified essential technologies in burn care, emphasizing the need for further research on “soft” technologies. The findings support the promotion of evidence-based nursing care for burn patients in intensive care and enhance knowledge about effective treatments.
- Kyohana Matos de Freitas Clementino
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ORIGINAL ARTICLE05-03-2024
What is the burden of multimorbidity and the factors associated with its occurrence in elderly Brazilians?
- Danielle Samara Tavares de Oliveira-Figueiredo ,
- Matteus Pio Gianotti Pereira Cruz Silva ,
- Paula Yhasmym de Oliveira Feitosa ,
- Bruna Cardoso Leite ,
- Fabiana Lucena Rocha , [ … ],
- Luciana Dantas Farias de Andrade
Abstract
ORIGINAL ARTICLEWhat is the burden of multimorbidity and the factors associated with its occurrence in elderly Brazilians?
Revista Brasileira de Enfermagem. 2024;77(1):e20220809
DOI 10.1590/0034-7167-2022-0809
- Danielle Samara Tavares de Oliveira-Figueiredo ,
- Matteus Pio Gianotti Pereira Cruz Silva ,
- Paula Yhasmym de Oliveira Feitosa ,
- Bruna Cardoso Leite ,
- Fabiana Lucena Rocha ,
- Luciana Dantas Farias de Andrade
Views0See moreABSTRACT
Objective:
To estimate the prevalence of multimorbidity in elderly people and its association with sociodemographic characteristics, lifestyle, and anthropometry.
Methods:
This was a cross-sectional study using data from the National Health Survey, 2019. A total of 22,728 elderly individuals from all 27 Brazilian states were randomly selected. Poisson regression models with robust variance were employed, and a significance level of 5% was adopted.
Results:
The prevalence of multimorbidity was 51.6% (95% CI: 50.4-52.7), with the highest estimates observed in the South and Southeast. Multimorbidity was associated with being female (aPR = 1.33; 95% CI: 1.27-1.39), being 80 years old or older (aPR = 1.12; 95% CI: 1.05-1.19), having low education (aPR = 1.16; 95% CI: 1.07-1.25), past cigarette use (aPR = 1.16; 95% CI: 1.11-1.21), insufficient physical activity (aPR = 1.13; 95% CI: 1.06-1.21), and screen use for 3 hours or more per day (aPR = 1.13; 95% CI: 1.08-1.18).
Conclusion:
Multimorbidity affects more than half of the elderly population in Brazil and is associated with social, demographic, and behavioral factors.
- Danielle Samara Tavares de Oliveira-Figueiredo
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ORIGINAL ARTICLE05-03-2024
Cancer patient satisfaction regarding the quality of information received: psychometric validity of EORTC QLQ-INFO25
Revista Brasileira de Enfermagem. 2024;77(1):e20230358
Abstract
ORIGINAL ARTICLECancer patient satisfaction regarding the quality of information received: psychometric validity of EORTC QLQ-INFO25
Revista Brasileira de Enfermagem. 2024;77(1):e20230358
DOI 10.1590/0034-7167-2023-0358
Views0See moreABSTRACT
Objectives:
to psychometrically validate the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire EORTC QLQ-INFO25 instrument and identify the domains that influence patients’ perception of the information received.
Methods:
a cross-sectional methodology with cancer patients in a Brazilian philanthropic hospital institution. Sociodemographic and clinical instruments, EORTC QLQ-C30, EORTC QLQ-INFO25 and Supportive Care Needs Survey – Short Form 34 were used. Analysis occurred using Cronbach’s alpha coefficients, intraclass correlation, test-retest and exploratory factor analysis.
Results:
128 respondents participated. Cronbach’s alpha coefficient was 0.85. The test-retest obtained p-value=0.21. In the factor analysis, one item was excluded. Satisfaction with the information received was 74%, with three areas with averages below 70%. In open-ended questions, there was a greater desire for information.
Conclusions:
validity evidence was obtained with instrument reliability, consistency and stability. Respondents expressed satisfaction with the information received.
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TECHNOLOGICAL INNOVATION06-04-2021
Integrated Care model: Transition from acute to chronic care
Revista Brasileira de Enfermagem. 2021;74:e20200910
Abstract
TECHNOLOGICAL INNOVATIONIntegrated Care model: Transition from acute to chronic care
Revista Brasileira de Enfermagem. 2021;74:e20200910
DOI 10.1590/0034-7167-2020-0910
Views0See moreABSTRACT
Objective:
Description and discussion dimensions of Integrated Care Model.
Methods:
A descriptive study is done that describe a technological innovation, intervention strategies for professional performance.
Results:
Integrated Care Model (ICM) has two main categories include individual and Group-and disease-specific Model. First, is used for risky patients or with comorbidities. In second category; Chronic Care Model (CCM) is common form of Integrated Care Model to improve resultants in the patients with chronic condition, to move from acute care to integrate, regular, long-lasting, preventative and community-based nursing.
Final considerations:
It is important to consider patient as an active member of the treatment team. It seems to be essential to monitor performance of care system. On the other hand, offer multidisciplinary care leads to present desirable care, tailored to the specific needs of patients regarding safety, patient-centered care and their culture.
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ORIGINAL ARTICLE04-15-2022
Analysis of the temporal trend of mortality from sickle cell anemia in Brazil
- Felipe Machado Mota ,
- Marcos Antonio Ferreira Júnior ,
- Andréia Insabralde de Queiroz Cardoso ,
- Carolina Mariana Pompeo ,
- Oleci Pereira Frota , [ … ],
- Albert Schiaveto de Souza
Abstract
ORIGINAL ARTICLEAnalysis of the temporal trend of mortality from sickle cell anemia in Brazil
Revista Brasileira de Enfermagem. 2022;75(4):e20210640
DOI 10.1590/0034-7167-2021-0640
- Felipe Machado Mota ,
- Marcos Antonio Ferreira Júnior ,
- Andréia Insabralde de Queiroz Cardoso ,
- Carolina Mariana Pompeo ,
- Oleci Pereira Frota ,
- Daniel Henrique Tsuha ,
- Albert Schiaveto de Souza
Views0See moreABSTRACT
Objectives:
To analyze the temporal trend of mortality from sickle cell anemia in Brazil, by region, in the period 1997-2017.
Methods:
epidemiological study, with an ecological design, with a temporal trend, carried out with data from the Mortality Information System. For descriptive analysis, absolute and relative frequencies were used. In the correlation analysis, the ANOVA test was used, followed by Tukey’s post-test. The temporal trend was obtained using the cubic polynomial regression test.
Results:
6,813 deaths from sickle cell anemia were registered. Brown individuals (50.87%) were more frequent, with a predominance of males (50.4%), aged between 25 and 34 years and a higher incidence of deaths in the Midwest (0.25/100 thousand inhabitants). The time curve showed an increasing trend of deaths in the country between 1997 and 2015 (R2 = 0.98).
Conclusions:
sickle cell anemia showed increasing mortality in the 21 years analyzed and alerts health professionals and managers.
- Felipe Machado Mota
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REVIEW03-07-2022
Implications of Cannabis and Cannabinoid Use in COVID-19: Scoping Review
- Caroline Figueira Pereira ,
- Divane de Vargas ,
- Fernanda Lima Toneloto ,
- Victor Daichi Ito ,
- Rosa Jacinto Volpato
Abstract
REVIEWImplications of Cannabis and Cannabinoid Use in COVID-19: Scoping Review
Revista Brasileira de Enfermagem. 2022;75:e20201374
DOI 10.1590/0034-7167-2020-1374
- Caroline Figueira Pereira ,
- Divane de Vargas ,
- Fernanda Lima Toneloto ,
- Victor Daichi Ito ,
- Rosa Jacinto Volpato
Views0See moreABSTRACT
Objective:
to identify and synthesize studies on the effects of cannabis use and its relation with SARS-CoV-2, as well as the therapeutic possibilities of using cannabinoids in the prevention and treatment of COVID-19.
Methods:
scoping review, in the BVS, PubMed, SCIELO, CINAHL, SCOPUS, Web of Science, MedNar, CAPES and ProQuest databases, with no language restriction and year limitation. Narrative synthesis was performed.
Results:
cannabis use causes changes in the respiratory and vascular system, it reduces the production of cytokines, which affects the users’ immune system, increasing the susceptibility to infection and progression of COVID-19. However, studies have suggested the use of cannabinoids in the prophylaxis and treatment of COVID-19, due to their anti-inflammatory effect.
Conclusions:
the use of inhaled cannabis increases the progression and severity of the infection. On the other hand, the benefits of cannabinoids seem promising to modulate the immune system, but it needs further studies.
- Caroline Figueira Pereira
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ORIGINAL ARTICLE03-24-2021
Content and usability validation of the Retire with Health web software
- Paloma de Souza Cavalcante Pissinati ,
- Yolanda Dora Martinez Évora ,
- Sonia Silva Marcon ,
- Thais Aidar de Freitas Mathias ,
- Ligia Fahl Fonseca , [ … ],
- Maria do Carmo Fernandez Lourenço Haddad
Abstract
ORIGINAL ARTICLEContent and usability validation of the Retire with Health web software
Revista Brasileira de Enfermagem. 2021;74(1):e20200133
DOI 10.1590/0034-7167-2020-0133
- Paloma de Souza Cavalcante Pissinati ,
- Yolanda Dora Martinez Évora ,
- Sonia Silva Marcon ,
- Thais Aidar de Freitas Mathias ,
- Ligia Fahl Fonseca ,
- Maria do Carmo Fernandez Lourenço Haddad
Views0See moreABSTRACT
Objectives:
to validate the content and usability of the Retire with Health web software.
Methods:
a methodological study. The content validation was carried out by seven experts in the aging subject, using an instrument that evaluated the objectives, contents, relevance, and the environment of the web software. Usability was validated by seven experts in software development, referring to ergonomics, functionality, usability, and efficiency. The data were submitted to statistical analysis, described by calculating the Content Validity Index.
Results:
the global Content Validity Index found 0.97 for the usability aspects and 1.00 for the content. After incorporating all the experts’ suggestions, the Retire with Health web software was made available on the internet (www.aposentarsecomsaude.com.br).
Conclusions:
content validation and usability showed that the web software meets the objective of supporting reflection on retirement, with a high level of agreement among experts.
- Paloma de Souza Cavalcante Pissinati
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REVIEW11-26-2022
Parental burnout: a scoping review
- Ana Júlia de Paula ,
- Paulo César Condeles ,
- André Luiz Moreno ,
- Maria Beatriz Guimarães Ferreira ,
- Luciana Mara Monti Fonseca , [ … ],
- Mariana Torreglosa Ruiz
Abstract
REVIEWParental burnout: a scoping review
Revista Brasileira de Enfermagem. 2022;75:e20210203
DOI 10.1590/0034-7167-2021-0203
- Ana Júlia de Paula ,
- Paulo César Condeles ,
- André Luiz Moreno ,
- Maria Beatriz Guimarães Ferreira ,
- Luciana Mara Monti Fonseca ,
- Mariana Torreglosa Ruiz
Views0See moreABSTRACT
Objective:
to map available evidence on parental burnout theme.
Method:
scoping review as according to the Joanna Briggs Institute. Search in January 2021, in six databases of publications in English, Portuguese or Spanish, without time limits. Data extracted and descriptively analyzed by three independent researchers.
Results:
374 articles were identified and 20 were included in the final sample, all published in English, from 2017 onwards. Parental burnout is a complex, multifactorial problem, distinct from burnout cases, depressive symptoms and other mental health alterations. It affects 0.2 to 20% of parents, has validated and suitable instruments for measurement; if not treated, can have consequences on marital life, work relationships, child neglect and violence.
Conclusions:
this is a recent theme that needs to be explored, due to the possible impact on children’s and families’ health and on parents’ work processes. Protocol registered in the Open Science Framework ().
- Ana Júlia de Paula
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04-26-2021
Content validity of the nursing diagnostic Breathing Pattern, Ineffective, in children with congenital heart defects
- Nayana Maria Gomes de Souza ,
- Viviane Martins da Silva ,
- Marcos Venícios de Oliveira Lopes ,
- Nirla Gomes Guedes ,
- Lívia Maia Pascoal , [ … ],
- Beatriz Amorim Beltrão
Abstract
Content validity of the nursing diagnostic Breathing Pattern, Ineffective, in children with congenital heart defects
Revista Brasileira de Enfermagem. 2021;74:e20190844
DOI 10.1590/0034-7167-2019-0844
- Nayana Maria Gomes de Souza ,
- Viviane Martins da Silva ,
- Marcos Venícios de Oliveira Lopes ,
- Nirla Gomes Guedes ,
- Lívia Maia Pascoal ,
- Beatriz Amorim Beltrão
Views0See moreABSTRACT
Objective:
To estimate the content validity of the nursing diagnostic Breathing Pattern, Ineffective, in children with congenital heart defects.
Method:
Methodological study in two stages: 1) integrative literature review; 2) content validation, with 23 nurses. An instrument with 10 related factors and 21 defining characteristics for data collection was used. The analysis by the evaluators was carried out using the relevance criteria. The Content Validity Index was used. Valid results were those above 0.9 with a Wilcoxon test above 0.05.
Results:
The final proposal incorporates nine from the ten causal factors. From them, five do not belong in the NANDA-I list. Regarding the defining characteristics, they were all considered to be relevant, and five are not among the list of signs and symptoms of the NANDA-I taxonomy.
Conclusion:
The findings of this study include specific elements of the pediatric population with congenital heart defect which are not present in the structure of the diagnostic being studied.
- Nayana Maria Gomes de Souza
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REVIEW11-19-2022
Nursing care for bed bath in patients with COVID-19: an integrative review
- Cristina Tavares de Aguiar Avilar ,
- Ítala Maria Araújo Andrade ,
- Cawana da Silva do Nascimento ,
- Larissa Vanessa Machado Viana ,
- Thatiana Lameira Maciel Amaral , [ … ],
- Patrícia Rezende do Prado
Abstract
REVIEWNursing care for bed bath in patients with COVID-19: an integrative review
Revista Brasileira de Enfermagem. 2022;75:e20200704
DOI 10.1590/0034-7167-2020-0704
- Cristina Tavares de Aguiar Avilar ,
- Ítala Maria Araújo Andrade ,
- Cawana da Silva do Nascimento ,
- Larissa Vanessa Machado Viana ,
- Thatiana Lameira Maciel Amaral ,
- Patrícia Rezende do Prado
Views0See moreABSTRACT
Objective:
to identify the main nursing care procedures for performing bed bath in patients with COVID-19.
Method:
an integrative literature review. Five stages were followed for this research: research question elaboration (identification of the problem), search of studies in literature, study assessment, data analysis, and presentation of review. To search for primary studies, the VHL and SciELO databases were selected.
Results:
initially, 55 publications were found. After reading and analyzing the abstracts, the sample consisted of 15 studies.
Conclusion:
patients with the new coronavirus have specific care to perform a bed bath, oral, intimate and skin hygiene. It is important that professionals use adequate personal protective equipment, perform humanized care, continuously observing patients’ vital signs to avoid occurrence of adverse events, promoting patient safety.
- Cristina Tavares de Aguiar Avilar
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ORIGINAL ARTICLE10-25-2022
Brazilian nursing in pandemic times and the bicentennial of Florence Nightingale
- Beatriz Maria dos Santos Santiago Ribeiro ,
- Fabio Scorsolini-Comin ,
- Sérgio Valverde Marques dos Santos ,
- Rita de Cassia de Marchi Barcellos Dalri
Abstract
ORIGINAL ARTICLEBrazilian nursing in pandemic times and the bicentennial of Florence Nightingale
Revista Brasileira de Enfermagem. 2022;75:e20210081
DOI 10.1590/0034-7167-2021-0081
- Beatriz Maria dos Santos Santiago Ribeiro ,
- Fabio Scorsolini-Comin ,
- Sérgio Valverde Marques dos Santos ,
- Rita de Cassia de Marchi Barcellos Dalri
Views0See moreABSTRACT
Objective:
To reflect on the role of Brazilian nursing during the COVID-19 pandemic, considering as a historical landmark the bicentenary of the birth of Florence Nightingale, a precursor of modern nursing, celebrated in 2020.
Method:
Theoretical-reflective study, based on Florence Nightingale’s environmental theory through a literature review, carried out in international and national virtual news from different sources and added to the authors’ experiences related to the pandemic.
Results:
It was possible to identify the weaknesses experienced by nurse practitioners as to contagion by COVID-19, the routine of exposure to risks, the lack of adequate protection in many scenarios, the high rates of illness, and also deaths that occurred in this profession.
Final considerations:
Florence Nightingale’s Environmental Theory describes the importance of the adequacy of the work environment. It also emphasizes the value of this professional for contemporary nursing and the redefinition of this professional category during the COVID-19 pandemic.
- Beatriz Maria dos Santos Santiago Ribeiro
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