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1.
Trauma Violence Abuse ; 25(4): 3164-3176, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38629804

RESUMO

Intimate partner violence (IPV) is a global public health issue that has grave physical and mental health consequences for millions of women. The judicial system plays a critical role in responding to IPV principally through the criminal justice system, family law, and/or child welfare jurisdictions. However, victims/survivors who interact with the legal system report negative experiences. An under-researched area of scholarship is the degree to which judicial actors understand the mental health impacts of IPV on victims/survivors and how they apply that knowledge in practice. This scoping review aimed to identify and synthesize existing scholarship on judicial actors' understanding of the mental health impacts of IPV on women survivors. We searched 10 databases (Medline, Scopus, PubMed, PsycINFO, EMBASE, Westlaw, HeinOnline, the Cochrane Library, and the Joanna Briggs Library databases) for studies published between 2000 and 2023. A total of 27 studies were included in the review. We identified five main themes, including: awareness of survivors' experiences, gap in judicial actors' knowledge, understanding of perpetrator tactics and risk factors, disclosing mental health problems, training, and guidance. The review highlights significant gaps in judicial actors' understanding of this issue and recommends strategies to increase the awareness and understanding of IPV among judicial actors. The findings can be used to justify future research to better understand the training and development needs of judicial actors to improve their level of awareness of the dynamics and impact of IPV and to make policy and practice recommendations to build the capacity of the judicial workforce.


Assuntos
Violência por Parceiro Íntimo , Saúde Mental , Humanos , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/legislação & jurisprudência , Feminino , Sobreviventes/psicologia , Vítimas de Crime/psicologia , Vítimas de Crime/legislação & jurisprudência , Função Jurisdicional
2.
3.
Nurs Inq ; 31(2): e12607, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37805823

RESUMO

Globally, one of every eight nurses is a migrant, but few studies have focused on the healthcare experiences of migrant nurses (MNs) as consumers or recipients of healthcare. We address this gap by examining MNs and their acculturation, barriers to healthcare access, and perceptions of healthcare encounters as consumers. For this mixed-methods study, a convenience sample of MNs working in Europe and Israel was recruited. The quantitative component's methods included testing the reliability of scales contained within the questionnaire and using Hayes Process Model #4 to test for mediation. The qualitative component's methods included analyzing interviews with iterative inductive thematic analysis. Quantitative findings on MNs (n = 73) indicated that the association between acculturation and perception of the healthcare encounter, which MNs experienced as healthcare consumers, was mediated by barriers to healthcare access, even after adjusting for age and gender (p = 0.03). Qualitative interviews with MNs (n = 13) provided possible explanations for the quantitative findings. Even after working in the host country's healthcare system for several years, MNs reported difficulties with their healthcare encounters as healthcare consumers, not only due to their limited knowledge about the culture and healthcare resources but also due to the biased responses they received.

4.
J Interpers Violence ; 37(9-10): NP7082-NP7108, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-33103547

RESUMO

Intimate partner violence (IPV) affects millions of people across the world and is associated with a significant impact on physical and mental health of the victim. IPV often takes place within the context of marriage, where gender role expectations can play an important part in shaping attitudes towards it. While there is much research carried out to understand the phenomenon of IPV, little relates to how a husband and wife's accounts of spousal role expectations of each other contribute to marital conflict. The issue of IPV within marriage is highly sensitive, particularly in a patriarchy such as Pakistan. The aim of this unique study was to explore the perspective of Pakistani men and women about a husband and wife's role expectations and how fulfillment of such spousal role expectations impacts on marital conflict, and thereby IPV. Using the community setting, data for this qualitative study were collected through 41 individual interviews, including 20 from Pakistan and 21 from the UK. The findings are presented in two main themes, each containing two subthemes. The theme "provider and protector" relates to the role expectations from a husband, whereas "caretaker and household manager" relates to the role expectations of a wife. Overall, husbands and wives have numerous expectations of each other, and these expectations are shaped by gender role attitudes alongside cultural and societal norms. Unmet expectations and deviation of behavior from the perceived norms can result in the development of marital conflict which can escalate to IPV. The significance of this study lies in understanding spousal role expectations from the perspectives of husbands and wives and how unmet expectations contribute to marital conflict and IPV is important for health care professionals within family health contexts. This article provides a detailed insight of this largely hidden phenomena.


Assuntos
Conflito Familiar , Violência por Parceiro Íntimo , Feminino , Humanos , Masculino , Casamento , Motivação , Cônjuges
5.
J Interpers Violence ; 36(9-10): 3965-3993, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-30019609

RESUMO

Limited research has been undertaken on the role of extended family members in Intimate Partner Violence (IPV). This study uniquely explores the perspective of Pakistani men and women about the role of a husband and wife's families in relation to marital conflict and IPV. For this qualitative study, data were collected through 41 individual interviews, including 20 from Pakistan and 21 from the United Kingdom. The findings are presented in four themes, including "privacy and personal space," "interference and instigation of problems," "conflicting and uncommunicated expectations," and "adjustment facilitation." A lack of privacy and personal space within a family home shared with extended family on the husband's side, interference in terms of mothers-in-law and sisters-in-law making complaints about the wife, and the couple's differing expectations of the husband's responsibility for his extended family could cause tension and conflict that could lead to IPV. The husband's family could also have a positive effect by minimizing conflict through offering the couple personal time and helping the wife to adjust to her new family. The wife's family was perceived as having a much more passive role in terms of not interfering, but instead allowing her to adjust to her new extended family. In conclusion, the husband's extended family can have a considerable impact on conflict within couples. Public health prevention initiatives for IPV in Pakistani people should address the role of the husband's extended family. The findings of the study are not only important for the population studied, which is part of an international diaspora, but also for other communities worldwide that value close family structure due to cultural and religious preferences.


Assuntos
Violência por Parceiro Íntimo , Feminino , Humanos , Masculino , Paquistão , Percepção , Cônjuges , Reino Unido
6.
Prim Health Care Res Dev ; 20: e2, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29642973

RESUMO

AimTo develop a simple health literacy intervention aimed at supporting informed reproductive choice among members of UK communities practising customary consanguineous marriage. BACKGROUND: The contribution of 'health literacy' to reducing health inequalities and improving primary health-care efficiency is increasingly recognised. Enhancing genetic literacy has received particular attention recently. Consanguineous marriage is customarily practised among some UK minority ethnic communities and carries some increased risk of recessive genetic disorders among offspring compared with unions among unrelated partners. The need to enhance genetic literacy on this issue has been highlighted, but no national response has ensued. Instead, a range of undocumented local responses are emerging. Important knowledge gaps remain regarding how the development and implementation of culturally appropriate, effective and sustainable responses can be achieved. METHODS: Our co-design approach involved active participation by local people. Initial insight generation employed six focus group discussions and 14 individual interviews to describe current understandings and information needs. A total of 11 personas (heuristic narrative portraits of community 'segments') resulted; four participatory workshops provided further understanding of: preferred information channels; feasible information conveyance; and responses to existing materials. Prototype information resources were then developed and feedback gathered via two workshops. Following further refinement, final feedback from health-care professionals and community members ensured accuracy and appropriateness.FindingsThe project demonstrated the utility of co-design for addressing an issue often considered complex and sensitive. With careful planning and orchestration, active participation by diverse community members was achieved. Key learning included: the importance of establishing trusting and respectful relationships; responding to diversity within the community; and engendering a creative and enjoyable experience. The resultant materials were heavily shaped by local involvement. Evaluative work is now needed to assess impacts on knowledge and service uptake. Longer term sustainability will depend on whether innovative community-level work is accompanied by broader strategy including investment in services and professional development.


Assuntos
Consanguinidade , Assistência à Saúde Culturalmente Competente/métodos , Letramento em Saúde/métodos , Casamento , Folhetos , Avaliação de Programas e Projetos de Saúde , Grupos Focais , Humanos , Entrevistas como Assunto , Fatores de Risco , Reino Unido
7.
J Interpers Violence ; 34(19): 4085-4113, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-29294618

RESUMO

Intimate partner violence (IPV) is a major social and public health problem affecting people from different cultures and societies. Much research has been undertaken to understand the phenomenon, its determinants, and its consequences in numerous countries. However, there is a paucity of research on IPV in many areas of the world including Pakistan. The present study aimed to develop a theory of the meaning and process of IPV from the perspective of Pakistani men and women living in and outside Pakistan.


Assuntos
Teoria Fundamentada , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Motivação , Adulto , Cultura , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão , Adulto Jovem
8.
J Clin Nurs ; 27(5-6): e1152-e1160, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29193568

RESUMO

AIM AND OBJECTIVE: To explore nurses' perspectives of language barriers and their impact on the provision of care to patients with limited English proficiency from diverse linguistic background. DESIGN AND METHODS: A qualitative descriptive approach was used. Using individual interviews and focus group discussions, data were collected from 59 nurses working in tertiary care hospitals in England. A thematic analysis was used to analyse the data. FINDINGS: Three themes, "multi-ethnicities and language barriers," "the impact of language barriers" and "communicating via interpreters," were identified. Communication was identified as the most important aspect of care provision and an essential component of a nurse's professional role regardless of the clinical area or speciality. Language barriers were identified as the biggest obstacles in providing adequate, appropriate, effective and timely care to patients with limited English proficiency. Use of professional interpreters was considered useful; however, the limitations associated with use of interpretation service, including arrangement difficulties, availability and accessibility of interpreters, convenience, confidentiality and privacy-related issues and impact on the patient's comfort were mentioned. CONCLUSIONS: Language barriers, in any country or setting, can negatively affect nurses' ability to communicate effectively with their patients and thereby have a negative impact on the provision of appropriate, timely, safe and effective care to meet patient's needs. RELEVANCE TO CLINICAL PRACTICE: An understanding of language barriers can help nurses find appropriate strategies to overcome such barriers and, consequently, enhance the provision of effective care to patients affected by language barriers in any clinical setting in any healthcare system. The findings of the study have international relevance as language barriers affect healthcare provision in any country or setting.


Assuntos
Barreiras de Comunicação , Acessibilidade aos Serviços de Saúde/organização & administração , Relações Enfermeiro-Paciente , Adulto , Assistência à Saúde Culturalmente Competente , Feminino , Grupos Focais , Humanos , Assistência Centrada no Paciente/organização & administração , Pesquisa Qualitativa , Reino Unido
9.
J Adv Nurs ; 73(2): 421-432, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27601267

RESUMO

AIM: The aim of this study was to explore bilingual nurses' perspective about providing language concordant care to patients with limited English proficiency (LEP) and its impact on patients and nurses. Factors affecting the provision of language concordant care to patients LEP were also explored. BACKGROUND: With an increase in migration and mobility of people across the world, the likelihood of experiencing language barriers while providing and receiving care is high. Nurses are responsible for providing care to patients regardless of their culture, religion, ethnic background or language. Language barriers, however, are hurdles that hamper development of effective communication between nurses and patients. Eliminating language barriers is a crucial step in providing culturally competent and patient-centred care. DESIGN: Qualitative descriptive study. METHODS: During January-August 2015, 59 nurses, working in acute hospitals in the UK, participated in 26 individual in-depth interviews and three focus group discussions. The data were analysed using thematic analysis. FINDINGS: Four themes: 'when we speak the same language'; 'when I speak my patient's language'; 'what facilitates provision of language concordant care' and 'what hinders the provision of language concordant care' were identified. Factors affecting nurses' ability to provide language concordant care included individual factors (confidence; years of experience as a nurse; years of experience in the work setting; and relationship with colleagues), patients' expectation, attitudes of other patients, colleagues and nurse managers, organizational culture and organizational policies. CONCLUSION: Bilingual nurses can play a very important role in the provision of language concordant for patients with LEP. Further research is needed to explore patient perspective.


Assuntos
Multilinguismo , Relações Enfermeiro-Paciente , Adulto , Atitude do Pessoal de Saúde , Barreiras de Comunicação , Feminino , Humanos , Masculino , Papel do Profissional de Enfermagem , Cuidados de Enfermagem , Assistência Centrada no Paciente , Reino Unido
10.
J Clin Nurs ; 26(21-22): 3271-3285, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28029719

RESUMO

AIMS AND OBJECTIVES: The aim of the review was to identify intimate partner violence screening interventions used in emergency departments and to explore factors affecting intimate partner violence screening in emergency departments. BACKGROUND: Intimate partner violence against women is now clearly recognised as a global health and societal issue. Nurses working in emergency and urgent care settings can play a crucial role in identification, prevention and management of intimate partner violence. Research exploring optimal methods of intimate partner violence screening and factors affecting intimate partner violence screening in emergency departments are relatively limited. DESIGN: Literature review: Rapid Evidence Synthesis. METHODS: Literature published between 2000-2015 was reviewed using the principles of rapid evidence assessment. Six electronic databases: CINAHL, MEDLINE, EMBASE, Psych Info, the Cochrane Library and Joanna Briggs Library. RESULTS: Twenty-nine empirical studies meeting the eligibility criteria were independently assessed by two authors using appropriate Critical Appraisal Skills Programme Checklists. Intimate partner violence screening in emergency departments is usually performed using electronic, face to face or pen- and paper-based instruments. Routine or universal screening results in higher identification rates of intimate partner violence. Women who screen positive for intimate partner violence in emergency departments are more likely to experience abuse in subsequent months. Factors that facilitate partner violence screening can be classified as healthcare professionals related factors, organisational factors and patient-related factors. CONCLUSIONS: Emergency departments provide a unique opportunity for healthcare professionals to screen patients for intimate partner violence. Competence in assessing the needs of the patients appears to be a very significant factor that may affect rates of intimate partner violence disclosure. RELEVANCE TO CLINICAL PRACTICE: Knowledge of appropriate domestic violence screening methods and factors affecting intimate partner violence screening in emergency can help nurses, and other healthcare professionals provide patient-centred and effective care to victims of abuse attending emergency department.


Assuntos
Serviço Hospitalar de Emergência/organização & administração , Programas de Rastreamento/métodos , Maus-Tratos Conjugais/diagnóstico , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Programas de Rastreamento/estatística & dados numéricos , Pesquisa Qualitativa , Ensaios Clínicos Controlados Aleatórios como Assunto , Maus-Tratos Conjugais/prevenção & controle , Inquéritos e Questionários
11.
Nurs Open ; 3(4): 193-202, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27708830

RESUMO

AIMS: To provide an overview of the peer review process, its various types, selection of peer reviewers, the purpose and significance of the peer review with regard to the assessment and management of quality of publications in academic journals. DESIGN: Discussion paper. METHODS: This paper draws on information gained from literature on the peer review process and the authors' knowledge and experience of contributing as peer reviewers and editors in the field of health care, including nursing. RESULTS: There are various types of peer review: single blind; double blind; open; and post-publication review. The role of the reviewers in reviewing manuscripts and their contribution to the scientific and academic community remains important.

12.
Int Emerg Nurs ; 29: 38-44, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26657803

RESUMO

AIM: To determine the factors that affect patient satisfaction with nurse-led-triage in EDs using a systematic review. BACKGROUND: Nurses' involvement in the triage services provided in the Emergency Department has been an integral part of practice for several decades in some countries. Although studies exploring patient satisfaction with nurse-led ED triage exist, no systematic review of this evidence is available. METHODS: MEDLINE, CINAHL, PsycInfo, EMBASE, the Cochrane Library, Joanna Briggs Library and Google Scholar were searched (January 1980-June 2013). RESULT: Eighteen studies that met the inclusion criteria were reviewed. Factors that affect patient satisfaction with nurse-led-triage include nurses' abilities to provide patient centred care, communication skills, nurses' caring abilities, concern for the patient and competence in diagnosing and treating the health problem. Other factors include availability and visibility of nurses, provision of appropriate health related information in a jargon-free language, nurses' ability to answer questions, and an ability to provide patients with an opportunity to ask questions. CONCLUSION: There is continued scope for nurse-led-triage services in the ED. Patients are generally satisfied with the service provided by nurses in EDs and report a willingness to see the same professional again in the future if needed.


Assuntos
Enfermeiras e Enfermeiros/normas , Satisfação do Paciente , Triagem/normas , Comunicação , Serviço Hospitalar de Emergência/organização & administração , Humanos , Relações Enfermeiro-Paciente , Assistência Centrada no Paciente/normas
13.
Trauma Violence Abuse ; 16(3): 299-315, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24626459

RESUMO

Intimate partner violence (IPV) is a major social and public health problem affecting people in various cultures and societies. Though the issue of IPV in Pakistan has been researched since the 1990 s, no attempt has been made systematically to review the available evidence on IPV in Pakistan. This article presents findings of a systematic review of available empirical literature related to IPV in Pakistan. Using various key words, MEDLINE, CINAHL, and PsycINFO were searched to identify relevant studies. This resulted in the identification of 55 potential studies for inclusion. After application of exclusion criteria 23 studies were identified, 20 of which used quantitative research designs, two used qualitative designs and one adopted a mixed method case study approach. All studies reported men as the perpetrators of IPV and women as its victims. Findings are presented and discussed for IPV for its forms, predictors, effects and victims' responses. Pakistani peoples' perceived reasons for and their attitudes towards IPV are also presented and discussed.


Assuntos
Mulheres Maltratadas/estatística & dados numéricos , Vítimas de Crime/estatística & dados numéricos , Violência Doméstica , Violência Doméstica/prevenção & controle , Violência Doméstica/psicologia , Feminino , Humanos , Relações Interpessoais , Violência por Parceiro Íntimo/prevenção & controle , Violência por Parceiro Íntimo/psicologia , Masculino , Paquistão , Fatores de Risco
14.
Nurse Educ Pract ; 11(5): 304-8, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21349767

RESUMO

This study explored the role of nurses in primary care and nurses' level of preparedness to work in the primary care sector in United Kingdom. The study was conducted in three primary care trusts (PCTs) in the north of England and participants were selected using a modified snowball sampling technique. Data were collected through telephone interviews. Fourteen nurses working at various levels in PCTs were interviewed. Data were analysed using thematic analysis. Participants believed that nurses work in a variety of roles in primary care including care provider, autonomous practitioner, health educator and patient's advocate. With regard to preparedness to work in primary care, a mixed response was identified. Some nurses believed that the pre-registration nursing curriculum generally prepares nurses well for the role; others believed it did not prepare them at all. A common perception was that the pre-registration nursing curriculum is generally acute care focused and does not educate nurses about the structure of the primary care setting. Participants recommended more emphasis on primary care, longer placements in community and primary care, increased involvement of the nurses working in primary care in the pre-registration nursing curriculum and preceptorship and mentorship programmes for novice nurses in primary care.


Assuntos
Atitude do Pessoal de Saúde , Competência Clínica , Papel do Profissional de Enfermagem/psicologia , Recursos Humanos de Enfermagem/psicologia , Atenção Primária à Saúde , Adulto , Inglaterra , Feminino , Humanos , Pessoa de Meia-Idade , Pesquisa em Educação em Enfermagem , Recursos Humanos de Enfermagem/educação , Pesquisa Qualitativa
15.
Nurse Educ Today ; 30(2): 157-62, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19683845

RESUMO

This paper reports findings of an exploratory study conducted to determine an association between academic and non-academic factors and academic success of nursing diploma students in a province of Pakistan. Data were collected from the academic records of a cohort of 628 students. Multiple linear regression was used to identify the predictive association between certain academic and non-academic factors and academic success of the students. Regression models for each of three years were developed. Results indicated academic factors including preadmission qualifications, previous academic performance, academic performance in year one, academic performance in year two and type of school are significantly associated with the academic success of the students. Among non-academic factors, gender and place of domicile were found to be significantly associated with the academic success of the students.


Assuntos
Programas de Graduação em Enfermagem/métodos , Avaliação Educacional/métodos , Estudantes de Enfermagem/estatística & dados numéricos , Adolescente , Adulto , Programas de Graduação em Enfermagem/normas , Avaliação Educacional/normas , Escolaridade , Feminino , Humanos , Modelos Lineares , Masculino , Paquistão , Projetos Piloto , Adulto Jovem
18.
J Pak Med Assoc ; 58(4): 198-203, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18655430

RESUMO

Understanding violence against women is as complex as its process. As a perusal of literature shows that most of the explanations were contextually and culturally based, this review attempts to analyze the issue of violence against women using theories applicable within the Pakistani context. Literature examining the issue of violence against women and its various theories was reviewed. A framework using the determinants of violence against women as proposed, include intrinsic and extrinsic factors within the people, the socio-economic-political and cultural system of Pakistan and the influences of surrounding countries. The Pakistani scenario has been described and the theoretical bases were presented. Each determinant has been discussed with supporting literature. Further studies are needed to strengthen the framework; however, it provided a modest view of violence against women in Pakistan. The framework would help the policy and decision makers to understand the dynamics of violence against women and may move them to action to bring about improvements in women's' lives.


Assuntos
Mulheres Maltratadas/classificação , Violência Doméstica/prevenção & controle , Saúde da Mulher , Agressão , Mulheres Maltratadas/estatística & dados numéricos , Características Culturais , Feminino , Humanos , Relações Interpessoais , Paquistão , Política , Fatores Desencadeantes , Delitos Sexuais/prevenção & controle , Delitos Sexuais/estatística & dados numéricos , Fatores Socioeconômicos
19.
J Pak Med Assoc ; 58(3): 128-32, 2008 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18517117

RESUMO

OBJECTIVE: To determine the relationship between admission criteria used to select students and their subsequent academic performance in general nursing diploma Programmeme in the province of Sindh METHODS: Using a descriptive co-relational study design, data was collected retrospectively from records of the entire nursing student population of the batch of 2004. Using multiple linear regression analysis method, three regression models were developed to identify the group of variables that could predict academic performance of the students in the three-year general nursing diploma programme. RESULTS: Results identified a significant relationship between admission criteria and subsequent academic performance of the students in the general nursing diploma programme. Specific factors which were found significant included entry qualification, previous academic performance and gender. CONCLUSION: The study concluded that academic factors considered in the admission criteria were better predictors of students' academic performance than the non academic factors. These factors should be considered in the admission criteria for general nursing diploma programme.


Assuntos
Educação em Enfermagem , Avaliação Educacional , Critérios de Admissão Escolar , Escolas de Enfermagem/normas , Adolescente , Adulto , Escolaridade , Feminino , Humanos , Modelos Lineares , Masculino , Paquistão , Estatística como Assunto
20.
Nurs Older People ; 19(3): 33-6; quiz 37, 2007 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-17476859

RESUMO

This article considers interventions and strategies used to manage the problems of an undernourished older adult residing in a nursing home. A brief introduction to the patient is followed by a discussion of the process of identifying care needs, and the planning and provision of care based on current evidence and outcome evaluation. The crucial role of nurses in meeting the nutritional needs of older patients is also emphasised.


Assuntos
Enfermagem Geriátrica/organização & administração , Desnutrição/prevenção & controle , Papel do Profissional de Enfermagem , Casas de Saúde/organização & administração , Apoio Nutricional/enfermagem , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/complicações , Dietética/organização & administração , Serviços de Alimentação , Avaliação Geriátrica , Ambiente de Instituições de Saúde/organização & administração , Necessidades e Demandas de Serviços de Saúde , Humanos , Desnutrição/diagnóstico , Desnutrição/etiologia , Planejamento de Cardápio , Avaliação Nutricional
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