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2.
Artigo em Inglês | MEDLINE | ID: mdl-34064970

RESUMO

People living with HIV (PLWH) face social stigma which makes disclosure of HIV status difficult. The purpose of this descriptive qualitative study was to understand the lived experiences of stigmatization in the process of disease disclosure among PLWH in Taiwan. Analysis of the semi-structured interviews from 19 PLWH in Taiwan revealed two phases and six themes. Phase one "experiences before disclosure" involved three themes: "Struggles under the pressure of concealing the HIV Status", "Torn between fear of unemployment/isolation and desire to protect closed ones", and "Being forced to disclose the HIV status." Phase two "experiences after disclosure" included three themes: "Receiving special considerations and requirements from school or work", "Receiving differential treatments in life and when seeking medical care", and "Stress relief and restart." Healthcare professionals need to assess stigmatization in PLWH and develop individualized approaches to assist with the disease disclosure process.


Assuntos
Infecções por HIV , Estereotipagem , Revelação , Humanos , Pesquisa Qualitativa , Estigma Social , Taiwan
3.
Nurs Outlook ; 69(5): 780-782, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34154794

RESUMO

During the COVID-19 pandemic, healthcare professionals and academic facilities are called to provide leadership in disseminating accurate and timely information through approaches that meet the needs of the public. Graduate students from a university in Taiwan collaborated with experts to provide interactive live broadcasting sessions on the COVID-related topics to the public through the Facebook platform. The broadcasting sessions also trained the students to communicate COVID-related information through succinct and interactive presentations. Twelve broadcasting sessions were conducted twice a week for three weeks in May 2020. Upon completion of the broadcasting sessions, students demonstrated growth in professional confidence, assessment of the public's knowledge gaps and needs, and preparation and delivery of professional live broadcasts. We recommend creating a live broadcast training application through an artificial intelligence (AI) expert system. Multidisciplinary academic-practice collaboration in preparing for the broadcasting and engaging in dialogues with the public is recommended.


Assuntos
COVID-19/prevenção & controle , Educação de Pós-Graduação em Enfermagem , Empoderamento , Educação em Saúde/organização & administração , Mídias Sociais , COVID-19/epidemiologia , COVID-19/transmissão , Humanos , Taiwan
4.
Nurse Educ Today ; 101: 104870, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33798986

RESUMO

BACKGROUND: Tube dislodgment has been ranked as the top three medical accidents for five years consecutively in Taiwan. Chest tube care accidents affect patient's health and life significantly. Typically, education on chest tube care focuses on the knowledge transmission with limited guiding nursing students in learning clinical reasoning. The Generation Z students prefer mobile devices. It is crucial to incorporate mobile applications to learning. PURPOSE: The purpose of this study was to evaluate effectiveness of the teaching intervention program ("iLearning app for chest tube care") in improving nursing students' clinical reasoning ability and self-directed learning. METHOD: A quasi-experimental study with a cluster sample was used. A total of 107 nursing students were recruited with the intervention group (n = 53) using the "iLearning app" to learn chest tube care, and the comparison group (n = 54) using the "traditional teaching". Data were collected before the intervention, one week and one month after the intervention. RESULT: The result showed that there was no difference in clinical reasoning and self-directed learning between groups before the intervention. However, the intervention group showed significantly higher clinical reasoning and self-directed learning scores than the comparison group (p < .05) one week and one month after the intervention. It indicated that the students' clinical reasoning abilities and self-directed learning improved with implementation of the intervention. CONCLUSION: The results indicated that the "iLearning app" intervention improved the clinical reasoning and self-directed learning in nursing students. This intervention used situated learning with concept mapping to guide student learning and demonstrated effectiveness in improving their clinical reasoning ability. Immediate feedback of the course instructor might trigger deeper learning and self-correction of clinical reasoning. The "iLearning app" could be used as a tool to improve students' clinical reasoning and self-directed learning, and thus enhance lifelong learning.


Assuntos
Tubos Torácicos , Bacharelado em Enfermagem , Estudantes de Enfermagem , Competência Clínica , Humanos , Taiwan
5.
Sensors (Basel) ; 20(24)2020 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-33321761

RESUMO

Toxemia of pregnancy is a very dangerous disease for pregnant women. The mortality rate of toxemia of pregnancy is close to 10% to 15%. Early detection of pregnancy toxemia is to monitoring uric acid concentration in urine. The current mainstream method for detecting uric acid requires an enzyme (urate oxidase), which needs to be stored in a low-temperature environment, and the method requires complex chemical steps, which takes a longer time and more samples. In this study, we propose an integrated miniature three-electrode electrochemical surface-enhanced Raman spectroscopy chip (EC-SERS chip) suitable for rapid EC-SERS detection applications. The integrated microfluidic reservoir on the chip makes it easy to use, which is very suitable for rapid detection applications. The SERS active working electrode for the proposed integrated EC-SERS chip is a nanocone array polycarbonate (PC) substrate decorated with an evenly distributed and tightly packed array of gold nanospheres. It showed good uniformity and can be easily reproduced. The integrated EC-SERS chip is very small compared to the traditional electrochemical cell, which reduces the sample volume required for the testing. In addition, the chip is for one-time use only. It eliminates the need to clean electrochemical cells for reuse, thereby reducing the possibility of contamination and inaccurate detection. Various low-concentration Rhodamine 6G (R6G) solutions were tested to verify the performance of the developed EC-SERS chip. Experimental results showed that the proposed EC-SERS chip has a strong enhancement factor of up to 8.5 × 106 and a very good EC-SERS uniformity (the relative standard deviation of EC-SERS intensity is as low as 1.41%). The EC-SERS chip developed has been further tested for the detection of uric acid in synthetic urine. The results showed that the EC-SERS signal intensity has a highly linear relationship with the logarithm of the uric acid concentration in synthetic urine, which indicates that the developed EC-SERS chip is suitable for the quantitative detection of uric acid in synthetic urine. Therefore, the developed EC-SERS chip is very promising to be used in routine and early diagnosis of pregnancy toxemia and may be used in many other medical tests, food safety, and biotechnology applications.


Assuntos
Nanopartículas Metálicas , Pré-Eclâmpsia , Ácido Úrico , Eletrodos , Feminino , Ouro , Humanos , Pré-Eclâmpsia/diagnóstico , Gravidez , Análise Espectral Raman
6.
ACS Nano ; 2020 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-33236625

RESUMO

Self-delivery of photosensitizer and immune modulator to tumor site is highly recommendable to improve the photodynamic immunotherapy yet remains challenging. Herein, self-delivery photoimmune stimulators (designated as iPSs) are developed for photodynamic sensitized tumor immunotherapy. Carrier-free iPSs are constructed by optimizing the noncovalent interactions between the pure drugs of chlorine e6 (Ce6) and NLG919, which avoid the excipients-raised toxicity and immunogenicity. Intravenously administrated iPSs prefer to passively accumulate on tumor tissues for a robust photodynamic therapy (PDT) with the induction of immunogenetic cell death (ICD) cascade to activate cytotoxic T lymphocytes (CTLs) and initiate antitumor immune response. Meanwhile, the concomitant delivery of NLG919 inhibits the activation of indoleamine 2,3-dioxygenase 1 (IDO-1) to reverse the immunosuppressive tumor microenvironment. Ultimately, the photodynamic sensitized immunotherapy with iPSs efficiently inhibit the primary and distant tumor growth with a low system toxicity, which would shed light on the development of self-delivery nanomedicine for clinical transformation in tumor precision therapy.

7.
Artigo em Inglês | MEDLINE | ID: mdl-32708617

RESUMO

Many adolescents with type 1 diabetes experience challenges in achieving good glycemic control and have insufficient understanding in executing interventions for glycemic control. This study aimed to understand self-management experiences of adolescents with type 1 diabetes in Taiwan. In this descriptive phenomenological study, we conducted in-depth interviews with 18 adolescents with type 1 diabetes from the pediatric outpatient clinic of a medical center. Data were analyzed using the Colaizzi's method. Four themes were identified: (1) misconception regarding self-management of blood glucose; (2) conflict between depending on and breaking away from parental assistance for glycemic control; (3) encounter with disruptions in glycemic control regimen due to the presence of schedule changes; and (4) lack of motivation to achieve good glycemic control. The findings indicated that the misconceptions of adolescents with type 1 diabetes about managing glycemic levels resulted from an insufficient understanding of self-management of diabetes. In Taiwan, the heavy emphasis of academic achievement and changes of schedules during breaks tended to disrupt the regimen for glycemic control. Healthcare professionals are encouraged to provide individualized education focusing on the adolescents' misconceptions regarding self-management of diabetes.


Assuntos
Diabetes Mellitus Tipo 1 , Autogestão , Adolescente , Glicemia , Diabetes Mellitus Tipo 1/terapia , Humanos , Motivação , Taiwan
8.
Huan Jing Ke Xue ; 40(8): 3612-3617, 2019 Aug 08.
Artigo em Chinês | MEDLINE | ID: mdl-31854767

RESUMO

Substrate type is an important factor affecting the quality of water deriving from rainfall onto extensively green roofed areas. Here, stabilized sludge was used as the main nutrient component of the substrate combined with biochar and a dual-substrate structure. Five green roof pilot facilities were constructed, and the effect of control measures on effluent quality was analyzed. The results showed that the stabilized sludge dosage was 3%, and the annual average mass concentrations of total nitrogen (TN) and nitrate nitrogen (NO3--N) were 3.27 mg·L-1 and 1.61 mg·L-1. The use of stabilized sludge as a nutrient component under real rainfall and temperature conditions in Shanghai did not cause significant leaching of TN and NO3--N. In order to further improve the quality of the effluent, biochar was used as an amendment measure. As a result, the concentrations of TN and NO3--N in the effluent were decreased to 2.16 mg·L-1 and 1.38 mg·L-1, respectively. Using an adsorption layer of pumice can alleviate the leaching of total phosphorus (TP) and chemical oxygen demand (COD). For the total nitrogen budget of each pilot facility, the retained TN was about 55% of the original TN after one year of operation. Thus, stabilized sludge could be used as a nutrient substrate to meet the long-term requirements of plants. In the substrate with biochar, the retained TN in the substrate and the NO3--N concentration in the effluent was decreased, which was related to the mineralization of organics during dry periods and the enhancement of denitrification during rainfall periods. Stabilized sludge was not a polluting source of N but was a source of P. Using biochar and a dual-substrate structure can effectively reduce the TN and COD load of the tested green roof facilities.

9.
Int J Nurs Pract ; 25(2): e12708, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30402922

RESUMO

AIM: Human immunodeficiency virus (HIV) stigma in people living with HIV is associated with depression and poor treatment adherence. The current literature lacks a Chinese instrument to measure HIV stigma in Taiwan. Thus, the purpose of this study was to develop an abbreviated Chinese translation version of Berger's HIV Stigma Scale. METHODS: The instrument development process was guided by Brislin's Translation Model of establishment of construct validity and convergent validity and verification of reliability. RESULTS: This study recruited 540 HIV-infected adults (January-November 2015). Data analysis using confirmatory factor analysis resulted in an 18-item abbreviated Chinese version of Berger's HIV Stigma Scale, consisting with four factors: personalized stigma (seven items), disclosure concerns (three items), negative self-image (four items), and concerns with public attitudes toward people with HIV (four items). The final model demonstrated a good fit. A positive correlation between HIV stigma and depression was found. The Cronbach α for internal consistency was 0.92. CONCLUSION: The 18-item abbreviated Chinese version of Berger's HIV Stigma Scale demonstrated adequate reliability and validity to assess HIV stigma among Chinese people living with HIV. It is a feasible tool that allows for rapid assessment of HIV-related stigma.


Assuntos
Infecções por HIV/psicologia , Estigma Social , Traduções , Adulto , China , Depressão/complicações , Análise Fatorial , Feminino , Infecções por HIV/complicações , Humanos , Masculino , Psicometria , Reprodutibilidade dos Testes , Autoimagem , Taiwan
10.
Nurse Educ Today ; 66: 110-116, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29702439

RESUMO

BACKGROUND: Clinical reasoning is an essential core competence for nurses. Maintaining quality of care and safety of patients results from cultivation of student's clinical reasoning competency. However, the concept of clinical reasoning in nursing students is complex and its meaning and process needs further clarification. OBJECTIVES: The objectives were to explore the meaning of clinical reasoning competency in Taiwanese nursing students and to operationalize the concept in order to structure a framework illustrating the process of clinical reasoning. SETTING AND PARTICIPANTS: Thirteen seasoned nursing experts who had more than ten years of experience in nursing education or clinical practice participated in the interviews. The interviews were conducted in settings that the participants perceived as convenient, quiet and free of disturbance. METHODS: Semi-structured interviews were conducted. The interviews were audio-recorded and field notes were taken. The data were analyzed using Waltz et al.'s (2010) method of content analysis. RESULTS: The data revealed four domains and 11 competency indicators. The four domains include: awareness of clinical cues, confirmation of clinical problems, determination and implementation of actions, and evaluation and self-reflection. Each domain comprises of 2-4 indicators of clinical reasoning competency. In addition, this study established a framework for cultivation of clinical reasoning competency in nursing students. CONCLUSION: The indicators of clinical reasoning competency in nursing students are interwoven, interactive and interdependent to form a dynamic process. The findings of this study may facilitate evaluation of nursing students' clinical reasoning competency and development of instruments to assess clinical reasoning in nursing students.


Assuntos
Competência Clínica , Docentes de Enfermagem/psicologia , Resolução de Problemas , Estudantes de Enfermagem , Adulto , Currículo , Bacharelado em Enfermagem , Feminino , Humanos , Entrevistas como Assunto , Pessoa de Meia-Idade , Pesquisa Qualitativa , Taiwan
11.
Eur J Oncol Nurs ; 22: 78-84, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27179896

RESUMO

PURPOSE: The purpose of this study was to understand the experiences of Taiwanese aboriginal adolescent survivors of childhood cancer during the process of recovery. METHOD: A snowball sampling strategy was used to recruit participants from the pediatrics unit of a medical center in the eastern region of Taiwan. In-depth interviews were conducted with 11 aboriginal adolescent childhood cancer survivors. The data were analyzed using content analysis. RESULTS: The results revealed three major themes with subthemes within each theme. The three major themes are: roots of resilience, transformation and growth, and meaning of traditional rituals for resilience. The three subthemes within "roots of resilience" include: "feeling secure through company of family, care and financial support", "receiving support from the important others and religion" and "learning to self-adjust". The three subthemes revealed within "transformation and growth" are: restructuring the relationship with peers, "appreciating parents' hard work", and "learning to seize the moment". The two subthemes within "meaning of traditional rituals to resilience" include: "feeling blessed with the power of ancestral spirits" and "strengthening ethnic identity". CONCLUSION: This study provided insight into the experiences of aboriginal adolescents as they recovered from childhood cancer. The experiences made positive impacts by inspiring growth in maturity and consolidating aboriginal ethnic identity. The adolescents were empowered by support from family, friends and clansmen, and by their participation in aboriginal rituals. As healthcare professionals care for the aboriginal adolescents, it is critical to consider this culturally and ethnically specific knowledge/experience of surviving cancer to improve quality of care.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Neoplasias/etnologia , Neoplasias/psicologia , Sobreviventes/psicologia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Acontecimentos que Mudam a Vida , Masculino , Neoplasias/terapia , Pais , Pesquisa Qualitativa , Resiliência Psicológica , Taiwan
12.
J Pediatr Nurs ; 30(2): 301-9, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25173181

RESUMO

The aim of this study was to understand the Indonesian mothers' experiences of managing preschool children's acute abdominal pain. The descriptive qualitative research design comprises semi-structured interviews with 11 Indonesian mothers. The qualitative content analysis revealed three themes, including (1) insight of abdominal pain, (2) "inheritance of the strategies for assessment of management for abdominal pain from the family of origin", (3) "obstacles and insights related to cultural differences". The results presented that pain management was affected by family, environment, cultural background and religious beliefs. Healthcare providers should provide culturally competent pain management care for the patients of difference nationalities.


Assuntos
Dor Abdominal/enfermagem , Atitude Frente a Saúde/etnologia , Assistência à Saúde Culturalmente Competente/métodos , Mães/psicologia , Dor Abdominal/fisiopatologia , Doença Aguda , Adulto , Feminino , Humanos , Indonésia/etnologia , Masculino , Relações Mãe-Filho/psicologia , Manejo da Dor/métodos , Pesquisa Qualitativa , Taiwan
13.
Opt Lett ; 37(9): 1559-61, 2012 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-22555737

RESUMO

This paper presents the design of a rugged and compact Fourier transform spectrometer (FTS) utilizing a birefringent prism, a pair of polarizers and a linear CCD array. This design improves on existing FTS by eliminating moving parts and spreading the optical path difference (OPD) spatially (rather than temporal scanning), making the system smaller, more reliable, and dramatically reducing measurement times. Both the theoretical models for the design and experimental results of the prototype are presented. The optical performance is tested using LEDs of known wavelengths, with the fringe counting technique employed during interferogram acquisition to ensure accurate sampling of the interferogram at constant OPD intervals. Reconstructing the spectra showed that the detected wavelengths deviated from the actual wavelengths by less than 1 nm.

14.
J Pediatr Oncol Nurs ; 28(6): 326-35, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22194145

RESUMO

Neuroblastoma is a common malignant tumor among children. Seventy percent of children with neuroblastoma have metastatic disease when the diagnosis is established. The aim of this study was to understand the main caregivers' lived experiences in managing pain for children with neuroblastoma. A descriptive qualitative design was used. Twelve main caregivers of children with neuroblastoma were interviewed. Two themes evolved: experiences of pain and coping with pain. Three subthemes were found under the theme "experience of pain": pain assessment based on language expressions and behavioral observations, tendency of misdiagnosing tumor metastasis-related pain, and unique manifestations of pain at various phases. Four subthemes evolved under the theme "coping with pain": utilization of pharmacological and nonpharmacological modalities for pain management, learning to confront pain, seeking mental and emotional support, and adjustment of family lifestyle. The results provide a description regarding the expression of pain in children with neuroblastoma and the pain management modalities used by the main caregivers. The findings serve as a reference for health care providers in Taiwan as they manage pain for children with neuroblastoma and seek to understand the needs of the main caregivers.


Assuntos
Cuidadores/psicologia , Neuroblastoma/enfermagem , Dor/tratamento farmacológico , Adaptação Psicológica , Adolescente , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Neuroblastoma/complicações , Dor/etiologia , Taiwan
15.
Hu Li Za Zhi ; 55(3): 21-5, 2008 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-18543181

RESUMO

Exercise-induced bronchospasms (EIBs) are transient constrictions of the airways resulting from exercise. They often occur after 10 to 15 minutes of moderate to vigorous exercise. EIBs are a very prevalent phenomenon. They occur in about 12% of the US pediatric population. Within this population, 30% of them may develop asthma. With proper pharmacological and nonpharmacological interventions, the symptoms of EIB can be properly managed. The roles of nurses in the management of EIB include: providing education in relation to the pharmacological and nonpharmacological interventions, and assisting parents and patients in setting realistic goals for activity and medication. With proper interventions, EIB should not limit either participation or success in activities.


Assuntos
Asma Induzida por Exercício/terapia , Asma Induzida por Exercício/diagnóstico , Asma Induzida por Exercício/etiologia , Criança , Humanos , Papel do Profissional de Enfermagem
16.
IEEE Trans Biomed Eng ; 55(2 Pt 1): 614-25, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18269997

RESUMO

A flexible high-resolution sensor capable of measuring the distribution of pressure beneath the foot via a microfabricated optical waveguide system is presented. The uniqueness of the system is in its batch fabrication process, which involves a microfabrication molding technique with polydimethylsiloxane (PDMS) as the optical medium. The sensor manufacturing technique is described in detail, the optical performance of the waveguides is quantified and the effect of using a matching fluid to improve fiber-coupling efficiency is demonstrated. Mechanical loading tests were performed on a 4 x 4 array with a 2-mm spacing between sensing elements. Loading displacement curves were obtained using a 0 to 0.4 mm triangle loading profile. A force of 0.28 N applied to one of the sensing elements produced a displacement of a 0.325 mm and 39% change in the output light intensity. Multiple loadings were conducted to demonstrate the repeatability of the sensor. A force image algorithm with a two-layer neural network system was used to identify four load magnitudes and four different shaped applicators. All four shapes were successfully identified with the neural network.


Assuntos
Algoritmos , Técnicas Biossensoriais/instrumentação , Pé/fisiologia , Manometria/instrumentação , Redes Neurais de Computação , Óptica e Fotônica/instrumentação , Desenho de Equipamento , Análise de Falha de Equipamento , Humanos , Miniaturização , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
17.
Hu Li Za Zhi ; 53(4): 11-6, 2006 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-16874597

RESUMO

Sudden infant death syndrome (SIDS) is the unexplained sudden death of an infant under one year of age. In Taiwan, although the number of SIDS cases decreased between 1997 and 2003, the ratio for the number of such cases to infant mortality has been consistently increasing. Even though the cause of SIDS is unknown, risk factors have been identified in the literature on the subject. Nurses may help in reducing the risk of SIDS by educating parents about the risk factors. The purpose of this paper is to describe SIDS and to recommend nurses to implement the new recommendations of the American Academy of Pediatrics (AAP) to reduce the risk of SIDS. Released in 2005, these emphasize the importance of the prone position, the use of a pacifier during sleep, and the dangers of using soft bedding and of bed sharing. Side position is no longer recommended as a rational alternative of prone position. The recommendations also indicate the need to educate secondary caregivers and health care providers about SIDS.


Assuntos
Sono , Morte Súbita do Lactente/prevenção & controle , Humanos , Lactente , Cuidado do Lactente , Recém-Nascido , Postura , Fatores de Risco , Morte Súbita do Lactente/etiologia
18.
J Nurs Res ; 11(4): 241-50, 2003 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-14685930

RESUMO

Little information was found in studying Taiwanese children's pain experiences. Because pain is culturally shaped, health care providers should not assume Taiwanese children's pain to be identical to those of children in the US. Thus, a qualitative descriptive study with semi-structured interview of 90 hospitalized Taiwanese children with acute pain was conducted to understand Taiwanese children's pain experiences. Krippendorff's (1980) content analysis was used to guide the data analysis. Seven themes from the interview data were presented, including definition of pain, quality of pain, previous pain experiences, pain expectation, pain acceptance, causes of pain and meaning of pain. Surprisingly, the results of this study revealed few differences in the experiences and meanings of pain. Most results are consistent with the studies done in the US. Differences are minor, including the interpretation of children's crying and how Taiwanese parents talk with their children about pain, and are probably related to the sample sizes and methodology of the studies. Further research is necessary about the influence of culture upon children's pain experiences.


Assuntos
Atitude Frente a Saúde/etnologia , Criança Hospitalizada/psicologia , Dor/etnologia , Psicologia da Criança , Doença Aguda , Adaptação Psicológica , Adolescente , Fatores Etários , Causalidade , Criança , Comportamento Infantil/etnologia , Comportamento Infantil/psicologia , Pré-Escolar , Comparação Transcultural , Choro/psicologia , Expressão Facial , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pesquisa Metodológica em Enfermagem , Dor/etiologia , Dor/prevenção & controle , Pesquisa Qualitativa , Inquéritos e Questionários , Taiwan , Estados Unidos
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