ABSTRACT

This paper discusses the potentiality of using narratives and field diaries for and in health education in the module ‘Encounters and Production of Narratives’ of the Work in Health Axis, which is part of the curriculum of Health Courses of the Health and Society Institute of the Baixada Santista Campus of the Federal University of São Paulo. Discourse analysis was used as a tool for analyzing field diaries and narratives from 2017 and 2019. Gradual changes promoted by narrative encounters linked to the social-environmental health content introduced in the module can be seen in the statements. The discourse in the diaries and narrative is permeated with polysemic gaps that give new meanings to the learning. Thus, a shift from the familiar and reproduction of the hegemonic become evident, adopting a perspective that advocates for the guarantee of rights, including the right to health, and expresses an expanded understanding of the health and disease process and its relationship to the socio-environmental issue.

KEYWORDS
Environmental impact; Interprofessional education; Problem-based learning

Introduction

Socio-environmental health is the study of the social impact resulting from the environmental conditions that act as determinants in the disease process and includes complex educational modalities of prevention, screening, assistance, cure, and social care aimed at a comprehensive health care approach based on health promotion^{11 Ferretti N. Saúde socioambiental e conselho local de saúde: um estudo no âmbito da Estratégia Saúde da Família no município do Rio Grande/RS. [dissertação]. Rio Grande: Universidade Federal do Rio Grande; 2009. [acesso em 2021 out 15]. Disponível em: http://repositorio.furg.br/bitstream/handle/1/2402/nadia%20ferretti.pdf?sequence=1.
http://repositorio.furg.br/bitstream/han... ,22 Castelo Branco J. Convenção de Estocolmo Sobre Poluentes Orgânicos Persistentes: Impactos Ambientais, Sociais e Econômicos Associados. [dissertação]. Diadema: Universidade Federal de São Paulo; 2016. [acesso em 2021 out 16]. Disponível em: https://repositorio.unifesp.br/handle/11600/46547.
https://repositorio.unifesp.br/handle/11...} .

From this perspective, the training aims to provide students with the opportunity to develop a view beyond the management of disease toward a vision of health promotion, prevention, and screening that seeks ways to develop questioning thinking about the origins of disease intertwined with environmental issues. The opportunity to broaden the perspective of future professionals who’ll work in a variety of professional settings helps to foster a critical awareness of social-ecological issues in health upon graduation.

The goal is to cover the undergraduate student’s view of the environmental issue from the presentation of environmental problems that have occurred and are currently occurring with a focus in the social issue associated with these situations. Likewise, attention will be drawn to the importance of interdisciplinary action necessary to observe, understand, and act on these processes. Environmental problems are related to health and social issues, and it is important to bring this broader concept into professional training.

From a socio-environmental health perspective, education is needed that teaches broader, more complex practices that focus on the health needs of populations and their interactions with the environment and territories, including in socio-environmentally impacted communities, as explained by Augusto^{33 Augusto SGL. Inter-relações entre a Saúde Ambiental e Saúde do Trabalhador e a Atenção Básica de Saúde no SUS. In: Associação Brasileira de Saúde Coletiva. I Conferência Nacional de Saúde Ambiental. Rio de Janeiro: Abrasco; 2009. p. 105-108. [acesso em 2021 out 15]. Disponível em: http://www5.ensp.fiocruz.br/biblioteca/dados/txt_7832566.pdf.
http://www5.ensp.fiocruz.br/biblioteca/d... (107)}:

Working with the environment-health-society tripod in health education consists in anchoring education in the concreteness of everyday life, and in the case of narratives, in addition to the facts, with the people who are directly or indirectly affected. Through life stories, then, we aim to understand the process of health and disease, taking the environmental issue as a starting point. Considering the approach of the common health clinic^{44 Capozzolo AA, Imbrizi JM, Liberman F, et al. Formação descentrada na experiência. In: Capozzolo AA, Casetto SJ, Henz AO, organizadores. Clínica Comum: Itinerário de uma formação em Saúde. São Paulo: Hucitec; 2013. p. 124-50.}, social-ecological health aims to add this dimension to the health clinic. In this way, a critical-reflexive understanding of socio-environmental health is created.

This study discusses the use of field diaries and narratives in health education based on experiences with transversal integration of socio-environmental health in interprofessional health education.

Methodology

Context and scope of the study

This study includes the partial results of a research under development, which focuses on the experience of transversal involvement of social and environmental health in the module ‘Encounters and Production of Narratives’ of the common Health Work Axis of the Institute of Health and Society (ISS) of the Federal University of São Paulo, Campus Baixada Santista.

The Health Work Axis aims to take a comprehensive look at the health-disease-care process and the Unified Health System (SUS)^{44 Capozzolo AA, Imbrizi JM, Liberman F, et al. Formação descentrada na experiência. In: Capozzolo AA, Casetto SJ, Henz AO, organizadores. Clínica Comum: Itinerário de uma formação em Saúde. São Paulo: Hucitec; 2013. p. 124-50.,55 Capozzolo AA, Casetto SJ, Imbrizi JM, et al. Narrativas na Formação Comum de Profissionais de Saúde. Trab. Educ. Saúde. 2014 [acesso em 2020 nov 6]; 12(2):443-56. Disponível em: https://doi.org/10.1590/S1981-77462014000200013.
https://doi.org/10.1590/S1981-7746201400... (244),66 Azevedo AB, Pezzato LM, Mendes R. Formação interdisciplinar em saúde e práticas coletivas. Saúde debate. 2017 [acesso em 2021 fev 3]; 41(113):647-57. Disponível em: https://doi.org/10.1590/0103-1104201711323.
https://doi.org/10.1590/0103-11042017113... ,77 Batista NA, Rossit RAS, Batista SHSS, et al. Educação Interprofissional na Formação em Saúde: a experiência da Universidade Federal de São Paulo, campus Baixada Santista, Santos, Brasil. Interface. 2018 [acesso em 2020 dez 10]; (2):1705-15. Disponível em: https://doi.org/10.1590/1807-57622017.0693.
https://doi.org/10.1590/1807-57622017.06...} . In the module Encounters and Production of Narratives, which is developed in the third semester of the courses, activities related to health work are developed, including relationship facilitators and difficulties between professionals and health care users, limits faced by users and service workers, although the students are still in the condition of being educated^{44 Capozzolo AA, Imbrizi JM, Liberman F, et al. Formação descentrada na experiência. In: Capozzolo AA, Casetto SJ, Henz AO, organizadores. Clínica Comum: Itinerário de uma formação em Saúde. São Paulo: Hucitec; 2013. p. 124-50.,55 Capozzolo AA, Casetto SJ, Imbrizi JM, et al. Narrativas na Formação Comum de Profissionais de Saúde. Trab. Educ. Saúde. 2014 [acesso em 2020 nov 6]; 12(2):443-56. Disponível em: https://doi.org/10.1590/S1981-77462014000200013.
https://doi.org/10.1590/S1981-7746201400...} .

This module has as general objective to:

It also seeks to promote a humanistic education of future health professionals by participating in the educational processes designed to prepare them to provide comprehensive health care and by rejecting the reduction of the subject to a purely biological condition^{99 Oliveira CM, Batista NA, Batista SHSS, et al. A escrita de narrativas e o desenvolvimento de práticas colaborativas para o trabalho em equipe. Interface. 2016 [acesso em 2020 dez 8]; 1005-14. Disponível em: https://doi.org/10.1590/1807-57622015.0660.
https://doi.org/10.1590/1807-57622015.06...} .

Forty-one students from the six ISS courses (nutrition, psychology, social work, physical therapy, occupational therapy, and physical education) participated in the classroom activities that constituted the study. The students met with people affected by pollution and environmental contamination in their residential areas in the cities of Santos and Cubatão, in the metropolitan region of Baixada Santista, in the state of São Paulo.

In this proposal, students begin by listening to life stories and writing them down in field diaries and later elaborating on the text of the narratives, taking into account the context in which these stories are found and trying to trace and grasp the constituent factors of the historical moment in which the narrators meet. The narrators are people who live in marginal neighborhoods, on stilts, with poor sanitation, in areas with heavy environmental pollution and negative impacts.

These neighborhoods have suffered from environmental impacts for decades that are important for understanding socio-environmental health, primarily related to human exposure to chemical emissions from industrial port activities. These ‘chronic’ negative impacts were exacerbated by the 2015 fire at a fuel terminal near these communities, which resulted in days of heavy pollution, with serious public health impacts.

The other group of narrators was formed by workers of a chemical industry in the Cubatão region, who were exposed to persistent organic pollutants during the working day and were chronically intoxicated with hexachlorobenzene (HCB). Even today, more than 30 years after the event, these workers suffer social and health consequences of various kinds due to contact with this chemical compound.

Data production process

The narrative developed in this specific educational context is a hybrid composition: influence of the thematic oral history^{1010 Meihy JCSB, Holanda F. História oral: como fazer, como pensar. 2. ed. (4). São Paulo: Contexto; 2015. p. 33-42.} and narrative medicine^{1111 Charon R. Narrative Medicine - A Model for Empathy, Reflection, Profession, and Trust. JAMA. 2001 [acesso em 2020 nov 11]; 286(15):1897-1902. Disponível em: https://doi.org/10.1001/jama.286.15.1897.
https://doi.org/10.1001/jama.286.15.1897...} .

Within the broader concept of the health-disease process, the use of narratives is considered to go beyond a clinical, purely biological perspective. In the context of the analyzed experience, it is also a resource for students’ understanding of social and health harms that result from ecological imbalances created by human actions in the environment.

Narrative was not the only form of analysis in this study. Field diaries were also used, written after each meeting, and their density of content - descriptive, reflective, and intensive - is important to the study. The final report (or the narrative of an individual student) was also considered a field diary, as it represents material for reflection on the process.

From the perspective of Barber^{1313 Barbier R. A pesquisa-ação. Brasília, DF: Liber Livro; 2002.(133)}, the diary can be understood as:

By exercising self-knowledge through the movement of self-writing, through the reflection of the lived encounters, stories, territories, through the effort to recognize their limitations and previously developed concepts, students have the opportunity to practice reflective criticism in working in the health field.

As a place to record experiences, the field diary has the power to generate new perspectives on the interactions and situations experienced, to engage with what concerns them. In the words of Spink^{1414 Spink PK. Pesquisa de campo em psicologia social: Uma perspectiva pós-construcionista. Psicol. Soc. 2003 [acesso em 2022 abr 7]; 15(2):18-42. Disponível em: https://doi.org/10.1590/S0102-71822003000200003.
https://doi.org/10.1590/S0102-7182200300... (36)}:

In the educational experience under study, the field diaries not only tracked students’ reflections on the experience of the meetings, but also opened rifts in what was observed and what was unobserved, silences, mobilized affects, activated memories, and existential territories^{1515 Alvarez J, Passos E. Cartografar é habitar um território existencial. In: Passos E, Kastrup V, Escóssia L, organizadores. Pistas do método da cartografia: pesquisa-intervenção e produção de subjetividade. Porto Alegre: Sulina; 2012. p. 131-149.}.

This study presents the discourse analysis of a couple’s narrative from 2017 and a student’s five field diaries from 2019. For the selection of these field diaries, the corpora that bring more reflections and student descriptions become so-called concepts-analysis.

Data analysis process

Discourse analysis views the text as a ‘monument’ into which cuts can be made in order to interpret the discourse inherent in the text, which is a “complex unit of meanings”^{1616 Minayo MCS. O desafio do conhecimento: pesquisa qualitativa em saúde. 14. ed. São Paulo: Hucitec; 2014. p. 318-27.(321)}. The way a text, created in a particular context and originating from a particular historical subject, is interpreted aims at meeting the research objective through thematic analysis in the context of social and environmental health.

Any discourse analysis is an interpretation of the meanings promoted by the discourses, by the words that circulate, in which the speaker speaks with the idea of producing a meaning for the receiver, who in turn may not interpret in the same way as the sender, because there is a conception of the world that influences the way the message is also internalized. We aimed to interpret and understand what the text meant in the context of this study, remembering that words do not have a meaning by themselves, but in the context of memory, as Orlandi^{1717 Orlandi EP. Interpretação: autoria, leitura e efeitos do trabalho simbólico. 5. ed. Campinas: Pontes Editores; 2007.(52)} says, “it is the text that means”. Starting from the material surface of the text, the analytical movement of describing and interpreting the meaning of the text is undertaken.

The procedure proposed in this study was to analyze the paraphrases of the text, that is, the return to the same space of saying, with the matrices of meaning, similar to what Freire^{1818 Freire S. Análise de Discurso - Procedimentos Metodológicos. Manaus: Instituto Census: Educação e Gestão do Conhecimento; 2014.} proposed. There is an intrinsic relationship between paraphrase, the return to existing meanings (which are more socially delimited, such as patriarchy) and polysemy, the possibility of breaking with what is said, the ‘new’ meanings for symbolic objects^{1717 Orlandi EP. Interpretação: autoria, leitura e efeitos do trabalho simbólico. 5. ed. Campinas: Pontes Editores; 2007.,1919 Orlandi EP. Análise de Discurso: princípios & procedimentos. 8. ed. Campinas: Pontes; 2009.,2020 Brandão HHN. Introdução à análise do discurso. 2. ed. rev. Campinas: Unicamp; 2004.}. That is, in the paraphrasing movement of discourse stagnated in meaning, polysemy can occur, indicating a tendency to deviate from sociocultural determinations, therefore, from what is customary, because “despite the particularities, paraphrase and polysemy interpenetrate and press meaning between preservation and change”^{2121 Ribeiro VV. Memória, paráfrase e polissemia em diários de leituras: análise dos gestos de intepretação de estudantes do ensino médio. Rev Memorare. 2018 [acesso em 2020 abr 10]; 5(2):58-82. Disponível em: https://doi.org/10.19177/memorare.v5e2201858-82.
https://doi.org/10.19177/memorare.v5e220... (62)}, summarizing in the present context the expression of what was experienced in the field.

The study was approved by the Research Ethics Committee and received Certificate of Ethical Appreciation CAAE No. 81066017.3.0000.5505. The students and narrators were given code names of authors and characters from Brazilian literature.

Results

Exploring the field diaries

The analyzed diaries were written by Ana Aurora do Amaral Lisboa, from the Social Work course, and the narrator was Pedro Rubião, who was in a very fragile state of health and had a history of repeated strokes, sudden fainting spells, and weakness. The conversations focused on the industrial pollution he had experienced and the consequences on his health. The concepts of analysis that emerged were: polluted territory, health effects, case details, environmental justice, social-ecological issue and identification with the issue.

The words ‘difficult to understand’ indicate the injustice that seems obvious to the student. With regard to the motion filed by Pedro in the judiciary, Ana’s speech shows the discursive formation that contrasts with the length of the court proceedings. For the student, there is sufficient evidence that damage has been done that needs to be repaired, that justice needs to be established in favor of the narrator. She argues that there is documented evidence of pollution and health effects that weaken the narrator, so justice is urgently needed.

As a learner, Ana Aurora takes a position that shows that experiencing the narrative encounter and knowing the whole process involved in the case contributed to reflection. In her position as a learning subject, her attitude changed from the uncritical belief in law compliance that she had learned in other places and courses, and the practical learning in this context touched her and triggered strong feelings. She found that in practice there were deficiencies in the enforcement of laws that she once believed would be followed to the letter if they benefited workers. This made her realize that there is another movement besides the laws themselves: There are people and powers that move in opposing interests.

Ana’s statement is intended to stimulate reflection on socio-environmental health and, briefly, begins by referring to the socio-environmental issue in determinants and conditions of health. She lists various factors that affect the environment through human actions, including what she’s come to know (workers from some sectors, community activities). She does not limit the criticism to humans themselves and their actions in the environment, but wants to point out that there are effects of these actions on humans themselves, who are affected and influenced by them. The word ‘changes’ refers to adverse effects on the environment.

In the position of someone who is in the process of learning, Ana Aurora summarizes in the context of socio-environmental health to signal that there is an expanded understanding of environmental issues and the health and disease process that results from human actions that have caused imbalance and changes in the environment.

The narrative suggests that there were changes in matters about which she thought she knew everything. Thus, it was not only a matter of writing a narrative that was challenging for her, but also of reviewing what she previously thought she possessed and what she thought she ‘already knew’. Such ‘necessary confrontations’ during the process were important for the student to reflect that there is always something to learn, even in areas where she considers herself knowledgeable. Ana Aurora left the quiet place she had occupied at the beginning of the module as she ‘develops a greater social and environmental awareness’.

The meaning that Ana Aurora expresses in her statement is that from the beginning she was open to the development of narratives on social-environmental health, since she had professional knowledge in the fields of environment and occupational safety, but there was a shift in the perception of what was already known. Therefore, added to the perspective of the meetings and classroom instruction was the challenge of re-elaborating what was already known about the environment.

Exploring the narrative

The analyzed narrative was by Aurélia Camargo and was written by the duo Rachel de Queiroz, from the Psychology course, and her partner Cecília Meireles, from the Social Work course. The concepts of analysis that emerged were: Health Conditions, Case Details, Health Impacts, Socio-environmental issues and Environmental Justice.

The students place the reader in the subject of the fire and articulate what is written with what the episode means to the narrator. They begin with the impact on Aurelia’s life, which was permanent. They describe the contents of the tanks that contained fuel, the name of the company, and the location of the event, placing the recipient of the message in what it is all about. With the ‘signs of destruction’ they refer to the importance of the fire scenario, because from the tanks there were flames that would spread if the fire was not contained in time.

The duo conveys what the fire represented from the perspective of the narrator and the other inhabitants, as the feelings of fear and uncertainty were common to all. The use of expressions with opposite meanings, such as ‘little’ and ‘much’ when referring to information about what was happening, is meant to emphasize the effect on the inhabitants.

To point out that the consequences of the fire were much greater for residents living near the company’s premises, the students used words that refer to intensity: ‘all the pollution’.

In this way, the students want to point out the environmental injustice of having a fire in close proximity to the people in the community and its consequences in the air. Working with the notion of intensity with the reader, they have an idea of what the air quality was like on the days of intense environmental degradation (long days).

The duo’s narrative statement is meant to show that there were victims, the narrator herself being an example. The words ‘numerous victims’ represent the health consequences of the fire.

The students present a narrative discourse that there was a social and environmental injustice with Aurelia and many other people who were not recognized as victims, even though they suffer from the damage to this day.

Discussion

Gradual changes promoted by the narrative encounters between Ana Aurora Lisboa and Rubião can be seen in the statements, which are related to the social-environmental health content introduced in the module. This is confirmed by Capozzolo et al.^{55 Capozzolo AA, Casetto SJ, Imbrizi JM, et al. Narrativas na Formação Comum de Profissionais de Saúde. Trab. Educ. Saúde. 2014 [acesso em 2020 nov 6]; 12(2):443-56. Disponível em: https://doi.org/10.1590/S1981-77462014000200013.
https://doi.org/10.1590/S1981-7746201400...} and Goulart et al.^{2222 Goulart PM, Pezzato LM, Junqueira V. Experiências narrativas: um relato de formação em saúde. Linhas Críticas (UNB). 2018 [acesso em 2021 fev 2]; (24): 237-54. Disponível em: https://doi.org/10.26512/lc.v24i0.18978.
https://doi.org/10.26512/lc.v24i0.18978...} when they speak of changes and transformations that occur in the educational process through narrative encounters.

As Morin^{2323 Morin E. O Método 4. As ideias: habitat, vida, costumes, organização. 4. ed. Porto Alegre: Sulina; 2008.(35)} points out,

The liveliness created by dialogic encounters and the exchange of ideas between students and narrators with different life stories and perspectives and unfavorable socio-environmental circumstances contributes to the flexibility of the students’ field experience.

Ana Aurora gradually demonstrates the extent to which Rubião’s revelations contribute to her rethinking of the positions anchored in her concepts and her self-perception as a subject in transition. This process of reflection that Ana Aurora carries out with the help of the field diary is a pedagogical-didactic tool that encourages self-reflection, because:

And it is in line with meaningful learning, which, for Rogers^{2525 Rogers CR. Tornar-se Pessoa. 5. ed. São Paulo: Martins Fontes; 2001.(323)}, is

And as Pelizzari et al.^{2626 Pelizzari A, Kriegl ML, Baron MB, et al. Teoria da aprendizagem significativa Segundo Ausubel. Rev. PEC. 2002; 2(1):37-42.} explain, it is about the student’s learning to learn, which moves toward the modification and/or extension of structures that enable the construction and reconstruction of knowledge. The student also shows interest in expanding on topics brought up at the meetings as she seeks more information, such as the details of the names of chemical products and their effects. Highlighting what Souza, Vilaça and Teixeira^{2727 Souza ALD, Vilaça ALA, Teixeira HJB. Os benefícios da metodologia ativa de aprendizagem na educação. In: Costa GMC, organizador. Metodologias ativas: métodos e práticas para o século XXI. Quirinópolis: Editora IGM; 2020. p. 33-45.(44)} say,

The use of a field diary in health education from a socio-environmental health perspective made it possible to observe the processes set in motion in each movement of the students in the module, thus representing the triangular relationship between the experience of encountering those who need health care, the articulation with the theoretical framework of the module, and the mediation by the professor in this process. As Vieira^{2828 Vieira JA. O uso do diário em pesquisa qualitativa. Cad. Ling. Soc. 2001 [acesso em 2021 jan 13]; (5):93-104. Disponível em: https://periodicos.unb.br/index.php/les/article/view/6518/5597.
https://periodicos.unb.br/index.php/les/...} states, the diaries have the ‘sincerity’ factor, since there is no right and wrong. Therefore, there is more freedom when writing about fears, doubts, emotions and sensations that may not appear when sharing in a group with peers.

The narrative discourse of the pair of students is developed to represent the narrator’s perception of the health-disease process that resulted from the fire, as well as the changes that have occurred in Aurelia’s living conditions since then. The students point out that Aurelia’s position has changed and she now begins to see herself as a victim of the fire. She now has a different perspective, that of finding legal professionals who can support her in a claim for damages. This situation confirms Cunha^{2929 Cunha MI. Conta-me agora! As narrativas como alternativas pedagógicas na pesquisa e no ensino. R. Fac. Educ. 1997 [acesso em 2021 jan 11]; (23):185-95. Disponível em: https://doi.org/10.1590/S0102-25551997000100010.
https://doi.org/10.1590/S0102-2555199700... (187)}, who says: “When a person reports the facts that he or she is experienced, it is felt that he or she is reconstructing the path traveled and giving it new meanings”.

Narratives are considered a task that involves art, transcreation. Based on the fact that it is a feedback for the narrator, this narrative is usually constructed as the students perceive this narrator. The central theme of the narrative encounters, the fire and its consequences for individual and collective health, runs through the narrative. However, the description of the narrator, her personality, tastes, and perceptions of the facts were not disregarded in order to bring the person into focus and give her a leading role.

Aurora expresses her perception in the field diary that no matter how much she plans the meeting, there is the uncertainty factor inherent in actions between people, that is, the meeting does not take place exactly as it is idealized, as it begins with the narrator, how he decides to share his memories, as well as what he conceals. If we follow Ana Aurora’s field diary from the first encounter with the narrator, noticing the process of estrangement, the resistance to previous certainties and those resulting from previous formations, as well as her perception of having left another person in the process, and even changes that are not perceived but are contained in the meaning of the discourse, there is a confirmation of what Capozzolo et al.^{55 Capozzolo AA, Casetto SJ, Imbrizi JM, et al. Narrativas na Formação Comum de Profissionais de Saúde. Trab. Educ. Saúde. 2014 [acesso em 2020 nov 6]; 12(2):443-56. Disponível em: https://doi.org/10.1590/S1981-77462014000200013.
https://doi.org/10.1590/S1981-7746201400... (453)} say about health work in encounters and in the production of narratives:

This possibility, referred to by the authors, can be observed in the way the narrative is elaborated, reflecting the forms of approach that have been built up, which include affection, attention, estrangement, and familiarity. In the field diary, in addition to the descriptive observations, the thoughts and feelings evoked by the narrative encounters are also presented in more detail, as all senses are intertwined and permeate professional health care practice.

Final considerations

Field diaries and narratives as pedagogical strategies and tools that mobilize creativity, sensitivity, and interest in what the other has to say about his or her health-disease process and life story are consistent with training that invites the trainee to co-author the training process. They are important allies in capturing emerging and relevant issues that can be brought into the health education process as material for study and analysis. There is also the dimension of individual feedback to the students, which opens up new possibilities of understanding and openness.

The discourse in the diaries and in the narrative is permeated by polysemic gaps, as it tends to give new meanings to learning. Thus, movements that abandon the familiar, the reproduction of the hegemonic, and adopt perspectives that advocate for the guarantee of rights, including the right to health, are perceived as articulating an expanded understanding of the health-disease process and its relationship to the socio-environmental issue.

It is important to develop future studies on the inclusion of socio-environmental health in health education in other educational contexts and from other methodological perspectives.

Acknowledgment

The authors would like to thank the Coordination for the Improvement of Higher Education Personnel (CAPES) and the research participants.

References

Publication Dates

History