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RESEARCH
Assessing the adequacy of workload measurement tools using a quality-based methodology
Revista Brasileira de Enfermagem. 2017;70(1):39-46
01-01-2017
Abstract
RESEARCHAssessing the adequacy of workload measurement tools using a quality-based methodology
Revista Brasileira de Enfermagem. 2017;70(1):39-46
01-01-2017DOI 10.1590/0034-7167-2016-0246
Views0See moreABSTRACT
Objective:
determine which tool (NEMS and NAS) is most suitable for use in intensive care units using a quality-based methodology.
Method:
after identifying the opportunity for improvement “Inadequacy of the NEMS for determining nursing workload in the intensive care unit (ICU)”, we assessed the NEMS and the NAS, as a proposed improvement to the NEMS, using quality improvement cycles methodology based on the following criteria: measurement of daily nursing workload on a daily and shift basis; the tool encompasses all nursing activities undertaken in the ICU; and workload assessed per patient and unit.
Results:
there was no significant difference in level of compliance for the NEMS (67%). The comparison NEMS-NAS showed that there was a statistically significant improvement for all criteria except criterion 1. The NEMS only assesses criterion 1 (64.22%); while the NAS assessed all four criteria, obtaining a compliance rate of 64.74% for criteria 1, 2, and 4, and 100% for criterion 3.
Conclusion:
the NAS is more suitable for measuring nursing workload in UCIs.
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RESEARCH
Educational nursing intervention to reduce the hyperphosphatemia in patients on hemodialysis
Revista Brasileira de Enfermagem. 2017;70(1):31-38
01-01-2017
Abstract
RESEARCHEducational nursing intervention to reduce the hyperphosphatemia in patients on hemodialysis
Revista Brasileira de Enfermagem. 2017;70(1):31-38
01-01-2017DOI 10.1590/0034-7167-2016-0015
Views0See moreABSTRACT
Objective:
to evaluate the effectiveness of an educational nursing intervention to reduce hyperphosphataemia in chronic renal patients on hemodialysis.
Method:
quasi-experimental study with 63 hyperphosphatemic patients on hemodialysis. The intervention consisted of developing and providing a printed and illustrated manual to patients containing information on disease control. The participant was asked to complete a daily checklist with the aim to reinforce aspects provided in the manual. Laboratory tests and itching intensity were analyzed at the beginning of the study, and at 30 and 60 days after the educational intervention.
Results:
the mean age of participants was 58±13.1 years, with a treatment time of 51.1±44.7 months. A reduction in serum phosphorus values of 7.06 ± 1.43 to 5.80 ± 1.53 (p <0.001) and the intensity of itching after the intervention was observed.
Conclusion:
the educational nursing intervention was effective in reducing phosphate and decreasing itching in hyperphosphatemic patients.
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RESEARCH
Filial care and the relationship with the elderly in families of different nationalities
Revista Brasileira de Enfermagem. 2017;70(1):22-30
01-01-2017
Abstract
RESEARCHFilial care and the relationship with the elderly in families of different nationalities
Revista Brasileira de Enfermagem. 2017;70(1):22-30
01-01-2017DOI 10.1590/0034-7167-2015-0050
Views0See moreABSTRACT
Objective:
identify how filial care and the relationship with the elderly occur in families of different nationalities.
Method:
qualitative study carried out in a town on the triple frontier of Paraná, comprising 33 elderly people of five different nationalities, adopting the Symbolic Interactionism and the Grounded Theory as theoretical-methodological strategy.
Results:
among Lebanese people, the Muslim religion teaches children to obey and respect parents; among French, distant family relationships and institutions for the elderly stand out. Paraguayans hold close family relationships; Chinese people consider filial care as a tacit obligation; Brazilians, in turn, tend to embrace and take care of their parents in old age.
Conclusion:
family care prevailed, but the traditions of each society lead the actions of that care, demanding health professionals’ capacity of recognizing in which context the elderly is inserted.
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RESEARCH
Excess fluid volume: sociodemographic and clinical analysis in haemodialysis patients
Revista Brasileira de Enfermagem. 2017;70(1):15-21
01-01-2017
Abstract
RESEARCHExcess fluid volume: sociodemographic and clinical analysis in haemodialysis patients
Revista Brasileira de Enfermagem. 2017;70(1):15-21
01-01-2017DOI 10.1590/0034-7167-2015-0138
Views0See moreABSTRACT
Objective:
To analyse the defining characteristics and related factors in the nursing diagnosis Excess fluid volume and its relationship to sociodemographic and clinical variables in haemodialysis patients.
Method:
Cross-sectional study, conducted using a form and physical examination, with a sample of 100 patients, between December 2012 and April 2013 at a university hospital and a dialysis clinic.
Results:
It was found 10 significant statistical associations between the defining characteristics/ related factors of Excess fluid volume and the sociodemographic and clinical variables.
Conclusion:
The defining characteristics and related factors of Excess fluid volume could be influenced by sociodemographic and clinical variables in haemodialysis clientele.
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RESEARCH
Excesso de volume de líquidos: análise clínica e sociodemográfica em pacientes de hemodiálise
Revista Brasileira de Enfermagem. 2017;70(1):15-21
01-01-2017
Abstract
RESEARCHExcesso de volume de líquidos: análise clínica e sociodemográfica em pacientes de hemodiálise
Revista Brasileira de Enfermagem. 2017;70(1):15-21
01-01-2017DOI 10.1590/0034-7167-2015-0138
Views0See moreRESUMEN
Objetivo:
analizar las características definitorias y los factores relacionados con el diagnóstico enfermero de exceso de volumen líquido y su relación con variables sociodemográficas y clínicas en pacientes de hemodiálisis.
Método:
estudio transversal, realizado mediante un formulario y examen físico, con una muestra de 100 pacientes, entre diciembre de 2012 y abril de 2013 en un hospital universitario y una clínica de diálisis.
Resultados:
se encontraron 10 asociaciones estadísticamente significativas entre las características definitorias, factores relacionados de volumen de exceso de líquido y las variables sociodemográficas y clínicas.
Conclusión:
las características definitorias y los factores relacionados de exceso de volumen líquido podrían estar influenciados por variables sociodemográficas y clínicas en clientes de hemodiálisis.
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EDITORIAL
Enfrentando desafios em tempos de adversidades
Revista Brasileira de Enfermagem. 2017;70(1):1-2
01-01-2017
Abstract
EDITORIALEnfrentando desafios em tempos de adversidades
Revista Brasileira de Enfermagem. 2017;70(1):1-2
01-01-2017DOI 10.1590/0034-7167.2017700101
Views0Na confluência da tradição, do respeito pela história e da abordagem crítica das questões inerentes ao desenvolvimento da profissão de enfermagem, a Associação Brasileira de Enfermagem (ABEn) vem consolidando uma trajetória exemplar na sociedade brasileira. Ao longo da sua história, as reflexões, discussões e decisões sobre assuntos pertinentes e prementes da profissão têm possibilitado intervenções […]See more -
EDITORIAL
Facing challenges in times of adversity
Revista Brasileira de Enfermagem. 2017;70(1):1-2
01-01-2017
Abstract
EDITORIALFacing challenges in times of adversity
Revista Brasileira de Enfermagem. 2017;70(1):1-2
01-01-2017DOI 10.1590/0034-7167.2017700101
Views0At the confluence of tradition, respect for history and a critical approach to the issues inherent to the development of the nursing profession, the Brazilian Nursing Association (ABEn) has been consolidating an exemplary trajectory in Brazilian society. Throughout its history, the reflections, discussions and decisions on pertinent and urgent subjects of the profession have made […]See more -
REFLECTION
Epistemology of nursing care: a reflection on its foundations
Revista Brasileira de Enfermagem. 2016;69(6):1240-1245
01-01-2016
Abstract
REFLECTIONEpistemology of nursing care: a reflection on its foundations
Revista Brasileira de Enfermagem. 2016;69(6):1240-1245
01-01-2016DOI 10.1590/0034-7167-2016-0331
Views0See moreABSTRACT
Objective:
to reflect on nursing care and its epistemology from its historical, theoretical, philosophical, spiritual dimensions and as a social practice.
Method:
discussions originated in the discipline “Epistemology of caring”, from the graduate nursing program of the School of Nursing, Federal University of Minas Gerais, and in critical analysis of nursing literature together with the professional practice of the authors.
Results:
we identified the necessity of developing a critical conscience on health care provision, research, and teaching, as well as on challenges in maintaining high standards of working interpersonal relationships, which has a profound impact on population health.
Conclusion:
we suggest the rescue of integrality, humanization, unity, and spirituality in researches and practices of individual, familiar, and community care, as an advance in incorporating epistemology of caring in nursing.
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ORIGINAL ARTICLE
Validity of the TBApp mobile application for self-care management for people with tuberculosis
Revista Brasileira de Enfermagem. 2024;77(2):e20230195
06-14-2024
Abstract
ORIGINAL ARTICLEValidity of the TBApp mobile application for self-care management for people with tuberculosis
Revista Brasileira de Enfermagem. 2024;77(2):e20230195
06-14-2024DOI 10.1590/0034-7167-2023-0195
Views1See moreABSTRACT
Objectives:
to describe the validity process of the TBApp mobile application for self-care management for people with tuberculosis linked to Primary Health Care.
Methods:
methodological research developed with ten expert judges, carried out virtually. The application was assessed in relation to content and technology quality in seven domains (objectivity; structure and appearance; relevance; functionality; reliability; usability; and efficiency), using an instrument with a Likert scale.
Results:
TBApp was considered valid, relevant, functional, reliable and effective by expert judges. The objectives, structure and presentation and relevance domains presented an overall Content Validity Index of 0.93, and the functionality, reliability, usability and efficiency domains presented characteristics and sub-characteristics values greater than 0.80.
Conclusions:
TBApp is a creative and innovative tool that can be used by people with TB and disseminated in the scientific community.
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Evolution of nursing teaching in the use of education technology: a scoping review
Revista Brasileira de Enfermagem. 2021;74:e20200422
05-21-2021
Abstract
Evolution of nursing teaching in the use of education technology: a scoping review
Revista Brasileira de Enfermagem. 2021;74:e20200422
05-21-2021DOI 10.1590/0034-7167-2020-0422
Views1See moreABSTRACT
Objective:
To identify and map the technological tools of information and communication to support the teaching learning process in Nursing teaching courses.
Methods:
This is a scoping review whose search was carried out in seven databases and in grey literature. After an initial analysis of the selection, 88 texts were read integrally, and 29 made up the final sample.
Results:
Virtual learning environment and object, simulation, hypermedia, and software or cellphone applications were the tools the nursing professors used the most. Studies highlight that the application of technology was important in the teaching-learning process, since it encouraged teaching based on safe care, motivating and developing abilities/competences, supported on significant, effective, flexible, and autonomous learning.
Conclusion:
The contribution of the technology for nursing formation stands out, but it should be highlighted that its employment must be critical, reflective, based on pedagogical theories and developed by trained professors.
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ORIGINAL ARTICLE
Self-care of elderly people with diabetes mellitus and the nurse-patient interpersonal relationship
Revista Brasileira de Enfermagem. 2022;75(1):e20201257
10-01-2022
Abstract
ORIGINAL ARTICLESelf-care of elderly people with diabetes mellitus and the nurse-patient interpersonal relationship
Revista Brasileira de Enfermagem. 2022;75(1):e20201257
10-01-2022DOI 10.1590/0034-7167-2020-1257
Views1INTRODUCTIONChronic non-communicable diseases are the main causes of death and health problems in the world, causing about 41 million deaths each year, which corresponds to approximately 71% of all deaths. Among these diseases, diabetes mellitus has stood out due to the increase in its incidence and prevalence().Estimates indicate that 463 million people live with diabetes […]See more -
ORIGINAL ARTICLE
Nurses’ performance in palliative care: spiritual care in the light of Theory of Human Caring
Revista Brasileira de Enfermagem. 2022;75(1):e20210029
09-24-2022
Abstract
ORIGINAL ARTICLENurses’ performance in palliative care: spiritual care in the light of Theory of Human Caring
Revista Brasileira de Enfermagem. 2022;75(1):e20210029
09-24-2022DOI 10.1590/0034-7167-2021-0029
Views1See moreABSTRACT
Objectives:
to analyze nurses’ role in assisting patients in palliative care, with emphasis on the spiritual dimension, in the light of Theory of Human Caring.
Methods:
this is an exploratory, qualitative study, carried out in a hospital in João Pessoa, Paraíba, between August and December 2019, with 10 nurses. For data collection, semi-structured interviews were used. For analysis, we opted for content analysis.
Results:
the spiritual dimension of care is contemplated by several religious and spiritual practices. These are respected and encouraged by nurses, although there is difficulty in providing care for the spiritual dimension.
Final Considerations:
nurses have attitudes consistent with Jean Watson’s Theory and apply the Caritas Process elements during assistance to patients’ spiritual dimension in palliative care.
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ORIGINAL ARTICLE
Adaptation and validation of an adult patient classification instrument with emphasis on the family dimension
Revista Brasileira de Enfermagem. 2023;76(2):e20220530
03-27-2023
Abstract
ORIGINAL ARTICLEAdaptation and validation of an adult patient classification instrument with emphasis on the family dimension
Revista Brasileira de Enfermagem. 2023;76(2):e20220530
03-27-2023DOI 10.1590/0034-7167-2022-0530
Views1ABSTRACT
Objectives:
to adapt and validate an instrument for classifying adult patients that emphasizes the family support network in the demand for nursing care.
Methods:
methodological study, carried out in three phases: adaptation of an instrument considering the reality of adult patients; content validation with seven experts and assessment of measurement properties (construct validity and internal consistency) with 781 hospitalized patients.
Results:
in content validation, the indicators reached the values established for the Content Validity Index (0.85-1.00). In the confirmatory factor analysis, the 11 indicators were distributed in three domains and presented average variance extracted and factor loading greater than 0.5. Composite reliability was greater than 0.7.
Conclusions:
the present study adapted and made available, with evidence of validity and reliability, an instrument for classifying adult patients that considers the family support network in the demand for nursing care.
Keywords:Factor AnalysisFamilyHospital Organization and AdministrationPatient-Centered CareValidation StudiesSee more -
ORIGINAL ARTICLE
Guide for Systematization of Care and Nursing Process: educational technology for professional practice
Revista Brasileira de Enfermagem. 2023;76:e20210975
04-14-2023
Abstract
ORIGINAL ARTICLEGuide for Systematization of Care and Nursing Process: educational technology for professional practice
Revista Brasileira de Enfermagem. 2023;76:e20210975
04-14-2023DOI 10.1590/0034-7167-2021-0975
Views1ABSTRACT
Objective:
to elaborate and validate the content of a digital guide educational technology on Systematization of Nursing Care and Nursing Process.
Methods:
applied research of technological development, developed between 2020 and 2021, in three steps. First, a scoping review was carried out to elaborate the content. In the second step, the content was validated with 46 nurse judges selected for convenience. The minimum criterion of agreement among judges was 80%. The third step consisted of content organization and layout.
Results:
the guide content was elaborated from the Federal Nursing Council legislation, scientific articles and textbooks. Content was considered appropriate, relevant and organized by judges.
Final considerations:
the digital guide is an alternative that can contribute to the NP execution and implementation, supporting the planning and implementation of actions for quality of care.
Keywords:Educational TechnologyNursing ProcessNursing RecordsProfessional PracticeStandardized Nursing TerminologySee more -
ERRATUM
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e01
01-15-2024
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e01
01-15-2024DOI 10.1590/0034-7167.20247701e01
Views1In the article “The ethics of nursing care for transgender people”, with DOI number: , published in Revista Brasileira de Enfermagem, 2023;76(Suppl 3):e20220797, in authorship:Where it read:[…]See more -
REVIEW
Telenursing contributions in Primary Health Care in the COVID-19 pandemic context: an integrative review
Revista Brasileira de Enfermagem. 2024;77(5):e20240093
11-22-2024
Abstract
REVIEWTelenursing contributions in Primary Health Care in the COVID-19 pandemic context: an integrative review
Revista Brasileira de Enfermagem. 2024;77(5):e20240093
11-22-2024DOI 10.1590/0034-7167-2024-0093
Views1See moreABSTRACT
Objective:
to identify telenursing contributions in Primary Health Care during the COVID-19 pandemic.
Methods:
an integrative literature review, conducted between January and August 2022 in the PubMed, CINAHL, LILACS, BDENF, Scopus, WoS, EMBASE and SciELO databases. A total of 493 studies was found, 62 were read in full, and of these, 16 were selected. For analysis, a dynamic reading of the studies and synthesis of the main results were carried out.
Results:
the main results highlighted telenursing practice as a challenge for professionals and the population. Among the contributions and positive points and aspects that require improvement, practice showed promise when considered in a post-pandemic scenario.
Final considerations:
through telenursing, the population’s access to Primary Health Care was guaranteed in the face of the COVID-19 pandemic. However, a critical look at current technological advances in healthcare is necessary.
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ORIGINAL ARTICLE
Quality of life, depressive and minor psychiatrics symptoms in nursing students
Revista Brasileira de Enfermagem. 2020;73:e20190134
07-10-2020
Abstract
ORIGINAL ARTICLEQuality of life, depressive and minor psychiatrics symptoms in nursing students
Revista Brasileira de Enfermagem. 2020;73:e20190134
07-10-2020DOI 10.1590/0034-7167-2019-0134
Views0See moreABSTRACT
Objective:
To assess quality of life, prevalence of depressive and minor psychiatric symptoms in Nursing students.
Methods:
Cross-sectional study, conducted from March to April 2018, at a federal university. Sample composed of 242 Nursing students, from the 1st to the 8th semester. Data was collected using the quality of life instruments, Beck Depression Inventory and Self-Report Questionnaire. A significance level of 0.05 was considered.
Results:
The mean age was 22.9 ± 5.1 years. It was found that 25% of the students had severe depressive symptoms and 54% of the students had minor psychiatric disorders, with a higher prevalence in the first semesters. An inverse relationship was observed between the frequency of depressive symptoms and quality of life scores (p = 0.05).
Conclusion:
Nursing students showed a high prevalence of depressive symptoms, indicating the importance of implementing actions to promote and prevent mental health.
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ORIGINAL ARTICLE
Permanent education and matrix support in primary health care: family health routine
Revista Brasileira de Enfermagem. 2020;73(6):e20190076
08-07-2020
Abstract
ORIGINAL ARTICLEPermanent education and matrix support in primary health care: family health routine
Revista Brasileira de Enfermagem. 2020;73(6):e20190076
08-07-2020DOI 10.1590/0034-7167-2019-0076
Views0See moreABSTRACT
Objective:
To analyze the understanding of the professionals working on the Family Health Support by about permanent education and matrix support in the daily routine of primary health care.
Methods:
Descriptive research with a qualitative approach. Data were collected through semi-structured interviews with the participation of 19 professionals from different backgrounds. The results were organized based on Thematic Content Analysis.
Results:
Thematic categories emerged from the analysis: Permanent Health Education: knowledge and daily activities; Matrix support as a premise of Permanent Health Education; The principle of integrality as the foundation of the supporting teams; Conditions of praxis in the promotion of Permanent Health Education.
Final Considerations:
The study evidenced that professionals experience their routines within the service and that the sharing of knowledge to transform the reality of users and the territory is based on matrix support and integrality. However, they face structural difficulties in carrying out actions.
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ORIGINAL ARTICLE
Frailty in the elderly: screening possibilities in Primary Health Care
Revista Brasileira de Enfermagem. 2022;75(2):e20200973
10-01-2022
Abstract
ORIGINAL ARTICLEFrailty in the elderly: screening possibilities in Primary Health Care
Revista Brasileira de Enfermagem. 2022;75(2):e20200973
10-01-2022DOI 10.1590/0034-7167-2020-0973
Views0See moreABSTRACT
Objectives:
to evaluate two instruments for screening frailty in the elderly in Primary Health Care.
Methods:
this is an observational, cross-sectional study, with a quantitative approach, with 396 elderly people. SPSS software helped to perform the statistical analyses. The study used the kappa coefficient and Spearman’s correlation.
Results:
the kappa coefficient between the Clinical-Functional Vulnerability Index 20 and the Edmonton Frailty Scale was 0.496, considered moderate. There was a positive and significant correlation (r = 0.77; p < 0.001) between the frailty conditions and the total score of the two instruments.
Conclusions:
when this article assessed fragility through the kappa coefficient, both instruments presented positive correlation and agreement. However, the identification of frailty was higher when it used the Edmonton Frailty Scale.
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ORIGINAL ARTICLE
Inclusion of mental health in primary health care: care strategy in the territory
Revista Brasileira de Enfermagem. 2019;72(6):1677-1682
10-21-2019
Abstract
ORIGINAL ARTICLEInclusion of mental health in primary health care: care strategy in the territory
Revista Brasileira de Enfermagem. 2019;72(6):1677-1682
10-21-2019DOI 10.1590/0034-7167-2018-0806
Views0See moreABSTRACT
Objective:
To analyze the strategies, challenges and possibilities of the articulation between mental health and primary health care from the perspective of health managers.
Method:
Exploratory, qualitative research carried out with 28 managers of mental health and primary care. The data were collected through semi-structured interviews between July and November 2013 and submitted to thematic content analysis.
Results:
The inclusion of mental health actions in primary care made it possible, in the view of managers, to increase users’ access to the care they need. This care strategy allows the extension of care practices in the territory, with matrix support as the main tool for the implementation of this care strategy.
Final considerations:
The articulation between primary care and mental health is a powerful device for psychosocial care, but it demands a new conformation of the Psychosocial Care Centers (Caps) and primary care services.
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ORIGINAL ARTICLE
Evaluation of delirium in aged patients assisted at emergency hospital service
Revista Brasileira de Enfermagem. 2019;72:153-160
12-05-2019
Abstract
ORIGINAL ARTICLEEvaluation of delirium in aged patients assisted at emergency hospital service
Revista Brasileira de Enfermagem. 2019;72:153-160
12-05-2019DOI 10.1590/0034-7167-2018-0386
Views0See moreABSTRACT
Objective:
identify the occurrence of delirium in aged patients assisted in emergency services and verify its relationship with sociodemographic and clinical variables.
Method:
cross-sectional, prospective study with a quantitative approach. Two hundred aged hospitalized patients participated. The Confusion Assessment Method was used for data collection. For statistical analysis, chi-square tests, likelihood ratio and Fisher’s test were used, with a significance level of 5%.
Results:
male gender and mean age of 71.8 years were predominant. In the first 24 hours of hospitalization, 56 (28%) aged individuals presented delirium. An association of the disease with lack of physical activity, presence of a caregiver, hypertension, dyslipidemia and cerebrovascular diseases was identified.
Conclusion:
Delirium was associated with no physical activity, the need of a caregiver, and the presence of comorbidities. The importance of conducting other studies that may lead to early identification of the condition to prevent its complications is emphasized.
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ORIGINAL ARTICLE
Conflict management strategies used by Portuguese nurse managers
Revista Brasileira de Enfermagem. 2020;73:e20190336
10-28-2020
Abstract
ORIGINAL ARTICLEConflict management strategies used by Portuguese nurse managers
Revista Brasileira de Enfermagem. 2020;73:e20190336
10-28-2020DOI 10.1590/0034-7167-2019-0336
Views0See moreABSTRACT
Objectives:
to analyze the perception and conflict management strategies used by nurses in the management of people in Portuguese health services.
Methods:
descriptive, correlational study, carried out in Portuguese health services, with an intentional non-probabilistic sample, totaling 95 nurse managers. A questionnaire and Conflict Management Scale were used, analyzing the variables of managerial activities and conflict management, with the aid of software.
Results:
it was identified that 60% of the managers, report having to mediate conflicts daily, and the majority report adopting dialogue in conduct. However, through the Kruskal-Wallis test, it was shown that enforcement strategies in conflict management prevail (p = 0.008), with collaborative ones being more restricted to monthly intervals (p = 0.049).
Conclusions:
managers perceive the importance of collaboration in the mediation of conflicts, however, in their daily lives; they tend to maintain imposing behaviors, signaling for a little transformational leadership style.
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EDITORIAL
Advanced Practice Nursing in Latin America and the Caribbean: seeking its implementation
Revista Brasileira de Enfermagem. 2021;74:e74suppl601
03-15-2021
Abstract
EDITORIALAdvanced Practice Nursing in Latin America and the Caribbean: seeking its implementation
Revista Brasileira de Enfermagem. 2021;74:e74suppl601
03-15-2021DOI 10.1590/0034-7167.202174suppl601
Views0Healthcare organizations are increasingly complex and specialized, seeking to optimize their quality and safety standards, and be able to meet the growing needs of their users. To face this reality, health professionals need to adapt to respond in time to the demands of the health context. In turn, the World Health Organization (WHO), through the […]See more
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