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ORIGINAL ARTICLE12-08-2023
Sociodemographic factors associated with suicidal behavior at a federal public university in the Western Brazilian Amazon
Revista Brasileira de Enfermagem. 2023;76:e20230102
Abstract
ORIGINAL ARTICLESociodemographic factors associated with suicidal behavior at a federal public university in the Western Brazilian Amazon
Revista Brasileira de Enfermagem. 2023;76:e20230102
DOI 10.1590/0034-7167-2023-0102
Views0See moreABSTRACT
Objective:
to determine risk factors for suicidal behavior among students and employees of a federal public university in the Brazilian Western Amazon.
Methods:
an analytical cross-sectional study of survey and association between variables with a sample of 475 participants. Statistical analyzes were performed using the Mann-Whitney test, Pearson’s chi-square test, likelihood ratio test or Fisher’s exact test and a logistic regression model. A significance level of 5% was used (p-value< 0.05).
Results:
a higher proportion of suicidal behavior was found in younger participants, females, who had no religion or had one, but were non-practicing, who did not have children and/or had a monthly family income of less than two minimum wages. Lower proportions of suicidal behavior were identified in heterosexuals and/or married or in a stable relationship.
Conclusion:
the study suggests a relationship between sociodemographic factors and suicidal behavior in the studied academic community.
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ORIGINAL ARTICLE12-08-2023
Polypharmacy, potentially inappropriate medications and associated factors among older adults with hypertension in primary care
Revista Brasileira de Enfermagem. 2023;76:e20220785
Abstract
ORIGINAL ARTICLEPolypharmacy, potentially inappropriate medications and associated factors among older adults with hypertension in primary care
Revista Brasileira de Enfermagem. 2023;76:e20220785
DOI 10.1590/0034-7167-2022-0785
Views0See moreABSTRACT
Objective:
to identify the prevalence and associations of polypharmacy and potentially inappropriate medication use among older adults with hypertension treated in primary care.
Methods:
a cross-sectional study carried out with older adults with hypertension treated at a Family Health Strategy unit. Data collection included analysis of medical records, interviews and multidimensional assessment of older adults. Socio-demographic information and clinical variables were collected. Statistical analysis was performed by multiple logistic regression.
Results:
polypharmacy prevalence was 38.09%, and potentially inappropriate medication (PIM), 28.57%. There was a significant association between polypharmacy and PIM use, altered sleep and ethnicity. PIM use was associated with polypharmacy, worse family functioning, and absence of a caregiver. Cognitive decline reduces the prevalence of these medications.
Conclusions:
polypharmacy and PIM use among older adults with hypertension represent a problem in this population, especially among the most vulnerable.
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ORIGINAL ARTICLE12-08-2023
Care for older adults with disabilities in Long Term Care Facility
Revista Brasileira de Enfermagem. 2023;76:e20220767
Abstract
ORIGINAL ARTICLECare for older adults with disabilities in Long Term Care Facility
Revista Brasileira de Enfermagem. 2023;76:e20220767
DOI 10.1590/0034-7167-2022-0767
Views0See moreABSTRACT
Objective:
to analyze the constitution of care offered to older adults with disabilities, from Long Term Care Facility professionals’ perspective.
Methods:
this is a discourse analysis based on the post-structuralist framework. Participants in this study are professionals involved in the care for older adults, totaling 14 respondents, 13 women and one man.
Results:
from professionals’ perspective, there is a fine line between caring for older adults with disabilities and maintaining their autonomy. Care in which autonomy is restricted predisposes older adults to a process of dependency.
Final considerations:
caring for older adults with disabilities constitutes the challenge between caring and maintaining independence. Thus, older adult-centered care should be taken as a premise so that their individualities are respected.
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ORIGINAL ARTICLE12-08-2023
Fear of COVID-19 when experiencing pregnancy or childbirth in the pandemic: what are the associated factors?
Revista Brasileira de Enfermagem. 2023;76:e20220755
Abstract
ORIGINAL ARTICLEFear of COVID-19 when experiencing pregnancy or childbirth in the pandemic: what are the associated factors?
Revista Brasileira de Enfermagem. 2023;76:e20220755
DOI 10.1590/0034-7167-2022-0755
Views0See moreABSTRACT
Objective:
to identify factors associated with fear of COVID-19 among women who experienced pregnancy or childbirth during the pandemic.
Methods:
a cross-sectional study, nested within a prospective cohort, using an online survey, from August 2021 to February 2022, based on descriptive data analysis.
Results:
of the 431 participants, 52.8% were postpartum women and 20.1% were pregnant women. With regard to fear of COVID-19, a mean score of 20.46 was obtained (moderate fear). The highest fear scores were present in women whose newborns were admitted to hospital in neonatal critical units (p=0.032), and the lowest among those covered by supplementary health (insurance) (p=0.016).
Conclusion:
among pregnant and postpartum women, high fear of COVID-19 translated into the possibility of having newborns admitted to hospital in a critical unit. The importance of supporting actions to support pregnant/postpartum women’s mental health in relation to COVID-19 or other threats that may influence the neonatal outcome stands out.
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ORIGINAL ARTICLE12-08-2023
A relação entre o nível de conhecimento e o comportamento de prevenção do corrimento vaginal para estudantes de enfermagem
Revista Brasileira de Enfermagem. 2023;76:e20220602
Abstract
ORIGINAL ARTICLEA relação entre o nível de conhecimento e o comportamento de prevenção do corrimento vaginal para estudantes de enfermagem
Revista Brasileira de Enfermagem. 2023;76:e20220602
DOI 10.1590/0034-7167-2022-0602
Views0See moreRESUMEN
Objetivo:
la salud reproductiva de las adolescentes es muy importante. Determinar la relación entre el nivel de conocimientos y la conducta de prevención del flujo vaginal en estudiantes de enfermería.
Métodos:
estudio cuantitativo, transversal, con 155 estudiantes de primer año de una facultad privada de enfermería. Los datos se recopilaron de febrero a marzo de 2022 a través de un cuestionario electrónico.
Resultados:
los participantes con buen nivel de conocimientos correspondieron al 98,1% y los que practican buenas conductas para prevenir el flujo vaginal, el 92,3%.
Conclusión:
un buen conocimiento produce conductas de prevención adecuadas. El resultado de este estudio puede contribuir con reflexiones y referencias para un estudio más profundo de los factores que influyen en el nivel de conocimiento y comportamiento sobre la enfermedad de los genitales y los peligros del flujo vaginal patológico.
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ORIGINAL ARTICLE12-08-2023
The relationship between level of knowledge and vaginal discharge prevention behavior for nursing student
Revista Brasileira de Enfermagem. 2023;76:e20220602
Abstract
ORIGINAL ARTICLEThe relationship between level of knowledge and vaginal discharge prevention behavior for nursing student
Revista Brasileira de Enfermagem. 2023;76:e20220602
DOI 10.1590/0034-7167-2022-0602
Views0See moreABSTRACT
Objective:
Reproductive health in adolescent girls is very important. To determine the relationship between the level of knowledge and the behavior of preventing vaginal discharge among nursing students.
Methods:
a quantitative, cross-sectional study, with 155 first-year female students at a private faculty of nursing. Data were collected from February to March 2022, using an electronic questionnaire.
Results:
98.1% of participants have a good level of knowledge and 92.3% of participants practice good vaginal discharge prevention behavior.
Conclusion:
good knowledge produces appropriate prevention behavior. The result of this study can be used as a contribution of thoughts and references as a more in-depth study of the factors that influence the level of knowledge and behavior about the disease of the genitalia and the dangers of pathological vaginal discharge.
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Nursing experiences in specialized services in child and adolescent mental health: a systematic review of qualitative studies
Revista Brasileira de Enfermagem. 2023;76:e20220550
Abstract
Nursing experiences in specialized services in child and adolescent mental health: a systematic review of qualitative studies
Revista Brasileira de Enfermagem. 2023;76:e20220550
DOI 10.1590/0034-7167-2022-0550
Views0See moreABSTRACT
Objective:
to synthesize evidence from qualitative studies on nursing experiences regarding child and adolescent mental health care in specialized services.
Method:
a systematic review with meta-synthesis of qualitative studies according to JBI guidelines. CINAHL, EMBASE, MEDLINE, LILACS, PSYCinfo, Scopus and Web of Science databases were used. The findings were classified according to the level of reliability and credibility and categorized by similarity between contents.
Results:
229 articles were identified, and five were included in the final sample and organized into the categories: Emotional impact; and Understanding nursing role. The level of evidence found was moderate.
Final considerations:
nursing experiences are permeated by emotional exhaustion, feelings of frustration and difficulty in understanding their professional role. The need for training spaces that qualify this care is highlighted.
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ORIGINAL ARTICLE09-06-2024
Factors associated with burnout in military police officers in a city in Paraná
Revista Brasileira de Enfermagem. 2024;77(4):e20230510
Abstract
ORIGINAL ARTICLEFactors associated with burnout in military police officers in a city in Paraná
Revista Brasileira de Enfermagem. 2024;77(4):e20230510
DOI 10.1590/0034-7167-2023-0510
Views0See moreABSTRACT
Objective:
to analyze the association between burnout and sociodemographic, work factors, lifestyle habits and health conditions of military police officers in a municipality in the state of Paraná, Brazil.
Method:
cross-sectional research with 131 military police officers. Data were analyzed using the Statistical Package for the Social Sciences software and the R program. Chi-square, Fisher’s exact and Poisson Generalized Linear Model tests were used.
Results:
most participants (65.6%) had a high level of burnout. In relation to protective factors, those who carried out leisure activities had a 33.6% chance of not developing burnout. Conjugality was also a protective factor. Not practicing physical activity and leisure activities are factors that can contribute to the occurrence of burnout.
Conclusions:
important factors and high rates of burnout were observed in the police officers investigated. It is necessary to implement public health policies to reduce burnout with attention focused on this professional category.
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ORIGINAL ARTICLE09-06-2024
Development and content validation of a risk classification instrument
Revista Brasileira de Enfermagem. 2024;77(4):e20230502
Abstract
ORIGINAL ARTICLEDevelopment and content validation of a risk classification instrument
Revista Brasileira de Enfermagem. 2024;77(4):e20230502
DOI 10.1590/0034-7167-2023-0502
Views0See moreABSTRACT
Objective:
Develop and validate the content of an instrument for patient risk classification in emergency services of Primary Health Care.
Method:
The study included two stages: item generation and content validity. A literature review and retrospective analysis of medical records were conducted to create the instrument items. The Content Validity Ratio (CVR) was used to assess agreement among judges during content validation.
Results:
In the first and second rounds, 75 and 71 judges validated the risk classification instrument, respectively. The minimum adherence score for the latent variable item based on the final number of judges was 0.22 and 0.18; thus, 52 items, divided into three classification categories (red, orange, and yellow), were retained.
Conclusion:
The instrument was considered valid regarding clarity, relevance, pertinence, and agreement regarding the severity indicated in the item.
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REVIEW09-06-2024
Nursing students’ mindfulness and emotional regulation: an integrative review
Revista Brasileira de Enfermagem. 2024;77(4):e20230466
Abstract
REVIEWNursing students’ mindfulness and emotional regulation: an integrative review
Revista Brasileira de Enfermagem. 2024;77(4):e20230466
DOI 10.1590/0034-7167-2023-0466
Views0See moreABSTRACT
Objective:
to identify the scientific evidence available in national and international literature on the relationships between nursing students’ mindfulness and emotional regulation.
Methods:
an integrative literature review, in four databases, with a time frame from January 2002 to December 2022. Articles in English, Spanish and Portuguese available in full were included.
Results:
the sample consisted of six original articles, predominantly with a quantitative approach, with cross-sectional designs standing out.
Conclusion:
the synthesis of scientific production revealed that there is a lack of research at national and international level on the subject with experimental and qualitative designs that enable conclusions about cause and effect and/or take into account subjective experiences of the applicability of mindfulness-based practice in nursing students’ emotional regulation.
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ORIGINAL ARTICLE09-06-2024
Nursing Process implementation in a gerontogeriatric context: qualitative research
Revista Brasileira de Enfermagem. 2024;77(4):e20230465
Abstract
ORIGINAL ARTICLENursing Process implementation in a gerontogeriatric context: qualitative research
Revista Brasileira de Enfermagem. 2024;77(4):e20230465
DOI 10.1590/0034-7167-2023-0465
Views0See moreABSTRACT
Objective:
to describe Nursing Process implementation in a faith-based senior living community.
Method:
strategic action research with 19 nursing professionals and three managers of a faith-based senior living community. Implementation took place in four phases: diagnosis, planning, implementation and assessment. The data collected through semi-structured interviews and focus groups were subjected to discursive textual analysis.
Results:
the central categories were constructed: Nursing Process in faith-based senior living community: diagnosis of knowledge and application; Nursing Process in faith-based senior living community: implementation; Nursing process in faith-based senior living community: assessment after its implementation.
Conclusion:
Nursing Process implementation made it possible to structure work management/organization, contributing to knowledge, organization and continuity of care for safety and professional support.
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ORIGINAL ARTICLE09-06-2024
Adherence to sepsis protocol in a high-risk maternity reference center
Revista Brasileira de Enfermagem. 2024;77(4):e20230453
Abstract
ORIGINAL ARTICLEAdherence to sepsis protocol in a high-risk maternity reference center
Revista Brasileira de Enfermagem. 2024;77(4):e20230453
DOI 10.1590/0034-7167-2023-0453
Views0See moreABSTRACT
Objective:
To describe the adherence to the sepsis protocol by obstetric nurses in the obstetric triage of a high-risk maternity reference center.
Methods:
This was a quantitative, documental, and retrospective study involving 105 pregnant women treated in obstetric triage under sepsis criteria. Data were collected through electronic medical records using structured forms and were organized into tables employing descriptive statistics. This research adhered to ethical principles concerning human studies.
Results:
Of the checklists for initiating the SEPSIS protocol by obstetric nurses, 105 were identified. Regarding the protocol steps performed, lactate was collected in 97.1% of cases and blood cultures in 98.1%, antibiotic therapy was administered in 94.3%, and hydration was carried out in 51.4% of the cases.
Conclusion:
The initiation of the sepsis protocol for all women meeting the criteria was confirmed. However, the steps were not fully implemented as recommended by the institutional protocol, and the recommended broad-spectrum antibiotic was not administered.
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ORIGINAL ARTICLE09-06-2024
Effect of Brazilian green propolis in chronic ulcer treatment: a randomized clinical trial
Revista Brasileira de Enfermagem. 2024;77(4):e20230418
Abstract
ORIGINAL ARTICLEEffect of Brazilian green propolis in chronic ulcer treatment: a randomized clinical trial
Revista Brasileira de Enfermagem. 2024;77(4):e20230418
DOI 10.1590/0034-7167-2023-0418
Views0See moreABSTRACT
Objective:
to assess the effectiveness of 5% Brazilian green propolis (ointment) in individuals with chronic ulcers.
Methods:
a randomized clinical trial, developed with 40 patients randomized equally to control group (treated with essential fatty acid) and experimental group (treated with 5% green propolis) for 30 days. The outcomes of interest were sociodemographic, clinical and laboratory characteristics, lesion characteristics, such as type of tissue in the bed, presence of exudate, edge characteristics, microbial content and pain.
Results:
regarding sociodemographic, clinical and laboratory characteristics, the two groups did not show statistically significant differences. After assessment in 30 days, an effect was observed for both treated groups, but for the experimental group, greater effectiveness in terms of the type of tissue in the bed, type of exudate, edge characteristics, microbial content and pain.
Conclusion:
propolis-based ointment showed a healing effect, presenting itself as a potential tool in healing chronic ulcers.
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Progress Test in nursing: perspectives for undergraduate education
Revista Brasileira de Enfermagem. 2024;77(4):e20230413
Abstract
Progress Test in nursing: perspectives for undergraduate education
Revista Brasileira de Enfermagem. 2024;77(4):e20230413
DOI 10.1590/0034-7167-2023-0413
Views0ABSTRACT
Objective:
to reflect on the perspectives of adopting the Progress Test in undergraduate nursing education.
Methods:
this is a reflective study, based on authors’ critical thinking and supported by national and international literature on the Progress Test application in undergraduate health courses.
Results:
the Progress Test is as a valuable teaching-learning strategy, with potential applications and benefits for students, professors, and academic management.
Final considerations:
systematic nursing education assessment indicates valuable information for different stakeholders. Understanding its potential benefits, the Progress Test is presented as a strategy that can be replicated in undergraduate nursing education, either individually, by institutions, or collaboratively, by the establishment of partnerships or consortiums of institutions.
Keywords:Academic PerformanceEducation, NursingEducational MeasurementNursing Faculty PracticeSchoolsSee more -
ORIGINAL ARTICLE09-06-2024
Physical and psychological changes of the COVID-19 infodemic by the older adult population
Revista Brasileira de Enfermagem. 2024;77(4):e20230339
Abstract
ORIGINAL ARTICLEPhysical and psychological changes of the COVID-19 infodemic by the older adult population
Revista Brasileira de Enfermagem. 2024;77(4):e20230339
DOI 10.1590/0034-7167-2023-0339
Views0See moreABSTRACT
Objective:
to analyze the physical and psychological changes of the COVID-19 infodemic for the older adult population of Rio de Janeiro.
Method:
a cross-sectional, web-based survey to find out about access to news and information about COVID-19 among older adult in Rio de Janeiro, between July and December 2020. Univariate analysis and bivariate analysis were carried out using non-parametric statistical methods.
Results:
390 older adults took part, predominantly female (75.1%), aged between 66 and 75 (35.4%), married (51.0%), white (60.3%), owning their own home (81.8%), located in urban areas (91%), with complete or incomplete primary education (31.8%) and retired or pensioners (79.2%). Younger people were significantly affected both physically and psychologically by social networks when compared to television (<0.001).
Conclusion:
Physical and psychological changes from exposure to information about COVID-19 have affected the lives of the older adult, having an impact on this population.
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EDITORIAL03-08-2024
A enfermagem como protagonista no enfrentamento da hesitação e recusa vacinal
Revista Brasileira de Enfermagem. 2024;77:e77suppl101
Abstract
EDITORIALA enfermagem como protagonista no enfrentamento da hesitação e recusa vacinal
Revista Brasileira de Enfermagem. 2024;77:e77suppl101
DOI 10.1590/0034-7167.202477suppl101pt
Views0Desde a década de 1970, o Ministério da Saúde do Brasil instituiu o Programa Nacional de Imunização (PNI), que precedeu o Sistema Único de Saúde e que lhe foi incorporado e fortalecido, devido ao modelo descentralizado aos municípios, mas de comando único ao nível central. Seu objetivo era e ainda é coordenar as ações de […]See more -
EDITORIAL03-08-2024
Nursing as a player in tackling vaccine hesitancy and refusal
Revista Brasileira de Enfermagem. 2024;77:e77suppl101
Abstract
EDITORIALNursing as a player in tackling vaccine hesitancy and refusal
Revista Brasileira de Enfermagem. 2024;77:e77suppl101
DOI 10.1590/0034-7167.202477suppl101
Views1Since the 1970s, the Brazilian Ministry of Health established the Brazilian National Immunization Program (PNI – Programa Nacional de Imunização), which preceded the Brazilian Health System and which was incorporated and strengthened due to the decentralized model to municipalities, but under single command at central level. Its objective was and still is to coordinate vaccination […]See more -
EDITORIAL02-26-2024
Enfermeiro Navegador de Pacientes com Câncer: contribuições para a discussão no cenário nacional
Revista Brasileira de Enfermagem. 2024;77(2):e770201
Abstract
EDITORIALEnfermeiro Navegador de Pacientes com Câncer: contribuições para a discussão no cenário nacional
Revista Brasileira de Enfermagem. 2024;77(2):e770201
DOI 10.1590/0034-7167.2024770201pt
Views0A prática profissional da navegação de pacientes é algo incipiente no Brasil e, sendo assim, é indispensável uma ampla discussão com vários setores da sociedade, sendo essa a principal propositura deste editorial. Comecemos pela história.A navegação de pacientes foi definida em 1989 como uma intervenção de prestação de serviços baseada na comunidade, com o objetivo […]See more -
EDITORIAL02-26-2024
Nurse Navigator of Cancer Patients: contributions to the discussion on the national stage
Revista Brasileira de Enfermagem. 2024;77(2):e770201
Abstract
EDITORIALNurse Navigator of Cancer Patients: contributions to the discussion on the national stage
Revista Brasileira de Enfermagem. 2024;77(2):e770201
DOI 10.1590/0034-7167.2024770201
Views0The professional practice of patient navigation is incipient in Brazil and, therefore, a broad discussion with various sectors of society is essential, which is the main purpose of this editorial. Shall we start with the story.Patient navigation was defined in 1989 as a community-based service delivery intervention aimed at appropriately promoting access to diagnosis and […]See more -
ERRATUM02-26-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e02
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e02
DOI 10.1590/0034-7167.20247701e02
Views0In the article “Active teaching model to promote critical thinking”, with DOI number: , published in Revista Brasileira de Enfermagem, 2019;72(1):293-8, on page 297:Include before REFERENCES:[…]See more -
REVIEW02-26-2024
Practice of immersion in hot water to relieve pain in neonatology: an integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20230260
Abstract
REVIEWPractice of immersion in hot water to relieve pain in neonatology: an integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20230260
DOI 10.1590/0034-7167-2023-0260
Views0See moreABSTRACT
Objectives:
to identify immersion use in hot water to relieve pain in newborns.
Methods:
an integrative literature review, carried out in the PubMed, VHL, EMBASE, Scopus, CINAHL, Cochrane and SciELO databases, with investigations in English, Spanish, French or Portuguese, published between 2002 and 2022. The Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH) were used to answer the following question: what are the uses of hot water immersion in relieving pain in newborns?
Results:
nine studies were included, mainly Brazilian, experimental, with a predominance of strong and moderate levels of evidence. Hydrotherapy and bath use (immersion and bandaging) was observed, promising interventions in reducing pain scores, assessed using scales, physiological and endocrine parameters.
Conclusions:
hot water proved to be a promising non-pharmacological intervention in relieving pain in infants in different contexts.
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ORIGINAL ARTICLE02-26-2024
Artificial intelligence to predict bed bath time in Intensive Care Units
Revista Brasileira de Enfermagem. 2024;77(1):e20230201
Abstract
ORIGINAL ARTICLEArtificial intelligence to predict bed bath time in Intensive Care Units
Revista Brasileira de Enfermagem. 2024;77(1):e20230201
DOI 10.1590/0034-7167-2023-0201
Views0See moreABSTRACT
Objectives:
to assess the predictive performance of different artificial intelligence algorithms to estimate bed bath execution time in critically ill patients.
Methods:
a methodological study, which used artificial intelligence algorithms to predict bed bath time in critically ill patients. The results of multiple regression models, multilayer perceptron neural networks and radial basis function, decision tree and random forest were analyzed.
Results:
among the models assessed, the neural network model with a radial basis function, containing 13 neurons in the hidden layer, presented the best predictive performance to estimate the bed bath execution time. In data validation, the squared correlation between the predicted values and the original values was 62.3%.
Conclusions:
the neural network model with radial basis function showed better predictive performance to estimate bed bath execution time in critically ill patients.
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REVIEW02-26-2024
Evidence of intrauterine device insertion by nurses in Primary Health Care: an integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20230134
Abstract
REVIEWEvidence of intrauterine device insertion by nurses in Primary Health Care: an integrative review
Revista Brasileira de Enfermagem. 2024;77(1):e20230134
DOI 10.1590/0034-7167-2023-0134
Views0ABSTRACT
Objectives:
to synthesize and analyze evidence on intrauterine device insertion by nurses in Primary Health Care.
Methods:
an integrative review, carried out in the BDENF, CINAHL, LILACS, SciELO, Scopus, PubMed and Web of Science databases in June 2022, delimiting the period from 1960 to 2022.
Results:
141 articles were identified in the initial search, and 10 studies made up the final sample. Four (40%) were developed in the United States and one (10%) in Brazil, with publications from 1979 to 2021. The findings were grouped into three categories: Nurse training to insert an intrauterine device; Nurses’ competency to insert an intrauterine device; and Women’s access to intrauterine devices.
Conclusions:
nurse theoretical and practical training is a prominent element, consolidated in the favorable outcomes of insertions performed by nurses and satisfaction among women, a practice that has expanded access to the contraceptive method in Primary Health Care.
Keywords:Advanced Practice NursingIntrauterine DevicesLong-Acting Reversible ContraceptionNursesPrimary Health CareSee more
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