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ORIGINAL ARTICLE01-10-2024
Nursing students and the internet: a reflection of digital ethics
Revista Brasileira de Enfermagem. 2024;77:e20230459
Abstract
ORIGINAL ARTICLENursing students and the internet: a reflection of digital ethics
Revista Brasileira de Enfermagem. 2024;77:e20230459
DOI 10.1590/0034-7167-2023-0459
Views0See moreABSTRACT
Objectives:
to identify how first-year nursing students use cyberspace and propose an orientation guide with criteria guiding the use of cyberspace.
Methods:
qualitative and descriptive research, carried out with 24 nursing students from a federal public institution in Rio de Janeiro. Data collection was carried out through semi-structured interviews. Data analysis occurred using IRAMUTEQ®. The research was approved by the institution’s Research Ethics Committee.
Results:
students use cyberspace to communicate, study, find “cool things”, share photos and memories. Furthermore, they are concerned about hate speech, intolerance and fake news. The good and bad sides and the types of technologies most used were also portrayed.
Final considerations:
the moral and ethical values of physical coexistence, together with awareness of individual responsibility, are the pillars for using cyberspace. The guide comes as an awareness tool.
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ORIGINAL ARTICLE01-10-2024
Maternity behind and beyond bars: analysis from the perspective of protection bioethics
Revista Brasileira de Enfermagem. 2024;77:e20220576
Abstract
ORIGINAL ARTICLEMaternity behind and beyond bars: analysis from the perspective of protection bioethics
Revista Brasileira de Enfermagem. 2024;77:e20220576
DOI 10.1590/0034-7167-2022-0576
Views0See moreABSTRACT
Objective:
to analyze how motherhood is expressed in female prison units from the perspective of Bioethics of Protection.
Method:
qualitative research with an ethnographic approach, developed in two women’s prison units. Participantes were: six mothers deprived of liberty, 15 health professionals, and nine prison officers. For data collection, semi-structured interviews and descriptive observation were used. Data analysis was based on the Content Analysis technique, thematic category.
Results:
three categories emerged: women and children violated behind bars (inequities); mothers and children in prison exacerbating imbalances, tensions and conflicts; and limits and references for resocialization.
Final Considerations:
the Bioethics of Protection proposal appears as a valid tool for the analytical direction of the process of confronting issues in the scope of public health in prison units, considering vulnerable groups and aiming at equity and human dignity.
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ORIGINAL ARTICLE01-10-2024
Self-harm in the two years of greatest restrictions during the covid-19 pandemic: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77:e20240289
Abstract
ORIGINAL ARTICLESelf-harm in the two years of greatest restrictions during the covid-19 pandemic: a cross-sectional study
Revista Brasileira de Enfermagem. 2024;77:e20240289
DOI 10.1590/0034-7167-2024-0289
Views0See moreABSTRACT
Objective:
to analyze occurrence of self-harm, sociodemographic profile of victims and referrals in the first 24 months of the COVID-19 pandemic in São Paulo.
Method:
cross-sectional study carried out by the Notifiable Diseases Information System with data on self-harm in São Paulo. The period outlined was March 2020 to February 2022. R (4.0.2) software and chi-square test were used.
Results:
there were 15,946 incidents. Victims were young, white, single, heterosexual women. There was high incidence of people with previous mental disorders more than once and without clear motivation. The method used was poisoning/intoxication. There was a considerable number of referrals to the health network, although not totalitarian.
Conclusion:
the years of greater insecurity in relation to the pandemic have given rise to self-harm cases with peculiar characteristics. Agile health policies must be applied in atypical conditions, such as pandemics, especially for adolescents/young people with previous mental disorders.
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REVIEW01-10-2024
Health of quilombola children as a challenge for the Sustainable Development Goals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20240106
Abstract
REVIEWHealth of quilombola children as a challenge for the Sustainable Development Goals: a scoping review
Revista Brasileira de Enfermagem. 2024;77:e20240106
DOI 10.1590/0034-7167-2024-0106
Views0See moreABSTRACT
Objective:
to map the literature on quilombola children’s health and its relationship with the Sustainable Development Goals.
Method:
a scoping review, which followed the JBI protocol and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Searches were conducted in the LILACS, BDENF, Web of Science, Scopus, MEDLINE databases and Google Scholar platform. The research protocol was registered in the Open Science Framework.
Results:
eighteen articles out of 2,055 studies were selected as relevant for this study. The articles were grouped into four axes: Access to healthcare services; Nutritional aspects of quilombola children; Health problems of quilombola children; and Care for quilombola children. The relationship between these articles and SDGs 1, 3, 4, 6 and 10 was observed.
Final considerations:
the study provided an extremely important mapping of the theme of quilombola children’s health and themes related to the Sustainable Development Goals.
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REVIEW01-10-2024
Prevalence and exposure variables of latent infection by mycobacterium tuberculosis in healthcare workers
Revista Brasileira de Enfermagem. 2024;77:e20240052
Abstract
REVIEWPrevalence and exposure variables of latent infection by mycobacterium tuberculosis in healthcare workers
Revista Brasileira de Enfermagem. 2024;77:e20240052
DOI 10.1590/0034-7167-2024-0052
Views0See moreABSTRACT
Objectives:
To identify in the scientific literature the prevalence, diagnostic methods, and exposure variables of latent infection by Mycobacterium tuberculosis in healthcare workers.
Methods:
An integrative review of the scientific literature based on the following review question: What are the available scientific evidence in the literature that address the prevalence of latent infection by Mycobacterium tuberculosis in healthcare workers and its association with possible risk factors among these workers?
Results:
Being a physician or nurse, being older, and being male were generally associated with higher prevalences. The study also showed that interferon-gamma release assays were more commonly used as a diagnostic method compared to skin tests.
Conclusions:
More studies are needed regarding the epidemiology of latent infection by Mycobacterium tuberculosis in the context of healthcare workers, aiming for higher impact actions that contribute to the reduction of tuberculosis worldwide.
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EDITORIAL08-19-2024
Sexual abuse, abortion and public health in Brazil: when moral judgment accentuates inequities
Revista Brasileira de Enfermagem. 2024;77:e77suppl0401
Abstract
EDITORIALSexual abuse, abortion and public health in Brazil: when moral judgment accentuates inequities
Revista Brasileira de Enfermagem. 2024;77:e77suppl0401
DOI 10.1590/0034-7167.202477suppl0401
Views0Here is an academic-political editorial that aims to call on the scientific field to reflect on the dangers of decisions regarding the right to abortion under moral rules, since there is no evidence that such a perspective translates into practices of care, protection of childhood and gender equity – elements that are so urgent and […]See more -
ORIGINAL ARTICLE08-19-2024
The use of individual tracking programs in public health: a bioethics dilemma
Revista Brasileira de Enfermagem. 2024;77:e20230041
Abstract
ORIGINAL ARTICLEThe use of individual tracking programs in public health: a bioethics dilemma
Revista Brasileira de Enfermagem. 2024;77:e20230041
DOI 10.1590/0034-7167-2023-0041
Views0See moreABSTRACT
Objective:
to understand the bioethical perspectives on mobile tracking device use.
Methods:
theoretical study based on action research, carried out with eight graduate students from a public university. A focus group was used, with a thematic content analysis methodology with a codebook structure, approved by the Research Ethics Committee.
Results:
from the analysis, there was a concern about using devices after the pandemic ended. Using or not the device, rights inherent to humans, legislation and effectiveness of methods deepen interpretations, moving participants from a personalistic conception of the topic to a vision focused on professional implications about the methods.
Final considerations:
the debate on the impact of using technological devices on health, especially those that imply restriction of rights that refer to individuals’ private life, involves a discussion of a professional nature, in addition to requirement for clear rules on the topic.
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ORIGINAL ARTICLE08-19-2024
Bioethical issues in the family health strategy: Considerations for nursing care management
Revista Brasileira de Enfermagem. 2024;77:e20220818
Abstract
ORIGINAL ARTICLEBioethical issues in the family health strategy: Considerations for nursing care management
Revista Brasileira de Enfermagem. 2024;77:e20220818
DOI 10.1590/0034-7167-2022-0818
Views0See moreABSTRACT
Objective:
To understand the bioethical issues involved in the care management of nurses working in the Family Health Strategy.
Method:
A qualitative study was conducted through five focus groups with 36 nurses selected in the sample. Thematic content analysis was performed based on the bioethical framework, and the synthesis was presented in a conceptual map.
Results:
Bioethical issues were identified in the nursing care practice, related to both specific bioethical themes and the peculiarities of the work. Additionally, challenges and facilitators that interfere with addressing these issues were identified.
Final considerations:
Understanding the bioethical issues involved in the care management of nurses was possible with the theoretical support of different bioethical perspectives. The identified issues relate to persistent and current themes in the field of bioethics. However, some aspects intrinsic to daily practice are still imperceptible to professionals, contributing to the difficulty of discussing bioethics in this care model.
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REVIEW07-29-2024
Telenursing in the postoperative period: a scoping review
Revista Brasileira de Enfermagem. 2024;77(3):e20240066
Abstract
REVIEWTelenursing in the postoperative period: a scoping review
Revista Brasileira de Enfermagem. 2024;77(3):e20240066
DOI 10.1590/0034-7167-2024-0066
Views0See moreABSTRACT
Objectives:
to map available evidence on telenursing use in the postoperative period and its impact on patient outcomes.
Methods:
a scoping review, conducted according to the JBI model and the PRISMA-ScR checklist. The search was carried out in the CINAHL, Embase, LILACS, PubMed, Web of Science, SciELO, Scopus and Cochrane Library databases.
Results:
twelve studies were included, published between 2011 and 2023, 66.6% of which were in developed countries. Of the positive outcomes, we highlight improved levels of disability, autonomy and quality of life, lower rates of post-operative complications, pain and reduced costs. Telephone monitoring was the most widely used modality, but there were few studies in the pediatric context and in Brazil.
Conclusions:
of the studies, 11 (91.6%) identified at least one positive outcome in telenursing use and none showed negative aspects in the postoperative period. The role of nurses in digital health needs further study.
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ORIGINAL ARTICLE07-29-2024
Men’s perception of paternal parenthood and the promotion of child development
Revista Brasileira de Enfermagem. 2024;77(3):e20230514
Abstract
ORIGINAL ARTICLEMen’s perception of paternal parenthood and the promotion of child development
Revista Brasileira de Enfermagem. 2024;77(3):e20230514
DOI 10.1590/0034-7167-2023-0514
Views0See moreABSTRACT
Objectives:
to comprehend men’s perception of paternal parenthood while caring for infants to promote child development.
Methods:
this qualitative study adopts an exploratory approach and was conducted with undergraduate and graduate students, faculty, and staff who are fathers of infants up to 6 months old from a higher education institution, excluding fathers from mononuclear families. Data collection occurred through semi-structured interviews and was analyzed using thematic categorical analysis.
Results:
fifteen men participated in the study. From the analysis, two empirical categories emerged: “Perception of being a father: challenges and novelties” and “Promotion of child development: actions carried out by fathers”. Fathers revealed feeling unprepared, the need for emotional support, and recognized activities aimed at their children’s development.
Final Considerations:
the relevance of the paternal figure for child development is highlighted, as well as the need for public policies to encourage paternal parenthood.
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ORIGINAL ARTICLE07-29-2024
Contribution of informal caregivers to self-care in individuals with heart failure
Revista Brasileira de Enfermagem. 2024;77(3):e20230492
Abstract
ORIGINAL ARTICLEContribution of informal caregivers to self-care in individuals with heart failure
Revista Brasileira de Enfermagem. 2024;77(3):e20230492
DOI 10.1590/0034-7167-2023-0492
Views0See moreABSTRACT
Objectives:
to evaluate the contribution of informal caregivers to the self-care of individuals with heart failure.
Methods:
a cross-sectional study was conducted with 87 caregivers from March to October 2022 in the city of João Pessoa/PB. The caregivers’ contribution was assessed using the Caregiver Contribution to Self-Care of Heart Failure Index instrument. Scores ≥ 70 points indicate adequate contribution. Data were analyzed using descriptive statistics and Spearman’s correlation.
Results:
the sample consisted of 81.6% female caregivers. Median scores obtained for the self-care contribution scales were: 63.3 for maintenance; 55.5 for management; and 66.6 for confidence. Caregivers never or rarely recommended monitoring body weight, regular physical exercise, extra use of diuretics, and fluid restriction.
Conclusions:
informal caregivers showed inadequate contribution in the areas of maintenance, management, and confidence in self-care of individuals with heart failure.
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Reflections on theoretical framework use in nursing research
Revista Brasileira de Enfermagem. 2024;77(3):e20230486
Abstract
Reflections on theoretical framework use in nursing research
Revista Brasileira de Enfermagem. 2024;77(3):e20230486
DOI 10.1590/0034-7167-2024-0486
Views0See moreABSTRACT
Objectives:
to reflect on theoretical framework use in nursing research.
Methods:
a theoretical-reflexive study, based on concepts and constructs pertinent to using nursing theories and other sciences, considering issues of epistemology or philosophy of science.
Results:
we presented what it is and why to do nursing research and what a theoretical framework is and why to use it, in addition to some considerations regarding theoretical framework use in nursing research, essential for constructing disciplinary knowledge, which enables the materialization of researchers’ work and the presentation of propositions resulting from investigations in and for nursing as a discipline and science.
Final Considerations:
based on a reflection based on epistemological conceptions, it is possible to affirm that a theoretical framework is the core of researchers’ thinking, delimiting a problem to be investigated and, based on it, outlining methodological strategies to be followed, supporting nursing action and thinking as discipline and science.
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REVIEW07-29-2024
Nursing diagnoses for people hospitalized with heart failure: an integrative review
Revista Brasileira de Enfermagem. 2024;77(3):e20230471
Abstract
REVIEWNursing diagnoses for people hospitalized with heart failure: an integrative review
Revista Brasileira de Enfermagem. 2024;77(3):e20230471
DOI 10.1590/0034-7167-2023-0471
Views0See moreABSTRACT
Objectives:
to identify in the literature the main nursing diagnoses according to the NANDA-I diagnostic classification for people hospitalized with heart failure.
Methods:
an integrative literature review, carried out in February 2019 and updated in July 2023, in the MEDLINE via PubMed, LILACS, SciELO and CINAHL databases. Given the use of acronym PEO, studies without a time cut in Portuguese, English and Spanish were included. Descriptive analysis was carried out to present the identified information.
Results:
analysis of 27 articles identified 24 nursing diagnoses, with emphasis on Decreased Cardiac Output, Excessive Fluid Volume, Decreased Activity Tolerance and Fatigue.
Final Considerations:
evidence can contribute to better diagnostic decisions centered on people with heart failure in search of more assertive health results and have the potential to support future studies on a possible syndromic pattern in this population.
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RESEARCH01-01-2017
Chronic hepatitis B and D: prognosis according to Child-Pugh score
Revista Brasileira de Enfermagem. 2017;70(5):1048-1053
Abstract
RESEARCHChronic hepatitis B and D: prognosis according to Child-Pugh score
Revista Brasileira de Enfermagem. 2017;70(5):1048-1053
DOI 10.1590/0034-7167-2016-0205
Views0See moreABSTRACT
Objective:
compare chronic hepatitis B patients to those superinfected with hepatitis D virus, according to Child-Pugh score regarding disease severity.
Method:
retrospective descriptive study, performed with 59 patients followed in the ambulatory, of which 22 (37.3%) were chronically infected with hepatitis B virus (Group HBV) and 37 (62.7%) superinfected with Delta virus (Group HBV+HDV); variables of sex, age and items of Child-Pugh score were collected by consulting medical records.
Results:
out of the patients, 57.6% were male, with a mean age of 30.5 years. Score A, which indicates lesser severity, was found in 100% of group HBV and 78.4% of group HBV+HDV. Score B, which indicates greater severity, was found only in group HBV+HDV in 21.6% of the patients.
Conclusion:
by means of the Child-Pugh score, it was observed that patients with superinfection by HDV tended to present a worse prognosis.
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RESEARCH01-01-2017
Humanization in the Intensive Care: perception of family and healthcare professionals
Revista Brasileira de Enfermagem. 2017;70(5):1040-1047
Abstract
RESEARCHHumanization in the Intensive Care: perception of family and healthcare professionals
Revista Brasileira de Enfermagem. 2017;70(5):1040-1047
DOI 10.1590/0034-7167-2016-0281
Views0ABSTRACT
Objective:
Understanding perceptions of family members and healthcare professionals about humanization at the Intensive Care Unit (ICU) to direct it to an educational action.
Method:
Exploratory descriptive and qualitative study conducted in an ICU level 3 of a public hospital in Porto Alegre, RS, Brazil, with fourteen subjects, eight family members and six healthcare professionals. Data collection carried out through semi-structured interviews and focus group. Content Analysis was used.
Results:
Emerged categories were: welcoming; communication; ethical and sensible professionalism; unfavorable aspects; perception on humanization; and religiosity/spirituality.
Final considerations:
Although the subjects have expressed their perceptions about humanization in different ways, both groups pointed out the same needs and priorities to improve humanization in Intensive Care. From the results, we created a reflective manual of humanizing assistance practices for professionals, a board to facilitate communication of these professionals with patients and a guideline book for family members.
Keywords:Assistance HumanizationCritical CareHealth EducationHealth PersonnelProfessional-Family RelationshipSee more -
RESEARCH01-01-2017
Knowledge of adolescents regarding sexually transmitted infections and pregnancy
Revista Brasileira de Enfermagem. 2017;70(5):1033-1039
Abstract
RESEARCHKnowledge of adolescents regarding sexually transmitted infections and pregnancy
Revista Brasileira de Enfermagem. 2017;70(5):1033-1039
DOI 10.1590/0034-7167-2016-0531
Views0See moreABSTRACT
Objective:
To investigate the knowledge of adolescents related to sexually transmitted infections (STIs), AIDS, and pregnancy, and understand the role of school in sex education.
Method:
A qualitative descriptive study, developed through a semi-structured interview and a form for participant characterization, with 22 high school students from a public school aged 16 to 19 years. Data were submitted to content analysis.
Results:
After analysis, four thematic categories were developed: sexuality and sex education; understanding of risk behaviors; knowledge of STI/AIDS; and knowledge of and practices for prevention.
Final considerations:
This study showed the need for preventive educational actions for adolescents, because the lack of information contributes to their vulnerability. The adolescents recognize the importance of sex education; therefore it is important to implement strategies to promote and protect health in the school environment to encourage and strengthen self-care in health.
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RESEARCH01-01-2017
Care necessities: the view of the patient and nursing team
Revista Brasileira de Enfermagem. 2017;70(5):1026-1032
Abstract
RESEARCHCare necessities: the view of the patient and nursing team
Revista Brasileira de Enfermagem. 2017;70(5):1026-1032
DOI 10.1590/0034-7167-2016-0197
Views0ABSTRACT
Objectives:
To compare care necessities as perceived by the patient and nursing team and to investigate the sociodemographic factors associated with these perceptions.
Method:
A comparative study was conducted in units and hospitalized patients of a hospital institution in the state of São Paulo. The participants comprised 100 health professionals (50 nurses and 50 nursing technicians and auxiliaries) and 50 patients. A questionnaire was constructed and validated regarding care needs and was completed by the participants.
Results:
Considering cut-off value kappa ≥ 0.61, or that is, good and very good intervals, the greatest agreement between the perception of the patients and the nursing team was in the areas of: Care and Communication, both with 92.6% agreement; followed by Basic Care with 74.1%. The lowest value was found in the field of Care Planning and Organization, 64.3%.
Conclusion:
In a general manner, there was an agreement between the care needs from the view of the patients themselves and the nursing team.
Keywords:Determination of Healthcare NecessitiesEvaluation in NursingHospitalized PatientsNursing CareQuality of HealthcareSee more -
RESEARCH01-01-2017
Critical incidents connected to nurses’ leadership in Intensive Care Units
Revista Brasileira de Enfermagem. 2017;70(5):1018-1025
Abstract
RESEARCHCritical incidents connected to nurses’ leadership in Intensive Care Units
Revista Brasileira de Enfermagem. 2017;70(5):1018-1025
DOI 10.1590/0034-7167-2016-0137
Views0See moreABSTRACT
Objective:
The goal of this study is to analyze nurses’ leadership in intensive care units at hospitals in the state of São Paulo, Brazil, in the face of positive and negative critical incidents.
Method:
Exploratory, descriptive study, conducted with 24 nurses by using the Critical Incident Technique as a methodological benchmark.
Results:
Results were grouped into 61 critical incidents distributed into categories. Researchers came to the conclusion that leadership-related situations interfere with IC nurses’ behaviors. Among these situations they found: difficulty in the communication process; conflicts in the daily exercise of nurses’ activities; people management; and the setting of high quality care targets.
Final considerations:
Researchers identified a mixed leadership model, leading them to the conclusion that nurses’ knowledge and practice of contemporary leadership theories/styles are crucial because they facilitate the communication process, focusing on behavioral aspects and beliefs, in addition to valuing flexibility. This positively impacts the organization’s results.
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RESEARCH01-01-2017
Cross-cultural adaptation and validation of the Moral Distress Scale-Revised for nurses
Revista Brasileira de Enfermagem. 2017;70(5):1011-1017
Abstract
RESEARCHCross-cultural adaptation and validation of the Moral Distress Scale-Revised for nurses
Revista Brasileira de Enfermagem. 2017;70(5):1011-1017
DOI 10.1590/0034-7167-2016-0518
Views0See moreABSTRACT
Objective:
Cross-culturally adapt and validate the Moral Distress Scale-Revised for nurses.
Method:
Quantitative, analytical cross-sectional study conducted with 157 nurses of two hospital institutions of Southern Brazil, one public and one philanthropic. Procedures conducted: cultural adaptation of the instrument according to international recommendations; validation for the Brazilian context.
Results:
Face and content validation was considered satisfactory as assessed by a specialist committee and a pretest. The instrument demonstrated satisfactory internal consistency through frequency and intensity analysis per question in the 157 items and per subgroups of the various hospital units. Cronbach’s alpha was 0.88 for the instrument and between 0.76 and 0.94 for hospital units. Pearson’s correlation found a moderate association for moral distress among nurses.
Conclusion:
The Moral Distress Scale-Revised – Brazilian version is a valid instrument for the assessment of moral distress in nurses.
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RESEARCH01-01-2017
Sexual orientation and quality of life of people living with HIV/Aids
Revista Brasileira de Enfermagem. 2017;70(5):1004-1010
Abstract
RESEARCHSexual orientation and quality of life of people living with HIV/Aids
Revista Brasileira de Enfermagem. 2017;70(5):1004-1010
DOI 10.1590/0034-7167-2016-0420
Views0See moreABSTRACT
Objective:
To analyze whether sexual orientation affects the quality of life of people living with HIV/Aids (PLWHA).
Method:
A cross-sectional analytical study was carried out with 146 PLWHA in Teresina, capital city of the state of Piauí, in 2013, by means of the WHOQOL-HIV-bref. Descriptive analysis and multiple linear regression were used for data analysis.
Results:
There was a prevalence of men (63.7%), non-heterosexual (57.0%), aged between 19 and 39 years (89%). Of the total, 75.5% mentioned presence of negative feelings, such as fear and anxiety, and 38% reported have suffered stigma. With regard to the dimensions investigated, the most affected were “environment” and “level of independence”. Non-heterosexual orientation was negatively associated with quality of life in almost all dimensions.
Conclusion:
Living with HIV/Aids and having a non-heterosexual orientation have a negative impact on quality of life.
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RESEARCH01-01-2017
Prevention of chronic complications of diabetes mellitus according to complexity
Revista Brasileira de Enfermagem. 2017;70(5):996-1003
Abstract
RESEARCHPrevention of chronic complications of diabetes mellitus according to complexity
Revista Brasileira de Enfermagem. 2017;70(5):996-1003
DOI 10.1590/0034-7167-2016-0080
Views0ABSTRACT
Objective:
To assess the prevention by primary health care providers of chronic complications of diabetes mellitus according to the complex thinking theoretical approach.
Method:
Evaluative research based on the complex thinking theoretical approach. The following techniques for data collection were used: interviews with 38 participants; observation in collective and individual appointments; and analysis of medical records of people with diabetes. The triangulation applied for data analysis was the ATLAS.ti software.
Results:
The prevention and management of chronic complications of diabetes did not meet the requirements set forth by ministerial public policies aimed at this population. Systematic monitoring to prevention of chronic complications showed significant gaps.
Final considerations:
Primary health care did not consider preventive actions for diabetes mellitus complications. This context was marked by disjunctive, fragmented, and dissociated practices types of care targeted to the totality of the assisted people.
Keywords:Assessment of Health ServicesChronic DiseaseComplications of DiabetesDiabetes MellitusPrimary Health CareSee more
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