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ORIGINAL ARTICLE03-11-2024
Ethnically distinct populations and coping with violence against children in the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77:e20230350
Abstract
ORIGINAL ARTICLEEthnically distinct populations and coping with violence against children in the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2024;77:e20230350
DOI 10.1590/0034-7167-2023-0350
Views0See moreABSTRACT
Objective:
To identify policies and programs adopted by a Brazilian municipality to address violence against children during the COVID-19 pandemic.
Method:
A qualitative documentary study. The study setting was the municipality of Ananindeua, Pará, Brazil. Data was collected from official websites between November 2021 and February 2022. Thematic content analysis was used with the support of webQDA software.
Results:
Three empirical categories emerged: a) Impacts of the COVID-19 pandemic on violence against children; b) Action strategies for tackling violence against children in the COVID-19 pandemic; c) Evaluation indicators and targets for action strategies for tackling violence against children.
Final considerations:
The documents revealed few direct mentions of children, especially traditional populations; they presented superficial and ineffective evaluations of the policies and programs adopted, using exclusively quantitative indicators.
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ORIGINAL ARTICLE03-11-2024
Experiences of women with physical disabilities in labor and delivery assistance
Revista Brasileira de Enfermagem. 2024;77:e20230290
Abstract
ORIGINAL ARTICLEExperiences of women with physical disabilities in labor and delivery assistance
Revista Brasileira de Enfermagem. 2024;77:e20230290
DOI 10.1590/0034-7167-2023-0290
Views0See moreABSTRACT
Objective:
To understand the meaning attributed by women with physical disabilities to the health care received and expected during labor and delivery.
Methods:
Qualitative study, based on Social Network Theory, conducted through an online workshop in April 2022, with the participation of six women with physical disabilities. Data, collected through the focus group technique, underwent thematic content analysis with the assistance of the IRaMuTeQ tool.
Results:
Three thematic categories emerged: Challenges experienced during pregnancy; The experience within the maternity ward; and, The importance of social networks. The assistance provided by healthcare professionals sometimes differed between what was expected and what was received by women with physical disabilities during labor and delivery.
Final Considerations:
Experiences were predominantly negative, resulting from inappropriate professional conduct due to ableist attitudes. Support from members of social networks is crucial for preventing stressors.
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03-11-2024
O uso da ultrassonografia point-of-care na prática clínica do enfermeiro como alicerce para a segurança do paciente
Revista Brasileira de Enfermagem. 2024;77:e77suppl0201
Abstract
O uso da ultrassonografia point-of-care na prática clínica do enfermeiro como alicerce para a segurança do paciente
Revista Brasileira de Enfermagem. 2024;77:e77suppl0201
DOI 10.1590/0034-7167.202477suppl0201pt
Views0Recentemente, mais um caso de dano grave associado ao cuidado em saúde foi reportado pela mídia. Uma jovem grávida teve a mão e o punho amputados depois de dar à luz ao terceiro filho em um hospital do Rio de Janeiro(). Após o incidente ocasionado pelo acesso vascular, a mulher apresentou hemorragia e foi reinternada.Os […]See more -
REVIEW03-11-2024
Continuing nursing education actions in the face of homophobia: an integrative review
Revista Brasileira de Enfermagem. 2024;77:e20230094
Abstract
REVIEWContinuing nursing education actions in the face of homophobia: an integrative review
Revista Brasileira de Enfermagem. 2024;77:e20230094
DOI 10.1590/0034-7167-2023-0094
Views0See moreABSTRACT
Objectives:
to analyze continuing nursing education actions in the scientific literature in the face of homophobia.
Methods:
an integrative literature review with structured search in June 2022 in eight databases, using the descriptors Nursing Education, Homophobia, Sexual and Gender Minorities. Final sample consisted of six primary studies.
Results:
continuing nursing education actions are supported by strategies such as use of teaching materials, lectures, case studies and focus groups, addressing content such as gender identity issues and affective-sexual orientation, health disparities and their relationship with homophobia in healthcare settings.
Final considerations:
carried out in various healthcare settings, continuing education actions proved to be successful in raising nurses’ awareness in facing homophobia in health services, however, their expansion is necessary to create health spaces that meet the specific needs of these people.
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03-11-2024
The use of point-of-care ultrasound in nurses’ clinical practice as a foundation for patient safety
Revista Brasileira de Enfermagem. 2024;77:e77suppl0201
Abstract
The use of point-of-care ultrasound in nurses’ clinical practice as a foundation for patient safety
Revista Brasileira de Enfermagem. 2024;77:e77suppl0201
DOI 10.1590/0034-7167.202477suppl0201
Views0Recently, another case of serious harm associated with healthcare was reported by the media. A young pregnant woman had her hand and wrist amputated after giving birth to her third child in a hospital in Rio de Janeiro(). After the incident caused by vascular access, the woman suffered hemorrhage and was readmitted.The harm caused to […]See more -
03-08-2024
A enfermagem como protagonista no enfrentamento da hesitação e recusa vacinal
Revista Brasileira de Enfermagem. 2024;77:e77suppl101
Abstract
A 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 -
03-08-2024
Nursing as a player in tackling vaccine hesitancy and refusal
Revista Brasileira de Enfermagem. 2024;77:e77suppl101
Abstract
Nursing 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 -
02-26-2024
Nurse Navigator of Cancer Patients: contributions to the discussion on the national stage
Revista Brasileira de Enfermagem. 2024;77(2):e770201
Abstract
Nurse 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
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ORIGINAL ARTICLE11-10-2023
Construction and validity of educational technology in audiovisual media on premature newborn care
Revista Brasileira de Enfermagem. 2023;76:e20220403
Abstract
ORIGINAL ARTICLEConstruction and validity of educational technology in audiovisual media on premature newborn care
Revista Brasileira de Enfermagem. 2023;76:e20220403
DOI 10.1590/0034-7167-2022-0403
Views0See moreABSTRACT
Objectives:
to construct and validate an educational video storyboard about care for premature newborns at home.
Methods:
a methodological study, with the construction of an educational video storyboard, validated with 14 judges. Content was selected from scoping review. For data collection, a validated instrument was used. The criterion for validity was agreement greater than 80%, analyzed using the Content Validity Index.
Results:
the storyboard construction was guided by the Cognitive Theory of Multimedia Learning theoretical framework. Construction and validity took place from May to December 2020. The storyboard’s final version lasted 10 minutes, and was validated in terms of objective, structure, presentation and relevance, with a Content Validity Index of 0.9.
Conclusions:
the storyboard of the educational video proved to be valid and adequate for health promotion in developing care for premature newborns at home.
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ORIGINAL ARTICLE12-08-2023
Early ambulation and dhikr complementary therapies effect on intestinal peristaltic in post-open cholecystectomy patients
Revista Brasileira de Enfermagem. 2023;76:e20220636
Abstract
ORIGINAL ARTICLEEarly ambulation and dhikr complementary therapies effect on intestinal peristaltic in post-open cholecystectomy patients
Revista Brasileira de Enfermagem. 2023;76:e20220636
DOI 10.1590/0034-7167-2022-0636
Views0ABSTRACT
Objectives:
to analyze and determine the effect of a combination intervention of early ambulation and dhikr therapy on intestinal peristaltic recovery in post-open cholecystectomy patients.
Methods:
a pre-experimental design with one group pre and post-test design was used. The samples were 15 post-open cholecystectomy patients which were selected using the purposive sampling technique. The data were collected using the instrument observation sheet and analyzed using the Wilcoxon test. Early ambulation used standard operational procedure in the hospital and dhikr therapy was carried out at 2 hours post-operation for 10-15 minutes.
Results:
there was an effect of early ambulation and dhikr therapy on intestinal peristaltic recovery in post-open cholecystectomy patients with general anesthesia (Z=-3.442; p=0.001).
Conclusions:
a combination of early ambulation and dhikr therapy can be recommended as interventions to improve intestinal peristaltic in a post-open cholecystectomy patient with general anesthesia.
Keywords:Anesthesia, GeneralCholecystectomyComplementary TherapiesEarly AmbulationPerioperative NursingSee more -
ORIGINAL ARTICLE11-13-2023
Educational technology on tuberculosis: construction shared with Primary Health Care nurses
Revista Brasileira de Enfermagem. 2023;76:e20230025
Abstract
ORIGINAL ARTICLEEducational technology on tuberculosis: construction shared with Primary Health Care nurses
Revista Brasileira de Enfermagem. 2023;76:e20230025
DOI 10.1590/0034-7167-2023-0025
Views0See moreABSTRACT
Objective:
to develop, in a participatory way, an educational technology to assist nurses in the management of tuberculosis cases in Primary Health Care.
Methods:
methodological research with a qualitative approach. Data were collected between June and October 2022, in 25 Basic Health Units, with 41 nurses interviewed individually. Thematic content analysis was carried out to guide technology elaboration.
Results:
three empirical categories were organized, demonstrating the facilities and difficulties in tuberculosis management, the conceptions about educational technology as a facilitator of the teaching-learning process in Primary Health Care and participatory development of technology. Nurses were in favor of constructing an instructional guide technology, and made suggestions to encourage its creation and use in daily service routine.
Final considerations:
the participatory process made it possible to create technology to assist nurses in the teaching-learning process in Primary Health Care about caring for people with tuberculosis.
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07-31-2023
First graduate of the Master of Nursing in Advanced Practice in Oncology in Chile
Revista Brasileira de Enfermagem. 2023;76:e76suppl401
Abstract
First graduate of the Master of Nursing in Advanced Practice in Oncology in Chile
Revista Brasileira de Enfermagem. 2023;76:e76suppl401
DOI 10.1590/0034-7167.202376suppl401
Views0In 2020, the guidelines for Advanced Nursing Practice (APN) implementation() were published by the International Council of Nursing (ICN). On that occasion, I was invited to comment on the reality of specialist nurses in Chile, expressing the expectation of implementing an APN program, specifically Clinical Nurse Specialists (CNS). CNS are one of the most internationally […]See more -
ORIGINAL ARTICLE03-15-2024
Is there scientific relevance to the plot of films and documentaries about eating disorders?
Revista Brasileira de Enfermagem. 2024;77(1):e20220547
Abstract
ORIGINAL ARTICLEIs there scientific relevance to the plot of films and documentaries about eating disorders?
Revista Brasileira de Enfermagem. 2024;77(1):e20220547
DOI 10.1590/0034-7167-2022-0547
Views1See moreABSTRACT
Objectives:
to analyze films and documentaries about eating disorders from the last twenty years, identifying the way they approach the topic as well as their relevance for didactic use in teaching the health field.
Methods:
a descriptive study, whose data collection was carried out on the main streaming and video platforms, resulting in the survey of 60 media. Of these, only 25 had audio/subtitles in Portuguese (inclusion criteria). scientific relevance was analyzed considering psychopathological and epidemiological aspects of these disorders. A questionnaire about the plot, characters and descriptive data analysis were used.
Results:
most media were dramas about female teenagers who tried to conform to beauty stereotypes, whose symptoms portrayed converged with current medical diagnostic manuals.
Conclusions:
in practical terms, a classificatory list of 11 media was prepared that could be used as a teaching resource for teaching this topic in the health field.
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ORIGINAL ARTICLE02-26-2024
Technological prospecting of patents related to monitoring accidents due to falls in hospitals
Revista Brasileira de Enfermagem. 2024;77(1):e20230084
Abstract
ORIGINAL ARTICLETechnological prospecting of patents related to monitoring accidents due to falls in hospitals
Revista Brasileira de Enfermagem. 2024;77(1):e20230084
DOI 10.1590/0034-7167-2023-0084
Views0See moreABSTRACT
Objectives:
to map the production of technologies aimed at monitoring falls in a hospital environment protected by registered patents.
Methods:
a technological prospecting of international patents, with a quantitative approach, with search carried out between February and March 2022 in the Derwent Innovations Index database with descriptors fall, hospital, monitoring.
Results:
212 patents were found, with the majority filed and published since 2010, by Tran B (9) and Cerner Innovation Inc (9), focused on health technology. Universities were responsible for 13% of deposits. There was a predominance of records from the United States (43.4%), China (21.7%) and Japan (12.3%), in addition to technological strategies classified as devices for the environment (80.7%) and for preventing falls (66.5%) as well as trend towards resources with multiple functionalities in the same technology.
Conclusions:
the plurality of functions in the same device reflects the search for optimizing resources and the concern with comprehensive care.
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REVIEW03-15-2024
Use of podcasts for health education: a scoping review
Revista Brasileira de Enfermagem. 2024;77(1):e20230096
Abstract
REVIEWUse of podcasts for health education: a scoping review
Revista Brasileira de Enfermagem. 2024;77(1):e20230096
DOI 10.1590/0034-7167-2023-0096
Views0See moreABSTRACT
Objectives:
to map the scientific evidence related to the characteristics, themes, and outcomes of using health education podcasts aimed at individuals over 18 years of age in intra or extrahospital environments.
Methods:
a scoping review, based on the Joanna Briggs Institute method, conducted in 11 databases, including studies from 2004 to 2022.
Results:
11 studies were selected, categorized, highlighting the characteristics, evaluated outcomes, areas, and conditions of podcast application, indicating it as an effective tool for promoting behavioral change, health promotion, and social interaction, demonstrating its potential to improve well-being, quality of life, and user/client autonomy.
Conclusions:
the use of podcasts proves to be an effective, innovative, and low-cost tool, with a significant social impact, being effective for behavioral change, satisfaction, and social interaction. However, the lack of comprehensive studies on podcast development methodologies represents challenges to be overcome.
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ORIGINAL ARTICLE03-15-2024
Health Management of an HIV Testing and Counseling Center: Nursing Contributions
Revista Brasileira de Enfermagem. 2024;77(1):e20230217
Abstract
ORIGINAL ARTICLEHealth Management of an HIV Testing and Counseling Center: Nursing Contributions
Revista Brasileira de Enfermagem. 2024;77(1):e20230217
DOI 10.1590/0034-7167-2023-0217
Views0See moreABSTRACT
Objectives:
to analyze the role of nursing in the establishment of an HIV/AIDS Testing and Counseling Center in a Brazilian municipality.
Methods:
a historical study utilizing primary sources, including documents and oral accounts, involving a total of ten participants. The study encompasses the years 1997 and 1998. The research took place at the Testing and Counseling Center in São João de Meriti. Data was collected from March to May 2022.
Results:
nursing made significant contributions through the development of training initiatives led by nurses, who were also responsible for individual and group counseling, as well as HIV testing requests.
Final Considerations:
nursing played a crucial role in the center and in the management of Sexually Transmitted Infections, being involved in all stages of treatment in accordance with current public health policy.
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ORIGINAL ARTICLE05-09-2022
The meaning of patient safety for nursing students
Revista Brasileira de Enfermagem. 2022;75(5):e20210567
Abstract
ORIGINAL ARTICLEThe meaning of patient safety for nursing students
Revista Brasileira de Enfermagem. 2022;75(5):e20210567
DOI 10.1590/0034-7167-2021-0567
Views0See moreABSTRACT
Objective:
To understand the meanings attributed to patient safety by nursing students.
Methods:
Descriptive study of qualitative approach, based on the theoretical-methodological proposal of Symbolic Interactionism, conducted with 12 students completing the nursing course of a public higher education institution in a city in the state of Amazonas. The data were collected through a semi-structured interview. For interpretation of the results, it was used thematic analysis.
Results:
The meanings attributed by the students to patient safety are: the reduction of harm, the guarantee of the integrity of the patient, family members, and health professionals, the promotion of health through the knowledge acquired in the academy, the attitude of the professional and the practice. Final considerations: The meanings originated are in line with the literature produced; however, the students have knowledge gaps that enable patient safety development in their academic training and as nurses.
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ORIGINAL ARTICLE12-13-2019
Applying best practices to pregnant women in the obstetric center
Revista Brasileira de Enfermagem. 2019;72:191-196
Abstract
ORIGINAL ARTICLEApplying best practices to pregnant women in the obstetric center
Revista Brasileira de Enfermagem. 2019;72:191-196
DOI 10.1590/0034-7167-2018-0422
Views0See moreABSTRACT
Objective:
To identify the meaning attributed by nursing technicians to good care practices based on scientific evidence used with the pregnant women during the dilation stage of labor.
Method:
A qualitative study, based on Grounded Theory principles. Twelve interviews with nursing technicians attending labor in the obstetric center of two public hospitals, in Florianópolis/SC, were performed, from August of 2016 to March of 2017. Data were analyzed using open, axial coding.
Results:
The implementation of good practices, for nursing technicians, means adequately performing their activities, providing humanized care to the pregnant woman, respecting her autonomy, promoting pain relief, and a peaceful labor.
Final Considerations:
An adequate number of technicians must be determined to maintain quality of care, and to complete nursing records in a more detailed and systematized manner.
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ORIGINAL ARTICLE12-13-2019
Musical educational technology for lactation physiology learning: knowledge translation
Revista Brasileira de Enfermagem. 2019;72:220-226
Abstract
ORIGINAL ARTICLEMusical educational technology for lactation physiology learning: knowledge translation
Revista Brasileira de Enfermagem. 2019;72:220-226
DOI 10.1590/0034-7167-2018-0528
Views1See moreABSTRACT
Objective:
create and validate a musical educational technology for lactation physiology learning for professional training in health.
Method:
methodological study with application of a conceptual framework of Knowledge Translation. In the creation cycle, the knowledge of the physiology of lactation was synthetized in key points to create the lyrics and the melody. In the action cycle, the content of the musical educational technology was validated by judges experts in breast feeding, in the period from September to December 2017.
Results:
18 judges from all Brazilian regions participated in the validation. The content of the technology obtained a global Content Validity Index of 0.94 with one round of validation.
Conclusion:
the musical educational technology is validated to introduce the content of the physiology of lactation in the learning process of students, mediated by the teacher.
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ORIGINAL ARTICLE10-18-2022
Health education for hospitalized patient in nursing care: a conceptual analysis
Revista Brasileira de Enfermagem. 2022;75(2):e20200459
Abstract
ORIGINAL ARTICLEHealth education for hospitalized patient in nursing care: a conceptual analysis
Revista Brasileira de Enfermagem. 2022;75(2):e20200459
DOI 10.1590/0034-7167-2020-0459
Views0INTRODUCTIONOver the years, the development of health education practices is related to the historical moment of society(). The nineteenth and twentieth centuries presented decisive situations in the evolution process that we know today as health education. Nursing began to consider health educational practices after Florence Nightingale initially focused on professional training. Florence contributed to the […]See more -
ORIGINAL ARTICLE04-09-2020
Nursing work and competence in hemotherapy services: an ergological approach
Revista Brasileira de Enfermagem. 2020;73(3):e20180775
Abstract
ORIGINAL ARTICLENursing work and competence in hemotherapy services: an ergological approach
Revista Brasileira de Enfermagem. 2020;73(3):e20180775
DOI 10.1590/0034-7167-2018-0775
Views0See moreABSTRACT
Objetives:
to analyze the ingredients of the competence that the nurses use in the performance of their work in hemotherapy.
Methods:
qualitative study with 22 nurses, accomplished through documentary study, observation and semi-structured interview, with resources of Atlas.ti software based on the foundations of Historical Materialism Dialectic and Ergology. Performed Content Analysis.
Results:
the domain of specific knowledge of hemotherapy and the time of experience in the area, allied to the motivation of the worker and the ability to work in a team favor the competent action in the work activities. On the other hand, the lack of adequate work conditions, especially in relation to adequate materials, equipment and structure, impairs the work of the nurse in hemotherapy.
Final Considerations:
experience gained is critical to successful decision making. In addition, adequate working conditions, updating of knowledge and ability in teamwork favor a scenario of safe practices.
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EXPERIENCE REPORT02-10-2020
Overcoming the challenges to offer quality training in psychiatric nursing
Revista Brasileira de Enfermagem. 2020;73(1):e20180208
Abstract
EXPERIENCE REPORTOvercoming the challenges to offer quality training in psychiatric nursing
Revista Brasileira de Enfermagem. 2020;73(1):e20180208
DOI 10.1590/0034-7167-2018-0208
Views0See moreABSTRACT
Objective:
to report the experience of the Psychiatric Nursing professors of the Nursing Undergraduate Course of the Nursing School, Universidade Federal de Minas Gerais (UFMG) and the challenges faced to offer quality training.
Method:
This is an experience report about the experience of Psychiatric Nursing professors of the Nursing Undergraduate Course of the Nursing School, UFMG.
Results:
After losing the workload of 120 hours in the Psychiatric Nursing Undergraduate Course, the area developed elective disciplines with a total of 330-hour load, in addition to extension and research projects.
Final considerations:
the precariousness of the area of Nursing training after curricular restructuring in a higher education institution, whether in relation to hour load or in the allocation of teaching vacancies, is in line with advances of the Brazilian Psychiatric Reform and epidemiological data of psychic illness and drug use.
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ORIGINAL ARTICLE10-25-2022
Clinical characterization, disability, and mortality in people with strokes during 90 days
Revista Brasileira de Enfermagem. 2022;75(2):e20201383
Abstract
ORIGINAL ARTICLEClinical characterization, disability, and mortality in people with strokes during 90 days
Revista Brasileira de Enfermagem. 2022;75(2):e20201383
DOI 10.1590/0034-7167-2020-1383
Views0See moreABSTRACT
Objectives:
to describe clinical characteristics and mortality of people with ischemic cerebrovascular accidents (strokes); to compare disability before the event and 90 days after.
Methods:
longitudinal study with 308 people hospitalized in Salvador-BA. Data collection took place from 03/2019 to 01/2020. Descriptive and inferential statistics were used.
Results:
mean age was 64.8 years, and National Institute of Health Stroke Scale score was 10.7. The median length of stay in the hospital was 11 days. Afro-descendants predominated (84%), elementary educational level (68.4%), income up to three minimum wages (89.1%), arrival within 4.5 hours of symptoms (57.9%) and admission to a specialized unit (71.8%). Prevalence of thrombolysis: 26%. The asymptomatic before the event category predominated (85.3%) as did the moderate/severe disability (41.5%) after 90 days. 19.7% of the sample evolved to death. Conclusions: the high mortality and disability generated by the event have implications for health management and care.
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ORIGINAL ARTICLE03-30-2020
Kangaroo-mother care method: a documentary study of theses and dissertations of the brazilian nurse (2000-2017)
Revista Brasileira de Enfermagem. 2020;73(2):e20180598
Abstract
ORIGINAL ARTICLEKangaroo-mother care method: a documentary study of theses and dissertations of the brazilian nurse (2000-2017)
Revista Brasileira de Enfermagem. 2020;73(2):e20180598
DOI 10.1590/0034-7167-2018-0598
Views0See moreABSTRACT
Objectives:
to characterize theses and dissertations that address Kangaroo-Mother Care Method produced in Brazilian Graduate Nursing Programs from 2000 to 2017.
Methods:
a documentary study of qualitative approach. From a total of 207 papers, 185 were excluded and 22 were selected.
Results:
in 2006 and 2014 there was a higher number of master’s dissertations. In 2001, 2013 and 2017, there were three productions of doctoral theses. Universidade Federal de Santa Catarina (Federal University of Santa Catarina) presented the largest number of publications, with five studies, followed by Universidade Federal da Bahia (Federal University of Bahia), with four.
Final considerations:
Kangaroo-Mother Care Method has been researched in Brazilian Graduate Nursing Programs, mainly from the qualitative approach, highlighting the importance, contributions and difficulties of its application as a public policy.
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