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ORIGINAL ARTICLE12-16-2024
Complexities of nursing in healthcare waste management in hospitals
Revista Brasileira de Enfermagem. 2024;77(6):e20230391
Abstract
ORIGINAL ARTICLEComplexities of nursing in healthcare waste management in hospitals
Revista Brasileira de Enfermagem. 2024;77(6):e20230391
DOI 10.1590/0034-7167-2023-0391
Views0See moreABSTRACT
Objectives:
to understand how healthcare waste management is developed by nursing professionals in hospitals.
Methods:
qualitative research, whose theoretical and methodological frameworks were Complexity Theory and Grounded Theory. Thirty-two nursing professionals from a public hospital in Rio de Janeiro participated in the study. Semi-structured interviews were used.
Results:
nursing affects healthcare waste management multidimensionally. Shortage of materials and work overload were identified as factors that influence professionals’ decision-making and increase the risk of improper waste disposal. The lack of knowledge on the subject also influences nursing practice. However, professionals value actions related to hazardous waste.
Final Considerations:
nursing professionals recognize themselves in healthcare waste management and understand the need to develop systemic awareness for sustainable practice.
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ORIGINAL ARTICLE12-16-2024
Predisposing factors for symptoms of anxiety, depression, and insomnia in university students
Revista Brasileira de Enfermagem. 2024;77(6):e20230387
Abstract
ORIGINAL ARTICLEPredisposing factors for symptoms of anxiety, depression, and insomnia in university students
Revista Brasileira de Enfermagem. 2024;77(6):e20230387
DOI 10.1590/0034-7167-2023-0387
Views0See moreABSTRACT
Objectives:
to characterize the sociodemographic and psychological aspects of university students who sought psychiatric care at a Student Support Center of a Federal University and to analyze associations between mental health issues and predisposing factors.
Methods:
a retrospective analysis of 103 medical records was conducted. The statistical analysis consisted of two steps: a descriptive analysis and a predictive analysis using the Logistic Regression Model.
Results:
the majority of the students were female. Symptoms of anxiety, depression, and insomnia were the main reasons for seeking care. Students who reported having emotional difficulties that negatively impacted their studies and those who had undergone some form of health treatment showed a higher probability of experiencing anxiety symptoms. Notable correlations were found between anxiety and emotional difficulties, depression and diarrhea, and insomnia and a sedentary lifestyle.
Conclusions:
symptoms of anxiety, depression, and insomnia led students to seek psychiatric care at the university. Understanding the predisposing factors for mental health issues in university students can inform care strategies and promote academic success.
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ORIGINAL ARTICLE12-16-2024
Educational technology to empower patients as participants in their care
Revista Brasileira de Enfermagem. 2024;77(6):e20230359
Abstract
ORIGINAL ARTICLEEducational technology to empower patients as participants in their care
Revista Brasileira de Enfermagem. 2024;77(6):e20230359
DOI 10.1590/0034-7167-2023-0359
Views0See moreABSTRACT
Objectives:
to build and validate an educational technology to empower patients as participants in their own care.
Methods:
methodological study to develop an educational technology based on the elaboration, validation, and evaluation that were carried out in five stages at a teaching hospital in Amazonas. The study was carried out from 2019 to 2022, with the participation of 19 judges specialized in patient safety and 72 patients admitted to the hospital’s medical and surgical clinics, the study setting.
Results:
the agreement between the judges obtained an overall index of 0.85, being considered validated. The overall analysis of the booklet obtained an assessment of the level of agreement above 85%.
Final Considerations:
the educational technology presented here was validated and suitable for promoting patient/professional rapprochement and consolidating health care in a way that increases the patient’s ability to contribute to their treatment and prevent the occurrence of adverse events.
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REVIEW12-16-2024
Strategies for expanding vaccination coverage in children in Brazil: systematic literature review
Revista Brasileira de Enfermagem. 2024;77(6):e20230343
Abstract
REVIEWStrategies for expanding vaccination coverage in children in Brazil: systematic literature review
Revista Brasileira de Enfermagem. 2024;77(6):e20230343
DOI 10.1590/0034-7167-2023-0343
Views0See moreABSTRACT
Objectives:
to identify the strategies found in the literature for increasing vaccination coverage among children in Brazil. It is justified mainly by the current scenario of falling vaccination coverage.
Methods:
systematic literature review. The search was carried out in the Pubmed (MEDLINE), Embase and Scopus databases, following the PRISMA guidelines.
Results:
initially, 4,824 results were returned. In the end, 6 studies were included for narrative synthesis using the SWiM methodology. Of these, 50% dealt with studies related to the Bolsa Família Program (PBF). The others explored strategies for approaching parents directly, Rapid Vaccination Monitoring (MRV) and the Community Health Agents Program (PACS). The PBF did not guarantee compliance with the conditionality of keeping vaccinations up to date. The MRV and PACS are effective strategies, especially because they allow active search for absentees.
Conclusions:
we conclude that more publications are needed on strategies to increase vaccination coverage among children in Brazil.
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ORIGINAL ARTICLE12-16-2024
The nursing practice environment and hospital sociotechnical complexity: a mixed-methods study
Revista Brasileira de Enfermagem. 2024;77(6):e20230315
Abstract
ORIGINAL ARTICLEThe nursing practice environment and hospital sociotechnical complexity: a mixed-methods study
Revista Brasileira de Enfermagem. 2024;77(6):e20230315
DOI 10.1590/0034-7167-2023-0315
Views1See moreABSTRACT
Objectives:
to analyze the relationship between the nursing practice environment and hospital sociotechnical complexity as perceived by nurses.
Methods:
a sequential explanatory mixed-methods study was conducted in a hospital in southern Brazil. The Brazilian version of the Practice Environment Scale-Nursing Work Index and the Complexity Characterization Questionnaire were administered to 132 nurses. Subsequently, semi-structured interviews were conducted with 18 participants, and the data were subjected to thematic analysis. Data integration was achieved through a connection approach.
Results:
the nursing practice environment was found to be favorable, except in the subscale concerning Staffing and Resource Adequacy, where complexity was present in the activities. The three emerging categories explained human and technical aspects related to complexity in the practice environment, quality of care, and patient safety. Unexpected variability was inversely correlated with the practice environment.
Conclusions:
the study results indicate a relationship between these constructs, with implications for the quality and the safety of care.
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ORIGINAL ARTICLE12-16-2024
Factors associated with maternal well-being during childbirth among postpartum women in Minas Gerais
Revista Brasileira de Enfermagem. 2024;77(6):e20230304
Abstract
ORIGINAL ARTICLEFactors associated with maternal well-being during childbirth among postpartum women in Minas Gerais
Revista Brasileira de Enfermagem. 2024;77(6):e20230304
DOI 10.1590/0034-7167-2023-0304
Views0See moreABSTRACT
Objectives:
to analyze the factors associated with maternal well-being during childbirth among postpartum women in Minas Gerais.
Methods:
a cross-sectional study nested within a cohort was conducted with postpartum women in a municipality of Minas Gerais. The Maternal Well-being in Childbirth Scale 2 was used. The prevalence of maternal well-being during childbirth was estimated. The magnitude of the association between maternal distress and care practices was estimated using the Prevalence Ratio (PR), applying Poisson regression.
Results:
a total of 183 postpartum women aged between 15 and 46 years participated, with 26.2%, 27.9%, and 45.9% reporting excellent, adequate, and poor well-being during childbirth care, respectively. Maternal distress was more prevalent among women who underwent cesarean sections (PR = 1.60) and those who did not receive breastfeeding information (PR = 1.59).
Conclusions:
a high prevalence of maternal distress during childbirth was observed, associated with cesarean delivery and the lack of breastfeeding information.
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ORIGINAL ARTICLE12-16-2024
Prevalence and factors associated with musculoskeletal pain among hospital cleaning staff
Revista Brasileira de Enfermagem. 2024;77(6):e20230237
Abstract
ORIGINAL ARTICLEPrevalence and factors associated with musculoskeletal pain among hospital cleaning staff
Revista Brasileira de Enfermagem. 2024;77(6):e20230237
DOI 10.1590/0034-7167-2023-0237
Views0RESUMO
Objetivos:
verificar a prevalência e os fatores associados à dor musculoesquelética em trabalhadores do serviço hospitalar de limpeza.
Métodos:
estudo transversal, realizado com trabalhadores de limpeza de um hospital de ensino do Sul do Brasil. Utilizaram-se questionário com variáveis sociodemográficas, laborais e de saúde, o Nordic Musculoskeletal Questionnaire e o Diagrama de Corlett e Manenica. Realizou-se análise bivariada.
Resultados:
participaram 149 trabalhadores. Prevaleceu dor musculoesquelética na coluna lombar no último ano (65,8%) e últimos sete dias (42,3%). Constataram-se associações entre automedicação e dor na parte inferior das costas (p=0,020) e ombros (p=0,026); sedentarismo, oito horas de sono diárias e dor nos tornozelos (p=0,041) e pés (p=0,039); ex-tabagismo, uso de medicamento e dor nos punhos (p=0,015) e mãos (p=0,004).
Conclusões:
prevaleceram lombalgias associadas a hábitos de saúde e vida. Um programa de educação em saúde e recomendações de melhorias nos processos de trabalho podem minimizar a exposição à dor musculoesquelética.
Keywords:Dor MusculoesqueléticaSaúde do TrabalhadorServiço Hospitalar de LimpezaServiços HospitalaresTranstornos Traumáticos CumulativosSee more
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ORIGINAL ARTICLE06-14-2024
Mid-range theory of the nursing diagnosis Overweight
Revista Brasileira de Enfermagem. 2024;77(2):e20230372
Abstract
ORIGINAL ARTICLEMid-range theory of the nursing diagnosis Overweight
Revista Brasileira de Enfermagem. 2024;77(2):e20230372
DOI 10.1590/0034-7167-2023-0372
Views0See moreABSTRACT
Objective:
To build a mid-range theory for the nursing diagnosis Overweight in adolescents and young adults.
Methods:
A methodological study in the light of the theoretical frameworks of Roy and of Lopes, Silva and Herdman. A total of 3,925 articles were retrieved and assessed using the State of the Art Through Systematic Review software. The final sample consisted of 28 articles.
Results:
The findings converged to 3 essential attributes, 13 antecedents, and 7 consequences. A mid-range theory was built consisting of an illustrated diagram, 11 propositions, and 12 causal relationships.
Final considerations:
From the creation of the theory, it was possible to better understand the nursing diagnosis Overweight within the context of adolescents and young adults. Understanding nursing phenomena contributes to nursing science’s advancement and strengthening.
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ORIGINAL ARTICLE06-14-2024
Cardiovascular Risk and Lifestyle: comparison between teaching workers in Portugal and Brazil
Revista Brasileira de Enfermagem. 2024;77(2):e20230354
Abstract
ORIGINAL ARTICLECardiovascular Risk and Lifestyle: comparison between teaching workers in Portugal and Brazil
Revista Brasileira de Enfermagem. 2024;77(2):e20230354
DOI 10.1590/0034-7167-2023-0354
Views0ABSTRACT
Objective:
Compare Cardiovascular Risk between workers in Brazil and Portugal who work in the teaching context and its relationship with Lifestyle and Common Mental Disorder.
Methods:
Cross-sectional study that compared the cardiovascular health conditions of teaching workers in Manaus (Brazil) and Coimbra (Portugal). The odds ratio between groups was estimated.
Results:
The differences were: Smoking and hypercholesterolemia in participants from Portugal. Hypertension, chronic disease, increased abdominal perimeter, common mental disorder, and absence from work in Brazil. The variables with the greatest effect for high cardiovascular risk were: Country-Portugal [17.273 (95%CI1.538-193.951)], sex-male [61.577 (95%CI5.398-702.469)] and smoking [593.398 (95%CI57.330-6.142.020)].
Conclusion:
The differences in risk between groups showed that participants from Portugal, men, with high blood pressure and/or smokers are the most vulnerable to having a cardiovascular event. There is a need for interventions to promote cardiovascular health in the workplace in both countries.
Keywords:Community-Based Participatory ResearchHeart Disease Risk FactorsLife StyleOccupational HealthUniversitiesSee more -
ORIGINAL ARTICLE06-14-2024
Functional performance assessment scale for children and adolescents with cancer: cross-cultural study
Revista Brasileira de Enfermagem. 2024;77(2):e20230331
Abstract
ORIGINAL ARTICLEFunctional performance assessment scale for children and adolescents with cancer: cross-cultural study
Revista Brasileira de Enfermagem. 2024;77(2):e20230331
DOI 10.1590/0034-7167-2023-0331
Views0ABSTRACT
Objectives:
to describe the methodological process of cross-cultural adaptation of the PlayPerformance Scale for Children to Brazilian Portuguese.
Methods:
methodological study of translation and cross-cultural adaptation in six stages: translation, synthesis of translations, back-translation, evaluation by a committee of judges, evaluation by expert nurses, and pretest. The agreement and representativeness of the items were assessed using the content validity index. A minimum value of 80% agreement was considered.
Results:
all stages of the translation and cross-cultural adaptation process were satisfactory. In the evaluation performed by the committee of judges, all items obtained agreement above 80%. Fifteen pediatric nurses conducted the content validation, suggesting necessary modifications for understanding and application. Thirty children and adolescents with cancer were assessed with the scale for the pre-test.
Conclusions:
the scale was cross-culturally adapted to Brazilian Portuguese. The need for psychometric testing in a consistent sample is emphasized.
Keywords:Cross-Cultural ComparisonNursing Methodology ResearchOncologyPediatric NursingPhysical Functional PerformanceSee more -
ORIGINAL ARTICLE06-14-2024
Meanings attributed to health-related quality of life by caregivers of adolescents with diabetes
Revista Brasileira de Enfermagem. 2024;77(2):e20230314
Abstract
ORIGINAL ARTICLEMeanings attributed to health-related quality of life by caregivers of adolescents with diabetes
Revista Brasileira de Enfermagem. 2024;77(2):e20230314
DOI 10.1590/0034-7167-2023-0314
Views0See moreABSTRACT
Objective:
to interpret the meanings attributed to the health-related quality of life by caregivers of adolescents with type 1 diabetes mellitus.
Methods:
qualitative, descriptive-exploratory study of 14 caregivers of adolescents with diabetes developed at the reference outpatient clinic for endocrine diseases in a city in the state of Paraíba. Interviews were performed between May and September 2021. Inductive thematic analysis of the empirical material, and its interpretation in light of the concepts of health-related quality of life and family functioning were performed.
Results:
the meanings attributed by caregivers to the health-related quality of life of adolescents converged on the feeling of being healthy, healthy eating, satisfactory family income, family involvement in care and effective access to the care network.
Final Considerations:
knowledge of these meanings enables health professionals to develop strategies that meet the unique demands of caregivers experiencing this diagnosis.
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REVIEW06-14-2024
Critical analysis of the scientific production on Jean Watson’s Theory of Human Care
Revista Brasileira de Enfermagem. 2024;77(2):e20230231
Abstract
REVIEWCritical analysis of the scientific production on Jean Watson’s Theory of Human Care
Revista Brasileira de Enfermagem. 2024;77(2):e20230231
DOI 10.1590/0034-7167-2023-0231
Views0See moreABSTRACT
Objectives:
to analyze current scientific production on the use of the theoretical-methodological precepts of Jean Watson’s Theory of Human Care/Clinical Caritas Process.
Methods:
quantitative, exploratory, descriptive study using data from 1979 to 2023 in the Scopus database. Analysis was carried out using VOSviewer software.
Results:
the 73 studies included establish a network of collaboration among 221 authors from 155 institutions in 18 countries, who discuss the development of ethical behavior in nursing staff, through technical improvement, implementation, and validation of instrumental strategies capable of measuring and evaluating the quality of holistic and empathetic care. The Theory of Human Caring contributes to nursing training and care, and Process Clinical Caritas-Veritas is useful for the different possibilities of practice and education.
Conclusions:
it is important to strengthen with more empirical data a nursing work model centered on individual human care, supporting the evolution of scientific nursing knowledge.
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REVIEW06-14-2024
Primary health care professionals’ practice in the face of leprosy: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20230207
Abstract
REVIEWPrimary health care professionals’ practice in the face of leprosy: a scoping review
Revista Brasileira de Enfermagem. 2024;77(2):e20230207
DOI 10.1590/0034-7167-2023-0207
Views0See moreABSTRACT
Objectives:
to identify Primary Health Care professionals’ practice in the face of leprosy.
Methods:
a scoping review, carried out between November 2022 and January 2023, conducted according to the methodological structure proposed by JBI and checklist Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews in six databases and additional literature.
Results:
the sample consisted of 11 articles, published between 2008 and 2022. The findings were synthesized into three categories: Early diagnosis and timely treatment; Physical disability prevention; and Household and social contact surveillance.
Final Considerations:
there is a need to align the practices carried out with those recommended by the Brazilian National Program for Leprosy Control and Elimination, as some were not identified in studies, which implies losses to qualified assistance directed to patient demands, with a view to control and elimination of leprosy.
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ORIGINAL ARTICLE06-14-2024
Validity of the TBApp mobile application for self-care management for people with tuberculosis
Revista Brasileira de Enfermagem. 2024;77(2):e20230195
Abstract
ORIGINAL ARTICLEValidity of the TBApp mobile application for self-care management for people with tuberculosis
Revista Brasileira de Enfermagem. 2024;77(2):e20230195
DOI 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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Palliative care strategies in the management of people with serious cases of COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220308
Abstract
Palliative care strategies in the management of people with serious cases of COVID-19
Revista Brasileira de Enfermagem. 2023;76:e20220308
DOI 10.1590/0034-7167-2022-0308
Views0See moreABSTRACT
Objectives:
to analyze the assistance strategies in palliative care developed in the COVID-19 pandemic for critically ill patients and their families.
Methods:
an integrative review carried out in August 2021 and updated in April 2022 in the Base de Dados de Enfermagem (BDENF), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), US National Library of Medicine (PubMed), Web of Science databases, and presented in the PRISMA flowchart.
Results:
thirteen works were selected for reading and content analysis, from which emerged the two main themes that reflect the reality evidenced in this context: The sudden advent of COVID-19 with impacts on palliative care; and The strategies used in palliative care to mitigate these impacts.
Final Considerations:
palliative care is the best strategy for providing health care, used as a comfort to bring relief and comfort to patients and families.
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ORIGINAL ARTICLE03-06-2023
Construct elaboration and validity of the Pregnancy Depression Risk Scale
Revista Brasileira de Enfermagem. 2023;76(2):e20220306
Abstract
ORIGINAL ARTICLEConstruct elaboration and validity of the Pregnancy Depression Risk Scale
Revista Brasileira de Enfermagem. 2023;76(2):e20220306
DOI 10.1590/0034-7167-2022-0306
Views0See moreABSTRACT
Objectives:
to elaborate and analyze the Pregnancy Depression Risk Scale psychometric properties.
Methods:
methodological research, in six steps: theoretical model empirical definition; elaboration of scale items with literature review; consultation with five professional health experts and 15 pregnant women; content validity with six experts; pre-test-semantic validity with 24 pregnant women; scale factor structure definition with 350 pregnant women; pilot study with 100 pregnant women, totaling 489 pregnant women and 11 experts. Data were analyzed by content analysis, exploratory factor analysis, multitrait-multimethod analysis and internal consistency.
Results:
sixty-eight risk factors were identified for item formulation. The final version of the scale consisted of 24 items in five domains. The scale demonstrated satisfactory construct content, semantic, validity and reliability.
Conclusions:
the scale proved to be valid in terms of content and semantics, with a factor structure defined according to the adopted theoretical model and satisfactory psychometric properties.
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ORIGINAL ARTICLE03-06-2023
Medication reconciliation in pediatrics: a validation of instruments to prevent medication errors
Revista Brasileira de Enfermagem. 2023;76(2):e20210755
Abstract
ORIGINAL ARTICLEMedication reconciliation in pediatrics: a validation of instruments to prevent medication errors
Revista Brasileira de Enfermagem. 2023;76(2):e20210755
DOI 10.1590/0034-7167-2021-0755
Views0ABSTRACT
Objectives:
to develop and validate the content of two instruments for promoting medication reconciliation for the transition of care of hospitalized children.
Methods:
methodological study, conducted in five stages: scope review for conceptual structure; elaboration of the initial version; content validation with five specialists using the Delphi technique; reassessment; and construction of the final version of the instruments. A content validity index of at least 0.80 was adopted.
Results:
three rounds of evaluation were carried out to reach the validity index of the proposed contents, whereas a new analysis of 50% of the 20 items of the instrument aimed at families, and 28.5% of the 21 items aimed at professionals was necessary. The instrument aimed at families reached an index of 0.93, and the instrument for professionals, 0.90.
Conclusions:
the proposed instruments were validated. It is now possible to proceed with practical implementation studies to identify their influence on safety during medication reconciliation at transition of care.
Keywords:Medication errorsMedication ReconciliationPatient SafetyPediatricsProfessional-Family RelationsSee more -
ORIGINAL ARTICLE03-06-2023
Organizational politics and professional struggles in nursing
Revista Brasileira de Enfermagem. 2023;76(1):e20220180
Abstract
ORIGINAL ARTICLEOrganizational politics and professional struggles in nursing
Revista Brasileira de Enfermagem. 2023;76(1):e20220180
DOI 10.1590/0034-7167-2022-0180
Views0See moreABSTRACT
Objective:
to analyze the professional struggles between nursing organizational entities, in Rio de Janeiro, during the Regional Nursing Council’s electoral process (1990-1993 administration).
Method:
historical study. We used journalistic articles, normative documents, legislation and semi-structured interviews with five nursing professionals who participated in this process. Interpretation of findings was supported by Bourdieu’s concepts of habitus, field, capital, and symbolic power.
Results:
Electoral Code changes of the aforementioned council, under the influence of administration (1987-1990), candidate for re-election, influenced the disclosure and eligibility criteria, making it difficult for broad participation, especially of Associação Brasileira de Enfermagem Rio de Janeiro Section.
Final considerations:
nursing, in this period, generated a field of disputes related to positions of power and gender, which was evidenced in the electoral process studied, which highlighted using limiting strategies by a group, making it difficult for the entire category to participate.
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EDITORIAL02-06-2023
Proyecto Termómetro Social COVID-19: articulaciones transnacionales para abordar poblaciones en situación de vulnerabilidad social
Revista Brasileira de Enfermagem. 2023;76:e76suppl201
Abstract
EDITORIALProyecto Termómetro Social COVID-19: articulaciones transnacionales para abordar poblaciones en situación de vulnerabilidad social
Revista Brasileira de Enfermagem. 2023;76:e76suppl201
DOI 10.1590/0034-7167.202376suppl201es
Views0El COVID-19 es una enfermedad infecciosa que ha impactado significativamente diferentes contextos alrededor del mundo, directa y/o indirectamente, y en mayor escala en países pobres y/o en vías de desarrollo(). No sabemos con certeza los efectos acumulativos del COVID-19 en las poblaciones (trastornos mentales, insomnio, ansiedad, trombosis, déficit cognitivo, problemas de memoria, etc.) tras la […]See more -
EDITORIAL02-06-2023
COVID-19 Social Thermometer Project: transnational articulations to approach populations in situations of social vulnerability
Revista Brasileira de Enfermagem. 2023;76:e76suppl201
Abstract
EDITORIALCOVID-19 Social Thermometer Project: transnational articulations to approach populations in situations of social vulnerability
Revista Brasileira de Enfermagem. 2023;76:e76suppl201
DOI 10.1590/0034-7167.202376suppl201
Views0COVID-19 is an infectious disease that has significantly impacted different contexts around the world, directly and/or indirectly, and on a larger scale in poor and/or developing countries(). We do not know for sure the cumulative effects of COVID-19 on populations (mental disorders, insomnia, anxiety, thrombosis, cognition deficit, memory problems, etc.) after exposure to infection by […]See more
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