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EDITORIAL
Chronicity and its impact on workers’ health: a call for concrete actions
Revista Brasileira de Enfermagem. 2023;76:e76suppl301
12-04-2023
Abstract
EDITORIALChronicity and its impact on workers’ health: a call for concrete actions
Revista Brasileira de Enfermagem. 2023;76:e76suppl301
12-04-2023DOI 10.1590/0034-7167.202376suppl301
Views0The relationship between chronicity and work has been a growing concern in contemporary society. As the number of chronic illnesses increases around the world, it is critical to understand how these conditions impact workers’ health(). In this editorial, we will explore the impacts of chronicity on workers’ health, highlighting data from the Global Burden of […]See more -
EDITORIAL
A cronicidade e o seu impacto na saúde do trabalhador: uma chamada para ações concretas
Revista Brasileira de Enfermagem. 2023;76:e76suppl301
12-04-2023
Abstract
EDITORIALA cronicidade e o seu impacto na saúde do trabalhador: uma chamada para ações concretas
Revista Brasileira de Enfermagem. 2023;76:e76suppl301
12-04-2023DOI 10.1590/0034-7167.202376suppl301pt
Views0A relação entre cronicidade e trabalho tem sido uma preocupação crescente na sociedade contemporânea. À medida que o número de doenças crônicas aumenta em todo o mundo, é fundamental compreender como essas condições impactam a saúde dos trabalhadores(). Neste editorial, exploraremos os impactos da cronicidade na saúde do trabalhador, destacando dados da Carga Global de […]See more -
ORIGINAL ARTICLE
Fatores que afetam a atitude da comunidade em relação à vacinação contra a COVID-19: estudo transversal
Revista Brasileira de Enfermagem. 2023;76:e20220597
12-04-2023
Abstract
ORIGINAL ARTICLEFatores que afetam a atitude da comunidade em relação à vacinação contra a COVID-19: estudo transversal
Revista Brasileira de Enfermagem. 2023;76:e20220597
12-04-2023DOI 10.1590/0034-7167-2022-0597
Views0RESUMEN
Objetivo:
El objetivo de este estudio fue analizar los factores que afectan la actitud de la comunidad hacia la vacunación contra el COVID-19 en el distrito de Tangerang.
Métodos:
Estudio transversal en el que se utilizó un muestreo por conveniencia para seleccionar a 400 encuestados. Los criterios de inclusión fueron vivir en el distrito de Tangerang, edad 18-55 años y trabajar. Se utilizó un cuestionario en línea, el cual pasó pruebas de validez y confiabilidad. Este estudio recibió aprobación ética.
Resultados:
La mayoría de los encuestados tenía un alto nivel de educación (48,50%), bajos ingresos (72,50%), alto conocimiento (78%) y una actitud positiva (76,50%) respecto a la vacunación contra el COVID-19. La prueba chi-cuadrado reveló una correlación entre el conocimiento y las actitudes hacia la vacunación contra el COVID-19 (p=0,001) y los niveles educativos (p=0,001). No hubo correlación entre los ingresos y las actitudes (p=0,094).
Conclusiones:
Los profesionales de la salud deben realizar una amplia socialización y visitas cara a cara con personas con acceso limitado a la información para promover una actitud positiva y ampliar el alcance de la vacunación contra el COVID-19.
Keywords:Atitude Frente a SaúdeCobertura VacinalCOVID-19Hesitação VacinacionalVacinas Contra COVID-19See more -
ORIGINAL ARTICLE
Estresse laboral entre enfermeiros na pandemia de COVID-19: Quais são os fatores contribuintes?
Revista Brasileira de Enfermagem. 2023;76:e20220586
12-04-2023
Abstract
ORIGINAL ARTICLEEstresse laboral entre enfermeiros na pandemia de COVID-19: Quais são os fatores contribuintes?
Revista Brasileira de Enfermagem. 2023;76:e20220586
12-04-2023DOI 10.1590/0034-7167-2022-0586
Views0See moreRESUMEN
Objetivo:
Analizar los factores contribuyentes del estrés laboral entre enfermeros en la pandemia de COVID-19.
Métodos:
Estudio transversal realizado con 101 enfermeros de dos hospitales de Java Occidental, Indonesia. Se distribuyó un cuestionario en línea para evaluar el estrés laboral y los datos se analizaron mediante regresión logística ordinal.
Resultados:
Más de la mitad de los enfermeros experimentaron un estrés laboral moderado. El estudio reveló que los enfermeros mayores de 35 años tenían una menor probabilidad de experimentar estrés laboral (AOR: 0.173; IC95%: 0.038-0.782) y los enfermeros casados tenían una mayor probabilidad (AOR: 7.156; IC95%: 1.456-35.163). Los enfermeros con cargas de trabajo bajas y moderadas tenían una probabilidad menor, (AOR: 0.003; IC95%: 0.000-0.051) y (AOR: 0.025; IC95%: 0.005-0.116), respectivamente.
Conclusión:
Es fundamental considerar la edad, el estado civil y la carga de trabajo para un abordaje eficaz del estrés laboral entre los enfermeros.
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REVIEW
Contributions of the institutions for the nursing professionalization: integrative review (2010-2020) in the light of freidsonian conceptions
Revista Brasileira de Enfermagem. 2023;76(1):e20220153
11-28-2023
Abstract
REVIEWContributions of the institutions for the nursing professionalization: integrative review (2010-2020) in the light of freidsonian conceptions
Revista Brasileira de Enfermagem. 2023;76(1):e20220153
11-28-2023DOI 10.1590/0034-7167-2022-0153
Views0See moreABSTRACT
Objective:
To analyze the contributions of the Brazilian Nursing Association and the Federal and Regional Nursing Councils in the literature for the professionalization of nursing in the light of Eliot Freidson’s theoretical conceptions.
Methods:
Integrative review of the literature, of socio-professional historical interest, carried out from June to November 2021, through the question: How did professional associations contribute to the professionalization of Brazilian nursing according to the literature from 2010 to 2020? The evidence were organized in a synoptic table, which allowed the construction of a conceptual map.
Results:
In the 23 selected studies, the professional associations presented scientific, social and political contributions, which shape the professional field of nursing, enabling knowledge/expertise, autonomy and self-regulation.
Final considerations:
The efforts of these institutions reaffirm nursing as an academic and consulting profession, capable of exerting control over the essence of nursing work. They strive to consolidate nursing as a legitimate professional field of health in Brazil.
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REVIEW
Simulated scenarios in nursing: an integrative literature review
Revista Brasileira de Enfermagem. 2023;76(1):e20220123
11-28-2023
Abstract
REVIEWSimulated scenarios in nursing: an integrative literature review
Revista Brasileira de Enfermagem. 2023;76(1):e20220123
11-28-2023DOI 10.1590/0034-7167-2022-0123
Views0See moreABSTRACT
Objectives:
to identify in scientific literature which simulated clinical scenarios were developed and validated for teaching and learning in nursing.
Methods:
integrative review, carried out in seven sources of information. The Rayyan program was used for selection, content analysis to explore the findings and the methodological assessment tool of the validity process, entitled Quality Appraisal tool for Validity Studies.
Results:
initially, 1,179 manuscripts were identified and 14 were part of the sample. Two categories were defined: Profile of simulated clinical scenarios produced in nursing; and Clinical skills developed and their assessment mechanisms.
Final Considerations:
there was a preponderance of high-fidelity scenarios, built in Brazil in the last five years, aimed at nursing students on the themes of emergency, maternal care and stomatherapy, addressing the assessment of cognitive, psychomotor and affective skills in nursing. Most studies obtained good methodological quality in their content validity process.
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ORIGINAL ARTICLE
Factors associated with psychopathological symptoms among nurses at a university hospital
Revista Brasileira de Enfermagem. 2023;76(1):e20220075
11-28-2023
Abstract
ORIGINAL ARTICLEFactors associated with psychopathological symptoms among nurses at a university hospital
Revista Brasileira de Enfermagem. 2023;76(1):e20220075
11-28-2023DOI 10.1590/0034-7167-2022-0075
Views0See moreABSTRACT
Objectives:
to analyze the factors associated with psychopathological symptoms among nurses at a university hospital.
Methods:
a cross-sectional study developed at a university hospital in Pernambuco, in which 90 nurses participated. A questionnaire with social and professional characteristics and the Symptom Assessment Scale were used.
Results:
an association was found between the variable changing profession and the presence of characteristic symptoms of psychoticism, somatization and anxiety among nurses.
Conclusions:
the emergence of psychopathological symptoms has influenced nurses’ desire to search for another profession. This evidence reinforces the need for greater investments in better working conditions and welcoming actions in the work environment, in order to provide a better quality of professional life and promote the health of these workers.
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ORIGINAL ARTICLE
Managed clinical protocol: impact of implementation on sepsis treatment quality indicators
Revista Brasileira de Enfermagem. 2021;74(2):e20200282
05-28-2021
Abstract
ORIGINAL ARTICLEManaged clinical protocol: impact of implementation on sepsis treatment quality indicators
Revista Brasileira de Enfermagem. 2021;74(2):e20200282
05-28-2021DOI 10.1590/0034-7167-2020-0282
Views1See moreABSTRACT
Objectives:
to assess the impact of the implementation of a managed sepsis protocol on quality indicators of treatment for septic patients in an emergency department of a university hospital.
Methods:
an observational epidemiological study involving septic patients. The study was divided into two phases, pre-intervention and intervention, resulting from the implementation of the managed sepsis protocol. The study variables included sepsis treatment quality indicators. The results were statistically analyzed using the program Epi InfoTM.
Results:
the study sample included 631 patients, 95 from pre-intervention phase and 536 from intervention phases. Implementing the protocol increased patients’ chances of receiving the recommended treatment by 14 times. Implementing the protocol reduced the hospitalization period by 6 days (p <0.001) and decreased mortality (p <0.001).
Conclusions:
this study showed that implementing the managed protocol had an impact on the improvement of sepsis treatment quality indicators.
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ORIGINAL ARTICLE
Development of an appearance validity instrument for educational technology in health
Revista Brasileira de Enfermagem. 2020;73:e20190559
12-21-2020
Abstract
ORIGINAL ARTICLEDevelopment of an appearance validity instrument for educational technology in health
Revista Brasileira de Enfermagem. 2020;73:e20190559
12-21-2020DOI 10.1590/0034-7167-2019-0559
Views1ABSTRACT
Objectives:
to develop and evaluate the convergence of the instrument for the appearance validity of educational technologies in health.
Methods:
methodological study conducted in two steps. In step 1, the instrument items were developed, with subsequent content validity by nine specialists in the development of educational technologies in health. In step 2, the convergent validity between another instrument and the appearance instrument was performed. Correlation results above r> 0.3 and p <0.05 were considered as plausible convergent validity.
Results:
the ten items of the initial version of the appearance instrument were submitted to content validity that resulted in a final version with 12 items (Content Validity Index = 0.93). The correlation indexes were strong with the objective and appearance domains; moderate with motivation, organization and total; and weak with writing style.
Conclusions:
the appearance instrument demonstrated content validity and convergent validity, in addition to a strong correlation with the other instrument.
Keywords:Educational TechnologyHealth EducationMethodological Research in NursingTechnological DevelopmentValidation StudiesSee more -
REVIEW
Middle range theory for the nursing diagnosis Excess Fluid Volume in pregnant women
Revista Brasileira de Enfermagem. 2020;73:e20190334
09-21-2020
Abstract
REVIEWMiddle range theory for the nursing diagnosis Excess Fluid Volume in pregnant women
Revista Brasileira de Enfermagem. 2020;73:e20190334
09-21-2020DOI 10.1590/0034-7167-2019-0334
Views1See moreABSTRACT
Objective:
To stablish a middle range theory for the understanding of the causal mechanisms and clinical consequentes of the nursing diagnosis Excess Fluid Volume (00026) among pregnant women.
Method:
The Middle Range Theory was constructed in five stages: defining of construction approach, establishing main concepts, elaborating propositions, developing a pictorial diagram, and establishing the causal relationships and evidence for practice of the Middle Range Theory.
Results:
We identified 14 clinical indicators and 6 causal factors of Excess Fluid Volume. A pictorial diagram was developed and relationships between Excess Fluid Volume elements were established with 6 propositions for them.
Conclusion:
The Middle Range Theory included both physiological and pathological conditions to explain Excess Fluid Volume. This Middle Range Theory might help in the better understanding of interactions between causal factors and clinical indicators of Excess Fluid Volume.
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ORIGINAL ARTICLE
Nurses’ work process in an emergency hospital service
Revista Brasileira de Enfermagem. 2020;73(5):e20180923
07-06-2020
Abstract
ORIGINAL ARTICLENurses’ work process in an emergency hospital service
Revista Brasileira de Enfermagem. 2020;73(5):e20180923
07-06-2020DOI 10.1590/0034-7167-2018-0923
Views1ABSTRACT
Objectives:
to analyze the nurses’ work process in an Emergency Hospital Service.
Methods:
a qualitative, exploratory and descriptive research conducted with 17 nurses from the emergency service of a high complexity hospital in southern Brazil. Data were collected through interviews, focus group and document analysis. Data analysis followed the thematic content analysis framework.
Results:
four categories emerged: Work environment characteristics; Assistance dimension; Management dimension; Care management.
Final Considerations:
the nurses’ work process in Emergency Hospital Service is characterized by the peculiarities of the setting, with centrality in care and care management aiming at quality care and safety to patients.
Keywords:Emergency NursingEmergency Service, HospitalHealth ManagementNurse's RoleProfessional PracticeSee more -
ORIGINAL ARTICLE
Quality of life at work in a central sterile processing department
Revista Brasileira de Enfermagem. 2020;73(2):e20180792
03-09-2020
Abstract
ORIGINAL ARTICLEQuality of life at work in a central sterile processing department
Revista Brasileira de Enfermagem. 2020;73(2):e20180792
03-09-2020DOI 10.1590/0034-7167-2018-0792
Views1See moreABSTRACT
Objectives:
to evaluate the quality of life of nursing professionals who work in a central sterile processing department.
Methods:
a descriptive, quantitative, exploratory study, conducted with 82 nursing professionals working in the Central Sterile Processing Department of a University Hospital, from September to November 2017. A semi-structured instrument and the questionnaire “Medical Outcomes Study Short-Form 36” were used. Results: most of the participants were female, married, aged 31-40 years; 47.6% with 6-10 years of profession, and 82.9% reported working in CSPD for 1-5 years. The most affected quality of life domains were Pain, Vitality, General Health Status and Social Aspects.
Conclusions:
This study showed a need for rethinking and re-creating the labor dynamics in CSPD to improve the quality of life of these nursing professionals.
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ORIGINAL ARTICLE
Care complexity in hospitalized elderly according to cognitive performance
Revista Brasileira de Enfermagem. 2019;72:134-139
12-05-2019
Abstract
ORIGINAL ARTICLECare complexity in hospitalized elderly according to cognitive performance
Revista Brasileira de Enfermagem. 2019;72:134-139
12-05-2019DOI 10.1590/0034-7167-2018-0357
Views1See moreABSTRACT
Objective:
to investigate possible differences in care complexity, functional performance and biopsychosocial and health system aspects among hospitalized elderly with or without cognitive decline.
Method:
quantitative, cross-sectional and analytical study in which was used the INTERMED method and cognitive and functional screening scales. We investigated 384 elderly patients admitted to a medical and surgical clinic of a University Hospital located in São Paulo/SP.
Results:
cognitive decline was present in 40.1% of the sample, most of them were longer-lived elderly individuals with less schooling and income, more dependent in activities of daily living and had greater vulnerability in different domains of INTERMED. After adjustments, the elderly with cognitive decline presented greater vulnerability in the psychological domain.
Conclusion:
the relationship between cognitive decline and psychological vulnerability highlights the need to adopt long-term care based on involvement of the family, health team and different services, thereby maximizing the quality of care.
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ORIGINAL ARTICLE
Spatial analysis on tuberculosis and the network of primary health care
Revista Brasileira de Enfermagem. 2019;72(5):1197-1202
09-16-2019
Abstract
ORIGINAL ARTICLESpatial analysis on tuberculosis and the network of primary health care
Revista Brasileira de Enfermagem. 2019;72(5):1197-1202
09-16-2019DOI 10.1590/0034-7167-2017-0897
Views1See moreABSTRACT
Objective:
to analyze the spatial distribution of new cases of tuberculosis compared to the location of the Primary Healthcare Units that performed the compulsory notification.
Method:
ecological study conducted in Belém, Pará, with 5,294 new cases of tuberculosis notified to Sistema de Informação de Agravos de Notificação for the period from 2010 to 2014. The cases were georeferenced using the software applications ArcGis 10.2 and TerraView 4.2.2. The techniques of Kernel density and global Moran geostatistics were used.
Results:
the incidence of tuberculosis cases did not vary significantly between the years studied, however there was a variation in incidence between neighborhoods. Health units that exhibited higher number of notifications can suffer great influence of migration from nearby neighborhoods.
Conclusion:
the spatial dynamics of tuberculosis associated with health services allows to know the areas with increased risk of tuberculosis and the density of notifications of health units.
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ORIGINAL ARTICLE
Team-Based Learning: a randomized clinical trial in undergraduate nursing
Revista Brasileira de Enfermagem. 2020;73(2):e20180621
03-30-2020
Abstract
ORIGINAL ARTICLETeam-Based Learning: a randomized clinical trial in undergraduate nursing
Revista Brasileira de Enfermagem. 2020;73(2):e20180621
03-30-2020DOI 10.1590/0034-7167-2018-0621
Views0ABSTRACT
Objectives:
To compare the knowledge on surgical safety through the team-based learning methodology and lecture classes for undergraduate Nursing students, and evaluate the learning satisfaction with team-based learning.
Methods:
Randomized, controlled, parallel, two-arm, unblinded clinical trial developed in the Faculty of Medicine of a public university in Botucatu, Brazil. The groups included 14 students for team-based learning and 11 students for lecture classes.
Results:
Students’ apprehension of knowledge in the team-based learning group was significantly higher compared to the control group (p<0.002) by considering the pre-test results. After 30 days, there was no significant difference between groups. The experience with the methodology was considered positive among students.
Conclusions:
Team-based learning is an important pedagogic tool available and has proven effective in education and learning with students playing the role of protagonists.
Keywords:Higher EducationNursingPatient SafetyRandomized Controlled Clinical TrialValidation StudiesSee more -
Factors associated with anxiety in multiprofessional health care residents during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2021;74:e20200961
04-14-2021
Abstract
Factors associated with anxiety in multiprofessional health care residents during the COVID-19 pandemic
Revista Brasileira de Enfermagem. 2021;74:e20200961
04-14-2021DOI 10.1590/0034-7167-2020-0961
Views0See moreABSTRACT
Objective:
To estimate the prevalence and factors associated with anxiety among multiprofessional health residents during the COVID-19 pandemic.
Methods:
Cross-sectional study, conducted in July 2020 with multiprofessional health residents (n = 67) from a university hospital. We used the Beck Anxiety Inventory to assess anxiety. Analyzing data through the chi-square test, likelihood ratio, and multiple analysis using Poisson regression with robust variance.
Results:
The proportion of moderate/severe anxiety was 31.3%, which showed significant association with working in sectors involving COVID-19 and directly with suspected/confirmed cases of COVID-19. During the multiple analysis, we found prevalence of anxiety in participants who needed psychological support after entering their residence and those who used psychotropic meds.
Conclusion:
The results seem to indicate that residents had their mental health impaired during the pandemic, but the maintenance of the variables in the model also suggests that they sought help to control anxiety.
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REVIEW
The use of children’s stories in nursing care for the child: an integrative review
Revista Brasileira de Enfermagem. 2019;72:333-342
12-13-2019
Abstract
REVIEWThe use of children’s stories in nursing care for the child: an integrative review
Revista Brasileira de Enfermagem. 2019;72:333-342
12-13-2019DOI 10.1590/0034-7167-2018-0456
Views0See moreABSTRACT
Objective:
To identify how children’s stories can be used in child care.
Method:
Integrative literature review, conducted in databases between 2000 and 2018, in three languages. Full research articles were included that agreed with the following question: “How can children’s stories be used in child care?”.
Results:
From the analysis of 16 selected articles, three categories emerged: The use of stories in the hospital; Specialized nursing intervention; and Stories in the educational dimension.
Final considerations:
Evidence shows benefits to children, families, institutions and nursing. The use of children’s stories as a care intervention can occur in different situations and settings, values; boosts bonds, reduces anxiety in children and families, encourages children’s participation in care, and promotes health education. It is a low-cost and still incipient strategy in nursing.
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ORIGINAL ARTICLE
Nursing practices in a psychological care center
Revista Brasileira de Enfermagem. 2020;73(1):e20180175
02-10-2020
Abstract
ORIGINAL ARTICLENursing practices in a psychological care center
Revista Brasileira de Enfermagem. 2020;73(1):e20180175
02-10-2020DOI 10.1590/0034-7167-2018-0175
Views0ABSTRACT
Objective:
To analyze the practices developed by nursing professionals in a Psychosocial Care Center (CAPS).
Method:
A qualitative and evaluative research based on the Fourth Generation Assessment and conducted in a CAPS II of Santa Catarina State in 2014. For data collection, semi-structured interviews, field observation, and data recycling group were used with workers. Constant Comparative Method was used for data analysis.
Results:
Practices aimed at the subject and their clinical, social, prevention, treatment and articulation with the health network were identified. Medication care is a specificity of nursing that aims to promote autonomy and social reintegration. There is a need for greater articulation between the nursing and pharmacy staff, as well as creating spaces for users to talk about medication.
Conclusion:
Nursing practices are focused on biopsychosocial care, aiming to deconstruct care models focused on the disease and symptoms.
Keywords:Health Services EvaluationMental HealthMental Health ServicesNursing ProcessPsychiatric NursingSee more -
REFLECTION
Empathic listening: welcoming strategy for nursing Professional in coping with with the coronavirus pandemic
Revista Brasileira de Enfermagem. 2021;74:e20200721
02-05-2021
Abstract
REFLECTIONEmpathic listening: welcoming strategy for nursing Professional in coping with with the coronavirus pandemic
Revista Brasileira de Enfermagem. 2021;74:e20200721
02-05-2021DOI 10.1590/0034-7167-2020-0721
Views0See moreABSTRACT
Objective:
to reflect on empathic listening use as a welcoming strategy for nursing professionals to cope with the challenges during the pandemic caused by the new coronavirus.
Methods:
this is a reflection study based on updated data surveys and theoretical-conceptual aspects of Non-Violent Communication and empathic listening.
Results:
in the performance during the COVID-19 pandemic, nursing professionals are exposed to violence of different natures related to occupational stress, work overload, anguishes and silenced suffering, with implications for the workers’ health, who can be benefited and strengthened with empathetic listening.
Final considerations:
the health crisis has highlighted the weaknesses of the health system. Nursing acts as the largest contingent of the health workforce in coping with the pandemic. Empathetic listening is a powerful strategy in caring for and strengthening nursing professionals.
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ORIGINAL ARTICLE
Factors associated with stress, anxiety and depression in nursing professionals in the hospital context
Revista Brasileira de Enfermagem. 2022;75:e20210263
02-25-2022
Abstract
ORIGINAL ARTICLEFactors associated with stress, anxiety and depression in nursing professionals in the hospital context
Revista Brasileira de Enfermagem. 2022;75:e20210263
02-25-2022DOI 10.1590/0034-7167-2021-0263
Views0See moreABSTRACT
Objective:
to determine the factors associated with stress, anxiety and depression, concomitantly, in nursing professionals who work in the hospital context.
Methods:
a quantitative and cross-sectional study with 353 nursing professionals from a hospital. A sociodemographic questionnaire and the Depression, Anxiety and Stress Scale-21 were used. Data were subjected to descriptive statistical analysis, difference and correlation tests.
Results:
the main factors associated with stress, anxiety and depression, concomitantly, were being female, compromised family and social support, lack of autonomy at work, hostile relationship with colleagues, lack of professional recognition and satisfaction, feeling of being overwhelmed and insecurity.
Conclusions:
demographic, physiological, social and work factors impact the levels of stress, anxiety and depression in nursing professionals. The adoption of coping strategies for modifiable factors should be considered, in order to provide better quality of life for these professionals.
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Repercussions of intestinal ostomy on male sexuality: an integrative review
Revista Brasileira de Enfermagem. 2020;73(6):e20190245
08-10-2020
Abstract
Repercussions of intestinal ostomy on male sexuality: an integrative review
Revista Brasileira de Enfermagem. 2020;73(6):e20190245
08-10-2020DOI 10.1590/0034-7167-2019-0245
Views0INTRODUCTIONThe intestinal ostomy, also known as stoma and ostomy, consists of an artificial opening, produced surgically, whose purpose is to divert the flow of effluents to the external environment. Such a condition can impact the lives of affected individuals due to transformations that affect human multi-dimensionality, including negative repercussions involving sexuality(–).In the United States of […]See more
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